Indian Journal of Physiotherapy & Occupational Therapy-An International Journal

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Comparison of Helium Neon Laser with Gallium Arsenide Laser Therapy on Pain and Functional Ability in Patients with Trigger Points (Upper Trapezius Muscle)


Affiliations
1 Department of Physiotherapy, Institute of Allied Health (Paramedical) Services Education & Training IAHSET, Uttarakahnd Forest Hospital Trust & Medical College, Haldwani, India
     

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Abstract

Key words/ AbbreviationsMPS: Myofascial Pain Syndrome, Trapezius muscle, He- Ne: Helium Neon, Ga-As: Gallium Arsenide, TP: Trigger Points LLLT: Low Level Laser Therapy, VAS: Visual Analog Scale, NDI: Neck Disability Index, Tr P: Trigger Point

Purpose

The efficacy of low level laser therapy (LLLT) in myofacial trigger points seems controversial. The aim was to clarify the effect of Helium Neon or Gallium Arsenide Laser on pain and functional ability in patients with trigger points in the upper trapezius muscle.

Methodology

The study has an experimental design. Thirty subjects (14 female, 16 male) with myofascial pain in the upper trapezius muscle were taken and randomly assigned to one of the three groups. Based on inclusion and exclusion criteria, subjects were included in the study. Convenient sampling with random allocation to the three groups (A, B,&C). Group A (Experimental Group) received Helium Neon Laser therapy for 3 min followed by stretching exercises for 30 sec twice a day for10 days during a period of 2 weeks. Group B (Experimental Group) received Gallium Arsenide laser therapy followed by stretching exercises in the similar way as group A. Group C (Controlled Group) received only stretching exercises as The patients filled the VAS and NDI scale on zero, fifth and tenth day respectively to check the level of improvement.

Results

The data was analysed using the software SPSS 12.0. No significant difference was seen in VAS and NDI from 0 to 2nd week between the 3 groups. In result between the groups, Group C was found more effective than the other two groups. Stretching alone has positive, therapeutic effect on the underlying musculoskeletal trigger points. Within the groups, group B i.e. He-Ne laser with Stretching showed significant results from 0 to 2nd week and from 1st to 2nd week. Group A i.e. Ga-As with stretching showed significant improvement from 0 to 2nd week.

Conclusion

The study concludes that n o significant difference in the effects of He-Ne laser application with stretching and Ga- As laser with stretching when compared to stretching alone. This study does not conclude that stretching is an effective intervention as significant difference in the rate of improvement was found in group which received He-Ne laser with stretching. The duration over which accumulation of rate of improvement took place was small.

Clinical significance

No significant rate of improvement in patients receiving (He-Ne + Stretching) and (Ga-As + Stretching). Thus, both the modalities are not beneficial for the treatment of myofascial trigger points. However, stretching is the main stay as the treatment of myofascial trigger point. It can be given as an auto therapy to patients as home programme.


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  • Simon DG, Travell JG, Myofascial pain and dysfunction, the trigger point manual vol. 1, upper half of body, 2nd ed. Baltimore, William and Wilkins, 1999.

  • Joanne Borg- Stein, David G, Myofascial pain: A focused review. Arch. Phys Med Rehab, 83 supple 1, S 40-47, 2002.

  • Noramn B. Rosen,. The Myofascial Pain Syndrome. Phys. Med. Rehab. North America, 4, 41-63, 1993.

  • Robert G. Klein, Bjorn,. Low energy laser treatment and exercise for chronic low back pain: A double blind controlled trial. Arch Phys Maed and Rehab, 71, 34-37, 1990.

  • Leesa K. Huguenin,. Myofascial trigger points: the current evidence. Physical Therapy in Sport, 5, 2-12, 2004.

  • Gur A., Sarac AJ, Cevik R, Altindag O, Sarac S., Efficacy of 904 nm Gallium Arsenide low level laser therapy in the management of chronic myofascial pain in the neck: A double-blind and randomize-controlled trial. Lasers in Surgery and Medicine 35(3), 229-235, 2004.

  • Chang-Zern Hong,. Pathophysiology of Myofascial Trigger Point. J Formos Med Assoc, 95(2), 93-104, 1996.

