Volume 27, Issue 3 (Avicenna Journal of Clinical Medicine-Autumn 2020)                   Avicenna J Clin Med 2020, 27(3): 149-156 | Back to browse issues page

XML Persian Abstract Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Asadi M R, Saremi H, Radinmehr H, Rahbar S, Talimkhani A, Hajvalie G et al . The Comparison of Therapeutic Ultrasound and Laser Therapy in Treatment of Mild to Moderate Carpal Tunnel Syndrome: A Randomized Clinical Trial. Avicenna J Clin Med 2020; 27 (3) :149-156
URL: http://sjh.umsha.ac.ir/article-1-2092-en.html
1- , reza.asadi21@yahoo.com
Abstract:   (3053 Views)
Background and Objective: Carpal Tunnel Syndrome (CTS) is the most common compressive neuropathy of the upper limb and one of the causes of disability. The current study aimed to compare the therapeutic effects of Low-Level Laser Therapy (LLLT) and therapeutic ultrasound (US) in patients with mild to moderate carpal tunnel syndrome.
Materials and Methods: This single-blind randomized trial was conducted on 30 patients with CTS (58 wrists) who were randomly assigned to two treatment groups: laser therapy group (15 patients, 29 wrist (and Ultrasound therapy group (15 patients, 29 wrists). Low-level laser therapy (9 joules, 808 nm infrared laser at five points) and Ultrasound treatment (1 MHz, 1.5 W/cm2, duty cycle 20%, 5 min/session) were applied to the carpal tunnel for 10 daily treatment sessions (5 sessions/week). Outcome measures were Visual analogue scale, pinch & grip strength and Boston questionnaire (BQ), which measured before and after treatment (the end of the study). The pair and independent t-test were used to evaluate the variables.
Results: In both groups (laser therapy and Ultrasound therapy), there was a significant improvement in visual analog scale (P=0.000 and P=0.000, respectively), grip strength (P=0.01 and P=0.004, respectively), and pinch strength (P=0.001 and P=0.009, respectively). The results of the Boston Questionnaire also demonstrated an improvement (P=0.000 and P=0.000, respectively) at the end of the study, compared to baseline values. However, there was no significant difference in any of the measured variables between the two treatment groups.
Conclusion: As evidenced by the obtained results, both low-level laser therapy and ultrasound are effective in the reduction of pain and improvement of hand function in patients with mild-to-moderate CTS in the short-term.
Full-Text [PDF 876 kb]   (1133 Downloads)    
Type of Study: Original | Subject: Physical Therapy

