Effectiveness of low-level laser therapy for patients with carpal tunnel syndrome: design of a randomized single-blinded controlled trial

Background: Carpal tunnel syndrome is the most common neuropathy in the upper extremity, resulting from the compression of the median nerve at wrist level. Clinical studies are essentials to present evidence on therapeutic resources use at early restoration on peripheral nerve functionality. Low-level laser therapy has been widely investigated in researches related to nerve regeneration. Therefore, it is suggested that the effect of low-level laser therapy associated with other conservative rehabilitation techniques may positively affect symptoms and overall hand function in compressive neuropathies such as carpal tunnel syndrome. The aim of this study is to evaluate the effectiveness of low-level laser therapy in addition to orthoses therapy and home orientations in patients with carpal tunnel syndrome. Methods/Design: Patients older than 18 years old will be included, with clinical diagnosis of carpal tunnel syndrome, excluding comorbidies. A physiotherapist will conduct intervention, with a blinding evaluator. Randomization will be applied to allocate the patients in each group: with association or not to low-level laser therapy. All of them will be submitted to orthoses therapy and home orientations. Outcome will be assessed through: pain visual analogic scale, Semmes Weinstein monofilaments (TM) threshold sensibility test, Pinch Gauge T, Boston Carpal Tunnel Questionnaire and two point discrimination test. Discussion: This paper describes the design of a randomized controlled trial, which aim to assess the effectiveness of conservative treatment added to low-level laser therapy for patients with carpal tunnel syndrome. Trial registration: Brazilian Clinical Trials Registry (ReBec) - 75ddtf / Universal Trial Number: U1111-1121-5184Sao Paulo Research Foundation (FAPESP)Fundacao de Apoio ao Ensino, Pesquisa e Assistencia of Clinics Hospital, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo - FAEP

Effectiveness of low-level laser therapy for patients with carpal tunnel syndrome: design of a randomized single-blinded controlled trial

Abstract\ud \ud Background\ud Carpal tunnel syndrome is the most common neuropathy in the upper extremity, resulting from the compression of the median nerve at wrist level. Clinical studies are essentials to present evidence on therapeutic resources use at early restoration on peripheral nerve functionality. Low-level laser therapy has been widely investigated in researches related to nerve regeneration. Therefore, it is suggested that the effect of low-level laser therapy associated with other conservative rehabilitation techniques may positively affect symptoms and overall hand function in compressive neuropathies such as carpal tunnel syndrome. The aim of this study is to evaluate the effectiveness of low-level laser therapy in addition to orthoses therapy and home orientations in patients with carpal tunnel syndrome.\ud \ud \ud Methods/Design\ud Patients older than 18 years old will be included, with clinical diagnosis of carpal tunnel syndrome, excluding comorbidies. A physiotherapist will conduct intervention, with a blinding evaluator. Randomization will be applied to allocate the patients in each group: with association or not to low-level laser therapy. All of them will be submitted to orthoses therapy and home orientations. Outcome will be assessed through: pain visual analogic scale, Semmes Weinstein monofilaments™ threshold sensibility test, Pinch Gauge™, Boston Carpal Tunnel Questionnaire and two point discrimination test.\ud \ud \ud Discussion\ud This paper describes the design of a randomized controlled trial, which aim to assess the effectiveness of conservative treatment added to low-level laser therapy for patients with carpal tunnel syndrome.\ud \ud \ud Trial registration\ud Brazilian Clinical Trials Registry (ReBec) - 75ddtf / Universal Trial Number: U1111-1121-5184FAPESPFAEP

Brazilian version of the Patient Rated Wrist Evaluation (PRWE-BR): Cross-cultural adaptation, internal consistency, test-retest reliability and construct validity

