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Laser acupuncture for claudication symptoms in peripheral artery disease — Does it work? A randomized trial

BACKGROUND: Peripheral artery disease (PAD) receives little attention despite its clinical consequences. Intermittent claudication is the most disturbing symptom of the disease resulting in marked limitations to functional walking performance. Treadmill walking exercise is the first-line non-pharmac...

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Autores principales: Ahmad, Ahmad Mahdi, Abdel-Aziz, Hasnaa Ahmed
Formato: Online Artículo Texto
Lenguaje:English
Publicado: World Scientific Publishing Company 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9244600/
https://www.ncbi.nlm.nih.gov/pubmed/35782701
http://dx.doi.org/10.1142/S1013702522500044
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author Ahmad, Ahmad Mahdi
Abdel-Aziz, Hasnaa Ahmed
author_facet Ahmad, Ahmad Mahdi
Abdel-Aziz, Hasnaa Ahmed
author_sort Ahmad, Ahmad Mahdi
collection PubMed
description BACKGROUND: Peripheral artery disease (PAD) receives little attention despite its clinical consequences. Intermittent claudication is the most disturbing symptom of the disease resulting in marked limitations to functional walking performance. Treadmill walking exercise is the first-line non-pharmacological treatment in PAD; however, older patients may be unable to exercise because of the functional disability of the disease itself or deconditioning. OBJECTIVE: In an attempt to seek an alternative intervention, this study aimed to assess the effect of laser acupuncture on patient-reported claudication symptoms and walk performance in PAD. METHODS: Thirty male patients with PAD were assigned randomly to a control group ([Formula: see text] , [Formula: see text] years old, [Formula: see text] kg/m(2)) or a study group ([Formula: see text] , [Formula: see text] years old, [Formula: see text] kg/m(2)). Inclusion criteria were mild-to-moderate PAD, Fontaine stage II, unilateral or bilateral claudications, and older men. Exclusion criteria were asymptomatic PAD, resting pain, severe or critical limb ischemia, ischemic ulcers, and patients contraindicated for laser therapy. Both groups received pharmacological treatment, but only the study group received gallium aluminum arsenide (GaAlAs) laser therapy at nine acupuncture points, namely, Liver 2 (LV2), Stomach 41 (ST41), Urinary bladder 40 (UB40), UB60, UB61, Gall bladder 30 (GB30), GB34, GB38, and GB40 for 2 days/week and five consecutive weeks. A pen-type laser device was used at a wavelength of [Formula: see text] nm, with a power output of [Formula: see text] mW, a spot size of 0.08 cm(2), and an energy density of 2 J/cm(2), for 60 s/point. The Edinburgh Claudication Questionnaire (ECQ) and the 6-min walk distance (6-MWD) were the endpoints of the study. The McNemar–Bowker Test and Generalized Estimating Equations Ordinal Logistic Regression Model were used for the within- and between-group statistical analyses of the categorical data of ECQ, respectively; and a mixed model MANOVA was used for the within- and between-group analyses of the 6-MWD data. RESULTS: There was a significant improvement in patients’ response to ECQ only in the study group compared to the baseline ([Formula: see text]) and the controls ([Formula: see text]) after the intervention. The 6-MWD increased significantly in the study group compared to the baseline ([Formula: see text] m versus [Formula: see text] m, [Formula: see text]). CONCLUSION: The GaAlAs laser acupuncture applied at selected acupoints may be a promising intervention complementary to drug therapy that could help relieve claudication symptoms and improve physical functional performance in older men with PAD (Fontaine stage II). Trials were conducted under the Trial Registration No. PACTR201912698539774.
