Effect of anti-gravity treadmill (Alter G) training on gait characteristics and postural stability in adult with healed burns: A single blinded randomized controlled trial.

BACKGROUND: Burns constitute one of the foremost contributors to premature mortality and morbidity, and the recovery process from burn injuries is characterized by its intricate and protracted nature. OBJECTIVE: The principal aim of this study was to assess the influence of an anti-gravity treadmill (Alter G) training program on both gait characteristics and postural stability indices (PSI) in adult individuals who have recovered from burns. DESIGN: This study followed a single-blind, randomized, controlled design. METHODS: A total of 45 adults, aged 18-35 years, with healed lower extremity burns that were circumferential and encompassed 35-50% of their total body surface area (TBSA) were randomly allocated to either the anti-gravity treadmill (Alter G) Training group (n = 22) or the traditional physical therapy program (TPTP) group (n=23). The TPTP group received conventional physical therapy, while the anti-gravity treadmill (Alter G) training group engaged in anti-gravity treadmill exercises alongside the traditional physical therapy program. The primary outcome measures, evaluated at both baseline and the conclusion of the 12-week intervention, included gait characteristics assessed using the GAITRite system and PSI measured by the Biodex Balance System (BBS). RESULTS: The anti-gravity treadmill (Alter G) training group exhibited significantly greater enhancements than the TPTP group in terms of mean values and percentage changes in gait characteristics and PSI. Specifically, the percentage changes for the Alter G group were as follows: stride length (20.57%), step time (22.58%), step length (20.47%), velocity (15.67%), cadence (23.28%), and double support time (29.03%). In contrast, the TPTP group's percentage changes were: 6.73%, 8.19%, 7.65%, 7.75%, 8.89%, and 9.37%, respectively. Concerning PSI, the Alter G group exhibited percentage changes of 55.17% for the medio-lateral stability index (MLI), 48.21% for antero-posterior stability index (API), and 48.48% for the overall stability index (OSI). The TPTP group's corresponding percentage changes were 20%, 14.03%, and 16.41%. CONCLUSIONS: The amalgamation of anti-gravity treadmill training with the traditional physical therapy program yields greater efficacy than TPTP in isolation. Consequently, the findings underscore the efficiency of anti-gravity treadmill (Alter G) Training as a valuable tool for rehabilitating patients with burn injuries.

Long-term effect of full-body pulsed electromagnetic field and exercise protocol in the treatment of men with osteopenia or osteoporosis: A randomized placebo-controlled trial.

Background: Osteoporosis is the most prevalent metabolic disease affecting bones. Objective: To investigate the long-term effect of pulsed electromagnetic field (PEMF) combined with exercise protocol on bone mineral density (BMD) and bone markers in men with osteopenia or osteoporosis. Methods: Ninety-five males with osteopenia or osteoporosis (mean age, 51.26 ± 2.41 years; mean height, 176 ± 2.02 cm; mean weight, 83.08 ± 2.60 kg; mean body-mass index (BMI), 26.08 ± 1.09 kg/m 2) participated in the study, and they were randomly assigned to one of three groups: Group 1 received a full-body PEMF and exercise protocol (PEMF +EX), Group 2 received a placebo full-body PEMF and exercise protocol (PPEMF +EX), and Group 3 received a full-body PEMF alone (PEMF). PEMF was applied for the whole body using a full-body mat three times per week for 12 weeks, with an exercise protocol that includes flexibility, aerobic exercise, strengthening, weight-bearing, and balance exercises followed by whole-body vibration (WBV) training. Outcome measures include BMD of total hip and lumbar spine and bone markers [serum osteocalcin (s-OC), Serum amino-terminal cross-linking telopeptide of type I collagen (s-NTX), Serum carboxy-terminal cross-linking telopeptide of type I collagen (s-CTX), Parathyroid hormones (PTH), Bone-specific Alkaline Phosphatase (BSAP), and 25-hydroxy vitamin D (Vit D)]. Results: The BMD of total hip and lumbar spine was significantly increased post-treatment in all groups, and more so in Group 1 and Group 2 than Group 3. There was a significant difference in bone markers in all groups, more so in Group 1 and Group 2 than in Group 3. Conclusion: PEMF combined with exercise protocol exerts a potent role for treating OP, is more effective than exercise and PEMF alone for increasing BMD and enhancing bone formation, and suppresses bone-resorption markers after 12-weeks of treatment with the impact lasting up to 6 months.

