Avaliação da efetividade do laser de baixa intensidade nas mãos de pacientes com artrite reumatoide: estudo controlado randomizado duplo-cego

• Ano de defesa: 2008
• Autor(a) principal: Meireles, Sandra Mara [UNIFESP]
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Artrite reumatóide; Ensaio controlado aleatório; Mãos; Laser de baixa intensidade
• Link de acesso: http://repositorio.unifesp.br/handle/11600/9014

Rheumatoid arthritis is a chronic inflammatory disease that causes pain and affects functionality. The literature suggests that low-level laser therapy offers analgesic and anti-inflammatory benefits. A number of studies have shown that this type of laser therapy contributes toward the treatment of the disease. Results, however, remain controversial. Objective: Assess the effectiveness of low-level laser therapy on pain reduction and improvement in function in the hands of patients with rheumatoid arthritis. Material and Methods: A randomized double-blind controlled trial was carried out on 82 patients with rheumatoid arthritis. The experimental group was submitted to the application of laser therapy, whereas the control group received a placebo laser. An Aluminum Gallium Arsenide laser was used, at a wavelength of 785 nm, dose of 3 J/cm2 and mean power of 70 mW. Patients, therapist and evaluator were all blind to group allocation. Treatment was carried out twice a week for two months. Patients were assessed at the beginning and end of treatment with regard to the following parameters: pain, morning stiffness, grip strength, pinch strength, range of motion, inflammation, perimetry, function, overall hand condition and dexterity. At the end of treatment, the degree of patient satisfaction and the impression of improvement from the perspective of the therapist were analyzed. Results: The groups were homogenous at the beginning of the study with regard to the main variables (p > 0.05). There were no statistically significant differences between groups in 96% (157 of 163) of the measurements taken at the end of the intervention; the following variables were the exceptions: favoring the experimental group – inflammation of the interphalangeal joint of the right thumb (p = 0.012) and perimetry of the interphalangeal joint of the left thumb (p = 0.013); and favoring the control group – flexion of the proximal interphalangeal joint of the right fifth finger (p = 0.021), perimetry of the third proximal interphalangeal joint of the right hand (p = 0.044), grip strength in the left hand (p = 0.010) and the Work domain of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire (p = 0.010). There were statistically significant differences in the intra-group analysis for most of the measurements (p < 0.05). Conclusion: We conclude that low-level Aluminum Gallium Arsenide laser therapy is not effective at the wavelength, dosage and power studied for the treatment of hands among patients with rheumatoid arthritis.