Eficácia das terapias com laser de baixa intensidade e luz polarizada no tratamento da síndrome do túnel cárpico em mulheres com diabetes tipo 2

Autores

  • Saher Lotfy Elgayar Department of Physiotherapy Faculty of Allied Medical Sciences Middle East University Amman Jordan
  • Ehab Abdelhalim Department of Neurosurgery, Faculty of Medicine, Cairo University, Cairo, Egypt
  • Mohamed Gamil Omar Department of Physical Therapy for Women Health, Faculty of Physical Therapy, October University for Modern Sciences & Arts, Cairo, Egypt
  • Saad Mohamed Elgendy Department of Physiotherapy, Cairo University Hospitals, Cairo, Egypt
  • Mohamed Bayoumi Ibrahim Bayoumi Department of Physiotherapy Faculty of Allied Medical Sciences Middle East University Amman Jordan
  • Mohammed Youssef Elhamrawy
  • Nader Ibrahim Elsayed
  • Tarek M. Youssef Department of Physiotherapy Faculty of Allied Medical Sciences Middle East University Amman Jordan

DOI:

https://doi.org/10.47197/retos.v73.116876

Palavras-chave:

Síndrome do túnel cárpico, terapia laser de baixa intensidade, luz polarizada, diabetes mellitus tipo 2, mulheres

Resumo

Introdução: A síndrome do túnel cárpico continua a ser um dos problemas mais comuns entre as mulheres com diabetes.

Objectivo: Este estudo teve como objectivo comparar a eficácia da terapia laser de baixa intensidade e da luz polarizada no tratamento da síndrome do túnel cárpico em mulheres com diabetes tipo 2.

Métodos: Sessenta e seis mulheres foram aleatoriamente atribuídas a três grupos (n = 22 cada): tala de punho isolada (controlo), tala mais laser de baixa intensidade e tala mais luz polarizada durante 10 semanas. As avaliações pré e pós-tratamento incluíram latências motoras e sensoriais do nervo mediano distal, área de secção transversal, escala numérica arábica de avaliação da dor, força de preensão manual e o Questionário de Síndrome do Túnel Cárpico de Boston (escalas de gravidade dos sintomas e funcionais).

Resultados: A terapia laser de baixa intensidade apresentou melhorias significativamente maiores do que a luz polarizada na latência motora mediana (diferença média [DM] = −0,27 ms; IC de 95% = −0,81 a −0,03; p = 0,04), latência sensorial (DM = −0,24 ms; IC de 95% = −0,47 a −0,01; p = 0,02), dor (DM = −0,88; IC 95% = −2,04 a −0,2; p = 0,03), força de preensão (DM = 3,4 kg; IC 95% = 0,51 a 6,82; p = 0,01), gravidade dos sintomas (DM = −4,71; IC 95% = −9,39 a −10,79; p = 0,01) e função motora geral (DM = −1,81; IC 95% = −1,97 a −1,97). −0,03; p = 0,009) e gravidade funcional (DM = −1,92; IC 95% = −4,15 a −0,13; p = 0,02). As reduções na área transversal foram semelhantes em ambos os grupos (DM = −0,33 mm; IC 95% = −1,73 a 1,07; p = 0,94).

Conclusões: O laser de baixa intensidade é mais eficaz do que a luz polarizada no tratamento da síndrome do túnel cárpico em mulheres com diabetes tipo 2.

Referências

Ahmed, O. F., Elkharbotly, A. M., Taha, N., & others. (2017). Treatment of mild to moderate carpal tun-nel syndrome in patients with diabetic neuropathy using low level laser therapy versus ul-trasound: Controlled comparative study. BBA Clinical, 8, 43–47. https://doi.org/10.1016/j.bbacli.2017.07.001

Alanazy, M. H., Alaboudi, M., Almaari, A., & others. (2019). Translation and validation of the Arabic version of the Boston carpal tunnel syndrome questionnaire. Neurosciences, 24(4), 296–301. https://doi.org/10.17712/nsj.2019.4.20190014

Alghadir, A. H., Anwer, S., & Iqbal, Z. A. (2016). The psychometric properties of an Arabic numeric pain rating scale for measuring osteoarthritis knee pain. Disability and Rehabilitation, 38(24), 2392–2397. https://doi.org/10.3109/09638288.2015.1129441

Ali, M., Elgendy, A., Medhat, A., & others. (2020). Therapeutic and photobiomodulation effects of low-level laser irradiation on Egyptian patients with carpal tunnel syndrome: A placebo-controlled study. Journal of Arab Society for Medical Research, 15(1), 18. https://doi.org/10.4103/jasmr.jasmr_7_20

