Exploring the interplay between ankle muscle strength, postural control, and pain intensity in chronic ankle instability: A comprehensive analysis.

Background: Chronic Ankle Instability (CAI) is a common musculoskeletal condition characterized by recurring ankle sprains and impaired postural control (PC). Understanding the relationship between ankle muscle strength, PC, and the role of pain is essential for effective management. Objectives: This prospective cross sectional study aimed to 1. Compare ankle isometric muscle strength (IMS) and PC between CAI and asymptomatic sides. 2. Assess the correlations between ankle IMS and PC and explore the potential mediating effect of pain in individuals with CAI. Methods: A total of 44 individuals with CAI, were enrolled in the study. Ankle IMS (dorsiflexors, plantar flexors, invertors, and evertors) was measured using a dynamometer, while PC was evaluated using sway parameters (anterior-posterior and medial-lateral sway, ellipse area). Pain levels were reported using a Visual Analog Scale. Results: The CAI ankles exhibited significantly lower ankle IMS in all muscle groups compared to the asymptomatic ankles (p < 0.001). Additionally, the CAI side showed increased postural sway and a larger ellipse area (p < 0.001), indicating reduced PC. Negative correlations were observed between ankle IMS and PC parameters on the CAI side, with dorsiflexor strength showing correlations ranging from -0.423 to -0.387, plantar flexor strength ranging from -0.423 to -0.371, invertor strength ranging from -0.412 to -0.238, and evertor strength ranging from -0.451 to -0.365 (p < 0.001). Mediation analysis revealed that pain played a significant mediating role in connecting ankle IMS and PC parameters among individuals with CAI, with statistical significance (p < 0.05). Conclusions: Individuals with CAI exhibit weaker ankle IMS and diminished PC in comparison to their healthy side. Moreover, pain was identified as a mediator in the relationship between ankle IMS and PC in CAI. These findings underscore the importance of addressing both ankle IMS and pain in the rehabilitation and management of CAI.

Exploring the Interplay of Muscular Endurance, Functional Balance, and Limits of Stability: A Comparative Study in Individuals with Lumbar Spondylosis Using a Computerized Stabilometric Force Platform.

Lumbar spondylosis, characterized by degenerative changes in the lumbar spine, often leads to pain, reduced spinal stability, and musculoskeletal dysfunction. Understanding the impact of lumbar spondylosis on musculoskeletal function, particularly lumbar extensor endurance, functional balance, and limits of stability, is crucial for improving the management and well-being of affected individuals. This study aimed to assess lumbar extensor endurance, functional balance, and limits of stability in individuals with lumbar spondylosis compared to age-matched healthy individuals and explore the correlations among these parameters within the lumbar spondylosis group. The lumbar spondylosis group consisted of 60 individuals initially screened by an orthopedician and referred to physical therapy. Age-matched healthy controls (n = 60) were recruited. Inclusion criteria encompassed adults aged 45-70 years for both groups. Lumbar extensor endurance was assessed using the Sorensen test, functional balance with the Berg Balance Scale, and limits of stability using a computerized stabilometric force platform. Lumbar extensor endurance was significantly lower in individuals with lumbar spondylosis compared to healthy controls (23.06 s vs. 52.45 s, p < 0.001). Functional balance, as assessed by the Berg Balance Scale, demonstrated a significant decrement in the lumbar spondylosis group (48.36 vs. 53.34, p < 0.001). Additionally, limits of stability variables, under both eyes-open and eyes-closed conditions, exhibited marked impairments in the lumbar spondylosis group (p < 0.001 for all variables). Within the lumbar spondylosis group, lumbar extensor endurance exhibited significant positive correlations with functional balance (0.46, p < 0.001) and negative correlations with limits of stability variables (r ranging from -0.38 to -0.49, p < 0.01 for all variables). This study underscores the significance of addressing lumbar extensor endurance, functional balance, and stability impairments in the comprehensive management of lumbar spondylosis.

A Cross-Sectional Study on Mediating Effect of Chronic Pain on the Relationship between Cervical Proprioception and Functional Balance in Elderly Individuals with Chronic Neck Pain: Mediation Analysis Study.

