scholarly journals Non-pharmacological Management of Soft Tissue Disorders of the Shoulder

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Hainan Yu ◽  
Pierre Côté ◽  
Jessica J Wong ◽  
Heather M Shearer ◽  
Carol Cancelliere ◽  
...  
Keyword(s):  
Decision Making ◽  
Soft Tissue ◽  
Usual Care ◽  
Shoulder Pain ◽  
Low Level Laser Therapy ◽  
Evidence Based ◽  
Pharmacological Management ◽  
Shockwave Therapy ◽  
Level Laser ◽  
Multimodal Care

Objective: To develop an evidence‐based clinical practice guideline for the non‐pharmacological management of shoulder soft tissue disorders (shoulder pain). Methods: This guideline is based on seven systematic reviews. A multidisciplinary expert panel formulated recommendations based on evidence of effectiveness, safety, cost-effectiveness, societal and ethical values, and patient experiences (through qualitative research). Target audience includes clinicians; target population is adults with shoulder pain (sprains/strains, tendinopathies). Recommendations: When managing shoulder pain, clinicians should rule out major pathologies, assess prognostic factors for delayed recovery, offer education and reassurance, and provide care in partnership with the patient. For shoulder pain ≤3 months’ duration, clinicians may consider cervicothoracic manipulation and mobilization as adjunct to usual care, thoracic manipulation, multimodal care (heat/cold, mobilization, exercise), or low-level-laser therapy. For shoulder pain >3 months’ duration, clinicians may consider exercise, laser acupuncture, low-level-laser therapy, general practitioner care, thoracic manipulation, cervicothoracic manipulation and mobilization with usual care, or multimodal care (combining heat/cold, mobilization, exercise). Clinicians should not offer cervical mobilization as adjunct to multimodal care, cervicothoracic manipulation and mobilization as adjunct to exercise, multimodal care (combining exercise, mobilization, taping, psychological intervention, massage), shockwave therapy, ultrasound, taping, interferential current, diacutaneous fibrolysis, or massage. For calcific tendinitis, clinicians may consider shockwave therapy. Clinicians should reassess at every visit and determine whether discharge or a referral is indicated. Public health impact/implications: Our guideline provides evidence-based recommendations intended to optimize patient care, reduce inefficient practices and healthcare costs, and improve health outcomes related to shoulder pain. Our recommendations help guide shared decision-making with patients, bridge the gap between research and practice, and reduce variation in care among clinicians. Our guideline identifies interventions that may provide some benefit, little effect, or potential harm to assist policymakers with decision-making at the population level. Overall, this guideline contributes to preventing and limiting the burden of musculoskeletal disability.

EFFECT OF LOW LEVEL LASER THERAPY ON HEMIPLEGIC SHOULDER PAIN IN POST STROKE SUBJECTS

2021 ◽  
pp. 73-76
Author(s):  
Pappala kiran Prakash ◽  
Dommeti Sai Sushmitha ◽  
P.R.S Thulasi ◽  
Ganapathi Swamy
Keyword(s):  
Laser Therapy ◽  
Shoulder Pain ◽  
Upper Limb ◽  
Rehabilitation Programme ◽  
Low Level Laser Therapy ◽  
Post Stroke ◽  
Upper Limb Function ◽  
Level Laser ◽  
Group A ◽  
Group B

Shoulder pain is a common complication of a stroke which can impede participation in rehabilitation and has been associated with poor outcomes. Low Level LASER Therapy (LLLT) is one of the adjunct treatments of choice with exercise therapy for shoulder rehabilitation in Physiotherapy. The objective of this study was to investigate the effect of LLLT on Hemiplegic Shoulder Pain (HSP) in reducing shoulder pain and improving upper limb function in post Stroke subjects. Prospective study design. 68 subjects with mean age of 53 years having a clinical diagnosis of Stroke with HSP were randomly allocated into two groups. In Group-A (n=34) subjects were treated with LLLT and standardized Rehabilitation Programme, where as in Group-B (n=34) subjects were treated with standardized Rehabilitation Programme. Participants were given interventions twice a week for 8 weeks. The outcomes of this intervention were measured by SPADI for pain, disability and FMA-UE for function. Statistical analysis of the data revealed that within group comparison both groups showed signicant improvement in all parameters, where as in between groups comparison Group-A showed better improvement compared to the Group-B. After 8 weeks of interventions both Group-A and Group-B showed signicant improvement in reducing pain and improving upper limb function. However LLLT along with Standardized Rehabilitation Programme showed more improvement when compared to the Standardised Rehabilitation Programme alone. Thus this study concludes that LLLT is a useful adjunct in HSPalong with rehabilitation

Low level laser therapy and hair regrowth: an evidence-based review

2015 ◽  
Vol 31 (2) ◽  
pp. 363-371 ◽  
Author(s):  
Mina Zarei ◽  
Tongyu C. Wikramanayake ◽  
Leyre Falto-Aizpurua ◽  
Lawrence A. Schachner ◽  
Joaquin J. Jimenez
Keyword(s):  
Laser Therapy ◽  
Low Level Laser Therapy ◽  
Evidence Based ◽  
Hair Regrowth ◽  
Low Level ◽  
Low Level Laser ◽  
Level Laser

scholarly journals COMPARATIVE STUDY ON THE EFFECTIVENESS OF LOW LEVEL LASER THERAPY VERSUS PHONOPHORESIS IN THE MANAGEMENT OF LATERAL EPICONDYLITIS