Pulsed high-intensity laser therapy versus low level laser therapy in the management of primary dysmenorrhea.

[Purpose] To determine the effect of pulsed high intensity laser therapy (HILT) versus low level laser therapy (LLLT) in the treatment of primary dysmenorrhea. [Participants and Methods] This was a randomized clinical trial that included 30 females diagnosed with primary dysmenorrhea who were assigned randomly into two groups of equal numbers. The treatment was three sessions every cycle for three consecutive cycles, where group (A) received pulsed HILT and group (B) received LLLT. All participants were evaluated before and after treatment sessions by visual analogue scale (VAS) and at the end of treatment by pain relief scale (PRS). [Results] The results showed a significant decrease in the severity of pain in the two groups. Comparison between the two groups showed a statistically non-significant difference in the severity of pain and pain alleviation at the end of the treatment course. [Conclusion] Both pulsed HILT and LLLT are effective in the treatment of primary dysmenorrhea, with no significant differences between the two modalities.

Effect of high-power Nd:YAG laser on the growth of Staphylococcus aureus and Pseudomonas aeruginosa: an experimental study.

[Purpose] The aim of this study was to evaluate the effect of high-power Nd:YAG laser on Staphylococcus aureus and Pseudomonas aeruginosa bacterial growth. [Materials and Methods] Seven samples of S. aureus and seven samples of P. aeruginosa were prepared in the microbiology lab, one used as a control sample and the remaining six samples used as experimental samples, which were irradiated by a high-power laser (LASERSIX ME, 15W) with a total dose of 500 and 700 J. The primary measure was the semi-qualitative assessment of turbidity and bacterial count; the turbidity was assessed 24 h after laser application. [Results] There was a significant decrease in turbidity in all experimental samples of S. aureus and P. aeruginosa after 24 h of high-power laser application for 500 and 700 J and a significant decrease in the colony-forming unit (CFU) value in both types, and there were no significant differences in turbidity and CFU when comparing 500 and 700 J. [Conclusion] A high power Nd:YAG laser was found to be an effective modality for inhibition of S. aureus and P. aeruginosa growth.

Immediate effect of pulsed high-intensity neodymium-doped yttrium aluminum garnet (Nd: YAG) laser on staphylococcus aureus and pseudomonas aeruginosa growth: an experimental study.

[Purpose] The aim of this study was to evaluate the effect of pulsed high intensity neodymium-doped yttrium aluminum garnet (Nd: YAG) laser on staphylococcus aureus (S. aureus) and pseudomonas aeruginosa (P. aeruginosa) bacterial growth, which cause many health problems and establish which doses are effective in bacterial inhibition. [Materials and Methods] Five samples of S. aureus and five samples of P. aeruginosa were prepared in the microbiology lab, one used as control sample and the other 4 samples acted as experimental samples. The experimental samples received pulsed high intensity Nd: YAG laser with a total dose of 500, 600, 700 and 800 joules. The primary measures are colony count and the percentage decrease in colony count, the colony count was assessed at baseline and after 24 h of laser application. [Result] There was significant decrease in colony count and the percentage decrease in colony count after pulsed high intensity Nd: YAG laser application in all experimental samples of S. aureus and P. aeruginosa after 24 h of application for all doses (500, 600, 700 and 800 j) as compared with the control sample, with the most effect in higher doses of pulsed high intensity Nd: YAG laser than lower doses in both types of bacteria. [Conclusion] pulsed high intensity Nd: YAG laser was found to be an effective modality for inhibition of S. aureus and P. aeruginosa growth after a single application.

