THERAPEUTIC EFFECTS OF EXERCISE COMBINED LOW-LEVEL LASER THERAPY ON PATIENTS WITH PERIPHERAL ARTERY OCCLUSIVE DISEASE PLUS DIABETIC FOOT

Y.-J. Cheng^1,2, S.-Z. Chen³, T. Takahashi⁴, Y.-C. Chang⁵, L.-F. Fang⁵, T.-P. Li³, H.-H. Su⁶, H.-J. Lay⁷

¹China Medical University, Physical Therapy, Taichung, Taiwan, ²China Medical University Hospital, Department of Rehabilitation, Taichung, Taiwan, ³Ministry of Health and Welfare Feng Yuan Hospital, Division of Physical Therapy, Department of Rehabilitation, Taichung, Taiwan, ⁴Juntendo University, Faculty of Health Science, Tokyo, Japan, ⁵Ministry of Health and Welfare Feng Yuan Hospital, Department of Surgery, Taichung, Taiwan, ⁶Ministry of Health and Welfare Feng Yuan Hospital, Department of Rehabilitation, Taichung, Taiwan, ⁷Ministry of Health and Welfare Feng Yuan Hospital, Superintendent, Taichung, Taiwan

Background: Low-Level Laser Therapy (LLLT) is beneficial as an adjunct to conventional therapy in the treatment of diabetic foot ulcers (DFU). Exercises have been used in patients with DM or PAOD with maintaining functional status and walking ability. However, there is still no evidence of the effects of LLLT on patients with DFU plus peripheral artery occlusive disease (PAOD).

Purpose: The purpose of this study was to investigate the feasibility and therapeutic effects of exercise combined with LLLT in patients with DFU plus PAOD.

Methods: Ten patients with diabetic foot ulcers plus PAOD were recruited and stratified randomized into two groups. The subjects were allocated to either LLLT plus exercise (LLLT group) or exercise only (control group). The interventions were two to five times per week and continued for four weeks. The outcome measures were wound size and classification, sensory assessment, pain intensity, skin temperature, quality of life (SF-36), and the 6-minute walking test.

Results: The wound size was reduced significantly (p=0.0085) in the LLLT group when compared with the original wound size but not in the control group. The bodily pain in SF-36 was improved significantly (p=0.0397) when comparing the LLLT group and control group. Although not significantly, the improvement of 6MWD was 34.4 m in the LLLT group and 18 m in the control group respectively. All sensory was improved in the originally impaired feet of the unaffected legs but not in the legs with ulcers. There were no differences in the finding of other measurements between the 2 groups.

Conclusions: LLLT might enhance wound healing and reduce pain in patients with DFU plus PAOD. Exercises were able to maintain bodily function and walking ability. Because the sample size is small, further research is needed to confirm the therapeutic effects.

Implications: The results of this study can be applied to intervention strategies in patients with DFU plus PAOD.

Funding acknowledgements: This work was supported by the Ministry of Science and Technology in Taiwan (MOST 108-2410-H-039-009-MY2).

Keywords:
Low Level LASER Therapy
Peripheral artery occlusive disease
Diabetic foot ulcers

Topics:
Cardiorespiratory
Non-communicable diseases (NCDs) & risk factors

Did this work require ethics approval? Yes

Institution: Ministry of Health and Welfare Feng Yuan Hospital

Committee: Institutional Review Board, Feng Yuan Hospital, MOHW

Ethics number: 109003