Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-10T16:16:40.824Z Has data issue: false hasContentIssue false
  • English
  • Français

Defocused CO2 laser therapy in traumatic arthritis of the metacarpophalangeal joint: A randomized clinical study

Published online by Cambridge University Press:  01 November 2006

Anna Bergh ,
Görel Nyman ,
Lars Roepstorff ,
Qin Zhou ,
Mathias Hallberg ,
Stig Drevemo  and
Karin Roethlisberger-Holm
Anna Bergh*
Affiliation:
Department of Anatomy and Physiology, Swedish University of Agricultural Sciences, SE-75007 Uppsala, Sweden
Görel Nyman
Affiliation:
Department of Clinical Sciences, Swedish University of Agricultural Sciences, SE-75007 Uppsala, Sweden
Lars Roepstorff
Affiliation:
Department of Anatomy and Physiology, Swedish University of Agricultural Sciences, SE-75007 Uppsala, Sweden
Qin  Zhou
Affiliation:
Department of Pharmaceutical Biosciences, Uppsala University, SE-75124, Uppsala, Sweden
Mathias Hallberg
Affiliation:
Department of Pharmaceutical Biosciences, Uppsala University, SE-75124, Uppsala, Sweden
Stig Drevemo
Affiliation:
Department of Anatomy and Physiology, Swedish University of Agricultural Sciences, SE-75007 Uppsala, Sweden
Karin Roethlisberger-Holm
Affiliation:
Department of Clinical Sciences, Swedish University of Agricultural Sciences, SE-75007 Uppsala, Sweden
*
*Corresponding author: anna.bergh@afys.slu.se
Get access

Abstract

A prospective, blinded, randomized and controlled study was conducted in horses with traumatic arthritis of the metacarpophalangeal joint in order to evaluate the efficacy of defocused carbon dioxide (CO2) laser therapy. Sixteen horses were randomly assigned to two groups: active laser (an output power of 16 W, scanned over 42 cm2, an average dose of 91 J cm− 2) and sham laser (the laser beam directed at the non-reflecting floor). All the horses received a total of five treatments during 1 week. The horses were evaluated with respect to the degree of initial lameness by conventional lameness examination and an objective accelerometer technique before the onset of treatment, and at 1 and 3 weeks. The concentrations of substance P (SP), prostaglandin E2 (PGE2) and Met-enkephalin-Arg-Phe (MEAP) in synovial fluid were also assessed. Our study demonstrates that there was no significant difference in lameness score between the laser- and the sham-treated group before the treatment and at 1 and 3 weeks after the initial examination. Moreover, no significant difference in the concentrations of SP, PGE2 and MEAP in synovial fluid in the active laser group compared with the sham-treated group was observed. In conclusion, this study suggests that treatment with defocused CO2 laser in the management of traumatic arthritis of the metacarpophalangeal joint is not statistically better than sham treatment at reducing the grade of lameness as evaluated by conventional lameness examination and accelerometer technique.