(1) Background: Cervical proprioception maintains head orientation in space and contributes to maintaining bodily balance. Evaluating cervical proprioception in elderly individuals with chronic neck pain (CNP) and understanding how pain intensity mediates the relationship between proprioception and functional balance helps formulate treatment strategies for this population. The objectives of this study are to (a) compare the cervical proprioception and functional balance between CNP and asymptomatic, (b) investigate the relationship between cervical proprioception and functional balance ability in CNP individuals and (c) mediation effect of chronic pain on the relationship between cervical proprioception and functional balance tests (2) Methods: This cross-sectional comparative study recruited 60 elderly individuals with a diagnosis of CNP (mean age: 66.40 years) and 60 asymptomatic (mean age: 66.42 years). The cervical proprioception is measured using the target head repositing technique. The subjects were asked to close their eyes and reposition their head actively to the target position from the neutral position, and the reposition accuracy is estimated as joint position errors (JPE) in degrees. The cervical proprioception was measured in the directions of flexion, extension, and left and right rotation. The functional balance was assessed using the berg balance test (BBS) score and timed-up-and-go (TUG) test in seconds. (3) Results: The elderly individuals with CNP had increased cervical JPE compared to the asymptomatic group (p < 0.001) in all the directions tested, indicating that cervical proprioception is impaired in CNP patients. Moreover, the CNP individual functional balance is significantly impaired (p < 0.001) compared to asymptomatic. The BBS test scores were lower, and the TUG scores were higher in the CNP group. In CNP individuals, the cervical JPE showed a significant correlation with the BBS test scores (r = -0.672 to -0.732, p < 0.001) and TUG scores (r = 0.328 to -0.414, p < 0.001). (4) Conclusions: Cervical proprioception and functional balance are impaired in elderly individuals with CNP. Physical therapists and rehabilitation professionals may consider these factors during the evaluation and development of treatment strategies in elderly adults with CNP.

Investigating Knee Joint Proprioception and Its Impact on Limits of Stability Using Dynamic Posturography in Individuals with Bilateral Knee Osteoarthritis-A Cross-Sectional Study of Comparisons and Correlations.

(1) Background: Proprioception and limits of stability can significantly impact static and dynamic balance. Knee proprioception and limits of stability may be impaired in individuals with knee osteoarthritis (KOA). Impaired knee proprioception may impact the limits of stability, and understanding the associations between these factors is important for formulating treatment strategies in this population. The objectives of this study are to (a) compare the knee joint position error (JPE) and limits of stability between KOA and asymptomatic individuals and (b) assess the correlation between knee JPE and the limits of stability in KOA individuals. (2) Methods: This cross-sectional study included 50 individuals diagnosed with bilateral KOA and 50 asymptomatic individuals. Knee JPE was measured using a dual digital inclinometer at 25° and 45° of knee flexion (in the dominant and nondominant legs). The limits of stability variables, including reaction time (s), maximum excursion (%), and direction control (%), were evaluated using computerized dynamic posturography. (3) Results: The magnitude of the mean knee JPE is significantly larger in KOA individuals (p < 0.001) compared to asymptomatic individuals assessed at 25° and 45° of knee flexion in both the dominant and nondominant legs. The limits of stability test showed that KOA group individuals had a longer reaction time (1.64 ± 0.30 s) and reduced maximum excursion (4.37 ± 0.45) and direction control (78.42 ± 5.47) percentages compared to the asymptomatic group (reaction time = 0.89 ± 0.29, maximum excursion = 5.25 ± 1.34, direction control = 87.50 ± 4.49). Knee JPE showed moderate to strong correlations with the reaction time (r = 0.60 to 0.68, p < 0.001), maximum excursion (r = -0.28 to -0.38, p < 0.001) and direction control (r = -0.59 to -0.65, p < 0.001) parameters in the limits of stability test. (4) Conclusions: Knee proprioception and limits of stability are impaired in KOA individuals compared to asymptomatic individuals, and knee JPE showed significant relationships with the limits of stability variables. These factors and correlations may be considered when evaluating and developing treatment strategies for KOA patients.

Association between Handgrip Strength, Skinfold Thickness, and Trunk Strength among University Students.

OBJECTIVES: The main goal was to explore the relationship between hand grip strength (HGS), the thickness of the skinfold at multiple sites, and the trunk flexor (TF) and extensor (TE) muscle strength among healthy participants. METHODS: We employed a cross-sectional design and randomly recruited 40 participants. Ultimately, only 39 participants were included. First, measurements for demographic and anthropometric variables were carried out. After that, the evaluation of hand grip strength and skinfold was performed. DATA ANALYSIS: Descriptive statistics were used to explore the amount of interaction between the smoking and nonsmoking groups, and a repeated measures analysis of variance was employed. Furthermore, associations between dependent and independent variables were discovered through a multiple linear regression model. RESULTS: The participants had a mean age of 21.59 ± 1.19 years. The results of the repeated measures analysis of variance validated an acceptable interaction between the trunk and hand grip strength at a significance level of p < 0.01, further emphasized by their moderate association (p < 0.05). Multiple regressions between TE, TF, the independent variables T score, height, and age were also significant (p < 0.05). CONCLUSIONS: The trunk muscle strength can be used as a health indicator for comprehensive evaluation. The present study also found a moderate relationship between hand grip strength, trunk strength, and T score.

