Abstract
The purposes of this study are to determine and compare efficacy of laser acupuncture versus reflexology in elderly with rheumatoid arthritis. Thirty elderly patients with rheumatoid arthritis aged between 60 and 70 years were classified into two groups, 15 patients each. Group A received laser acupuncture therapy (904 nm, beam area of 1cm2, power 100 mW, power density 100 mW/cm2, energy dosage 4 J, energy density 4 J/cm2, irradiation time 40 s, and frequency 100,000 Hz). The acupuncture points that were exposed to laser radiation are LR3, ST25, ST36, SI3, SI4, LI4, LI11, SP6, SP9, GB25, GB34, and HT7. While group B received reflexology therapy, both offered 12 sessions over 4 weeks. The changes in RAQoL, HAQ, IL-6, MDA, ATP, and ROM at wrist and ankle joints were measured at the beginning and end of treatment. There was significant decrease in RAQoL, HAQ, IL-6, and MDA pre/posttreatment for both groups (p < 0.05); significant increase in ATP pre/posttreatment for both groups (p < 0.05); significant increase in ankle dorsi-flexion, plantar-flexion, wrist flexion, extension, and ulnar deviation ROM pre/posttreatment in group A (p < 0.05); and significant increase in ankle dorsi-flexion and ankle plantar-flexion ROM pre/posttreatment in group B (p < 0.05). Comparison between both groups showed a statistical significant decrease in MDA and a statistical significant increase in ATP in group A than group B. Percent of changes in MDA was 41.82%↓ in group A versus 21.68%↓ in group B; changes in ATP was 226.97%↑ in group A versus 67.02%↑ in group B. Moreover, there was a statistical significant increase in ankle dorsi-flexion, ankle plantar-flexion, wrist flexion, wrist extension, and radial deviation in group A than group B. Laser therapy is associated with significant improvement in MDA and ATP greater than reflexology. In addition, it is associated with significant improvement in ankle dorsi-flexion, ankle plantar-flexion, wrist flexion, wrist extension, and radial deviation greater than reflexology in elderly patients with rheumatoid arthritis.
Similar content being viewed by others
References
Steward K, Land M (2009) Perceptions of patients and professionals on rheumatoid arthritis care. A consultancy report by the King’s Fund for the Rheumatology Futures Group London: The King’s Fund
Yathish G, Balakrishnan C, Mangat G, Parikshit S (2015) Immunomodulators in managing geriatric rheumatoid arthritis. Internet J Rheumatol Clin Immunol 3 (S1)
Helmick CG, Felson DT, Lawrence RC, Gabriel S, Hirsch R, Kwoh CK, Liang MH, Kremers HM, Mayes MD, Merkel PA (2008) Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: part I. Arthritis Rheum 58(1):15–25
McInnes IB, O’Dell JR (2010) State-of-the-art: rheumatoid arthritis. Ann Rheum Dis 69(11):1898–1906
Shea B, Swinden MV, Tanjong Ghogomu E, Ortiz Z, Katchamart W, Rader T, Bombardier C, Wells GA, Tugwell P (2013) Folic acid and folinic acid for reducing side effects in patients receiving methotrexate for rheumatoid arthritis. Cochrane Database Syst Rev 5
Ernst E, Fugh-Berman A (2002) Complementary and alternative medicine: what is it all about? Occup Environ Med 59(2):140–144
Pagán JA, Pauly MV (2005) Access to conventional medical care and the use of complementary and alternative medicine. Health Aff 24(1):255–262
Hu W-L, Chang C-H, Hung Y-C, Tseng Y-J, Hung I-L, Hsu S-F (2014) Laser acupuncture therapy in patients with treatment-resistant temporomandibular disorders. PLoS One 9(10):e110528
Vargas JT (2005) Low level laser acupuncture. Medical Acupuncture 16(2):38–41
Choi W, Tak S, Yim J, Lee S (2015) Feasibility Study of Laser Acupuncture on Static Balance in Healthy Elderly Women: Pilot Study
Brosseau L, Welch V, Wells G, Tugwell P, De Bie R, Gam A, Harman K, Shea B, Morin M (2000) Low level laser therapy for osteoarthritis and rheumatoid arthritis: a metaanalysis. J Rheumatol 27(8):1961–1969