Keywords

CO2 laser therapytraumatic arthritishorserehabilitationaccelerometer techniquesubstance PMet-enkephalin-Arg-Phe
Type
Research Paper
Information
Equine and Comparative Exercise Physiology , Volume 3 , Issue 4 , November 2006 , pp. 169 - 177
Copyright
Copyright © Cambridge University Press 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Penell, JC, Egenvall, A, Bonnett, BN, Olson, P and Pringle, J (2005). Specific causes of morbidity among Swedish horses insured for veterinary care between 1997 and 2000. Veterinary Record 157: 470–477.CrossRefGoogle ScholarPubMed
2Gibson, KT, Hodge, H and Whittem, T (1996). Inflammatory mediators in equine synovial fluid. Australian Veterinary Journal 73: 148–151.CrossRefGoogle ScholarPubMed
3Hardy, J, Bertone, AL, Weisbrode, ST, Muir, WW, O'Dorisio, TM and Masty, J (1997). Cell trafficking mediator release and articular metabolism in acute inflammation of innervated or denervated isolated equine joints. American Journal of Veterinary Research 59: 88–100.CrossRefGoogle Scholar
4Kirker-Head, CA, Chandna, VK, Agarwal, RK, Morris, EA, Tidwell, A, O'Callaghan, MW, Rand, W and Kumar, MSA (2000). Concentrations of substance P-LI and prostaglandin E2 in sensorial fluid of normal and abnormal joints of horses. American Journal of Veterinary Research 6: 714–718.CrossRefGoogle Scholar
5Caron, JP (1996). Neurogenic factors in joint pain and diseases pathogenesis. In: McIlwraith, CW and Trotter, GW (eds), Joint Disease in the Horse (pp. 70–80). Philadelphia, Pa: WB Saunders Company.Google Scholar
6Bowker, RM, Sonea, IM, Vex, KB and Caron, JP (1993). Substance P-LI innervation of equine sensorial membranes: Joint differences and neural and nonneural receptor localizations. Neuroscience Letters 164: 76–80.CrossRefGoogle Scholar
7Nixon, AJ and Cummings, JF (1994). Substance P-LI immunohistochemical study of the sensory innervation of normal subchondral bone in the equine metacarpophalangeal joint. American Journal of Veterinary Research 55: 28–33.CrossRefGoogle Scholar
8Duggan, AW, Morton, CR, Zhao, ZQ and Hendry, IA (1987). Noxious heating of the skin releases immunoreactive substance P in the substantia gelatinosa of the cat: A study with antibody microprobes. Brain Research 403: 345–349.CrossRefGoogle Scholar
9Duggan, AW, Hendry, IA, Morton, CR, Hutchison, WD and Zhao, ZQ (1988). Cutaneous stimuli releasing immunoreactive substance P in the dorsal horn of the cat. Brain Research 451: 261–273.CrossRefGoogle ScholarPubMed
10Schaible, HG (2006). Basic mechanisms of deep somatic pain. In: McMahon, SB and Koltzenberg, M (eds), Wall and Melzack's Textbook of Pain 5th edn. (pp. 621–634). Philadelphia, Pa: Elsevier Churchill Livingstone.CrossRefGoogle Scholar
11May, SA, Hooke, RE, Peremans, KY, Verschooten, F and Lees, P (1994). Prostaglandin E2 in equine joint disease. Vlaams Diergeneeskd Tijdschrift 63: 187–191.Google Scholar
12Rosén, A, Lundeberg, T, Bytner, B and Nylander, I (2000). Central changes in nocicpetin dynorphin B and Met-enkephalin-Arg-Phe in different models of nociception. Brain Research 857: 212–218.CrossRefGoogle Scholar
13Sheehy, JG, Hellyer, PW, Sammonds, GE, Mama, KR, Powers, BE, Hendickson, DA and Magnusson, KR (2001). Evaluation of opioid receptors in sensorial membranes of horses. American Journal of Veterinary Research 62: 1408–1412.CrossRefGoogle Scholar
14Bertolucci, LE and Grey, T (1995). Clinical analysis of midlaser versus placebo treatment of arthralgic TMJ degenerative joints. Journal of Cranio Practitioners 13: 26–29.CrossRefGoogle ScholarPubMed
15Basford, JR, Sheffield, CG and Harmsen, BS (1999). Laser therapy: A randomised controlled trial of the effects of low-intensity Nd:YAG laser irradiation on musculoskeletal back pain. Archives of Physical Medicine and Rehabilitation 80: 647–652.CrossRefGoogle ScholarPubMed
16Bjordal, J, Couppe, C and Ljunggren, A (2001). Low-level laser therapy for tendonopathy: Evidence of a dose-response pattern. Physical Therapy Reviews 6: 91–99.CrossRefGoogle Scholar
17Bjordal, J, Couppe, C, Chow, R, Tuner, J and Ljunggren, A (2003). A systematic review of low-level laser therapy with location-specific doses for pain from chronic joint disorders. Journal of Physiotherapy 49: 107–116.Google ScholarPubMed
