Browsing by Author "Konstantinovic, Ljubica M. (16207335300)"

Objective: The aim of this study was to investigate the clinical effects of low-level laser therapy (LLLT) in patients with acute low back pain (LBP) with radiculopathy. Background Data: Acute LBP with radiculopathy is associated with pain and disability and the important pathogenic role of inflammation. LLLT has shown significant anti-inflammatory effects in many studies. Materials and Methods: A randomized, double-blind, placebo-controlled trial was performed on 546 patients. Group A (182 patients) was treated with nimesulide 200mg/day and additionally with active LLLT; group B (182 patients) was treated only with nimesulide; and group C (182 patients) was treated with nimesulide and placebo LLLT. LLLT was applied behind the involved spine segment using a stationary skin-contact method. Patients were treated 5 times weekly, for a total of 15 treatments, with the following parameters: wavelength 904nm; frequency 5000Hz; 100-mW average diode power; power density of 20mW/cm2 and dose of 3J/cm2; treatment time 150 sec at whole doses of 12J/cm2. The outcomes were pain intensity measured with a visual analog scale (VAS); lumbar movement, with a modified Schober test; pain disability, with Oswestry disability score; and quality of life, with a 12-item short-form health survey questionnaire (SF-12). Subjects were evaluated before and after treatment. Statistical analyses were done with SPSS 11.5. Results: Statistically significant differences were found in all outcomes measured (p<0.001), but were larger in group A than in B (p<0.0005) and C (p<0.0005). The results in group C were better than in group B (p<0.0005). Conclusions: The results of this study show better improvement in acute LBP treated with LLLT used as additional therapy. Copyright 2010, Mary Ann Liebert, Inc.

Objective: The aim of this study was to investigate the clinical effects of low-level laser therapy (LLLT) in patients with acute low back pain (LBP) with radiculopathy. Background Data: Acute LBP with radiculopathy is associated with pain and disability and the important pathogenic role of inflammation. LLLT has shown significant anti-inflammatory effects in many studies. Materials and Methods: A randomized, double-blind, placebo-controlled trial was performed on 546 patients. Group A (182 patients) was treated with nimesulide 200mg/day and additionally with active LLLT; group B (182 patients) was treated only with nimesulide; and group C (182 patients) was treated with nimesulide and placebo LLLT. LLLT was applied behind the involved spine segment using a stationary skin-contact method. Patients were treated 5 times weekly, for a total of 15 treatments, with the following parameters: wavelength 904nm; frequency 5000Hz; 100-mW average diode power; power density of 20mW/cm2 and dose of 3J/cm2; treatment time 150 sec at whole doses of 12J/cm2. The outcomes were pain intensity measured with a visual analog scale (VAS); lumbar movement, with a modified Schober test; pain disability, with Oswestry disability score; and quality of life, with a 12-item short-form health survey questionnaire (SF-12). Subjects were evaluated before and after treatment. Statistical analyses were done with SPSS 11.5. Results: Statistically significant differences were found in all outcomes measured (p<0.001), but were larger in group A than in B (p<0.0005) and C (p<0.0005). The results in group C were better than in group B (p<0.0005). Conclusions: The results of this study show better improvement in acute LBP treated with LLLT used as additional therapy. Copyright 2010, Mary Ann Liebert, Inc.

BACKGROUND: Neuropathic pain in early chronic low back pain is insufficiently recognized and treated. AIM: The aim of this study was to establish if there is a difference among chronic low back pain subjects with and without neuropathic pain and healthy subjects, in clinical characteristic and the level of trunk muscle activation. DESIGN: Cross sectional observational study. SETTING: Rehabilitation clinic, inpatient and outpatient. POPULATION: Thirty-three subjects in early chronic phase of low back pain and 26 healthy subjects were included in this research. METHODS: Clinical characteristics and relative thickness change of lumbar multifidus and transversal abdominal muscle, measured by ultrasound, in neuropathic, non-neuropathic chronic low back pain and healthy subjects were analyzed. RESULTS: Chronic low back pain subjects with neuropathic pain reported higher level of pain on Visual Analog Scale (VAS) (back pain P=0.016, leg pain P=0.006), had higher Oswestry Disability Score (P=0.029), had lower motor (P=0.001) and sensory leg scores (P=0.000), and decreased level of activation of transversal abdominal muscle (P=0.000) comparing to chronic low back pain group without neuropathic pain. Low back pain subjects with leg pain ≥5 on VAS were 11.2 times more prone to develop neuropathic pain. Motor leg score ≤47 increases this chance 35 times. Sensory leg score ≤25 increases this chance 14 times. Reduced activation of transversal abdominal muscle for 40-50% increases this chance 7-24 times. CONCLUSIONS: Chronic low back pain subjects with neuropathic pain were more painful and disabled, had lower motor and sensory scores, and lower relative thickness change of transversal abdominal muscle comparing to the low back pain group without neuropathic pain. Self -reported leg pain intensity of 5 or more on VAS, motor score of 47 and less, sensory scores of 25 and less and diminished activation of transversal abdominal muscle significantly increase the chance that chronic low back pain subject has neuropathic component of pain. CLINICAL REHABILITATION IMPACT: Neuropathic pain in early chronic low back pain subjects might be more readily recognized if patients with radiculopathy and diminished activation of transversal abdominal muscle were regularly screened for neuropathic pain. © 2018 EDIZIONI MINERVA MEDICA