Establishing Responsiveness and Minimal Clinically Important Difference of Quebec Back Pain Disability Scale (Hindi Version) in Chronic Low Back Pain Patients Undergoing Multimodal Physical Therapy.

Increasing emphasis is placed on physical functional measures to examine treatments for chronic low back pain (CLBP). The Quebec Back Pain Disability Scale (Hindi version) (QBPDS-H) has never been evaluated for responsiveness. The objectives of this study were to (1) examine the internal and external responsiveness of the Quebec Back Pain Disability Scale (Hindi version) (QBPDS-H) and (2) find out the minimal clinically important difference (MCID) and minimal detectable change (MDC) in the functional ability of patients with chronic low back pain (CLBP) undergoing multimodal physical therapy treatment. In this prospective cohort study, QBPDS-H responses were recorded at the baseline and after eight weeks from 156 CLBP patients undergoing multimodal physiotherapy treatment. To differentiate between the clinically unimproved (n = 65, age: 44.16 ± 11.8 years) and clinically improved (n = 91, age: 43.28 ± 10.7 years) scores of patients from the initial assessment to the last follow-up, the Hindi version of the Patient's Global Impression of Change (H-PGIC) scale was utilized. Internal responsiveness was large (E.S. (pooled S.D.) (n = 91): 0.98 (95% CI = 1.14-0.85) and Standardized Response Mean (S.R.M.) (n = 91): 2.57 (95% CI = 3.05-2.17)). In addition, the correlation coefficient and receiver operative characteristics (R.O.C.) curve were used to assess the QBPDS-H external responsiveness. MCID and MDC were detected by the R.O.C. curve and standard error of measurements (S.E.M.), respectively. The H-PGIC scale showed moderate responsiveness (ρ = 0.514 and area under the curve (A.U.C.) = 0.658; 95% CI, 0.596-0.874), while the MDC achieved 13.68 points, and the MCID was found have 6 points (A.U.C. = 0.82; 95% CI: 0.74-0.88, sensitivity = 90%, specificity = 61%). This study shows that QBPDS-H has moderate levels of responsiveness in CLBP patients receiving multimodal physical therapy treatment, so it can be used to measure the changes in disability scores. MCID and MDC changes were also reported with QBPDS-H.

Comparison of Neck Circumference, Waist Circumference, and Skinfold Thickness in Measuring the Subcutaneous Fat Distribution and Their Association with Handgrip Strength: Cross-Sectional Study.

Skinfold measurement (SKF) can accurately measure abdominal obesity and is regarded as a surrogate marker to predict non-communicable diseases. The objective of the present study was to observe the degree of association between neck circumference (NC), SKF and handgrip strength (HGS). Secondly, also to know the effects of smoking on NC, HGS and SKF. The mean and standard deviations and frequencies in percentage were analyzed, respectively. The degree of association between NC, anthropometric characters and HGS was also analyzed using the Pearson correlation. Furthermore, multiple linear regression models were used to study the degree of influence of independent variables on dependent variables. Correlation assessment for neck circumference with waist circumference and HGS revealed a weak association. While with SKF for four sites, a strong association was found. A significant regression was found among the smokers in the model (F (2, 7) = 5.2, p-value of 0.04 with an R2 of 0.598). The predictor variables, like waist and NC, can produce a variation of 59.8% in the dependent variable. Whereas, among non-smokers, an insignificant regression was seen. In conclusion, neck circumference is associated with SKF. However, a small sample size of young smokers revealed that NC and waist circumference influenced HGS.

Impact of Constraint-Induced Movement Therapy (CIMT) on Functional Ambulation in Stroke Patients-A Systematic Review and Meta-Analysis.