18Gur, A, Cosut, A, Sarac, AJ, Cevik, R, Nas, K and Uyar, A (2003). Efficacy of different therapy regimes of low-power laser in painful osteoarthritis of the knee: A double-blind and randomized-controlled trial. Lasers in Surgery and Medicine 33: 330–338.CrossRefGoogle ScholarPubMed
19Gur, A, Sarac, AJ, Cevik, R, Altindag, O and Sarac, S (2004). Efficacy of 904 nm gallium arsenid low level laser therapy in the management of chronic myofascial pain in the neck: A double blind and randomized controlled trial. Lasers in Surgery and Medicine 35: 229–235.CrossRefGoogle Scholar
20Chow, RT and Barnsley, L (2005). Systemic review of the literature of low-level laser therapy LLLT in the management of neck pain. Lasers in Surgery and Medicine 1–7.Google Scholar
21Basford, JR, Sheffield, CG and Cieslak, KR (2000). Laser therapy: A randomised controlled trial of the effects of low-intensity Nd:YAG laser irradiation on lateral epicondylitis. Archives of Physical Medicine and Rehabilitation 81: 1504–1510.CrossRefGoogle ScholarPubMed
22Brosseau, L, Wells, G, Marchand, S, Gaboury, I, Stokes, B, Morin, M, Casimiro, L, Yonge, K and Tugwell, P (2005). Randomized controlled trial on low level laser therapy LLLT in the treatment of osteoarthritis of the hand. Lasers in Surgery and Medicine 36: 210–219.CrossRefGoogle Scholar
23Beckerman, H, de Bie, RA and Bouter, LM (1992). The efficacy of laser therapy for musculoskeletal and skin disorders: A criterion based meta-analysis of randomized clinical trials. Physical Therapy 72: 483–491.CrossRefGoogle Scholar
24Basford, JR (1995). Low intensity laser therapy: Still not an established clinical tool. Lasers in Surgery and Medicine 16: 331–342.CrossRefGoogle ScholarPubMed
25Bergh, A, Nyman, G, Lundeberg, T and Drevemo, S (2006). Effect of defocused CO2 laser on equine tissue perfusion. Acta Veterinaria Scandinavica 47: 33–42.CrossRefGoogle ScholarPubMed
26Campana, VR, Moya, M, Gavotto, A, Spitale, L, Soriano, F and Palma, JA (2004). Laser therapy on arthritis induced by urate crystals. Photomedicine and Laser Surgery 22: 499–503.CrossRefGoogle ScholarPubMed
27Bjordal, J, Lopes-Martins, RAB and Iversen, VV (2006). A randomized placebo controlled trial of low level laser therapy for activated Achilles tendonitis with microdialysis measurements of peritendinous prostaglandin E2 concentrations. British Journal of Sports Medicine 40: 76–80.CrossRefGoogle ScholarPubMed
28Chen, J and Zhou, Y (1989). Effect of low level carbon dioxide laser radiation on biochemical metabolism of rabbit mandibular bone callus. Laser Therapy 1: 83–87.Google Scholar
29Tsai, CL, Huang, LLH and Kao, MC (1997). Effect of CO2 laser on healing of cultured meniscus. Lasers in Surgery and Medicine 20: 172–178.3.0.CO;2-N>CrossRefGoogle ScholarPubMed
30Cho, HJ, Lim, SC, Kim, SG, Kim, YS, Kang, SS, Choi, SH, Cho, YS and Bae, CS (2004). Effect of low level laser therapy on osteoarthropathy in rabbit. In Vivo 18: 585–592.Google ScholarPubMed
31Wesselmann, U, Lin, SF and Rymer, WZ (1991). Effects of Q-switched Nd-YAG laser irradiation on neural impulse propagation: I Dorsal roots and peripheral nerves. Physiology Chemistry Physics & Medicine 23: 81–100.Google ScholarPubMed
32Baxter, GD, Walsh, DM, Allen, JM and Bell, AJ (1994). Effects of low intensity infrared laser irradiation upon conduction in the human median nerve in vivo. Experimental Physiology 79: 227–234.CrossRefGoogle ScholarPubMed
33Lindholm, AC, Swensson, U, Mitri, NDE and Collinder, E (2002). Clinical effects of betamethasone and sodium hyaluronan and of defocalized carbon dioxide laser treatment on traumatic arthritis in the fetlock joints of horses. Journal of Veterinary Medicine A 49: 189–194.CrossRefGoogle Scholar
34Åsheim, A and Lindblad, G (1976). Intra-articular treatment of arthritis in race-horses with sodium hyaluronate. Acta Veterinaria Scandinavica 17: 379–394.CrossRefGoogle ScholarPubMed
35Hallberg, M, Johansson, P, Kindlundh, AM and Nyberg, F (2000). Anabolic-androgenic steroids affect the content of substance P-LI and substance P-LI1-7 in the rat brain. Peptides 21: 845–852.CrossRefGoogle Scholar
36Johansson, P, Hallberg, M, Kindlundh, A and Nyberg, F (2000). The effect on opioid peptides in the rat brain after chronic treatment with the anabolic androgenic steroid nandrolone decanoate. Brain Research Bulletin 51: 413–418.CrossRefGoogle ScholarPubMed
37Sharma, HS, Nyberg, F, Olsson, Y and Dey, PK (1990). Alteration of substance P-LI after trauma to the spinal cord: An experimental study in the rat. Neuroscience 38: 205–212.CrossRefGoogle Scholar
