High-Intensity Laser Therapy vs. Ultrasound Therapy
Research Question
The research question for this article is whether high-intensity laser therapy or ultrasound (US) therapy is more beneficial for short-term treatment of subacromial impingement syndrome (SAIS). There has been little evidence found on the effects of physical therapy treatment, with some studies showing effectiveness of US therapy and others showing limited effectiveness in this type of condition.
Review of Literature
According to Cameron, laser therapy increases collagen production and decreases inflammation, while hindering bacterial growth. It also promotes vasodilation so that blood and other nutrients are able to flow into the area. One indication for the use of laser therapy includes soft tissue healing, which would be beneficial in treating SAIS. Cameron also states that “laser therapy was associated with increased collagen synthesis, rate of healing and wound closure, tensile strength, tensile stress, number of degranulated mast cells, and reduced would healing time.”2
This article also looked at the benefits of US therapy in the patients with SAIS. According to Cameron, “thermal effects of ultrasound include acceleration of metabolic rate, reduction or control of pain and muscle spasm, alteration of nerve conduction velocity, increased circulation, and increased soft tissue extensibility.”2 US applies electrical current to the treatment area through a crystal in the transducer. The duration of the US depends on the total area being treated and a longer duration increases the amount of energy that is being transmitted into the tissue. Ultrasound is able to reach deeper tissues better than other types of physical agents. If the pur...
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...therapy clinics and I will probably use it more during my practice. I will examine the area that needs to be treated, taking into consideration the various contraindication and precautions, and begin my therapy session. Even though I believe that this is a beneficial intervention, if it is now showing any progress I will look into other types of modalities in order to help treat my patient.
Works Cited
1. Santamato A, Solfrizzi v, Fiore P, et al. Short-term effects of high-intensity laser therapy versus ultrasound therapy in the treatment of people with subacromial impingement syndrome: a randomized clinical trial. Physical Therapy [serial online]. July 2009;89(7):643-652. Available from: MEDLINE, Ipswich, MA. Accessed October 13, 2011.
2. Cameron, M.H. Physical Agents in Rehabilitation: From Research to Practice. St. Louis Missouri: Saunders Elsevier; 2009.
Sussmilch-Leitch, S. P., Collins, N., Bialocerkowski, A. E., Warden, S. J., & Crossley, K. M. (2012). Physical therapies for achilles tendinopathy: systematic review and meta-analysis. Journal of Foot and Ankle Research , 1-16.
Crowell MS, Wofford NH. Lumbopelvic manipulation in patients with patellofemoral pain syndrome. The Journal of Manual & Manipulative Therapy. 2012;20(3):113-120
Gadsby, JG: Transcutaneous Electrical Nerve Stimulation for Chronic Low back Pain. Cochrane Review Abstracts. December 1997
20. Watson CJ, Propps M, Ratner J, Zeigler DL, Horton P, Smith SS. Reliability and responsiveness of the lower extremity functional scale and the anterior knee pain scale in patients with anterior knee pain. J Orthop Sports Phys Ther. 2005;35:136-146. http://dx.doi.org/10.2519/jospt.2005.1403
DOI: 4/24/2013. This is a case of a 59-year-old female customer service representative who sustained injury to her left ankle when she got up after her foot “fell asleep”. As per OMNI notes, patient underwent ligament reconstruction with Brostrom repair on 1/16/2014 and left knee arthroscopy on 10/8/2014. As per office notes dated 6/21/16, the patient returns for interval followup visit. The patient has been working more and is explaining to me that she is having exacerbation of symptoms. The patient admits to increasing neuropathic pain secondary to complex regional pain syndrome. It was mention that the patient has been on Topamax and tramadol which allow the patient to get some improvement. She admits 40% improvement in the pain and she also
For descriptive purposes, factors related to shoulder impingement can be divided into intrinsic and extrinsic categories. Intrinsic factors directly involve the subacromial space and include changes in vascularity of the rotator cuff, degeneration, and anatomy or bony anomalies. Extrinsic factors include muscle imbalances and motor control problems of t...
Supraspinatus tendonitis is inflammation of the supraspinatus/rotator cuff tendon and/or the contiguous peritendinous soft tissues, according to Medscape. It is usually identified with shoulder impingement syndrome and is a recognized phase in the second stage of the disease. There are both extrinsic and intrinsic factors that can lead up to this condition. Primary and secondary impingement are what make up the extrinsic factors. Primary impingement is the outcome from increased subacromial loading, trauma, or overhead activities. Secondary impingement is the outcome from rotator cuff overload and muscle imbalance. The condition can also be caused by the diminishing in the supraspinatus outlet space because of the unstable glenohumeral joint.
These days muscle pain and spasms have become the most common complaint of many working men and women. To avoid this pain most of them rely upon spa’s to lessen their pain. One of the main techniques used in the spa’s to reduce muscle pain is heat therapy. This nonpharmacological technique helps in reducing the muscle pain as it vasodilates the muscle causing the blood flow to increase at the site of inflammation or injury (Mohammadpour et al. 2014). Due to an increase in the blood supply, the oxygen levels also rise which reduces the amount of inflammatory facilitators and triggers heat shock proteins. With the latest rehabilitation benefits, heat therapy is being used for curing many problems because of its positive feedback.
The student states to the nurse educator, “Outcomes for this patient will be pain control as evidenced by report of pain relief, blood pressure decrease, and comfort and positioning techniques that will alleviate pain.”
It is a home exercise program that allows the patient to take an active part in their healing. Gently moving the soft tissue prepares it for the treatment it receives from the therapist. Time previously spent during the therapy session to initiate change in the tissues is used instead to advance further release and flexibility. The therapist is able to focus treatment time on stubborn areas of connective tissue restriction that have not changed in response to exercise. The positioning the patient uses to complete the exercises helps the therapist identify the source of the problem which is not usually in the same place as the patient’s primary complaint. This partnership between the therapist and the patient translates into quicker recovery and improved pain relief for the
The dropout rate of this trial was 58% at 3 months showed that none of PRP, GC or saline injections adequately reduced the pain and disability of lateral epicondylitits.” 5
To diagnose the main cause of TJ pain, history, physical examination, laboratory tests, and imaging studies must be
In this study by Rompe et al. 8 a shockwave is generated in a handheld device then transferred to the patient using standard ultrasound gel as the coupling agent. The energy generated by the device varies greatly depending on the parameters used. In this instance, SWT was given three different times, with a week between each of the sessions. Each time a patient received treatment, 2000 pulses were delivered at a pressure of 2.5 bars. Participants in this study were divided between two different groups, and performed either eccentric loading exercises, or received SWT. The outcome measures of interest for the researchers were the subjects’ VISA-A score and whether or not they rated their achilles as worse, no difference, much improved, or fully recovered. These measures were taken at baseline and at the end of the study at 16 weeks. At 16 weeks, there was no significant difference between the ELE and SWT groups in mean VISA-A scores. The patient’s rating of the function of their achilles, however, showed significant difference. In the ELE group, only 28% of patients rated their achilles either much improved or fully recovered compared to 64% in the SWT group. This difference was statistically significant and demonstrated better recovery in the SWT group than in the ELE
... dr. Ostelo R., Koes B., van Tulder M. (2010) Exercise Therapy for Chronic Nonspecific Low-Back Pain. Best Practice & Research Clinical Rheumatology vol. 24 pp: 193–204.
Harvey Simon, MD, and David Zieve, MD (2012, May 3). Back Pain and Sciatica. Retrieved