Anders Mårdh1, Iréne Lund2. 1. Fysioterapiteamet, Drottningatan 88 F, SE-111 36 Stockholm, Sweden. 2. Department of Physiology and Pharmacology, Karolinska Institutet, SE-17177 Stockholm, Sweden.
Abstract
INTRODUCTION:Pain in the Achilles tendon during loading is a very common condition. Conservative treatments, such as low level laser therapy (LLLT) have been reported to give varying results. Recently, a new laser treatment technique, high power laser treatment (HPLT) (Swiss DynaLaser®), was introduced in Scandinavia, but has not, to our knowledge, been systematically tested before. The objective of this study was to evaluate the effects of HPLT compared to placebo HPLT in rated pain and assessed pain threshold in patients with chronic Achilles tendinosis. METHODS: The study was a randomized, single blind, placebo controlled trial. Patients were randomized to receive 6 treatments of either HPLT or placebo HPLT during a period of 3-4 weeks with a follow up period of 8-12 weeks. Outcome measures were rated pain according to questions of the Foot and Ankle Outcome Score (FAOS, Swedish version LK1.0) and assessment of electro-cutaneous stimulated pain threshold and matched pain (PainMatcher). RESULTS: The results of the study demonstrated significant changes of assessments within groups, that were more pronounced towards lower levels of rated pain in the HPLT group than in the placebo HPLT group. The between group difference were significant in four of nine questions regarding loading activities of the FAOS subscale. Assessed pain thresholds were found increased in the HPLT group, as compared to the placebo HPLT group. At individual level, the results varied. CONCLUSION: The results indicate that HPLT may provide a future option for treatment of Achilles tendinosis related pain, but further studies are warranted.
RCT Entities:
INTRODUCTION:Pain in the Achilles tendon during loading is a very common condition. Conservative treatments, such as low level laser therapy (LLLT) have been reported to give varying results. Recently, a new laser treatment technique, high power laser treatment (HPLT) (Swiss DynaLaser®), was introduced in Scandinavia, but has not, to our knowledge, been systematically tested before. The objective of this study was to evaluate the effects of HPLT compared to placebo HPLT in rated pain and assessed pain threshold in patients with chronic Achilles tendinosis. METHODS: The study was a randomized, single blind, placebo controlled trial. Patients were randomized to receive 6 treatments of either HPLT or placebo HPLT during a period of 3-4 weeks with a follow up period of 8-12 weeks. Outcome measures were rated pain according to questions of the Foot and Ankle Outcome Score (FAOS, Swedish version LK1.0) and assessment of electro-cutaneous stimulated pain threshold and matched pain (PainMatcher). RESULTS: The results of the study demonstrated significant changes of assessments within groups, that were more pronounced towards lower levels of rated pain in the HPLT group than in the placebo HPLT group. The between group difference were significant in four of nine questions regarding loading activities of the FAOS subscale. Assessed pain thresholds were found increased in the HPLT group, as compared to the placebo HPLT group. At individual level, the results varied. CONCLUSION: The results indicate that HPLT may provide a future option for treatment of Achilles tendinosis related pain, but further studies are warranted.