Efficacy of high intensity laser therapy in the management of foot ulcers: a systematic review.

[Purpose] The aim of this systematic review was to assess the efficacy of high intensity laser therapy (HILT) on wound surface area in patients with foot ulcers. [Methods] Four databases including PubMed, MEDLINE, the Cochrane library, and the Physiotherapy Evidence Database (PEDro) were searched up to the end of April 2018 to identify relevant studies. Studies were included if they met the following criteria: randomised controlled trial (RCT), assessed the efficacy of HILT in patients with foot ulcers, evaluated wound surface area, and written in English language with available full text. The PEDro scale was used to evaluate the quality of studies. [Results] A total of three RCTs met the inclusion criteria, with two studies of the efficacy of HILT in adult patients with diabetic foot ulcers and one in spina bifida children with neuropathic foot ulcers. According to the PEDro scale assessment, all three studies were rated as a fair quality. All studies found that HILT provided significantly better outcomes compared to sham laser or standard medical therapy. [Conclusion] This systematic review suggests that HILT is an effective modality for wound healing in patients with foot ulcers, but further large-scale studies are required to confirm its efficacy.

Effect of pulsed high intensity laser therapy on delayed caesarean section healing in diabetic women.

[Purpose] The objective of this study was to determine the effect of pulsed high intensity laser therapy on delayed caesarean section healing in diabetic women. [Subjects and Methods] This study was conducted on forty diabetic women with delayed caesarean wound healing, ranging in age from 28 to 38 years. They were randomly assigned into two groups; the group I (n=20) received pulsed high intensity laser therapy for 6-weeks, 3 times per week plus standard medical treatment for treatment of diabetes and caesarean wound patients, the group II (n=20) received sham laser treatment for 6 weeks, 3 times per week plus standard medical treatment for treatment of diabetes and caesarean wound patients. The wound size and appearance in all participants were measured by the tracing method and pressure sore status tool before and after the 6-week treatment. [Results] Pulsed high intensity laser therapy produced a significant difference in wound size and appearance in comparison to the sham laser treatment in diabetic women with delayed caesarean wound healing. [Conclusion] Pulsed high intensity laser therapy is effective in the treatment of delayed caesarean section healing in diabetic women.

Effect of vitamin D supplementation and isokinetic training on muscle strength, explosive strength, lean body mass and gait in severely burned children: A randomized controlled trial.

OBJECTIVE: To determine the effects of vitamin D (VD) supplementation and isokinetic training on muscle strength, explosive strength (counter movement jump) (ES), lean body mass (LBM) and gait parameters in severe pediatric burn. METHODS: Forty-eight burned children with circumferential lower extremity burns covering 40-55% of the total body surface area (TBSA), aged 10-16 years (Mean±SD 13.01±1.75), were randomized into the standard of care (n=16), isokinetic (n=17) and VD (n=15) groups. Unburned children (n=20) served as matched controls. All burned children received 12 weeks of routine physical therapy program (RPTP). In addition, the isokinetic group received isokinetic training for the quadriceps dominant limb 3 times per week at angular velocity 150°/s, and the VD group received the isokinetic training plus an oral daily dose of vitamin D3 1000 IU (Cholecalciferol). The primary measures, assessed at baseline and 12 weeks, included quadriceps strength by isokinetic dynamometer, ES, LBM by dual-energy X-ray absorptiometry (DEXA) and gait parameters by GAITRite system. RESULTS: The VD and isokinetic groups showed significant improvement in quadriceps strength, ES, LBM and gait parameters compared with the standard of care, and VD group show significant improvement in the VD level as compared with the other groups. The outcome measures (and percent of improvement where applicable) for the VD, isokinetic and standard of care are as follows: quadriceps strength, 85.25±0.93Nm (85%), 64.25±0.93 (36%) and 51.88±1.31Nm (12%); stride length, 94.00±2.69 (7%), 110.60±2.87 (25%) and 139.56±2.57 (60%); step length, 67.26±2.45 (72%), 55.25±2.49 (43%) and 43.76±1.34 (18%); velocity, 133.94±1.65 (82%), 99.94±1.65 (35%) and 80.11±1.91 (9%); and cadence, 140.63±1.36 (68%), 132.63±1.36 (58%) and 90.35±1.32 (9%), VD level 43.33±7.48 (75%), 24.77±7.38 (5%) and 25.63±8.39 (4%) respectively. CONCLUSIONS: VD supplementation combined with exercise training significantly increased muscle strength, ES, LBM, gait and VD level in severely burned children.

