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The therapeutic efficacy of high-intensity laser on pain management in dogs with degenerative joint disease
|關鍵字:||犬;退化性關節炎;雷射治療;多波鎖定系統;Dog;degenerative joint disease;laser therapy;multiwave locked system||引用:||1. Al Rashoud AS, Abboud RJ, Wang W, et al. Efficacy of low-level laser therapy applied at acupuncture points in knee osteoarthritis: a randomized double-blind comparative trial. Physiotherapy. 2014; 100: 242-248. 2. Alghadir A, Omar MT, Al-Askar AB, et al. Effects of low-level laser therapy in patients with chronic knee osteoarthritis: a single-blinded randomized clinical study. Laser Med Sci. 2014; 29: 749-755. 3. Allen MJ. Advances in total joint replacement in small animals. J Small Anim Pract. 2012; 53: 495-506. 4. Anders JJ, Lanzafame RJ, Arany PR. Low-level light/laser therapy versus photobiomodulation therapy. Photomed Laser Surg. 2015; 33: 183-184. 5. Anderson KL, O'Neill DG, Brodbelt DC, et al. Prevalence, duration and risk factors for appendicular osteoarthritis in a UK dog population under primary veterinary care. Sci Rep. 2018; 8: 5641. 6. Ando T, Xuan W, Xu T, et al. 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退化性關節炎是一種慢性漸進性的關節病症，其特徵是在滑液關節或可動關節出現病理性的變化，並伴隨有疼痛和活動困難等臨床症狀。近年來，有越來越多具有減緩疼痛功效的物理治療方式被提出，雷射治療就是其中一項。在基礎醫學研究的結果顯示，雷射光具有減緩疼痛的好處源自於可減少組織胺、緩激肽和物質P從受傷的組織中釋放出來，還可以降低感覺神經的傳導速度，並增加內生性的類鴉片物質釋放。因此，本研究的目的是要評估高能量雷射治療對於犬退化性關節炎疼痛管理的治療效果。本研究共有十隻犬隻經理學及影像學檢查確診後被納入為研究對象。使用多波鎖定系統 (Multiwave locked system, MLS®) 雷射治療機，此裝置可同時輸出808和905奈米波長的雷射光，且最高輸出能量可達75瓦特。每個受影響的關節分別會照射三個點，每個照射點的照射劑量分別為8焦耳/平方公分，在治療計畫期間共進行十次療程。在療程開始前、療程中和療程完整結束後，進行被動關節活動角度、後腳腿圍、疼痛評估表、步態和影像學檢查等評估，並分別以統計學的方式進行比較。結果顯示被動關節活動角度、後腳腿圍、步態和影像學檢查等評估在治療前後皆無顯著差異 (P>0.05)。然而，與生活品質相關的疼痛評估表評分在治療後具有顯著的降低 (P<0.05)。總結來說，高能量MLS®雷射治療具有減少關節疼痛及顯著提升生活品質的功效。
Degenerative joint disease (DJD) can be defined as a disorder of joints characterized by pathologic change of synovial or diarthrodial joint accompanied by clinical signs of pain and disability. Recently, many physical therapy agents have been introduced including laser therapy, which can produce analgesic effects not only by decreasing histamine, bradykinin and substance P released from injured tissues, but also by inhibiting Aδ and C fiber transmission of nerve impulses. The purpose of this study was to evaluate the therapeutic efficacy of high intensity laser therapy (HILT) on pain management in dogs with DJD. A total of ten adult dogs (16 hip joints, 4 stifle joints) with DJD diagnosed by physical and image examinations were enrolled in the study. The multiwave locked system (MLS) laser therapy was applied. This device is provided with the peak power of 75 W and produces infrared laser with the wavelength of 808 nm and 905 nm. Three points were irradiated on the affected joint and each point received dosage of 8 J/cm2 in each session, a course of treatment consists of ten sessions within one month. Pain disability index, range of motion, hindlimb circumference, gait and radiograph were measured at the beginning of the study (baseline), and evaluation was repeated after two weeks (six-session) and four weeks (ten-session) of treatment. The results showed that there were no statistically significant differences in range of motion, hindlimb circumference, gait and radiograph between the post-treatment and baseline (P>0.05). However, pain disability index which was used to assess the quality of life and showed statistically significant reduction in post-treatment as compared with baseline (P<0.05). In conclusion, HILT have significantly improved on the quality of life in terms of pain relief in dogs with DJD. Nevertheless, the improvement on stiffness caused by affected joint and the surrounding soft tissue hasn't observed during study period.
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