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spelling pubmed-92446002022-06-30 Laser acupuncture for claudication symptoms in peripheral artery disease — Does it work? A randomized trial Ahmad, Ahmad Mahdi Abdel-Aziz, Hasnaa Ahmed Hong Kong Physiother J Research Paper BACKGROUND: Peripheral artery disease (PAD) receives little attention despite its clinical consequences. Intermittent claudication is the most disturbing symptom of the disease resulting in marked limitations to functional walking performance. Treadmill walking exercise is the first-line non-pharmacological treatment in PAD; however, older patients may be unable to exercise because of the functional disability of the disease itself or deconditioning. OBJECTIVE: In an attempt to seek an alternative intervention, this study aimed to assess the effect of laser acupuncture on patient-reported claudication symptoms and walk performance in PAD. METHODS: Thirty male patients with PAD were assigned randomly to a control group ([Formula: see text] , [Formula: see text] years old, [Formula: see text] kg/m(2)) or a study group ([Formula: see text] , [Formula: see text] years old, [Formula: see text] kg/m(2)). Inclusion criteria were mild-to-moderate PAD, Fontaine stage II, unilateral or bilateral claudications, and older men. Exclusion criteria were asymptomatic PAD, resting pain, severe or critical limb ischemia, ischemic ulcers, and patients contraindicated for laser therapy. Both groups received pharmacological treatment, but only the study group received gallium aluminum arsenide (GaAlAs) laser therapy at nine acupuncture points, namely, Liver 2 (LV2), Stomach 41 (ST41), Urinary bladder 40 (UB40), UB60, UB61, Gall bladder 30 (GB30), GB34, GB38, and GB40 for 2 days/week and five consecutive weeks. A pen-type laser device was used at a wavelength of [Formula: see text] nm, with a power output of [Formula: see text] mW, a spot size of 0.08 cm(2), and an energy density of 2 J/cm(2), for 60 s/point. The Edinburgh Claudication Questionnaire (ECQ) and the 6-min walk distance (6-MWD) were the endpoints of the study. The McNemar–Bowker Test and Generalized Estimating Equations Ordinal Logistic Regression Model were used for the within- and between-group statistical analyses of the categorical data of ECQ, respectively; and a mixed model MANOVA was used for the within- and between-group analyses of the 6-MWD data. RESULTS: There was a significant improvement in patients’ response to ECQ only in the study group compared to the baseline ([Formula: see text]) and the controls ([Formula: see text]) after the intervention. The 6-MWD increased significantly in the study group compared to the baseline ([Formula: see text] m versus [Formula: see text] m, [Formula: see text]). CONCLUSION: The GaAlAs laser acupuncture applied at selected acupoints may be a promising intervention complementary to drug therapy that could help relieve claudication symptoms and improve physical functional performance in older men with PAD (Fontaine stage II). Trials were conducted under the Trial Registration No. PACTR201912698539774. World Scientific Publishing Company 2022-06 2022-02-12 /pmc/articles/PMC9244600/ /pubmed/35782701 http://dx.doi.org/10.1142/S1013702522500044 Text en © 2022, Hong Kong Physiotherapy Association https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article published by World Scientific Publishing Company. It is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 (CC BY-NC-ND) License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits use, distribution and reproduction, provided that the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
spellingShingle Research Paper
Ahmad, Ahmad Mahdi
Abdel-Aziz, Hasnaa Ahmed
Laser acupuncture for claudication symptoms in peripheral artery disease — Does it work? A randomized trial
title Laser acupuncture for claudication symptoms in peripheral artery disease — Does it work? A randomized trial
title_full Laser acupuncture for claudication symptoms in peripheral artery disease — Does it work? A randomized trial
title_fullStr Laser acupuncture for claudication symptoms in peripheral artery disease — Does it work? A randomized trial
title_full_unstemmed Laser acupuncture for claudication symptoms in peripheral artery disease — Does it work? A randomized trial
title_short Laser acupuncture for claudication symptoms in peripheral artery disease — Does it work? A randomized trial
title_sort laser acupuncture for claudication symptoms in peripheral artery disease — does it work? a randomized trial
topic Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9244600/
https://www.ncbi.nlm.nih.gov/pubmed/35782701
http://dx.doi.org/10.1142/S1013702522500044
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