2013 ◽  
Vol 03 (01) ◽  
pp. 35-44
Author(s):  
Mohamed Faisal C. K. ◽  
Mary Sumila ◽  
Lawrence Mathias ◽  
Ajith S.
Keyword(s):  
Soft Tissue ◽  
Laser Therapy ◽  
Lateral Epicondylitis ◽  
Soft Tissue Injuries ◽  
Low Level Laser Therapy ◽  
Low Level ◽  
Low Level Laser ◽  
Sodium Diclofenac ◽  
Level Laser ◽  
Laser Group

Abstract Background and Objectives: The use of electro physical agents for the management of any soft tissue injuries in Physical Therapy practice is very common for an early recovery from the injury. Among that, Low Level Laser Therapy (LLLT) and Phonophoresis are found to be very effective in soft tissue injuries. So the objective of this study is to know the comparative effectiveness of LLLT versus Phonophoresis in the treatment of lateral epicondylitis. Methods: Convenient sample of 40 patients with lateral epicondylitis were recruited for this study. They were assigned equally either to a laser (n = 20) or a Phonophoresis (n = 20) group. Laser group received the treatment with Ga-As (904nm) IR semiconductor diode laser. For Phonophoresis group a gel containing 1% sodium diclofenac was used as coupling agent. Each group was treated 3 times a week, for a total of 8 treatments, and was evaluated subjectively and objectively before and at the end of the treatment, by using VAS, pain free grip strength and functional pain scale as variables. Results: Comparison between laser group and Phonophoresis group is done using Mann Whitney U test. Comparison between pre and post is done using Wilcoxon's signed rank sum test. Form selection to the post treatment assessment, a significant decrease in symptoms was found in both laser and phonophoresis groups. But it is concluded that statistically; low level laser therapy was not significantly better than phonophoresis with the results of VAS (P = 0.53), FPS (P = 0.253), pain free grip strength. (P = 0.426). Interpretation and conclusions: The result of this study suggest that low level laser therapy as well as phonophoresis with sodium diclofenac gel as couplant medium gives a good result in the management of lateral epicondylitis. This study concludes that statistically there was no significant difference between Low level laser therapy and Phonophoresis with sodium diclofenac gel as coupling agent in the management of lateral epicondylitis.

Deprescribing in older people

2020 ◽  
Vol 81 (1) ◽  
pp. 1-9 ◽  
Author(s):  
M Sinead O'Mahony ◽  
Anita Parbhoo
Keyword(s):  
Decision Making ◽  
High Risk ◽  
Older People ◽  
Adverse Drug Events ◽  
Evidence Base ◽  
Adverse Outcomes ◽  
Evidence Based ◽  
Pharmacological Management ◽  
International Evidence ◽  
Evidence Based Guidelines

Polypharmacy and multimorbidity are both currently rising. The number of medicines taken is the single biggest predictor of adverse drug events. Deprescribing is an approach to managing polypharmacy and reducing adverse outcomes. Multiple international evidence-based guidelines are emerging to promote discontinuation of high-risk medications, and use of alternative medical and non-pharmacological management. This review outlines the evidence base behind deprescribing, and suggests some pragmatic approaches to decision making around medication review.

scholarly journals Effectiveness of Low-Level Laser Therapy Combined With an Exercise Program to Reduce Pain and Increase Function in Adults With Shoulder Pain: A Critically Appraised Topic

2013 ◽  
Vol 22 (1) ◽  
pp. 72-78 ◽  
Author(s):  
Aimee L. Thornton ◽  
Cailee W. McCarty ◽  
Mollie-Jean Burgess
Keyword(s):  
Laser Therapy ◽  
Shoulder Pain ◽  
Exercise Program ◽  
Low Level Laser Therapy ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Low Level ◽  
Low Level Laser ◽  
Shoulder Range Of Motion ◽  
Level Laser

Clinical Scenario:Shoulder pain is a common musculoskeletal condition that affects up to 25% of the general population. Shoulder pain can be caused by any number of underlying conditions including subacromial impingement syndrome, rotator-cuff tendinitis, and biceps tendinitis. Regardless of the specific pathology, pain is generally the number 1 symptom associated with shoulder injuries and can severely affect daily activities and quality of life of patients with these conditions. Two of the primary goals in the treatment of these conditions are reducing pain and increasing shoulder range of motion (ROM).3 Conservative treatment has traditionally included a therapeutic exercise program targeted at increasing ROM, strengthening the muscles around the joint, proprioceptive training, or some combination of those activities. In addition, these exercise programs have been supplemented with other interventions including nonsteroidal anti-inflammatory drugs, corticosteroid injections, manual therapy, activity modification, and a wide array of therapeutic modalities (eg, cryotherapy, EMS, ultrasound). Recently, low-level laser therapy (LLLT) has been used as an additional modality in the conservative management of patients with shoulder pain. However, the true effectiveness of LLLT in decreasing pain and increasing function in patients with shoulder pain is unclear.Focused Clinical Question:Is low-level laser therapy combined with an exercise program more effective than an exercise program alone in the treatment of adults with shoulder pain?

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