Long-term effects of pulsed high-intensity laser therapy in the treatment of post-burn pruritus: a double-blind, placebo-controlled, randomized study.

We assessed the long-term effects of pulsed high-intensity laser therapy (HILT) in post-burn pruritus treatment. A total of 49 adult burn patients with mean age of 31.53 ± 10.14 years participated, with 24 patients randomly assigned to the active laser group (ALG) and 25 in the placebo laser group (PLG). The ALG received HILT three times per week for 6 weeks, while the PLG received placebo HILT. Both groups received 10-mg cetirizine tablets twice daily and 10 mg at bedtime. All patients were advised to massage their burn scars with coconut oil for 5 min four times daily. The outcomes measured were the itch severity scale (ISS), impairment of pruritus-related quality of life (QoL), pain level by the visual analog scale (VAS), hand grip strength by handheld dynamometer, and daily cetirizine intake. Repeated-measures ANOVA was used to compare the baseline and post-treatment measurements and after 12 weeks of follow-up. Statistical significance was set at P < 0.05. ISS decreased significantly in the ALG after 6 weeks of treatment and after 12 weeks of follow-up compared with the PLG. The QoL results showed a significant improvement in the ALG compared with the PLG, which continued after 12 weeks. VAS results significantly decrease, hand grip strength significantly improved, and cetirizine intake significantly decreased post-treatment in the ALG relative to the PLG. HILT combined with cetirizine seems more effective in patients with post-burn pruritus than a placebo laser procedure with cetirizine.

Lower-Limb Muscular Strength, Balance, and Mobility Levels in Adults Following Severe Thermal Burn Injuries.

Severe burn injuries are associated with hypermetabolic response and increased catabolism. These lead to a vast loss of muscle mass and reduced muscle strength and function. Therefore, the aim of this study is to determine the impact of severe burn injuries on lower-limb muscular strength, balance, and mobility level in adults. Forty burned adults with burned TBSA (burned TBSA) ≥40% participated in this study. The peak torque and total work of quadriceps and knee flexors were calculated at 150°/sec using Biodex isokinetic dynamometer. Balance and mobility were tested via the Biodex balance device and the high mobility assessment tool, respectively. Twenty-three matched nonburned healthy adults were evaluated and served as a control group. Severely burned adults exhibited significantly lower peak torque and total work in their quadriceps (27.50 and 22.58%, P < .05) and knee flexors (23.72, and 21.65%, P < .05) relative to the nonburned adults. Burned adults had a significant decrease in stability index and balance including the dynamic limits of stability (P < .05). The high mobility assessment tool scores were significantly lower (42 ± 7.64, P < .05) when compared with control subjects (51 ± 1.62). Patients who had severe burns (burned TBSA ≥ 40%) showed muscular weakness, limited balance, and mobility levels between 16 and 24 weeks after discharge from the hospital compared with matched nonburned control subjects. These results can guide therapists in creating rehabilitation programs that focus on the specific difficulties faced by burned patients.

