Kanji Asada, Yasutaka Yutani, Akira Sakawa and Akira Shimazu. Department of Orthopedic Surgery, Osaka City University Medical School, Japan
The authors have been involved in the treatment of rheumatoid arthritis (RA), in particular chronic poly-arthritis and the associated pain complaints. The biggest problem facing such patients is joint contracture, leading to bony ankylosis. This in turn severely restricts the range of motion (ROM) of the RA-affected joints, thereby seriously restricting the patient’s quality of life (QOL). The authors have determined that in these cases, daily rehabilitation practice is necessary to maintain the patient’s QOL at a reasonable level.
The greatest problem in the rehabilitation practice is the severe pain associated with RA- affected joints, which inhibits restoration of mobility and improved ROM. LLLT or low reactive level laser therapy has been recognized in the literature as having been effective in pain removal and attenuation. The authors accordingly designed a clinical trial to assess the effectiveness of LLLT in RA related pain (subjective self-assessment) and ROM improvement (objective documented data).
From July 1988 to June 1990, 170 patients with a total of 411 affected joints were treated using a GaAlAs diode laser system (830 nm, 60 mW C/W). Patients mean age was 61 years, with a ratio of males: females of 1: 5.25 (16%: 84%). Effectiveness was graded under three categories: excellent (remarkable improvement), good (clearly apparent improvement), and unchanged (little or no improvement).
For pain attenuation, scores were: excellent – 59.6%; good – 30.4%; unchanged – 10%.
For ROM improvement the scores were: excellent – 12.6%; good – 43.7%; unchanged – 43.7%. This gave a total effective rating for pain attenuation of 90%, and for ROM improvement of 56.3%.