Hand, High Intensity Laser Therapy, Psoriasis
Conditions
Brief summary
The purpose of the study was to evaluate the therapeutic efficacy of pulsed high intensity level laser therapy in improving symptoms of psoriatic hand arthritis.
Detailed description
Psoriatic arthritis is a chronic, inflammatory joint disease affecting 20%-30% of patients with psoriasis. It affects peripheral joints and axial skeleton, causing pain, stiffness, swelling, and joint destruction. High-intensity laser therapy can control inflammation and improve pain relief, range of motion, and functional improvement. This study aims to examine High-intensity laser therapy efficacy in managing Psoriatic arthritis, aiming to provide a safe, effective, and noninvasive treatment method.
Interventions
The study employs a BTL-6000 high-intensity laser therapy (12 W) to apply high intensity laser therapy to deep tissues. high intensity laser therapy therapy uses powerful beams (\>500 mw) to penetrate deeper, delivering high multi-directional energy in a short time. Pulsed laser therapy, a form of high intensity laser therapy therapy, enhances cell metabolism without disrupting it. High-intensity laser therapy is a safe treatment method consisting of three phases. The first phase involves fast scanning around the wrist, hand, and fingers, with fluencies set at 510, 610, and 710mJ/cm2. The second phase involves holding the handpiece vertically to 90° on 10 fixed points around the metacarpophalangeal and interphalangeal joints, each radiated for 15 seconds, and a total dose of 1500 J. The third phase is the same but at a slower rate, with a total energy of 300 J.
DEVICEsham pulsed high intensity laser therapy
Patients in the control group will receive sham high-intensity laser therapy, where all parameters will be set up without switching on the start button and high intensity laser therapy machine is switched on with a visible light beam only
All patients of the study and control groups will receive the same routine physical therapy program for 30minutes and three times per week for successive eight weeks in the form of hot therapy, stretching and strengthening exercises. Hot therapy, in the form of warm baths for 10minutes, is applied before stretching exercises on the wrist joint and fingers to relieve joint pain and increase the range of motion. Strengthening exercises are in the form of isometric exercise for hand muscles and fingers to maintain muscles strength and joints flexibility
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
30 Years to 50 Years
Healthy volunteers
No
Inclusion criteria
* Both sexes of patients their age range between 30-50 years. * Bilateral PsA following psoriasis * All participants who are diagnosed with PsA, and experience clinical symptoms such as pain, swelling, tenderness and stiffness less than 1 year from the beginning of disease. * All patients enrolled to the study will have their informed consent.
Exclusion criteria
* Positive rheumatic factor * Circulatory disorders * Diabetes * Pregnant woman * Skin diseases like urticaria.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Assessment of change of Hand Grip Strength using manual dynamometer | at baseline and after 2 months | The Handheld Jamar dynamometer device 12-0600 will be used to measure hand grip strength, with a readout in pounds and kilograms. The strength will be measured with the elbow at 90° according to the American Society of Hand Therapists' recommendations. Patients will be instructed to sit while the affected limb is placed in shoulder adduction, internal rotation, elbow flexion, forearm mid position, and wrist neutral position. Three consecutive measurements will be performed with a 2-minute interval, and the mean strength value of the three trials will be considered as the hand grip measure. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| assessment of Joint counts for tenderness | at baseline and after 2 months | Joint counts for tenderness was the sum of the number of the affected joints |
| assessment of Joint swelling count | at baseline and after 2 months | Joint swelling count is the sum of the swollen joints at the dominant hand before and after the treatment |
| assessment of pain intensity using visual analogue scale | at baseline and after 2 months | The Visual Analog Scale was used to measure pain intensity, with a 100mm horizontal line starting with no pain and ending with worse pain. Patients marked their pain intensity points on the scale, and the researcher measured the distance between the no pain mark and the patient's mark, providing a range of scores from 0 to 100mm. |
Countries
Egypt
Outcome results
None listed