Long-term effect of pulsed high-intensity laser therapy in the treatment of post-mastectomy pain syndrome: a double blind, placebo-control, randomized study.

We assess the long-term effect of pulsed high-intensity laser therapy (HILT) in the treatment of the post-mastectomy pain syndrome (PMPS). A total of 61 women participated in this study (30 in the laser group and 31 in the placebo laser group), with a mean age of 53.56 ± 1.11 years. Patients who were randomly assigned to the laser group received HILT three times per week for 4 weeks, plus a routine physical therapy program (RPTP). The placebo laser group received placebo HILT plus RPTP. The outcomes measured were pain level by visual analog scale (VAS), shoulder range of motion (ROM), and quality of life (QOL). Statistical analysis was performed by ANOVA with repeated measures to compare the differences between baseline and post-treatment measurements and after 12 weeks of follow-up for both groups. The level of statistical significance was set at P < 0.05. Shoulder ROM significantly increased in the laser group after 4 weeks of treatment and after 12 weeks of follow-up compared with the placebo group. VAS results showed a significant decrease post-treatment in the laser group relative to the placebo group, and QOL results showed a significant improvement in the laser group compared with the placebo group and still improved after 12 weeks of follow-up. HILT combined with an RPTP appears to be more effective in patients with PMPS than a placebo laser procedure with RPTP.

Effect of isokinetic training on muscle strength, size and gait after healed pediatric burn: a randomized controlled study.

OBJECTIVE: The aim of this study was to investigate the effects of isokinetic training program on muscle strength, muscle size and gait parameters after healed pediatric burn. DESIGN: Randomized controlled trial. SUBJECTS: Thirty three pediatric burned patients with circumferential lower extremity burn with total body surface area (TBSA) ranging from 36 to 45%, and ages from 10 to 15 years participated in the study and were randomized into isokinetic group and a control group. Non-burned healthy pediatric subjects were assessed similarly to burned subjects and served as matched healthy controls. METHODS: Patients in the isokinetic group (n=16) participated in the isokinetic training program for 12 weeks for quadriceps dominant limb, 3 times per week, at angular velocity 150°/s, concentric mode of contraction, time rest between each set for 3 min, 3 sets/day and control group (n=17) participated in home based physical therapy exercise program without isokinetic. MAIN MEASURES: Assessment of quadriceps strength by isokinetic dynamometer, quadriceps size and gait parameters were performed at baseline and at the end of the training period for both groups. RESULTS: Patients in isokinetic group showed a significant improvement in quadriceps strength, quadriceps size and gait parameters as compared with those in the control group. Quadriceps strength and percentage of improvement was 79.25 ± 0.93 Nm (68.40%) for isokinetic group and 51.88 ± 1.31 Nm (9.84%) for the control group. Quadriceps size and percentage of improvement was 31.50 ± 0.89 cm (7.47%) for isokinetic group and 29.26 ± 1.02 cm (1.02%) for the control group. Stride length, step length, velocity and cadence and percentage of improvement for isokinetic group was 135.50 ± 2.82 (53.97%), 63.25 ± 2.97 (63.77%), 135.94 ± 1.65 (81.42%), 137.63 ± 1.36 (66.96%) and for the control group was 94.00 ± 2.69 (6.68%), 43.76 ± 1.34 (15.15%), 81.11 ± 1.91 (8.6%), 90.35 ± 1.32 (9.01%) respectively. CONCLUSIONS: Participation in the isokinetic training program resulted in a greater improvement in quadriceps muscle strength, size and gait parameters in pediatric burn.

Effect of pulsed Nd:YAG laser in the treatment of neuropathic foot ulcers in children with spina bifida: a randomized controlled study.

