Российская Арктика (Oct 2023)
Evaluation of the effectiveness of low-intensity laser radiation for the occupational polyneuropathies’s treatment of the upper extremities
Abstract
Abstract A feature of occupational polyneuropathies (OPP) of the upper extremities is the persistence of clinical and instrumental manifestations after cessation of contact with physical overload. The disease is relevant for the Arctic region, since the combined effect of the cooling microclimate leads to its occurrence in addition to the severity of the labor process. Low-intensity laser radiation (LILR) has a wide range of therapeutic effects, which allows it to be used in the treatment of various diseases of the nervous system. The purpose of the study is to evaluate the effectiveness of LILR in the treatment of professional PNP of the upper extremities with the determination of the main clinical and functional criteria of effectiveness. The article presents the results of treatment of 236 patients with an occupational PNP. All received traditional drug therapy; the treatment of patients in the main group differed from the comparison group in that they received additional treatment using LILR according to the developed method. The effectiveness of the therapy was assessed by studying the dynamics of pain in the hands using a visual pain rating scale, impulse conduction velocity along the sensory fibers of the median and ulnar nerves. Changes in each of these parameters in subgroups were assessed at different stages of observation (before and immediately after treatment, after 3 and after 6 months). The difference in impulse conduction velocity for the sensory fibers of the median and ulnar nerves immediately after treatment and after 3 months in the main group was significantly higher, regardless of the predominant nature of the damage to the nerve fibers, than in the comparison group. The main group was also characterized by a significant decrease in the level of pain up to 6 months after cessation of therapy. The use of LILR for the treatment of professional PNP of the upper extremities leads to an increase in the impulse conduction velocity parameters in the sensory fibers of the median and ulnar nerves with a simultaneous decrease in the severity of pain. The criteria for the effectiveness of the LLLR course according to the developed method are: an increase in impulse conduction velocity in the sensory fibers of the median and ulnar nerves by at least 10% of the initial values, as well as a decrease in pain in the hands by an average of 3-4 points according to the visual pain rating scale.
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