title: Efficacy of low-level laser therapy associated to orthoses for patients with carpal tunnel syndrome: A randomized single-blinded controlled trial.
abstract: OBJECTIVE
  Compare the efficacy of orthoses and patient education with and without the addition to Low-Level Laser Therapy (LLLT - 660 nm, 30 mW, a continuous regime and bean area of 0.06 cm2). The laser irradiation was delivered with the fluency of 10J/cm2 in patients with mild and moderate Carpal Tunnel Syndrome (CTS).
  
  
  METHODS
  48 patients were randomized and 30 finished the protocol (a sample loss of 37.5%), 90% female and 10% males. Randomization was applied to allocate the patients in each one of the groups, with association or not to LLLT (group orthoses or LLLT and orthoses). All of them were submitted to ergonomic home orientations. The short-term symptoms and function outcome were assessed through: Boston Carpal Tunnel Questionnaire (BCTQ) - Severity of Symptoms (SS) Functional Score (FS). Pain (VAS), Semmes-Weinstein monofilaments, 2PD and pinch strength was used for characterization of the sample. Most of the participants were women, over 4th decade enrolled on heavy hand duties occupations, right-handed, 66.7% affected on dominant hand, without alterations in sensory median nerve thresholds or pinch strength.
  
  
  RESULTS
  Both groups showed a reduction of total BCTQ score and its subdomains after six weeks, with significant difference (p< 0.05), comparing to baseline. No significant difference was found between groups. A Minimal clinical change was observed after the intervention in 92.3% of participants for BCTQ subdomain severity of symptoms at individual comparison for LLLT and orthoses group and 76.5% for the orthoses group, demonstrating clinical relevance. Effect size Cohen's index was moderate for the severity of symptoms.
  
  
  CONCLUSIONS
  LLLT in association to orthoses and ergonomic orientation seems to be effective in short-term symptoms relieve for patients with mild and moderate CTS.
authors.affiliation: Rehabilitation and Performance Program, University of São Paulo, Ribeirão Preto, Brazil.|Federal University of Santa Catarina, Araranguá, Brazil.
authors.forename: Rafael Inácio
authors.initials: RI
authors.lastname: Barbosa
authors.affiliation: Rehabilitation and Performance Program, University of São Paulo, Ribeirão Preto, Brazil.|Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, University of São Paulo, Ribeirão Preto, Brazil.
authors.forename: Marisa de Cássia Registro
authors.initials: Mde C
authors.lastname: Fonseca
authors.affiliation: Rehabilitation and Performance Program, University of São Paulo, Ribeirão Preto, Brazil.
authors.forename: Eula Katucha da Silva
authors.initials: EK
authors.lastname: Rodrigues
authors.affiliation: Rehabilitation and Performance Program, University of São Paulo, Ribeirão Preto, Brazil.
authors.forename: Guilherme
authors.initials: G
authors.lastname: Tamanini
authors.affiliation: Rehabilitation and Performance Program, University of São Paulo, Ribeirão Preto, Brazil.|Federal University of Santa Catarina, Araranguá, Brazil.
authors.forename: Alexandre Marcio
authors.initials: AM
authors.lastname: Marcolino
authors.affiliation: Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, University of São Paulo, Ribeirão Preto, Brazil.
authors.forename: Nilton
authors.initials: N
authors.lastname: Mazzer
authors.affiliation: Rehabilitation and Performance Program, University of São Paulo, Ribeirão Preto, Brazil.|Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, University of São Paulo, Ribeirão Preto, Brazil.
authors.forename: Rinaldo Roberto de Jesus
authors.initials: RR
authors.lastname: Guirro
authors.affiliation: School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada.
authors.forename: Joy
authors.initials: J
authors.lastname: MacDermid
mesh_terms: D002349:Carpal Tunnel Syndrome / Q000628:therapy*; D000072700:Conservative Treatment; D005260:Female; D006801:Humans; D028022:Low-Level Light Therapy; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D016037:Single-Blind Method; D013165:Splints; D064232:Visual Analog Scale
keywords: Carpal tunnel syndrome; conservative treatment; ergonomics; low-level laser therapy; orthoses; rehabilitation