Brosseau L, Welch V, Wells GA, de Bie R, Gam A, Harman K, Morin M, Shea B, Tugwell P (2005) Low level laser therapy (Classes I, II and III) for treating rheumatoid arthritis. The Cochrane Library
Alves ACA, de Carvalho PTC, Parente M, Xavier M, Frigo L, Aimbire F, ECPL J, Albertini R (2013) Low-level laser therapy in different stages of rheumatoid arthritis: a histological study. Lasers Med Sci 28(2):529–536
Attia AM, Ibrahim FA, Abd El-Latif NA, Aziz SW, Elwan AM, Aziz A, Aziz A, Elgendy A, Elgengehy FT (2016) Therapeutic antioxidant and anti-inflammatory effects of laser acupuncture on patients with rheumatoid arthritis. Lasers in surgery and medicine
Kunz K, Kunz B (1993) The complete guide to foot reflexology (revised) Albuquerque. New Mexico: Kevin and Barbara Kunz
Pitman V, MacKenzie K (2002) Reflexology: a practical approach. Nelson Thornes
Oleson T (2002) Auriculotherapy stimulation for neuro-rehabilitation. NeuroRehabilitation 17(1):49–62
Gozuyesil E, Baser M (2016) The effect of foot reflexology applied to women aged between 40 and 60 on vasomotor complaints and quality of life. Complement Ther Clin Pract 24:78–85
Adly AS (2016) Monitoring Laser Therapy Improvement in Range of Motion in Subjects with Tendinopathy Using a Novel Computer Vision System. Cairo University
Hecker H-U, Steveling A (2011) Color atlas of acupuncture: body points-ear points-trigger points. Thieme
Focks C (2008) Atlas of acupuncture. Elsevier Health Sciences
Mc Vicar A, Greenwood C, Fewell F, D’arcy V, Chandrasekharan S, Alldridge LC (2007) Evaluation of anxiety, salivary cortisol and melatonin secretion following reflexology treatment: a pilot study in healthy individuals. Complement Ther Clin Pract 13(3):137–145
David J, Townsend S, Sathanathan R, Kriss S, Dore C (1999) The effect of acupuncture on patients with rheumatoid arthritis: a randomized, placebo-controlled cross-over study. Rheumatology 38(9):864–869
Silman AJ (2002) The changing face of rheumatoid arthritis: why the decline in incidence? Arthritis Rheum 46(3):579–581
Alamanos Y, Drosos AA (2005) Epidemiology of adult rheumatoid arthritis. Autoimmun Rev 4(3):130–136
Emery P (2006) Treatment of rheumatoid arthritis. Br Med J 7534:152
Sommer OJ, Kladosek A, Weiler V, Czembirek H, Boeck M, Stiskal M (2005) Rheumatoid arthritis: a practical guide to state-of-the-art imaging, image interpretation, and clinical implications 1. Radiographics 25(2):381–398
WALT (2010) Recommended anti-inflammatory dosage for low level laser therapy. World Association for Laser Therapy. http://waltza.co.za/documentation-links/recommendations/dosage-recommendations/. Accessed 2014
AMAC (2012) Australian Medical Acupuncture College. http://www.chiro.org/acupuncture/FULL/Position_Statement_on_Laser_Acupuncture.shtml. Accessed 2014
Araki H, Imaoka A, Kuboyama N, Abiko Y (2011) Reduction of interleukin-6 expression in human synoviocytes and rheumatoid arthritis rat joints by linear polarized near infrared light (Superlizer) irradiation. Laser therapy 20(4):293
Carteron NL (2000) Cytokines in rheumatoid arthritis: trials and tribulations. Mol Med Today 6(8):315–323
Jazayeri JA, Carroll GJ, Vernallis AB (2010) Interleukin-6 subfamily cytokines and rheumatoid arthritis: role of antagonists. Int Immunopharmacol 10(1):1–8
Green VL, Alexandropoulou A, Walker MB, Walker AA, Sharp DM, Walker LG, Greenman J (2010) Alterations in the Th1/Th2 balance in breast cancer patients using reflexology and scalp massage. Exp Ther Med 1(1):97–108
van Amelsfort JM, Jacobs KM, Bijlsma JW, Lafeber FP, Taams LS (2004) CD4+ CD25+ regulatory T cells in rheumatoid arthritis: differences in the presence, phenotype, and function between peripheral blood and synovial fluid. Arthritis Rheum 50(9):2775–2785
Kumagai S, Jikimoto T, Saegusa J (2003) Pathological roles of oxidative stress in autoimmune diseases. Rinsho Byori Jpn J Clin Path 51(2):126–132