© 2015 Hanley & Belfus. Study design: Clinical measurements. Purpose: Perform the translation and cross-cultural adaptation of the Patient Rated Wrist Evaluation (PRWE) into a Brazilian version (PRWE-BR), and assess its internal consistency, test-retest reliability and construct validity. Methods: PRWE-BR was developed using standardized guidelines. Sixty-one patients with different wrist injuries were recruited. They were submitted to two assessments, 2-7 days apart. Reliability was measured by internal consistency (Cronbach\u27s alpha) and test-retest reliability (Intraclass Correlation Coefficient). Construct validity was determined via hypothesis testing (Spearman\u27s correlation) of correlations with subscales of SF-36 and DASH. Results: PRWE-BR and its subscales achieved high internal consistency (Cronbach\u27s alpha ≥ 0.85) and excellent test-retest reliability (ICC ≥ 0.90). Construct validity was established by confirmation of 85.7% of our previously formulated hypotheses. Conclusions: PRWE-BR is a valid and reliable tool for the assessment of pain and dysfunction in Brazilian patients with injuries involving the wrist joint. Level of evidence N/

Efficacy of low-level laser therapy associated to orthoses for patients with carpal tunnel syndrome: A randomized single-blinded controlled trial

© 2016 IOS Press and the authors. OBJECTIVE: Compare the efficacy of orthoses and patient education with and without the addition to Low-Level Laser Therapy (LLLT - 660 nm, 30 mW, a continuous regime and bean area of 0.06 cm 2). The laser irradiation was delivered with the fluency of 10J/cm 2 in patients with mild and moderate Carpal Tunnel Syndrome (CTS). METHODS: 48 patients were randomized and 30 finished the protocol (a sample loss of 37.5%), 90% female and 10% males. Randomization was applied to allocate the patients in each one of the groups, with association or not to LLLT (group orthoses or LLLT and orthoses). All of them were submitted to ergonomic home orientations. The short-term symptoms and function outcome were assessed through: Boston Carpal Tunnel Questionnaire (BCTQ) - Severity of Symptoms (SS) Functional Score (FS). Pain (VAS), Semmes-Weinstein monofilaments, 2PD and pinch strength was used for characterization of the sample. Most of the participants were women, over 4th decade enrolled on heavy hand duties occupations, right-handed, 66.7% affected on dominant hand, without alterations in sensory median nerve thresholds or pinch strength. RESULTS: Both groups showed a reduction of total BCTQ score and its subdomains after six weeks, with significant difference (p\u3c 0.05), comparing to baseline. No significant difference was found between groups. A Minimal clinical change was observed after the intervention in 92.3% of participants for BCTQ subdomain severity of symptoms at individual comparison for LLLT and orthoses group and 76.5% for the orthoses group, demonstrating clinical relevance. Effect size Cohen\u27s index was moderate for the severity of symptoms. CONCLUSION: LLLT in association to orthoses and ergonomic orientation seems to be effective in short-term symptoms relieve for patients with mild and moderate CTS

Effectiveness of low-level laser therapy for patients with carpal tunnel syndrome: design of a randomized single-blinded controlled trial

Abstract Background Carpal tunnel syndrome is the most common neuropathy in the upper extremity, resulting from the compression of the median nerve at wrist level. Clinical studies are essentials to present evidence on therapeutic resources use at early restoration on peripheral nerve functionality. Low-level laser therapy has been widely investigated in researches related to nerve regeneration. Therefore, it is suggested that the effect of low-level laser therapy associated with other conservative rehabilitation techniques may positively affect symptoms and overall hand function in compressive neuropathies such as carpal tunnel syndrome. The aim of this study is to evaluate the effectiveness of low-level laser therapy in addition to orthoses therapy and home orientations in patients with carpal tunnel syndrome. Methods/Design Patients older than 18 years old will be included, with clinical diagnosis of carpal tunnel syndrome, excluding comorbidies. A physiotherapist will conduct intervention, with a blinding evaluator. Randomization will be applied to allocate the patients in each group: with association or not to low-level laser therapy. All of them will be submitted to orthoses therapy and home orientations. Outcome will be assessed through: pain visual analogic scale, Semmes Weinstein monofilaments™ threshold sensibility test, Pinch Gauge™, Boston Carpal Tunnel Questionnaire and two point discrimination test. Discussion This paper describes the design of a randomized controlled trial, which aim to assess the effectiveness of conservative treatment added to low-level laser therapy for patients with carpal tunnel syndrome. Trial registration Brazilian Clinical Trials Registry (ReBec) - 75ddtf / Universal Trial Number: U1111-1121-5184</p