Low level laser therapy for reducing pain in rheumatoid arthritis and osteoarthritis: a systematic review

Introduction: Treatments for rheumatoid arthritis (RA) and osteoarthritis (OA) can reduce, modulate inflammation, and reduce deformities. Low-Level Laser Therapy is a biomodulator and may aid in the clinical picture of these conditions. Objective: To analyze the parameters most frequently used to determine the responses of patients with RA and OA in controlled and uncontrolled clinical trials. Method: This is a systematic review with search of articles in English, Portuguese and Spanish in PUBMED, SCOPUS, LILACS and Web of SCIENCE, of articles published between 2006 and 2018. MeSH terms were used. Inclusion criteria: evaluation of LLLT in the evaluations, evaluation and evaluation of the period, controlled and uncontrolled clinical trials, full publications. The base date of the energy dosimetry and the analysis of mean, median and mode of energy per point and energy per treatment. Results: Three articles on RA and 16 on OA were included in this study. Regarding dosimetry, it was one of the most recent of the pain, being this one with a greater energy dose. In OA, most of the articles presented are of importance, with variability in the dosage applied. Conclusion: There are several reports for patient studies purposes, mainly with doses of 6 J per point and 48 J. In the joints affected with OA and AR, it would be important to publish more scientific articles with better methodological quality and description of dosimetry

Orthotic use for CMC osteoarthritis: Variations among different health professionals in Brazil

© 2016 Hanley & Belfus Study Design Cross-sectional descriptive study. Introduction Osteoarthritis (OA) is the most prevalent musculoskeletal disease in the adult and older adult populations. The use of orthoses to stabilize the thumb\u27s articular complex is one of the most common conservative management strategies. Despite substantial research about this topic, there is insufficient evidence about the optimal use of orthoses to inform clinical practice, contributing to practice variations within and across health professionals. Purpose of the Study To identify the prescription patterns, design preferences, and barriers for the use of orthotic devices among Brazilian health care professionals involved in the treatment of patients with OA of the basal thumb joint. Methods An electronic questionnaire was sent to occupational therapists, physiotherapists, and rheumatologists across Brazil through professional association mailing lists. Survey included questions about orthosis design, materials, and barriers to the use of orthotic interventions. Respondents indicated their use based on photographs of 25 orthoses models that were selected through bibliographic review and expert consultation. Descriptive statistics, the chi-square test for independence, and the Fisher exact test were used to compare differences among orthotic prescription preferences, barriers, and challenges observed amidst the 3 participants\u27 professional classes. Results There was no consensus about orthotic prescription among 275 professionals who answered the survey. About 69% of participants reported the use of multiple orthosis during treatment of patients with thumb OA. Results suggest significant variations in the number of joints included and stabilization strategies adopted, with a preference for orthotics made in rigid materials and involving the wrist, carpometacarpal, and metacarpophalangeal joints (P \u3c .001). The lack of knowledge about orthotic options, institutional regulations, and policies were the major barriers reported by respondents (P \u3c .01). Conclusion A plentiful variety of different orthoses designs were observed in this study, and the prescriptions made by 3 professional classes showed differences regarding types of stabilization, joint involvement, and positioning. Despite the existence of clinical trials suggesting benefits for specific custom-made design models, our results indicated widespread clinical variation in practices and preferences. Level of Evidence Not applicable

Orthoses for patients with thumb osteoarthritis: what occupational therapists in Brazil indicate?

