Laser Therapy of Painful Shoulder and Shoulder-Hand Syndrome in Treatment of Patients after the Stroke

Abstract

The common complication after stroke is pain and dysfunction of shoulder of paralyzed arm, as well as the swelling of the hand. The aim of this study was to determine the effects of LASER therapy and to correlate with electrotherapy (TENS, stabile galvanization) in subjects after stroke. We analyzed 70 subjects after stroke with pain in shoulder and oedema of paralyzed hand. The examinees were divided in two groups of 35, and they were treated in the Clinic for Physical Medicine and Rehabilitation in Tuzla during 2006 and 2007. Experimental group (EG) had a treatment with LASER, while the control group (CG) was treated with electrotherapy. Both groups had kinesis therapy and ice massage. All patients were examined on the admission and discharge by using the VAS, DASH, Barthel index and FIM. The pain intensity in shoulder was significantly reduced in EG (p<0,0001), swelling is lowered in EG (p=0,01). Barthel index in both groups was significant higher (p<0,01). DASH was significantly improved after LASER therapy in EG (p<0,01). EG had higher level of independency (p<0,01). LASER therapy used on EG shows significantly better results in reducing pain, swelling, disability and improvement of independency.

Efficacy of high-intensity laser therapy on arthropathy of the hands in patients with systemic lupus erythematosus: a double-blinded, randomized controlled trial

“…29,37,38 High-intensity laser therapy could control inflammation by reducing C-reactive protein, neopterin, interleukin 1, and prostaglandin levels. 38 The current study results were in agreement with other studies [39][40][41] which revealed that laser therapy has anti-edema effect. Also, laser led to reduction of pain, swelling, disability and improvement of independency.…”

“…Also, laser led to reduction of pain, swelling, disability and improvement of independency. 41 In this study, the exercise program in the control group also increased the handgrip strength, decreased the swelling joints counts, tenderness joints counts and pain. The results of the current studies were in agreement with other studies that reported significant improvement in handgrip strength, pinch strength, dexterity and quality of life, and a significant decrease of pain in the exercise group.…”

Effects of Low-Level Laser Therapy and Interferential Current Therapy in the Treatment of Complex Regional Pain Syndrome

“…Also, significantly higher pain and edema reduction was achieved by the application of LLLT in patients with shoulderhand syndrome after cerebral ischemia, compared to the group in which electrotherapy (TENS, stabile galvanization) was applied (33).…”

How to treat complex regional pain syndrome in rehabilitation settings?

“…58 Despite their common presence, clinical trials investigated treatment options(benzodiazepines, botulinum toxin or baclofen) are all non comparative, so their effectiveness is yet to be established. 59,60 Regarding physical modalities in treatment of CRPS, there are limited evidences of superior effect of low level laser therapy to interferential currents in decreasing temperature in extremity 61 , pain, swelling and disability compared with electrotherapy (TENS and stabile galvanization) 62 Electromagnetic field therapy has been shown ineffective for CRPS in the high quality RCT. 63 Interestingly, there are no studies on transcutaneous electrical nerve stimulation(TENS) although it is an physical modality widely used for pain control, compering effects of physical and occupational therapy for CRPS, it is shown that both have positive effect on pain reduction and improved function, with some of the studies showing a slightly better effect and cost effectiveness for physical therapy 64,65 .…”