BACKGROUND: Neuropathic pain in early chronic low back pain is insufficiently recognized and treated. AIM: The aim of this study was to establish if there is a difference among chronic low back pain subjects with and without neuropathic pain and healthy subjects, in clinical characteristic and the level of trunk muscle activation. DESIGN: Cross sectional observational study. SETTING: Rehabilitation clinic, inpatient and outpatient. POPULATION: Thirty-three subjects in early chronic phase of low back pain and 26 healthy subjects were included in this research. METHODS: Clinical characteristics and relative thickness change of lumbar multifidus and transversal abdominal muscle, measured by ultrasound, in neuropathic, non-neuropathic chronic low back pain and healthy subjects were analyzed. RESULTS: Chronic low back pain subjects with neuropathic pain reported higher level of pain on Visual Analog Scale (VAS) (back pain P=0.016, leg pain P=0.006), had higher Oswestry Disability Score (P=0.029), had lower motor (P=0.001) and sensory leg scores (P=0.000), and decreased level of activation of transversal abdominal muscle (P=0.000) comparing to chronic low back pain group without neuropathic pain. Low back pain subjects with leg pain ≥5 on VAS were 11.2 times more prone to develop neuropathic pain. Motor leg score ≤47 increases this chance 35 times. Sensory leg score ≤25 increases this chance 14 times. Reduced activation of transversal abdominal muscle for 40-50% increases this chance 7-24 times. CONCLUSIONS: Chronic low back pain subjects with neuropathic pain were more painful and disabled, had lower motor and sensory scores, and lower relative thickness change of transversal abdominal muscle comparing to the low back pain group without neuropathic pain. Self -reported leg pain intensity of 5 or more on VAS, motor score of 47 and less, sensory scores of 25 and less and diminished activation of transversal abdominal muscle significantly increase the chance that chronic low back pain subject has neuropathic component of pain. CLINICAL REHABILITATION IMPACT: Neuropathic pain in early chronic low back pain subjects might be more readily recognized if patients with radiculopathy and diminished activation of transversal abdominal muscle were regularly screened for neuropathic pain. © 2018 EDIZIONI MINERVA MEDICA

Objective: The objective of the study was to investigate clinical effects of low-level laser therapy (LLLT) in patients with acute neck pain with radiculopathy. Design: Double-blind, randomized, placebocontrolled study. Setting: The study was carried out between January 2005 and September 2007 at the Clinic for Rehabilitation at the Medical School, University of Belgrade, Serbia. Patients and Intervention: Sixty subjects received a course of 15 treatments over 3 weeks with active or an inactivated laser as a placebo procedure. LLLT was applied to the skin projection at the anatomical site of the spinal segment involved with the following parameters: wavelength 905 nm, frequency 5,000 Hz, power density of 12 mW/cm2, and dose of 2 J/cm2, treatment time 120 seconds, at whole doses 12 J/cm2. Outcome measures: The primary outcome measure was pain intensity as measured by a visual analog scale. Secondary outcome measures were neck movement, neck disability index, and quality of life. Measurements were taken before treatment and at the end of the 3-week treatment period. Results: Statistically significant differences between groups were found for intensity of arm pain (P = 0.003, with high effect size d = 0.92) and for neck extension (P = 0.003 with high effect size d = 0.94). Conclusion: LLLT gave more effective short-term relief of arm pain and increased range of neck extension in patients with acute neck pain with radiculopathy in comparison to the placebo procedure.