38Skarzynski, DJ and Okuda, K (2000). Different actions of noradrenaline and nitric oxide on the output of prostaglandins and progesterone in cultured bovine luteal cells. Prostaglandins and Other Lipid Mediatorse 60: 35–47.CrossRefGoogle ScholarPubMed
39McIlwraith, CW and van Sickle, DC (1981). Experimental induced arthritis of the equine carpus: Histologic and histochemical changes in the articular cartilage. American Journal of Veterinary Research 42: 209–217.Google ScholarPubMed
40Nivbrant, B and Friberg, S (1992). Laser tycks ha effekt på knäledsartros men vetenskapligt bevis saknas. Läkartidningen 89: 859–861.Google Scholar
41Brosseau, L, Gam, A, Harman, K, Morin, M, Robinson, VA, Shea, BJ, Tugwell, P, Wells, G and de Bie, RA (2004). Low level laser therapy classes I II and III for treating osteoarthritis, The Cochrane Library Issue 3 Oxford, Update Software..CrossRefGoogle Scholar
42Tascioglu, F, Armagan, O, Tabak, Y, Corapci, I and Oner, C (2004). Low power laser treatment in patients with knee osteoarthritis. Swiss Medicine Weekly 134: 254–258.Google ScholarPubMed
43Gaustad, G, Dolvik, NI and Larsen, S (1999). Comparison of intra-articular injection of 2 ml of 09% NaCl solution with rest alone for treatment of horses with traumatic arthritis. American Journal of Veterinary Research 60: 1117–1121.CrossRefGoogle ScholarPubMed
44Verchooten, F and Desmet, P (1997). Het effect van intra-articulaire toediening van natriumhyaluronaat Hyonate® op gewrichtsaandoeningen bij het paard: Een klinische studie. Vlaams Diergeneeskd Tijdschrift 65: 21–27.Google Scholar
45Gaustad, G and Larsen, S (1995). Comparison of polysulphated glucosaminoglycan and sodium hyaluronate with placebo in treatment of traumatic arthritis in horses. Equine Veterinary Journal 27: 356–362.CrossRefGoogle Scholar
46Rydell, NW, Butler, J and Balazs, EA (1970). Hyaluronic acid in synovial fluid. Acta Veterinaria Scandinavica 11: 139–155.CrossRefGoogle Scholar
47Vernimb, GD, van Hoose, LM and Hennessey, PW (1977). Onset and duration of corticosteroid effect after injection of Betasone for treating equine arthropathies. Veterinary Medicine for Small Animal Clinicians 72: 241–244.Google ScholarPubMed
48Ramey, DW (1997). Prospective evaluation of forelimb flexion tests in practice: Clinical response radiographic correlations and predictive value for future lameness. Proceedings of 43rd Annual Convention of American Equine Practitioners 43: 116–120.Google Scholar
49Verchooten, F and Verbeeck, J (1997). Flexion test of the metacarpophalangeal joint in sound horses. Equine Veterinary Journal 29: 50–54.CrossRefGoogle Scholar
50Busschers, E and van Weeren, PR (2001). Use of the flexion test of the distal forelimb in the sound horse: Repeatability and effect of age gender weight height and fetlock joint range of motion. Journal of Veterinary Medicine A 48: 413–427.CrossRefGoogle ScholarPubMed
51Weishaupt, MA, Wiestner, T, Hogg, HP, Jordan, P, Auer, JA and Barrey, E (2001). Assessment of gait irregularities in the horse: Eye vs. gait analysis. Equine Veterinary Journal Supplement 33: 135–140.CrossRefGoogle Scholar
52Keegan, KG, Yonezawa, Y, Pai, PF and Wilson, DA (2002). Accelerometer-based system for the detection of lameness in horses. Biomedical Science Instruments 38: 107–112.Google ScholarPubMed
53Leleu, C, Bariller, F, Cotrel, C and Barrey, E (2004). Reproducibility of a locomotor test for trotter horses. Veterinary Journal 168: 160–166.CrossRefGoogle ScholarPubMed
54Amano, A, Miyagi, K, Azuma, T, Ishihara, Y, Katsube, S, Aoyama, I and Saito, I (1994). Histological studies on the rheumatoid synovial membrane irradiated with a low energy laser. Lasers in Surgery and Medicine 15: 290–294.CrossRefGoogle ScholarPubMed
55Ulugöl, A, Unalan, H, Dökmeci, I and Kokino, S (1997). Comparison of the effects of tenoxicam and mid-laser irradiation on chronic adjuvant arthritis in rats. Clinical and Experimental Rheumatology 15: 83–86.Google ScholarPubMed
56Barberis, G, Gamron, S, Acevedo, G, Cadile, I, Juri, H, Campana, V, Castel, A, Onetti, CM and Plama, JA (1996). In vitro synthesis of prostaglandin E2 by synovial tissue after helium-neon laser radiation in rheumatoid arthritis. Journal of Clinical Lasers in Surgery and Medicine 14: 175–177.CrossRefGoogle ScholarPubMed