  • Samunel A. Skootsky, Bernadette Jaeger, Robert K. Oye,. Prevalence of myofascial pain in general internal medicine practice. West Journal of Medicine, 151, 157- 160, 1989.

  • T. Micheal Cummings, Adrian R. White,. Needling therapies in the management of myofascial trigger point pain: A systematic review. Arch Phys Med Rehab, 82, 986-992, 2001.

  • William P. Hanten, Sharon L. Olson, Nicole L. Butts, Aimee L. Nowicki,. Effectiveness of a home programe of Ischemic Compression by sustained stretch for treatment of Myofascial Trigger Point. Physical Therapy, 80(10), 997-1003, 2000.

  • Lynn Synder-Mackler, Christopher Bork, Barbara Bourbon, David Trumbore,. Effect of Helium Neon Laser on Musculoskeletal Trigger Points. Physical Therapy, 66(7), 1087-1090, 1986.

  • Veronica M. Sciotti, Veronica L. Mittak, Lisa DiMarco, Lillian M. Ford, et al,. Clinical precision of myofascial trigger point location in the Trapezius muscle. Pain, 93, 259-266, 2001.

  • Hakguder A, Birtane M, Gurcan S, Kokino S, Turan FN,. Efficacy of low level laser therapy in myofascial pain syndrome: An algometric and thermographic evaluation. Lasers in Surgery and Medicine, 33, 339-343, 2003.

  • Ali Gur, Mehmet Karakoc, Remzi Cevik, Kemal Nas, Aysegul Jale Sarac, Meral Karakoc,. Efficacy of low power laser therapy and exercise on pain and functions in chronic low back pain. Lasers in Surgery and Medicine, 32, 233-238, 2003.

  • Donald D. Price, Patricia A. Mc Grath, Amir Rafii, Barbara Buckingham,. The validation of visual analogue scale as ratio scale measures for chronic and experimental pain. Pain, 17, 45-56, 1983.

  • Leon Chaitow, Judith Walker DeLany,. Clinical Application of Neuromuscular Techniques. Vol. 1, The upper body, Trigger Points, 65-84, Churchill Livingstone, 2000.

  • Arne N. Gam, Susan Warming, Lone H. Larsen, Bente Jensen et al,. Treatment of myofascial trigger points with ultrasound combined with massage and exercise: A randomized controlled trial. Pain, 77, 73-79, 1998.

  • Altan L., Bingol U., Aykac, Yurtkuran M., Investigation of the effect of GaAs laser therapy on cervical myofascial pain syndrome. Rheumatology International, 25(1), 23- 27, 2003.

  • Lale Altan, Umit Bingol, Merih Yurtkuran,. Low-Power Laser treatment for shoulder pain. Photomedicine and Laser Surgery, 23 (5), 459-464, 2005.

  • F. Ceccgerelli, L. Altafini, G. Lo. Castro, A. Avila, F. Ambrosis, G. P. Giron,. Diode laser in cervical myofascial pain: A double blind study versus placebo. The Clinical Journal of Pain. 5, 301-304, 1989.

  • David Hubbard, Gregory M. Berkoff,. Myofascial trigger points show spontaneous needle EMG activity. Spine, 18(13), 1803-1807, 1993.

  • Simons DG, Hong CZ,. Endplate potentials are common to midfiber myofascial trigger points. Am J Phys Med Rehab, 81(3), 212-222, 2002.

  • Chang Z. Hong, Ta-Shen Kuan, Jo-Tong Chen, Shu- Min Chen,. Referred pain elicited by palpation and by needling of myofascial trigger points: A Comparison. Arch Phys Med Rehab, 78, 957-960, 1997.

  • Randy S. Roth, Karyn Horowitz, Jan E. Bachman,. Chronic Myofascial Pain: Knowledge of Diagnosis and Satisfaction with Treatment. Arch Phys Med Rehab, 79, 966-970, 1998.

  • John Low and Ann Reed, Electrotherapy Explained: Principles and Practice, 3rd ed. , Laser Therapy, 356- 375, Butterworth Heinemann, 2000.

