COMPARATIVE STUDY ON THE EFFECTIVENESS OF LOW LEVEL LASER THERAPY VERSUS PHONOPHORESIS IN THE MANAGEMENT OF LATERAL EPICONDYLITIS

Mohamed Faisal C. K.; Mary Sumila; Lawrence Mathias; Ajith S.

doi:10.1055/s-0040-1703631

Journal of Health and Allied Sciences NU, Table of Contents

CC BY-NC-ND 4.0 · Journal of Health and Allied Sciences NU 2013; 03(01): 35-44
DOI: 10.1055/s-0040-1703631

Original Article

COMPARATIVE STUDY ON THE EFFECTIVENESS OF LOW LEVEL LASER THERAPY VERSUS PHONOPHORESIS IN THE MANAGEMENT OF LATERAL EPICONDYLITIS

Mohamed Faisal C. K.

¹Professor & Vice Principal, Nitte University, Mangalore - 575 018, India

,

Mary Sumila

²Physiotherapist, Nitte University, Mangalore - 575 018, India

,

Lawrence Mathias

³Professor, Department of Orthopaedics, K. S. Hegde Medical Academy Nitte University, Mangalore - 575 018, India

,

Ajith S.

⁴Assistant Professor, Nitte Institute of Physiotherapy, Nitte University, Mangalore - 575 018, India

› Author Affiliations

Abstract

PDF Download

Abstract

Background and Objectives: The use of electro physical agents for the management of any soft tissue injuries in Physical Therapy practice is very common for an early recovery from the injury. Among that, Low Level Laser Therapy (LLLT) and Phonophoresis are found to be very effective in soft tissue injuries. So the objective of this study is to know the comparative effectiveness of LLLT versus Phonophoresis in the treatment of lateral epicondylitis.

Methods: Convenient sample of 40 patients with lateral epicondylitis were recruited for this study. They were assigned equally either to a laser (n = 20) or a Phonophoresis (n = 20) group. Laser group received the treatment with Ga-As (904nm) IR semiconductor diode laser. For Phonophoresis group a gel containing 1% sodium diclofenac was used as coupling agent. Each group was treated 3 times a week, for a total of 8 treatments, and was evaluated subjectively and objectively before and at the end of the treatment, by using VAS, pain free grip strength and functional pain scale as variables.

Results: Comparison between laser group and Phonophoresis group is done using Mann Whitney U test. Comparison between pre and post is done using Wilcoxon's signed rank sum test. Form selection to the post treatment assessment, a significant decrease in symptoms was found in both laser and phonophoresis groups. But it is concluded that statistically; low level laser therapy was not significantly better than phonophoresis with the results of VAS (P = 0.53), FPS (P = 0.253), pain free grip strength. (P = 0.426).

Interpretation and conclusions: The result of this study suggest that low level laser therapy as well as phonophoresis with sodium diclofenac gel as couplant medium gives a good result in the management of lateral epicondylitis. This study concludes that statistically there was no significant difference between Low level laser therapy and Phonophoresis with sodium diclofenac gel as coupling agent in the management of lateral epicondylitis.

Keywords

Lateral epicondylitis; Low level laser Therapy - Phonophoresis - VAS - Pain free Grip Strength - Functional Pain Scale

PDF (280 kb)

