The purpose of
this study is to test the efficiency of the TerraQuant™
device on shoulder pain resulting from inflammation (OA, Tendonitis, Bursitis)
and muscle trigger points.
___________________________________________________________________________________
On
The TerraQuant™Device
For Shoulder Pain
Background:
The Terraquant is an unique device which
combines low level pulse laser therapy (LLLT), pulsating infrared radiation,
visible red light and static magnetic fields, providing their synergic
therapeutic effect. The primary effect of LLLT is a local time response
to direct irradiation and includes vasodilatation with increased circulatory
flow; increased macrophages and fibroblast activity and improved metabolic
function of depressed or damaged cells. Delayed response consists of a
systemic effect caused by circulating photoproducts of irradiation in the
blood and lymphatic systems. Increased plasma concentration of certain
types of prostaglandins and endorphins have all be identified and play
a major role in the mechanism of pain attenuation.
LLLT has been shown to be safe and effective
(1,2,3,4)
The Method:
Experimental design:
The design is an A-B design, (pre-test
post-test design) with a control group. The study is a double blind
using two indentical unmarded Terra Quant devices, which one of is a demo
device. A sample of convenience according to set criteria's will
be used. The patients will be randomly assigned to two groups.
The experimental group received both conventional therapy and the Terra
Quant treatment from a demo device.
Subjects:
Twenty subjects with moderate to severe
shoulder pain were recruited within a period of 1 month from the one of
the departments of neurological rehabilitation affiliated to theTel Aviv
University..
Candidantes were either inpatients
or outpatients and they were selected after evaluation of symptoms based
on these criterias:
1. 1.
All candidates must present shoulder pain of a musculoskeletal benign nature
such as inflammation,
arthritis,
muscle trigger point overuse, impingement, and degenerative changes.
2. 2.
All subjects must be referred by a Physician after a full physical evaluation
including radiography.
3. 3.
Onsest of symptoms should be between 2 weeks and 3 months.
4. 4.
Subjects should not have any additional medical conditions that will produce
confounding results. The subjects perceptual and cognitive status
should be preserved.
5. 5.
Subjects should be medically stable. Patients with aprevious myocardial
infarctions or pacemakers are excluded from the study.
6. 6.
Subjects will have to sign an informed consent.
Procedure:
Subjects have been evaluated by a Physician
and by a Physical therapist before the beginning of the treatment. Evaluation
of Active Range of Motion of the shoulder joint (GHJ) using a goniometer.
Evalution of muscle strength according
to MMT.
Evaluation of pain using the Visual Analog
Scale (VAS).
A total of 8 treatment procedures preformed
every other day. After the end of the treatment the subjects have been
evaluated again by the same PT and MD to maintain inter-rater reliability.
Follow up was performed 1month after termination
of treatment.
Conventional therapy:
A physical therapy protocol to treatment
according to the diagnosis may include: manual therapy, soft tissue manipulation,
AROM and strengthening but should not include modalities to prevent confounding
factors.
Average treatment tine: 30 min.
Terra Quant treatment: According to the
protocol; 5 min per zone, Frequency: 50 HZ
Results:
A total of 18 patients completed the study.
There were 12 individuals with spinal cord injury (SCI), and 6 with hemiplegia
following CVA. Among the SCI individuals, there were four with paraplegia
and eight with tetraplegia. The average age of the participants was 46
+ 15.5. 15 were males and 3 females. 12 of the total group had the VAS
evaluation done before and after the termination of the treatment.
The device A was used in 8 patients; B
in 10 patients.
There was a clear improvement in shoulder
ROM in the group treated with the device B (p=0.001).
The improvement in VAS scale was visible
in the group B, yet did not reach a statistical significance (p-0.1).
Conclusions:
Terraquant treatment proved to be significantly
more efficient than placebo in patients with decreased shoulder ROM, and
more efficient than placebo in patients with shoulder pain. No side-effects
were observed.
The positive outcome of this study as
well as the lack of side-effects suggests that Terraquant therapy may be
an effective and economical tool in the treatment of pain and reduced range
of motion in people with shoulder problems following CVA or SCI.
Larger and randomized trials are needed
in order to confirm this preliminary data.
1. Simunovic
Z. Low level laser therapy with trigger points technique: a clinical
study on 243 patients.
J Clin Laser Med Surg.
14(4): 163-167. 1996.
2. 2.
Ozdemir F et al. The clinical efficacy of low power laser therapy on pain
and function in cervical osteoarthritis. Clin Rheumatol. 20(3): 181-184.
2001.
3. 3.
Lewith GT, Machin D. A randomised trial to evaluate the effect of infra-red
stimulation of local trigger points versus placebo, on pain cused by cervical
osteoarthritis. Acupunct Electrother Res. 6(4): 277-284, 1981.
4. 4.
England et al. Low power laser therapy of shoulder tendinitis. Scan J Rheumatol.
18(6):427-31, 1989
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