Constraint-induced movement therapy (CIMT) has been delivered in the stroke population to improve lower-extremity functions. However, its efficacy on prime components of functional ambulation, such as gait speed, balance, and cardiovascular outcomes, is ambiguous. The present review aims to delineate the effect of various lower-extremity CIMT (LECIMT) protocols on gait speed, balance, and cardiovascular outcomes. Material and methods: The databases used to collect relevant articles were EBSCO, PubMed, PEDro, Science Direct, Scopus, MEDLINE, CINAHL, and Web of Science. For this analysis, clinical trials involving stroke populations in different stages of recovery, >18 years old, and treated with LECIMT were considered. Only ten studies were included in this review, as they fulfilled the inclusion criteria. The effect of CIMT on gait speed and balance outcomes was accomplished using a random or fixed-effect model. CIMT, when compared to controlled interventions, showed superior or similar effects. The effect of LECIMT on gait speed and balance were non-significant, with mean differences (SMDs) of 0.13 and 4.94 and at 95% confidence intervals (Cis) of (-0.18-0.44) and (-2.48-12.37), respectively. In this meta-analysis, we observed that despite the fact that several trials claimed the efficacy of LECIMT in improving lower-extremity functions, gait speed and balance did not demonstrate a significant effect size favoring LECIMT. Therefore, CIMT treatment protocols should consider the patient's functional requirements, cardinal principles of CIMT, and cardiorespiratory parameters.

Anxiety, depression, worry, and stress-related perceptions among antenatal women during the COVID-19 pandemic: Single group repeated measures design.

Background: Coronavirus disease 2019 (COVID-19) has rapidly spread across the globe, which has affected the health of all populations including antenatal women. Aims: The aim of the study was to evaluate the levels of anxiety, depression, stress, and worry in antenatal women during COVID-19 compared with the pre-COVID-19 levels and to evaluate the associations between the sociodemographic factors of antenatal women and Hospital Anxiety Depression Scale (HADS)-D, HADS-A, Generalized Anxiety Disorder (GAD)-7, Perceived Stress Scale (PSS), and Brief Measure of Worry Severity (BMWS) scores. Materials and Methods: This single group repeated measures design was conducted on 101 antenatal women who were referred to outpatient antenatal clinics from January 2020 (pre-COVID-19) to April 2020 (during the COVID-19 pandemic). Data were collected using four questionnaires including the HADS, GAD-7 scale, PSS, and BMWS. Results: Antenatal women (n = 101, Mage = 32.73 years, standard deviation = 5.67) during COVID-19 demonstrated significantly increased (P < 0.001) levels of anxiety, depression, stress, and worry compared with pre-COVID-19 levels. Multiple regression analysis indicated that panic disorder was significantly associated with HADS, PSS, and BMWS scores; pregnancy complications were significantly associated with HADS scores; associated health problems were significantly associated with PSS and BMWS scores; and current anxiety, depression, stress, and worry were significantly associated with HADS, GAD-7, and BMWS scores in antenatal women during COVID-19. Conclusion: Increased attention should be paid to the psychological health of antenatal women during this COVID-19 pandemic. Proper management of this current catastrophe is likely to result in global changes in social experiences, and interventions are necessary to address associated changes in mental health, especially among antenatal women.

Knowledge, Attitude, and Practice among Physical Therapists toward COVID-19 in the Kingdom of Saudi Arabia-A Cross-Sectional Study.

To curb the COVID-19 pandemic, the knowledge, attitude, and practice (KAP) of preventive measures play an essential role, and healthcare workers have had to endure a burden to care for COVID-19 patients. Thus, this study aimed to assess the weight of the KAP of physiotherapists in Saudi Arabia during the COVID-19 pandemic. This was a cross-sectional study, where we circulated an online KAP questionnaire to 1179 physical therapists, and among those, 287 participated and completed the questionnaire. The collected responses were analyzed using descriptive statistics, t-test, ANOVA, correlation, and regression analyses, and p-value ≤ 0.05 was considered statistically significant. Both males and females participated in almost equal numbers; most of the participants were <40 years, had a bachelor's level of education, and were from the central region of Saudi Arabia. Social media and the internet were the primary sources of COVID-19-related information (74.6%). Knowledge components A (92%) and B (73.9%) were excellent among most participants. Approximately half of the participants (50.5%) had a moderate attitude toward COVID-19, and regarding the practice component, most participants (74.6%) scored moderately. Correlation analysis showed a low positive relationship between knowledge A, attitude, and practice components. Still, there was a very low positive relationship between knowledge B, attitude, and practice components, but both were statistically significant. Our study showed that physical therapists in Saudi Arabia exhibit good knowledge, attitude, and practice toward COVID-19.

The Aftermath of the COVID-19 Crisis in Saudi Arabia: Respiratory Rehabilitation Recommendations by Physical Therapists.