OBJECTIVE: This study assessed the effects of pulsed Nd:YAG laser treatment of neuropathic foot ulcers in children with spina bifida. BACKGROUND DATA: Children with spina bifida face increased risk for developing neuropathic foot ulcers. METHODS: In a randomized controlled trial, 39 children and adolescents (ages 6-15 years) with spina bifida and stage III neuropathic foot ulcers were randomly assigned to the laser group or the placebo laser group. The former received pulsed Nd:YAG laser treatments (i.e., total energy of 300-350 J during three sessions/week) plus standard wound care, and the latter received sham laser treatments plus standard wound care. Wound size and wound appearance were assessed for all patients at the beginning of the treatment, after 5 weeks, and after 10 weeks. RESULTS: The decrease in wound surface area at 5 and 10 weeks post- treatment was significantly greater in the laser group (i.e., 2.44 ± 0.33 and 0.29 ± 0.25 cm(2), respectively) than in the placebo group (i.e., 3.81 ± 0.18 and 3.24 ± 0.44 cm(2), respectively). Also, the decrease in the total score for the Pressure Sore Status Tool (PSST) at 5 and 10 weeks post-treatment was significantly different for the laser group (i.e., 32.76 ± 2.30 and 17.52 ± 1.66, respectively) than for the placebo group (i.e., 46.50 ± 2.12 and 38.11 ± 3.17, respectively). CONCLUSIONS: Treatment with pulsed neodymium:yttrium aluminum garnet (Nd:YAG) laser combined with standard wound care decreases wound size and improves wound appearance for stage III neuropathic foot ulcers in children with spina bifida.

Effect of whole body vibration on leg muscle strength after healed burns: a randomized controlled trial.

OBJECTIVE: To investigate the effects of eight weeks whole body vibration training program on leg muscle strength (force-producing capacity) in adults after healed burns. DESIGN: Randomized controlled trial. SETTING: Faculty of Physical Therapy, Cairo University. SUBJECTS: Thirty-one burned patients participated in the study and were randomized into whole body vibration group and control group. Non-burned healthy adults were assessed similarly to burned subjects and served as matched healthy controls. METHODS: The whole body vibration group performed an eight weeks vibration program three times a week on a vibration platform; the control group received home based physical therapy program without vibration training. MAIN MEASURES: Assessment of knee extensors and ankle planter flexor strength by isokinetic dynamometer at 150°/s were performed at the beginning of the study and at the end of the training period for both groups. RESULTS: Subjects with burns more than 36% TBSA produced significantly less torque in the quadriceps and calf muscle than non-burned healthy subjects. Patients in whole body vibration group showed a significant improvement in knee extensor and ankle planter flexor strength as compared with those in the control group. Knee extensor strength and percent improvement was 233.40±5.74 (64.93±3.03 change score) and 38.54% for the vibration group and 190.07±3.99 (21.66±4.41 change score) and 12.86% for the control group, ankle plantar flexor strength and percent improvement was 156.27±5.95 (54.53±6.16 change score) and 53.70% for the vibration group and 116.13±3.24 (14.66±2.71 change score) and 14.52% for the control group. CONCLUSIONS: Participation in whole body vibration program resulted in a greater improvement in quadriceps and calf muscle strength in adults with healed thermal burn compared to base line values; a WBV program is an effective for strength gain in rehabilitation of burned patients.

Effect of 12-week isokinetic training on muscle strength in adult with healed thermal burn.

