Effect of different doses of low-intensity laser therapy on total active range of motion after hand flexor tendon repair

Abstract

Objective To investigate the difference between the effects of different doses of low-level laser therapy (4 or 1 J/cm2) on the return of hand active range of motion (ROM) after flexor tendon repair. Participants and methods A small trial was conducted on 33 patients with 45 injured fingers of both sexes who underwent primary repair after complete cut of hand flexor tendon. Their age ranged from 20 to 40 years old. They were recruited from the plastic surgery department. The treatment began the first day postoperatively after permission by surgeons using Duran protocol and splinting. Transcutaneous electrical nerve stimulation (TENS), as well as LASER therapy, was started the seventh day after surgery. Laser treatment lasted for 3 weeks only, whereas other modalities lasted for 3 months. The sample was randomly divided into three groups each of 15 injured tendons. Group A received the conventional treatment plus laser therapy (1 J/cm2), three sessions/week for 3 weeks. Group B received the traditional treatment plus laser therapy (4 J/cm2), three sessions/week for 3 weeks. Control group received the conventional treatment only. All patients received the early conventional physical therapy after permission by the surgeon: TENS plus early therapeutic exercises following Duran protocol, three sessions/week for 3 months. The ROM was measured at eighth and 12th week after the commencement of treatment. Results At second month after commencement of treatment, there was a positive effect of laser therapy with either doses 1 or 4 J/cm2 on total hand active ROM after flexor tendons repair, with more effect noticed in group B (4 J/cm2). At third month after commencement of treatment, best results in hand active ROM were seen in group B (4 J/cm2), with prognosis being excellent in 46.7% of patients, good in 33.3% and fair in 20.0% according to the modified Strickland classification. Conclusion The 4-J/cm2 laser dose is more efficient than laser dose of 1 J/cm2 in the treatment of repaired hand flexor tendons in addition to conventional treatment (TENS stimulation plus Duran protocol therapeutic exercises) in early regain of active ROM that can affect return of early better hand function.