  • George W. Waylonis, Sue Wilke, Donald O’ Tole, David A. Waylonis, Daniel B. Waylonis,. Chronic Myofascial Pain: Management of low output Helium Neon laser therapy. Arch Phys Med Rehab, 69, 1017-1020, 1988.

  • William P. Cheshire, Sandra W. Abashian, J. Douglas Mann,. Botulinum toxin in the treatment of myofascial pain syndrome. Pain, 69, 65-69, 1994.

  • Lars Bendtsen, Rigmor Jensen, Jes Olesen,. Qualitatively altered nociception in chronic myofascial pain. Pain, 65, 259-264, 1996.

  • J. Walker,. Relief from chronic pain by low power laser irradiation. Neuroscience Letters, 43, 339-344, 1983.

  • O. Komiyama, M. Kawara, M. Arai, T. Asano, K. Kobayashi,. Posture correction as part of behavioral therapy in treatment of myofascial pain with limited opening. Journal of Oral Rehabilitation, 26, 428-435, 1996.

  • George H. Kraft, Ernest W. Johnson, Myron M. LaBan,. The Fibrosotis Syndrome,. Arch Phys Med Rehab, 9, 155-162, 1968.


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  • Comparison of Helium Neon Laser with Gallium Arsenide Laser Therapy on Pain and Functional Ability in Patients with Trigger Points (Upper Trapezius Muscle)

Abstract Views: 623  |  PDF Views: 0

Authors

Dheeraj Lamba
Department of Physiotherapy, Institute of Allied Health (Paramedical) Services Education & Training IAHSET, Uttarakahnd Forest Hospital Trust & Medical College, Haldwani, India

Abstract


Abstract

Key words/ AbbreviationsMPS: Myofascial Pain Syndrome, Trapezius muscle, He- Ne: Helium Neon, Ga-As: Gallium Arsenide, TP: Trigger Points LLLT: Low Level Laser Therapy, VAS: Visual Analog Scale, NDI: Neck Disability Index, Tr P: Trigger Point

Purpose

The efficacy of low level laser therapy (LLLT) in myofacial trigger points seems controversial. The aim was to clarify the effect of Helium Neon or Gallium Arsenide Laser on pain and functional ability in patients with trigger points in the upper trapezius muscle.

Methodology

The study has an experimental design. Thirty subjects (14 female, 16 male) with myofascial pain in the upper trapezius muscle were taken and randomly assigned to one of the three groups. Based on inclusion and exclusion criteria, subjects were included in the study. Convenient sampling with random allocation to the three groups (A, B,&C). Group A (Experimental Group) received Helium Neon Laser therapy for 3 min followed by stretching exercises for 30 sec twice a day for10 days during a period of 2 weeks. Group B (Experimental Group) received Gallium Arsenide laser therapy followed by stretching exercises in the similar way as group A. Group C (Controlled Group) received only stretching exercises as The patients filled the VAS and NDI scale on zero, fifth and tenth day respectively to check the level of improvement.

Results

The data was analysed using the software SPSS 12.0. No significant difference was seen in VAS and NDI from 0 to 2nd week between the 3 groups. In result between the groups, Group C was found more effective than the other two groups. Stretching alone has positive, therapeutic effect on the underlying musculoskeletal trigger points. Within the groups, group B i.e. He-Ne laser with Stretching showed significant results from 0 to 2nd week and from 1st to 2nd week. Group A i.e. Ga-As with stretching showed significant improvement from 0 to 2nd week.

Conclusion

The study concludes that n o significant difference in the effects of He-Ne laser application with stretching and Ga- As laser with stretching when compared to stretching alone. This study does not conclude that stretching is an effective intervention as significant difference in the rate of improvement was found in group which received He-Ne laser with stretching. The duration over which accumulation of rate of improvement took place was small.

Clinical significance

No significant rate of improvement in patients receiving (He-Ne + Stretching) and (Ga-As + Stretching). Thus, both the modalities are not beneficial for the treatment of myofascial trigger points. However, stretching is the main stay as the treatment of myofascial trigger point. It can be given as an auto therapy to patients as home programme.


References