INTRODUCTION: Severe burns result in marked and prolonged skeletal muscle catabolism and weakness, which persist despite 'standard" rehabilitation programmes of occupational and physical therapy. Therefore, the objectives of this study were of twofold: to quantify the long-term effects of burns on leg muscle strength and to assess whether adults with thermal burn would benefit from the isokinetic training programme. MATERIALS AND METHODS: Burned adult patients, with 35-55% total body surface area (TBSA) burned, were assessed at 6 months after burn in respect to leg muscle strength at 150° s(-1), using isokinetic dynamometry. Non-burned adults were assessed similarly, and served as controls. The burned adults participated in the resistance training programme 3 times weekly. The isokinetic exercise programme was begun with 60% of the average peak torque. Intensity of isokinetic exercise was increased from one set to five sets during the first through fifth sessions and remained at six sets for the remaining 6th to 24th sessions. Finally, a dose of 10 sets was applied for the 25th to the 36th sessions. Each set consisted of five repetitions of concentric contraction in angular velocities of 150° s(-1) for knee extensors, and flexors. All exercise sessions were preceded by a 5-min warm-up period on the treadmill. RESULTS: Subjects with burns more than 35% of TBSA produced significantly less torque, work, and power in the quadriceps and hamstring than control subjects (20.5%, 15.2%, p<0.05). Three months after isokinetic programme, muscle strength further increased by 17.9%±10.1% compared to the baseline measurement for burned patients but continued to be below the concurrent age-matched, non-burned adult. CONCLUSION: We found that adults with severe burns, relative to non-burned adults, had significantly lower peak torque as well as total work performance using the extensors and flexors muscles of the thigh. Participation in isokinetic training resulted in a greater improvement in extensor and flexor muscle strength in adults with held thermal burn compared to base line values.

Effect of isokinetic training on quadriceps peak torgue in healthy subjects and patients with burn injury.

OBJECTIVE: To evaluate the improvement rate of quadriceps muscle peak torque in healthy subjects and patients with burn injuries after an isokinetic training programme. SUBJECTS: Thirty male volunteers, 15 healthy and 15 subjects with burn injury after complete healing, participated in the study. METHODS: Concentric and eccentric torque of quadriceps was measured for both groups using an isokinetic dynamometer before and after 6 weeks of isokinetic training. The tests were performed at angular velocities of 30°/s and 90°/s. RESULTS: There was a significant increase in the quadricep speak torque for both groups at both angular velocities after isokinetic training. During eccentric contraction at angular velocities of 30°/s and 90°/s the percentage improvement in the burned group was higher than in the healthy group(p = 0.003 and p = 0.0008, respectively). During concentric contraction at an angular velocity of 30°/s the percentage improvement in the burned group was higher than the healthy group (p = 0.020). However, during concentric contraction at an angular velocity of 90°/s there was no significant difference between the groups (p = 0.742). CONCLUSION: The isokinetic training programme was effective in increasing the concentric and eccentric peak torque of the quadriceps muscle for healthy subjects and patients with burn injuries.

Treatment of post-mastectomy lymphedema with laser therapy: double blind placebo control randomized study.

BACKGROUND: In post-mastectomy patients, lymphedema has the potential to become a permanent progressive condition and become extremely resistant to treatment. Thus, it can results in function impairment and decrease quality of life. The aim of this study was to evaluate the effect of low level laser therapy (LLLT) on limb volume, shoulder mobility, and hand grip strength. MATERIAL AND METHODS: Fifty women with breast cancer-related lymphedema were enrolled in a double-blind, placebo controlled trial. Patients were randomly assigned to active laser (n = 25) and placebo (n = 25) groups and received irradiation with Ga-As laser device that had wavelength of 904 nm, power of 5 mW, and spot size of 0.2 cm(2) over the axillary and arm areas, three times a week for 12 wk. The total energy applied at each point was 300 mjoules over seven points, giving a dosage of 1.5 joules/cm(2) in the active group. The placebo group received placebo therapy in which the laser had been disabled without affecting its apparent function. Limb circumference, shoulder mobility, and grip strength were measured before treatment and at 4, 8, and 12 wk. RESULTS: The two groups had similar parameters at baseline. The reduction of limb volume tended to decline in both groups. The trend being more significantly pronounced in active LLLT group than placebo at 8 and 12 wk, respectively (P < 0.05). Goniometric data for shoulder mobility and hand grip strength were statistically significance for LLLT group than for placebo. CONCLUSION: Laser treatment was found to be effective in reducing the limb volume, increase shoulder mobility, and hand grip strength in approximately 93% of patients with postmastectomy lymphedema.