1. Wang L. Guiding treatment for carpal tunnel syndrome. Phys Med Rehabil Clin N Am. 2018;29(4):751-60. PMID: 30293628 DOI: 10.1016/j.pmr.2018.06.009
2. Huisstede BM, Hoogvliet P, Franke TP, Randsdorp MS, Koes BW. Carpal tunnel syndrome: effectiveness of physical therapy and electrophysical modalities. an updated systematic review of randomized controlled trials. Arch Phys Med Rehabil. 2018;99(8):1623-34.e23. PMID: 28942118 DOI: 10.1016/j.apmr.2017.08.482
3. Banan KS, Etekaf OM, Taghipour M, Talebi GA. The effects of manual therapy on hand symptomes and median nerve tensionin in patients with carpal tunnel syndrome. Sci J Rehabil Med. 2016;5(2):184-92. DOI: 10.22037/jrm.2016.1100188
4. Ebenbichler GR, Resch KL, Nicolakis P, Wiesinger GF, Uhl F, Ghanem AH, et al. Ultrasound treatment for treating the carpal tunnel syndrome: randomised "sham" controlled trial. BMJ. 1998;316(7133):731-5. PMID: 9529407 DOI: 10.1136/bmj.316.7133.731
5. Naeser MA, Hahn KA, Lieberman BE, Branco KF. Carpal tunnel syndrome pain treated with low-level laser and microamperes transcutaneous electric nerve stimulation: a controlled study. Arch Phys Med Rehabil. 2002;83(7):978-88. PMID: 12098159 DOI: 10.1053/apmr.2002.33096
6. Hong CZ, Liu HH, Yu J. Ultrasound thermotherapy effect on the recovery of nerve conduction in experimental compression neuropathy. Arch Phys Med Rehabil. 1988;69(6):410-4. PMID: 3377665
7. Kramer JF. Effect of therapeutic ultrasound intensity on subcutaneous tissue temperature and ulnar nerve conduction velocity. Am J Phys Med. 1985;64(1):1-9. PMID: 3970155
8. Bakhtiary AH, Rashidy-Pour A. Ultrasound and laser therapy in the treatment of carpal tunnel syndrome. Aust J Physiother. 2004;50(3):147-51. PMID: 15482245 DOI: 10.1016/s0004-9514(14)60152-5
9. Chang YW, Hsieh SF, Horng YS, Chen HL, Lee KC, Horng YS. Comparative effectiveness of ultrasound and paraffin therapy in patients with carpal tunnel syndrome: a randomized trial. BMC Musculoskelet Disord. 2014;15:399. PMID: 25428566 DOI: 10.1186/1471-2474-15-399
10. Dincer U, Cakar E, Kiralp MZ, Kilac H, Dursun H. The effectiveness of conservative treatments of carpal tunnel syndrome: splinting, ultrasound, and low-level laser therapies. Photomed Laser Surg. 2009;27(1):119-25. PMID: 19196106 DOI: 10.1089/pho.2008.2211
11. Page MJ, O'Connor D, Pitt V, Massy-Westropp N. Therapeutic ultrasound for carpal tunnel syndrome. Cochrane Database Syst Rev. 2013;2013(3):Cd009601. PMID: 23543580 DOI: 10.1002/14651858.CD009601.pub2
12. Bekhet AH, Ragab B, Abushouk AI, Elgebaly A, Ali OI. Efficacy of low-level laser therapy in carpal tunnel syndrome management: a systematic review and meta-analysis. Lasers Med Sci. 2017;32(6):1439-48. PMID: 28580494 DOI: 10.1007/s10103-017-2234-6
13. Padua L, Padua R, Aprile I, Tonali P. Noninvasive laser neurolysis in carpal tunnel syndrome. Muscle Nerve. 1998;21(9):1232-3. PMID: 9703457 DOI: 10.1002/(sici)1097-4598(199809)21:9<1232::aid-mus23>3.0.co;2-s
14. Weintraub MI. Noninvasive laser neurolysis in carpal tunnel syndrome. Muscle Nerve. 1997;20(8):1029-31. PMID: 9236795 DOI: 10.1002/(sici)1097-4598(199708)20:8<1029::aid-mus14>3.0.co;2-q
15. Chang WD, Wu JH, Jiang JA, Yeh CY, Tsai CT. Carpal tunnel syndrome treated with a diode laser: a controlled treatment of the transverse carpal ligament. Photomed Laser Surg. 2008;26(6):551-7. PMID: 19025407 DOI: 10.1089/pho.2007.2234
16. Franke TP, Koes BW, Geelen SJ, Huisstede BM. Do patients with carpal tunnel syndrome benefit from low-level laser therapy? a systematic review of randomized controlled trials. Arch Phys Med Rehabil. 2018;99(8):1650-9.e15. PMID: 28629992 DOI: 10.1016/j.apmr.2017.06.002
17. Cheung WK, Wu IX, Sit RW, Ho RS, Wong CH, Wong SY, et al. Low-level laser therapy for carpal tunnel syndrome: systematic review and network meta-analysis. Physiotherapy. 2019;106:24-35. PMID: 32026843 DOI: 10.1016/j.physio.2019.06.005
18. Saeed FU, Hanif S, Aasim M. The effects of laser and ultrasound therapy on carpal tunnel syndrome. Pakistan J Med Heal Sci. 2012;6:238-41.
19. Ahmed OF, Elkharbotly AM, Taha N, Bekheet AB. Treatment of mild to moderate carpal tunnel syndrome in patients with diabetic neuropathy using low level laser therapy versus ultrasound controlled comparative study. BBA Clin. 2017;8:43-7. PMID: 28856107 DOI: 10.1016/j.bbacli.2017.07.001