Since late 2019, the number of COVID-19 patients has gradually increased in certain regions as consecutive waves of infections hit countries. Whenever this wave hits the corresponding areas, the entire healthcare system must respond quickly to curb the diseases, morbidities, and mortalities in intensive care settings. The healthcare team involved in COVID-19 patients' care must work tirelessly without having breaks. Our understanding of COVID-19 is limited as new challenges emerge with new COVID-19 variants appearing in different world regions. Though medical therapies are finding solutions to deal with the disease, there are few recommendations for respiratory rehabilitation therapies. A group of respiratory rehabilitation care professionals in Saudi Arabia and international experts have agreed with the World Health bodies such as the World Health Organization (WHO) on the treatment and rehabilitation of patients with COVID-19. Professionals participating in COVID-19 patient treatment, rehabilitation, and recovery formulated respiratory rehabilitation guidelines based on the DELPHI Method, combining scientific research and personal practical experience. As a result, it is envisaged that the number of individuals in the region suffering from respiratory ailments due to post-COVID-19 will decrease. This narrative review and clinical expertise guidelines may give physiotherapists acceptable and standard clinical guideline protocols for treating COVID-19 patients.

Low level laser therapy against radiation induced oral mucositis in elderly head and neck cancer patients-a randomized placebo controlled trial.

OBJECTIVES: Radiotherapy (RT) is treatment of choice for Elderly Head and Neck Cancer (HNC) patients. Oral mucositis (OM) during RT affects patient's routine oral activities and overall health. Low Level Laser Therapy (LLLT) provided some promising results against cancer therapy induced OM in children and adults. No study specifically evaluated effects of LLLT against RT induced OM in elderly HNC patients until date, hence we did this study. MATERIAL AND METHODS: This double blinded study randomized 46 elderly HNC patients scheduled for RT [Dosage=66 Gray (2 Gy/fraction), 5 fractions/week, total 33 fractions for 6.5 weeks], into laser (22) and placebo (24) groups. Laser group patients received LLLT [Helium-Neon, λ=632.8 nm, power density=0.024 W/cm(2), dosage=3.0 J/point at six anatomical sites bilaterally i.e. 12 locations, total dose/session=36 J, beam aperture diameter=0.6 mm, beam spot size=1 cm(2), irradiated area diameter=1 cm(2), irradiation time/point=125 s, 5 sessions/week, non-contact method-distance between probe and irradiated tissues <1 cm, whereas placebo group did not receive laser. OM grades (RTOG/EORTC Scale), oral pain, weight loss, need for morphine analgesics and tube feeding, and RT break were recorded by a blinded assessor. Descriptive statistics and repeated measures ANOVA were used for analysis keeping p<0.05. RESULTS: Significant reduction in the incidence and duration of severe OM (p=0.016) and severe pain (p=0.023) and weight loss (p=0.004) was observed in laser than placebo group. No difference was found for enteral feeding use (p=0.667) between two groups. CONCLUSIONS: LLLT decreased the severity of OM and oral pain in elderly HNC patients. Also, lesser weight loss, morphine analgesic use and radiation break happened in laser group.

Effect of low-level laser therapy on patient reported measures of oral mucositis and quality of life in head and neck cancer patients receiving chemoradiotherapy--a randomized controlled trial.

PURPOSE: Chemoradiotherapy (CRT)-induced oral mucositis (OM) adversely affects a patient's oral functions and quality of life (QOL). Low-level laser therapy (LLLT) showed some preventive and curative effects against clinically reported objective measures of OM in few trials including our recently published study. There is dearth of evidence regarding the effects of LLLT on patient's subjective experience of OM and QOL. Hence, we did this study to evaluate the effects of LLLT on a patient's reported measures of OM and QOL in head and neck cancer (HNC) patients receiving CRT. METHODS: This triple blinded study randomized 220 HNC patients scheduled for CRT (three weekly Cisplatin + RT = 66 Gray (2 Gy/session), five fractions/week for 6.5 weeks, total 33 fractions) into laser (110) and placebo (110) groups. The laser group received LLLT (Technomed Electronics Advanced Laser Therapy 1000, He-Ne, λ = 632.8 nm, power density = 24 mW/cm(2), dosage = 3.0 J at each point, total dose/session = 36-40 J, spot size 1 cm(2), irradiation time/point 125 s) before each radiation session, while the placebo group did not receive laser therapy. Methodology was similar to our recently published study (Gautam et al. Radiother Oncol 104:349-354, 2012). In this part of our study, a blinded assessor collected subjective outcomes of the patient's reported measures of OM using Oral Mucositis Weekly Questionnaire-Head and Neck (OMWQ-HN) and QOL using Functional Assessment of Cancer Treatment-Head and Neck (FACT-HN) Questionnaire. Data were analyzed using repeated measure ANOVA through general linear model. Statistical significance was kept at p < 0.05. RESULTS: Results analysis revealed that OMWQ-HN (F = 12.199, df = 6,1314, p < 0.001) and FACT-HN (p < 0.05) scores were significantly lower in LLLT than placebo group patients. Also, a significant reduction (p < 0.001) in incidence of severe OM, need for opioid analgesics, and total parenteral nutrition was observed. CONCLUSIONS: LLLT was effective in improving the patient's subjective experience of OM and QOL in HNC patients receiving CRT.

