Effectiveness of Low-Level Laser Therapy in Patients with Discogenic Lumbar Radiculopathy: A Double-Blind Randomized Controlled Trial. (2022)

PICO

Patient/Population

Acute low back pain and unilateral discogenic lumbar radiculopathy (n=110)

Intervention

  • LLLT
  • Conventional physical therapy

Comparison

  • Conventional physical therapy

Outcomes

  •  Pain

  • Functional disability

  • Lumbar range of motion (L-Flexion and L-Extension)

  • Straight leg raise

Translatability:   (3/3) Easy                                    

Comments:The low-level laser therapy at a wavelength of 830 nm and a dose of 3 J/point for the acute LBP with discogenic lumbar radiculopathy, proved as an efficient adjunct therapy to conventional physical therapy in significantly improving local trunk movements, pain intensity, and related functional disability….Moreover, the strength of correlation among the variables of the experimental group is more pronounced than that of control group. In addition, no major side effects were observed during and after the use of LLLT.”
Limitations:Patients with relatively strictly defined clinical forms of the condition (severe levels of pain and moderate-severe levels of disability) were selected due to the typical flow of patients to clinical treatment (selection bias). Randomization did not include the initial level of disability, MRI and EMG findings, duration of symptoms, or other psychosocial characteristics that could influence the therapeutic response. The results of this study suggest only short-term effects. The identification of true positive effects under conditions of this study is controversial given that we had no untreated group, especially when the history, level, and percentage of spontaneous recovery were unknown.”

Appraisals:

PEDro Scale  – (8/10) Blind subjects: No; Blind therapists. (by PEDro – confirmed)

Trustworthiness – The study contains no serious weaknesses. Based on this result you should conclude that the trustworthiness of the study is high (90%). This means there is a 10% chance that alternative explanations for the effect found are possible. The effect size was large and 95% CI was OK. (by CAT)

Metrics and
Journal Details:
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BTB

Intervention – 1

  • LLLT (830 nm)

Dose

  • 5,000Hz; 100 mW; 3 J/cm2 on each of the 4 points. 30 sec on each point.

Periodicity

  • 3 sessions per week for 6 to 8 weeks

Local/Technic:

The laser probe was held stationary in skin contact with special care of skin hygiene at 2.5 and 3.5 cm laterally of the spinous process of the involved nerve root (L4 or L5 or S1) and one distal level segment. 

    Intervention – 2

    • Conventional physical therapy

    Dose

    • Hot pack – 10 minutes.

    • Back extension exercises – 3 sets of 5 repetitions each.

    • Hold relax technique – sustained stretch in 3 sets of 5 repetitions each with 15 seconds hold.

    • Sciatic nerve mobilizations – 5 times in one set with 15 seconds hold.

    Periodicity

    • 3 sessions per week for 6 to 8 weeks

    Local/Technic:

    • The hot pack was placed on the lower lumbar region (L3-S2).
    • Back extension exercises, in prone lying position.
    • Hold relax technique was applied for hamstrings, gluteus maximus, and calf muscles followed by a sustained stretch.
    • Sciatic nerve mobilizations were performed

    Citation: Ahmed, I., Bandpei, M., Gilani, S. A., Ahmad, A., & Zaidi, F. (2022). Effectiveness of Low-Level Laser Therapy in Patients with Discogenic Lumbar Radiculopathy: A Double-Blind Randomized Controlled Trial. Journal of healthcare engineering,2022, 6437523. https://doi.org/10.1155/2022/6437523

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