20. Fusakul Y, Aranyavalai T, Saensri P, Thiengwittayaporn S. Low-level laser therapy with a wrist splint to treat carpal tunnel syndrome: a double-blinded randomized controlled trial. Lasers Med Sci. 2014;29(3):1279-87. PMID: 24477392 DOI: 10.1007/s10103-014-1527-2
21. Ansar N, Adeel M, Liaqat S, Maqsood I, Ghafoor I. The comparison of therapeutic ultrasound and local steroid injection in treatment of mild to moderate carpal tunnel syndrome: a randomized controlled trial. Ann King Edward Med Univ. 2017;23(3):335-42.
22. Levine DW, Simmons BP, Koris MJ, Daltroy LH, Hohl GG, Fossel AH, et al. A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome. J Bone Joint Surg Am. 1993;75(11):1585-92. PMID: 8245050 DOI: 10.2106/00004623-199311000-00002
23. Rezazadeh A, Bakhtiary AH, Samaei A, Moghimi J. Validity and reliability of the Persian Boston questionnaire in Iranian patients with carpal tunnel syndrome. Koomesh. 2014;15(2):138-45.
24. aralieva A, Georgiev GP, Karabinov V, Iliev A, Aleksiev A. Physical therapy and rehabilitation approaches in patients with carpal tunnel syndrome. Cureus. 2020;12(3):e7171. PMID: 32257712 DOI: 10.7759/cureus.7171
25. Oztas O, Turan B, Bora I, Karakaya MK. Ultrasound therapy effect in carpal tunnel syndrome. Arch Phys Med Rehabil. 1998;79(12):1540-4. PMID: 9862296 DOI: 10.1016/s0003-9993(98)90416-6
26. Prentice WE. Therapeutic modalities in sports medicine. 3rd ed. New York: WCB/McGraw-Hill; 1999.
27. Lazovic M, Ilic-Stojanovic O, Kocic M, Zivkovic V, Hrkovic M, Radosavljevic N. Placebo-controlled investigation of low-level laser therapy to treat carpal tunnel syndrome. Photomed Laser Surg. 2014;32(6):336-44. PMID: 24905929 DOI: 10.1089/pho.2013.3563
28. Jiang JA, Chang WD, Wu JH, Lai PT, Lin HY. Low-level laser treatment relieves pain and neurological symptoms in patients with carpal tunnel syndrome. J Phys Ther Sci. 2011;23(4):661-5. DOI: 10.1589/jpts.23.661
29. Tascioglu F, Degirmenci NA, Ozkan S, Mehmetoglu O. Low-level laser in the treatment of carpal tunnel syndrome: clinical, electrophysiological, and ultrasonographical evaluation. Rheumatol Int. 2012;32(2):409-15. PMID: 21120497 DOI: 10.1007/s00296-010-1652-6
30. Evcik D, Kavuncu V, Cakir T, Subasi V, Yaman M. Laser therapy in the treatment of carpal tunnel syndrome: a randomized controlled trial. Photomed Laser Surg. 2007;25(1):34-9. PMID: 17352635 DOI: 10.1089/pho.2006.2032
31. Rayegani SM, Moradi-Joo M, Raeissadat SA, Bahrami MH, Seyed-Nezhad M, Heidari S. Effectiveness of low-level laser therapy compared to ultrasound in patients with carpal tunnel syndrome: a systematic review and meta-analysis. J Laser Med Sci. 2019;10(Suppl 4):S82-9. PMID: 32021679 DOI: 10.15171/jlms.2019.S15
32. Crisci AR, Ferreira AL. Low-intensity pulsed ultrasound accelerates the regeneration of the sciatic nerve after neurotomy in rats. Ultrasound Med Biol. 2002;28(10):1335-41 PMID: 12467860 DOI: 10.1016/s0301-5629(02)00576-8
33. Johns LD. Nonthermal effects of therapeutic ultrasound: the frequency resonance hypothesis. J Athl Train. 2002;37(3):293-9. PMID: 16558674
34. ter Haar G. Therapeutic ultrasound. Eur J Ultrasound. 1999;9(1):3-9 PMID: 10099161 DOI: 10.1016/s0929-8266(99)00013-0
35. Bingöl U, Altan L, Yurtkuran M. Low-power laser treatment for shoulder pain. Photomed Laser Surg. 2005;23(5):459-64. PMID: 16262574 DOI: 10.1089/pho.2005.23.459
36. Brosseau L, Robinson V, Wells G, Debie R, Gam A, Harman K, et al. Low level laser therapy (Classes I, II and III) for treating rheumatoid arthritis. Cochrane Database Syst Rev. 2005;4:CD002049. PMID: 16235295 DOI: 10.1002/14651858.CD002049.pub2
37. Jablecki CK, Andary MT, So YT, Wilkins DE, Williams FH. Literature review of the usefulness of nerve conduction studies and electromyography for the evaluation of patients with carpal tunnel syndrome. AAEM Quality Assurance Committee. Muscle Nerve. 1993;16(12):1392-414. PMID: 8232399 DOI: 10.1002/mus.880161220

Add your comments about this article : Your username or Email:

Send email to the article author

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2024 CC BY-NC 4.0 | Avicenna Journal of Clinical Medicine

Designed & Developed by : Yektaweb