American Association of Electrodiagnostic Medicine, American Academy of Neurology, & American Academy of Physical Medicine and Rehabilitation. (2002). Practice parameter for electrodiag-nostic studies in carpal tunnel syndrome: Summary statement. Muscle & Nerve, 25(6), 918–922. https://doi.org/10.1002/mus.10185

Bahrami, H., Moharrami, A., Mirghaderi, P., & Mortazavi, S. M. J. (2022). Low-level laser and light ther-apy after total knee arthroplasty improves postoperative pain and functional outcomes: A three-arm randomized clinical trial. Arthroplasty Today, 19, 101066. https://doi.org/10.1016/j.artd.2022.10.016

Bakhtiary, A. H., & Rashidy-Pour, A. (2004). Ultrasound and laser therapy in the treatment of carpal tunnel syndrome. Australian Journal of Physiotherapy, 50(3), 147–151. https://doi.org/10.1016/s0004-9514(14)60152-5

Bohannon, R. W. (2019). Minimal clinically important difference for grip strength: A systematic review. Journal of Physical Therapy Science, 31(1), 75–78. https://doi.org/10.1589/jpts.31.75

Dimitrios, S. (2020). The effectiveness of polarized light in musculoskeletal, skin problems and burns. American Journal of Biomedical Research, 10(2), 159–167. https://doi.org/10.34297/ajbsr.2020.10.001492

Dimitrios, S., & Stasinopoulos, L. (2017). Treatment of carpal tunnel syndrome in pregnancy with po-larized polychromatic non-coherent light (Bioptron light): A preliminary, prospective, open clinical trial. Laser Therapy, 26(4), 289–295. https://doi.org/10.5978/islsm.17-OR-18

Duarte, K. C. N., Soares, T. T., Magri, A. M. P., & others. (2018). Low-level laser therapy modulates de-myelination in mice. Journal of Photochemistry and Photobiology B: Biology, 189, 55–65. https://doi.org/10.1016/j.jphotobiol.2018.09.024

Ekim, A., Armagan, O., Tascioglu, F., & others. (2007). Effect of low level laser therapy in rheumatoid arthritis patients with carpal tunnel syndrome. Swiss Medical Weekly, 137(23–24), 347–352. https://doi.org/10.4414/smw.2007.11581

Feehan, J., Burrows, S. P., Cornelius, L., & others. (2018). Therapeutic applications of polarized light: Tissue healing and immunomodulatory effects. Maturitas, 116, 11–17. https://doi.org/10.1016/j.maturitas.2018.07.009

Góralczyk, K., Szymańska, J., Szot, K., Fisz, J., & Rość, D. (2016). Low-level laser irradiation effect on endothelial cells under conditions of hyperglycemia. Lasers in Medical Science, 31(5), 825–831. https://doi.org/10.1007/s10103-016-1880-4

Joshi, A., Patel, K., Mohamed, A., & others. (2022). Carpal tunnel syndrome: Pathophysiology and com-prehensive guidelines for clinical evaluation and treatment. Cureus, 14(7), e27053. https://doi.org/10.7759/cureus.27053

López-de-Uralde-Villanueva, I., Fernández-de-Las-Peñas, C., Cleland, J. A., & others. (2024). Minimal clinically important differences in hand pain intensity (Numerical Pain Rate Scale) and related-function (Boston Carpal Tunnel Questionnaire) in women with carpal tunnel syndrome. Ar-chives of Physical Medicine and Rehabilitation, 105(1), 67–74. https://doi.org/10.1016/j.apmr.2023.07.018

Mohsen, A. A., Jassim, R. E., Al-Mousawi, S. Q. S., & others. (2025). The effect of rehabilitation exercises accompanied by ultrasound waves in reducing pain and healing from carpal tunnel compres-sion. Retos, 66, 1094–1102. https://doi.org/10.47197/retos.v66.113746

Mostafa, A. O., El-ghaffar, A. A., Hagag, A. A., & others. (2019). Laser therapy versus kinesio taping in treatment of carpal tunnel syndrome in type 2 diabetic patients: Comparative study. IOSR Jour-nal of Nursing and Health Science, 8(4), 19–33. https://www.iosrjournals.org/iosr-jnhs/papers/vol8-issue4/Series-9/C0804091218.pdf

Padua, L., Coraci, D., Erra, C., & others. (2016). Carpal tunnel syndrome: clinical features, diagnosis, and management. The Lancet. Neurology, 15(12), 1273–1284. https://doi.org/10.1016/S1474-4422(16)30231-9