Orthoses are the first line of action for the treatment of dysfunctions caused by osteoarthritis (OA) of the carpometacarpal joint of the thumb. However, there are no studies that investigate the preferences and orthotics prescriptions made by Brazilian health professionals. Objective: To identify orthotic designs indicated by occupational therapists for patients with thumb OA and the barriers encountered to use these devices. Methods: Cross-sectional, exploratory study conducted by electronic questionnaire with Brazilian occupational therapists. Data were analyzed using the distribution, frequency and percentage of responses. Results: 52 Brazilian occupational therapists who treated patients with rheumatic diseases participated in this study. Most of the participants indicated custom-made models (81%), involving more than one joint (83.7%). Institutional policies and lack of materials were the main barriers for 48.1% of the participants. Conclusion: The prescription of orthoses for patients with OA is present in the clinical practice of occupational therapists, and it is important to encourage strategies to the development and dissemination of rehabilitation actions for this population.Órteses são consideradas a primeira linha de atuação para o tratamento de disfunções causadas pela osteoartrite (OA) da articulação carpometacárpica do polegar. Entretanto, não existem estudos que investiguem as preferências e indicações de órteses por profissionais brasileiros. Objetivo: Identificar os modelos de órteses indicados por terapeutas ocupacionais para pacientes com OA do polegar, bem como as barreiras encontradas para o uso deste recurso. Métodos: Estudo exploratório transversal, realizado através de questionário eletrônico com terapeutas ocupacionais brasileiros. Os dados obtidos foram analisados por meio da distribuição, frequência e porcentagem das respostas. Resultados: Participaram da pesquisa 52 terapeutas ocupacionais de todo o Brasil, atuando junto a pacientes reumáticos. A maioria das indicações foi de órteses sob medida (81%), envolvendo mais de uma articulação (83,7%). Políticas institucionais e ausência de materiais foram as principais dificuldades para 48,1% dos participantes. Conclusão: A indicação de órteses para pacientes com OA se faz presente na prática clínica de terapeutas ocupacionais e torna-se importante o incentivo a estratégias que permitam o aperfeiçoamento e difusão de ações de reabilitação junto a esta população

Low level laser therapy for reducing pain in rheumatoid arthritis and osteoarthritis: a systematic review

Abstract Introduction: Treatments for rheumatoid arthritis (RA) and osteoarthritis (OA) can reduce, modulate inflammation, and reduce deformities. Low-Level Laser Therapy is a biomodulator and may aid in the clinical picture of these conditions. Objective: To analyze the parameters most frequently used to determine the responses of patients with RA and OA in controlled and uncontrolled clinical trials. Method: This is a systematic review with search of articles in English, Portuguese and Spanish in PUBMED, SCOPUS, LILACS and Web of SCIENCE, of articles published between 2006 and 2018. MeSH terms were used. Inclusion criteria: evaluation of LLLT in the evaluations, evaluation and evaluation of the period, controlled and uncontrolled clinical trials, full publications. The base date of the energy dosimetry and the analysis of mean, median and mode of energy per point and energy per treatment. Results: Three articles on RA and 16 on OA were included in this study. Regarding dosimetry, it was one of the most recent of the pain, being this one with a greater energy dose. In OA, most of the articles presented are of importance, with variability in the dosage applied. Conclusion: There are several reports for patient studies purposes, mainly with doses of 6 J per point and 48 J. In the joints affected with OA and AR, it would be important to publish more scientific articles with better methodological quality and description of dosimetry.</jats:p

Órteses para o paciente com osteoartrite do polegar: o que os terapeutas ocupacionais no Brasil indicam?

Órteses são consideradas a primeira linha de atuação para o tratamento de disfunções causadas pela osteoartrite (OA) da articulação carpometacárpica do polegar. Entretanto, não existem estudos que investiguem as preferências e indicações de órteses por profissionais brasileiros. Objetivo: Identificar os modelos de órteses indicados por terapeutas ocupacionais para pacientes com OA do polegar, bem como as barreiras encontradas para o uso deste recurso. Métodos: Estudo exploratório transversal, realizado através de questionário eletrônico com terapeutas ocupacionais brasileiros. Os dados obtidos foram analisados por meio da distribuição, frequência e porcentagem das respostas. Resultados: Participaram da pesquisa 52 terapeutas ocupacionais de todo o Brasil, atuando junto a pacientes reumáticos. A maioria das indicações foi de órteses sob medida (81%), envolvendo mais de uma articulação (83,7%). Políticas institucionais e ausência de materiais foram as principais dificuldades para 48,1% dos participantes. Conclusão: A indicação de órteses para pacientes com OA se faz presente na prática clínica de terapeutas ocupacionais e torna-se importante o incentivo a estratégias que permitam o aperfeiçoamento e difusão de ações de reabilitação junto a esta população.</jats:p