References

References
1 Tuomo T Pienimaki, Tuula K Tarvainen, Pertti T Siira, Heikki Vanharanta. Progressive strengthening and stretching exercises and ultrasound for chronic lateral epicondylitis. Physiotherapy. 1996. September; 82 (9):522–530.
2 William E Garrett Jr., Kevin P. Speer and Donald T. Kirkendall. Principles and Practice of Orthopaedic Sports Medicine. Philadelphia: Lippincott Williams P Wilkins; 2000.
3 James Cyriax. Text book of Orthopaedic Medicine. 6^th edition. London: Tailliere Tindall & Casstel; 1975.
4 Thomas G Wadsworth. Tennis elbow: Conservative, Surgical, and Manipulative treatment. British Medical Journal 1987 March;294: 621–624.
5 Maria Zuluaga, Christopher Briggs, Jhon Carlisle, Virginia Mc Donald, Joan Mc Meeken, Wendy Nickson. Sports physiotherapy; Applied st science and practice. 1 Edition. Hong Kong: Churchill Livingstone; 1995.
6 Monica Kesson and Elanie Atkins. Orthopaedic Medicine: A practical Approach. Great Britian: Butterworth & Heinemann; 1998.
7 David C. Reid. Sports Injury Assessment and Rehabilitation. United States of America: Churchill Livingstone; 1992.
8 Alain– Yvan Belanger. Evidence– Based guide to therapeutic physical agents. United States of America: Lippincott Williams and Wilkins; 2002.
9 John Low and Ann Reed. Electrotherapy Explained– principles and practice. 3^rd Edition. India: Butterworth & Heinemann; 2001.
10 Mark D. Klaiman, Joseph A. Shrader, Jerome V Danoff, Jeanne E. Hicks, William J. Pesce and James Ferland. Phonophoresis versus ultrasound in the treatment of common musculoskeletal conditions. Medicine and Science in Sports and Exercise 1998 May; 1349–1355.
11 Burnham R, Gregg R Healy P, Steadward. The effectiveness of topical Diclofenac for lateral epicondylitis. Clinical Journal Sports Medicine. 1998. April; 8(2):78–81.
12 Rosim GC, Barbieri CH,Lancas F M,Mazzer N. Diclofenac phonophoresis in human volunteers. Ultrasound Medical Biology. 2005 March; 3(3): 337–43.
13 Audrey Lowe, Jean Wessel, Michele C Battie. Test–Retest Reliability, Construct Validity, and Responsiveness of a Functional Pain Scale for Tennis Elbow. Physiotherapy Canada 2003; 55(2):114–122.
14 Ottar Vasseljen Jr, Nils Hoeg, Berit Kjeldstad, Anders Johnsson and Stig Larsen. Low level laser versus placebo in the treatment of Tennis elbow. Scandinavian Journal of Rehabilitation Medicine 1992;24:37-42.
15 Haker E, Lundeberg T. Is low– energy laser treatment effective in lateral epicondylalgia? Journal Pain Symptom Management 1991 May; 6(4):241–6.
16 Tam G. Low power Laser therapy and analgesic action. Journal Clinical Laser Medical Surgery 1999 February; 17 (1): 29–33.
17 Heather A E Benson, James C McElnay. Topical Non–steroidal Anti–inflammatory products as ultrasound Couplants: Their potential in Phonophoresis. Physiotherapy 1994 February; 80(2):74–76.
18 A Binder, G Hodge, A M Greenwood, BL Hazleman, D P Page Thomas. Is therapeutic ultrasound effective in treating soft tissue lesions? British Medical Journal February 1985; 290:512–514.
19 Moneet Kochar, Ankit Dogra. Effectiveness of a specific physiotherapy regimen on patient's with Tennis Elbow. Physiotherapy 2002 June; 88(6):333–341.
20 Ottar Vasseljen. Low-Level Laser versus Traditional Physiotherapy in the treatment of Tennis Elbow. Physiotherapy 1992 May; 78(5):329-334.
21 Samir Mitragotri, David A. Edwards, Daniel Blankschtein, Robert Langer. A Mechanistic study of Ultrasonically-Enhanced Transdermal Drug Delivery. Journal of Pharmaceutical sciences1995; 84(6):697-706.
22 Joseph A Balogun, Charles T Akomolafe, Lateef O Amusa. Grip strength: Effects of testing posture and elbow position. Archives physical medical Rehabilitation 1991April; 72:280-283.
23 Dr. Harry Whelan. Thor Laser therapy for wound Healing. Physical and occupational Therapy in Geriatrics 2000; 18(2): 1–19.
24 Jan M Bjordal, Christian Couppe, Roberta T Chow, Jan Tuner, Elisabeth Anne Ljunggren. A systemic review of low level laser therapy with location specific-doses for pain from chronic joint disorders. Australian Journal of Physiotherapy 2003; 49:107-115.
25 Leslley K Holdsworth, David M Anderson. Effectiveness of ultrasound used with a Hydrocortisone coupling medium or epicondylitis clasp to treat lateral epicondylitis: pilot study. Physiotherapy 1993 January; 79(1);19-25.