Wattanathorn J, Sutalangka C (2014) Laser acupuncture at HT7 acupoint improves cognitive deficit, neuronal loss, oxidative stress, and functions of cholinergic and dopaminergic systems in animal model of Parkinson’s disease. Evidence-Based Complementary and Alternative Medicine 2014
Kunz K, Kunz B (1999) Medical Applications of Reflexology: Findings in Research about Safety, Efficacy, Mechanism of Action and Cost-effectiveness of Reflexology. RRP Press
Huang Y-Y, Sharma SK, Carroll J, Hamblin MR (2011) Biphasic dose response in low level light therapy–an update. Dose-Response 9 (4):dose-response. 11–009. Hamblin
Evans DH, Abrahamse H 2008 Effect of laser irradiation on mitochondrial responses of stressed keratinocytes. In: International Conference of the World Association of Laser Therapy, Sun City, North West Province, South Africa. Retrieved from http://www.biolase.com/Medical/Documents/Effect-of-Laser-Irradiation-on-Mitochondrial.pdf
Wang L, Sikora J, Hu L, Shen X, Grygorczyk R, Schwarz W (2013) ATP release from mast cells by physical stimulation: a putative early step in activation of acupuncture points. Evidence-Based Complementary and Alternative Medicine 2013
Zhang D, Spielmann A, Wang L, Ding G, Huang F, Gu Q, Schwarz W (2012) Mast-cell degranulation induced by physical stimuli involves the activation of transient-receptor-potential channel TRPV2. Physiol Res 61(1):113–124
Ingham ED, Byers DC (1984) The Original Works of Eunice D. Ingham: Stories the Feet Can Tell Thru Reflexology: Stories the Feet Have Told Thru Reflexology. Ingham Pub
Sudmeier I, Bodner G, Egger I, Mur E, Ulmer H, Herold M (1999) Changes of renal blood flow during organ-associated foot reflexology measured by color Doppler sonography. Forschende Komplementarmedizin 6(3):129–134
Jones J, Thomson P, Lauder W, Howie K, Leslie SJ (2012) Reflexology has an acute (immediate) haemodynamic effect in healthy volunteers: a double-blind randomised controlled trial. Complement Ther Clin Pract 18(4):204–211
Chow RT, David MA, Armati PJ (2007) 830 nm laser irradiation induces varicosity formation, reduces mitochondrial membrane potential and blocks fast axonal flow in small and medium diameter rat dorsal root ganglion neurons: implications for the analgesic effects of 830 nm laser. J Peripher Nerv Syst 12(1):28–39
Poole H, Glenn S, Murphy P (2007) A randomised controlled study of reflexology for the management of chronic low back pain. Eur J Pain 11(8):878–887
Tiran D (2010) Reflexology in pregnancy and childbirth. Elsevier Health Sciences
Khan S, Otter S, Springett K (2006) The effects of reflexology on foot pain and quality of life in a patient with rheumatoid arthritis: a case report. Foot 16(2):112–116
McCullough J, Liddle S, Sinclair M, Close C, Hughes C (2014) The physiological and biochemical outcomes associated with a reflexology treatment: a systematic review. Evidence-Based Complementary and Alternative Medicine 2014
De Jong Z, van der Heijde D, McKenna S, Whalley D (1997) The reliability and construct validity of the RAQoL: a rheumatoid arthritis-specific quality of life instrument. Rheumatology 36(8):878–883
McDowell I (2006) Measuring health: a guide to rating scales and questionnaires. Oxford university press
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Funding
No funding was received.
Ethical approval
All procedures performed were in accordance with the ethical standards of Faculty of Physical Therapy research ethics committee, Cairo University and with the 1964 Helsinki declaration and its later amendments.
Informed consent
Informed consent was obtained from all individual participants included in the study.
Rights and permissions
About this article
Cite this article
Adly, A.S., Adly, A.S., Adly, M.S. et al. Laser acupuncture versus reflexology therapy in elderly with rheumatoid arthritis. Lasers Med Sci 32, 1097–1103 (2017). https://doi.org/10.1007/s10103-017-2213-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10103-017-2213-y