Low level laser therapy for concurrent chemoradiotherapy induced oral mucositis in head and neck cancer patients - a triple blinded randomized controlled trial.

BACKGROUND AND PURPOSE: Oral mucositis (OM) is most cumbersome acute side effect of concurrent chemoradiotherapy (CCRT) for head and neck cancer (HNC). OM associated pain affects oral functions and nutrition of the patient that may result in discontinuity of treatment. Several modalities have been tried to prevent and treat OM, but none proved completely successful until date. We used prophylactic low level laser therapy (LLLT) for the prevention and treatment of CCRT induced OM. MATERIALS AND METHODS: In this triple blinded study, 221 HNC patients scheduled to undergo CCRT (Cisplatin (1, 22, 43 day)+RT=66 Grays (2 Gy/fraction), 33 fractions, 5 fractions/week, for 45 days) were block randomized into laser (n=111) and placebo (n=110) group. Laser group received LLLT (HeNe, λ=632.8 nm, power-density=24 mW, dosage=3.0 J/point, total dosage/session=36-40 J, spot-size=1cm(2), 5 sessions/week) while placebo received sham treatment daily prior to radiation. OM (RTOG/EORTC Scale), oral pain (VAS), dysphagia (FIS), weight loss and CCRT break were assessed. Data were analyzed using frequencies and percentage, generalized estimating equations (GEE) and odds ratio. RESULTS: There was significant reduction in incidence of severe OM (F=16.64, df=8876, p<0.0001) and its associated pain (F=25.06, df=8876, p<0.0001), dysphagia (F=20.17, df=8876, p<0.0001) and opioid analgesics use (p<0.0001) in laser than placebo group patients. CONCLUSIONS: LLLT decreased the incidence of CCRT induced severe OM and its associated pain, dysphagia and opioid analgesics use.

Low level helium neon laser therapy for chemoradiotherapy induced oral mucositis in oral cancer patients - a randomized controlled trial.

BACKGROUND: Patients receiving chemoradiotherapy (CRT) for oral cancer (OC) often develop oral mucositis (OM). OM associated pain severely affects oral functions and nutrition of the patient, resulting in narcotic analgesic use and CRT interruption. Laser therapy has shown some promising results in preventing and treating OM caused by cancer therapies. So in this trial we used prophylactic Low Level Helium Neon (He-Ne) Laser for the prevention and treatment of CRT induced OM in OC patients. MATERIALS AND METHODS: This double blinded trial block randomized 121 primary OC patients scheduled to undergo CRT [RT dosage=66 Gray/33 fractions for 5 days/week and chemotherapy (3 weekly Cisplatin)] into laser (n=60) and placebo (n=61) group. Laser group received He-Ne Laser (λ=632.8 nm, P=24 mW, ED=3.5 J/cm(2)) while placebo received sham treatment just before radiation for 6.5 weeks. OM (RTOG/EORTC Scale), its associated pain, and total parenteral nutrition (TPN), were assessed on every week by a blinded assessor. Also opioid analgesic use, weight loss and any CRT break were recorded. Data was analyzed using descriptive statistics, t-test and Man Whitney U test. Level of significance was set at p<0.05. RESULTS: Incidence of severe OM (29% vs. 89%, p<0.001) and its associated pain (18% vs. 71%, p<0.001), opioid analgesic use (7% vs. 21%, p<0.001)and TPN (30% vs. 39% p=0.039) was significantly less in laser than placebo group patients. Also duration of severe OM and pain experienced was less in laser than placebo group. CRT break required only for placebo group (9%) patients. CONCLUSION: Low Level He-Ne Laser decreased the incidence of CRT induced severe OM and its associated pain, opioid analgesics use and TPN.