Padua, L., Pazzaglia, C., Caliandro, P., & others. (2008). Carpal tunnel syndrome: Ultrasound, neuro-physiology, clinical and patient-oriented assessment. Clinical Neurophysiology, 119(9), 2064–2069. https://doi.org/10.1016/j.clinph.2008.05.004

Perkins, B. A., Olaleye, D., & Bril, V. (2002). Carpal tunnel syndrome in patients with diabetic polyneu-ropathy. Diabetes Care, 25(3), 565–569. https://doi.org/10.2337/diacare.25.3.565

Postma, J. D., & Kemler, M. A. (2022). The effect of carpal tunnel release on health-related quality of life of 2346 patients over a 5-year period. Journal of Hand Surgery (European Volume), 47(4), 347–352. https://doi.org/10.1177/17531934211045634

Pourmemari, M. H., & Shiri, R. (2016). Diabetes as a risk factor for carpal tunnel syndrome: A system-atic review and meta-analysis. Diabetic Medicine, 33(1), 10–16. https://doi.org/10.1111/dme.12855

Raeissadat, S. A., Rayegani, S. M., Rezaei, S., & others. (2014). The effect of polarized polychromatic noncoherent light (bioptron) therapy on patients with carpal tunnel syndrome. Journal of La-sers in Medical Sciences, 5(1), 39–46. https://applications.emro.who.int/imemrf/j_lasers_med_sci/j_lasers_med_sci_2014_5_1_39_46.pdf

Rayegani, S. M., Bahrami, M. H., Eliaspour, D., & others. (2013). The effects of low intensity laser on clinical and electrophysiological parameters of carpal tunnel syndrome. Journal of Lasers in Medical Sciences, 4(4), 182–189. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4282005/pdf/jlms-4-182.pdf

Saadh, M. J., Allela, O. Q. B., Kareem, R. A., & others. (2025). Immune cell dysfunction: A critical player in development of diabetes complications. Current research in translational medicine, 73(3), 103510. https://doi.org/10.1016/j.retram.2025.103510

Sarraf, P., Malek, M., Ghajarzadeh, M., Miri, S., Parhizgar, E., & Emami-Razavi, S. Z. (2014). The best cutoff point for median nerve cross sectional area at the level of carpal tunnel inlet. Acta Medi-ca Iranica, 52(8), 613–618. https://pubmed.ncbi.nlm.nih.gov/25149885/

Sasaki, S., Ikeda, T., Okihara, S. I., & others. (2019). Principles and development of collagen-mediated tissue fusion induced by laser irradiation. Scientific Reports, 9, 9383. https://doi.org/10.1038/s41598-019-45486-4

Sasaki, T., Koyama, T., Kuroiwa, T., & others. (2022). Evaluation of the existing electrophysiological severity classifications in carpal tunnel syndrome. Journal of Clinical Medicine, 11(6), 1685. https://doi.org/10.3390/jcm11061685

Schulz, K. F., Altman, D. G., & Moher, D. (2010). CONSORT 2010 statement: Updated guidelines for re-porting parallel group randomised trials. Journal of Pharmacology and Pharmacotherapeutics, 1(2), 100–107. https://doi.org/10.4103/0976-500X.72352

Sevy, J. O., Sina, R. E., & Varacallo, M. (2023). Carpal tunnel syndrome. In StatPearls. StatPearls Pub-lishing. https://www.ncbi.nlm.nih.gov/books/NBK448179/

Stasinopoulos, D., Stasinopoulos, I., & Johnson, M. I. (2005). Treatment of carpal tunnel syndrome with polarized polychromatic noncoherent light (Bioptron light): A preliminary, prospective, open clinical trial. Photomedicine and Laser Surgery, 23(2), 225–228. https://doi.org/10.1089/pho.2005.23.225

Zimmerman, M., Gottsäter, A., & Dahlin, L. B. (2022). Carpal tunnel syndrome and diabetes—A com-prehensive review. Journal of Clinical Medicine, 11(6), 1674. https://doi.org/10.3390/jcm11061674

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Publicado

10-10-2025

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Artigos de caráter científico: trabalhos de pesquisas básicas e/ou aplicadas.

Como Citar

Lotfy Elgayar, S., Abdelhalim, E., Gamil Omar, M., Mohamed Elgendy, S., Bayoumi Ibrahim Bayoumi, M., Youssef Elhamrawy, M., Ibrahim Elsayed, N., & M. Youssef, T. (2025). Eficácia das terapias com laser de baixa intensidade e luz polarizada no tratamento da síndrome do túnel cárpico em mulheres com diabetes tipo 2. Retos, 73, 429-438. https://doi.org/10.47197/retos.v73.116876