Dr. Irena KOLA, Dr. Sandr KOLA
Abstract: . Introduction: Osteoartrosis (OA) is a chronic degenerative disorder characterized by many factors, like articular cartilago loss, bone remodeling and presence of subcondral osteofits formations. Minimisation and limitation of articular function and pain control are two main objectives for optimal treatment of (OA). Usually the knee is the most affected by OA. Medication, physiotherapy modalities, rehabilitating exercises are the modality of treatment. Laser therapy with low level (LLLT) is the most common modality. Our study is based on the assessment of efficiency of LLLT and high level laser therapy (HLLT) in the treatment of knee (OA) by comparing two different laser therapy. Material and methods: The study is based on treating patients with gonarthrosis in Hospital Center Mother Theresa, Tirana. This study is a prospective study. It is conducted in a period of 3 months (January 2013 - March 2013) and it is based on a questionnaire, Womac Index and Lequesne index. 30 patients with gonarthrosis were obtained in this study. The average age is 62.5 years old (from 45 - 80 years old). Patients were divided into three study groups: Group I: 10 patients were treated with LLLT (low level laser therapy) for 60 seconds each, in 4 pain areas on the surface of knee, 1.8 J / cm2 dose plus exercises; Group II: 10 patients were treated with HLLT for 120 seconds, 3.6 J / cm2 dose plus exercises; Group III: 10 patients were treated with placebo laser group plus exercises. All patients received a total of 10 cycles of treatment, therapy and exercise programs that continued throughout the study (3 months). All patients were assessed for pain evaluation according to VAS scale, evaluation of articular amplitude of the knee in flexion / extension, the global definition of walking, at a distance of 15 metres. Result: Post-therapy improvements were confirmed statistically in many parameters, in pain (assessed by VAS), in function (assessed by WOMAC and Lequesne) compared with the period before therapy in both groups that received laser therapy. Also we note pain decreasing in walking distance as well as during the morning, period which the patient suffer from stiffness. Improvements were observed more in the 2nd group in which laser therapy dose was doubled, compared with the other group. But on the other hand there was no difference in the improvement of pain and ROM in the group treated with placebo laser therapy. Conclusion: In conclusion, this study showed that treatment with laser therapy with low intensity in two different doses makes a significant reduction of pain and amplitude articular in OA. Although there are differences in the results obtained between the two active groups treated with laser therapy. As a result, we can say that the higher doses of LT, the higher the reduce in pain and the higher the improvement in ROM and functionality of genu articular.
Keywords: Osteoarthrosis, knee, degenerate articular, Laser therapy, pain, function