PMID- 37288499
OWN - NLM
STAT- MEDLINE
DCOM- 20230814
LR  - 20230817
IS  - 1096-9101 (Electronic)
IS  - 0196-8092 (Linking)
VI  - 55
IP  - 7
DP  - 2023 Sep
TI  - Photobiomodulation self-treatment at home after rotator cuff arthroscopic repair 
      accelerates improvement in pain, functionality, and quality of life: A 
      double-blind, sham-controlled, randomized clinical trial.
PG  - 662-673
LID - 10.1002/lsm.23692 [doi]
AB  - OBJECTIVE: To determine whether self-applied photobiomodulation (PBM) therapy at 
      home, following rotator cuff arthroscopic surgery (RCAS) can accelerate 
      improvement in patient-reported outcomes within the first 6 months postsurgery. 
      METHODS: This study was a prospective, double-blind, sham-controlled, randomized 
      clinical trial (NCT04593342). Patients (n = 50, age 55 +/- 7 years, male:female 
      29:21) who underwent primary RCAS were randomized to receive active (n = 22) or 
      sham (n = 28) PBM devices (B-Cure Laser Pro, Erica B-Cure LASER Ltd., Haifa, 
      Israel) in addition to standard care. Patients self-applied the treatments 
      (808 nm, 15 min, 16.5 J/cm(2) ) at home for 3 months postsurgery. Evaluations 
      were conducted before the surgery (baseline) and at 1-3 and 6 months post-RCAS 
      (FU-1M, FU-3M, FU-6M), and included Constant-Murley score (CMS), range of motion 
      (ROM), subjective pain by visual analogue scale (VAS), disability by QuickDASH, 
      and quality of life (QOL) by SF-12. The difference from baseline to follow-up 
      (DeltaFU), %patients achieving minimal clinical important difference (MCID), and 
      patient acceptable symptom score (PASS) were calculated. Comparisons were 
      conducted with superiority 2-sample t test and chi(2) . RESULTS: Baseline values 
      were not significantly different between groups. Both groups had similar 
      improvements in CMS and ROM. However, compared to Sham, PBM significantly 
      accelerated subjective pain reduction at 3 and 6 months (VAS mean +/- SD, 
      PBM-vs-Sham: DeltaFU-3M 32 +/- 33 vs. 16 +/- 27, p = 0.040; DeltaFU-6M: 41 +/- 36 vs. 23 +/- 26, 
      p = 0.038), with a significantly higher proportion of patients achieving MCID at 
      3 months (76% vs. 48%, p = 0.027) and PASS at 6 months (48% vs. 23%, p = 0.044). 
      PBM also significantly accelerated improvement in functionality and QOL at 6 
      months (QuickDASH DeltaFU-6M: 30 +/- 24 vs. 18 +/- 14, p = 0.029; SF-12 physical 
      component 6.8 +/- 12.5 vs. 0.4 +/- 8.6, p = 0.031; SF-12 mental component 8.5 +/- 9.1 
      vs. 2.2 +/- 12, p = 0.032). CONCLUSIONS: Self-applied photobiomodulation following 
      RCAS significantly accelerates decrease in pain and disability, and improves QOL. 
      This nonpharmacologic add-on therapeutic modality is easy to use and encourages 
      active patient involvement. Its potential use in rehabilitation following other 
      surgeries should be considered. LEVEL OF EVIDENCE: Level I, high-quality RCT.
CI  - (c) 2023 The Authors. Lasers in Surgery and Medicine published by Wiley Periodicals 
      LLC.
FAU - Abufoul, Rabie
AU  - Abufoul R
AD  - Orthopedic Department, The Holy Family Hospital, Nazareth, Israel.
FAU - Gavish, Lilach
AU  - Gavish L
AUID- ORCID: 0000-0003-0392-8958
AD  - Institute for Research in Military Medicine (IRMM), Faculty of Medicine, The 
      Hebrew University of Jerusalem and the Israel Defense Forces Medical Corps, 
      Jerusalem, Israel.
AD  - The Saul and Joyce Brandman Hub for Cardiovascular Research and the Department of 
      Medical Neurobiology, Institute for Medical Research (IMRIC), Faculty of 
      Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel.
FAU - Haddad, Marwan
AU  - Haddad M
AD  - Orthopedic Department, The Holy Family Hospital, Nazareth, Israel.
LA  - eng
SI  - ClinicalTrials.gov/NCT04593342
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20230608
PL  - United States
TA  - Lasers Surg Med
JT  - Lasers in surgery and medicine
JID - 8007168
SB  - IM
MH  - Humans
MH  - Male
MH  - Female
MH  - Middle Aged
MH  - *Rotator Cuff/surgery
MH  - *Rotator Cuff Injuries/surgery
MH  - Quality of Life
MH  - Prospective Studies
MH  - Treatment Outcome
MH  - Pain
MH  - Range of Motion, Articular
OTO - NOTNLM
OT  - arthroscopy
OT  - low-level-laser
OT  - photobiomodulation
OT  - rotator cuff
EDAT- 2023/06/08 06:42
MHDA- 2023/08/14 06:42
CRDT- 2023/06/08 04:38
PHST- 2023/05/22 00:00 [revised]
PHST- 2022/12/21 00:00 [received]
PHST- 2023/05/23 00:00 [accepted]
PHST- 2023/08/14 06:42 [medline]
PHST- 2023/06/08 06:42 [pubmed]
PHST- 2023/06/08 04:38 [entrez]
AID - 10.1002/lsm.23692 [doi]
PST - ppublish
SO  - Lasers Surg Med. 2023 Sep;55(7):662-673. doi: 10.1002/lsm.23692. Epub 2023 Jun 8.