Early photobiomodulation therapy on pain and range of motion following flexor tendon repair

Background: Postoperative rehabilitation of flexor tendons in the hand consists of a short period of immobilization until pain and swelling diminished, followed by progressive mobilization to maximize ROM of the affected fingers. Purpose: Different rehabilitation regimens are created depending on the time after repair and immobilization period and subsequent mobilization to solve the problem of tendon adhesion. Material and methods: Forty-four patients from both genders with age ranged between 20 to 50 years participated in this study. All patients with zone II and III flexor tendon injuries, suffered from pain and limitation of Range of Motion (ROM) following flexor tendon repair surgery. Patients were distributed into two equal groups. Each group underwent treatment over four weeks (three sessions per week). Group A treated by LLLT combined with a traditional physiotherapy program and medical treatment while Group B treated by Placebo LLLT combined with the traditional physiotherapy program and medical treatment. Visual analogue scale (VAS) used to assess incisional pain while goniometer was used to assess ROM of MCP Flexion, Extension, PIP Flexion and DIP Flexion. Measurements were done for both groups three times, the first before beginning of program, the second after two weeks of program and the last after four weeks of program. Results: There was significant difference of the mean values after two weeks of treatment and after four weeks of treatment between both groups on VAS, Metacarpophalangeal (MCP) flexion, MCP extension, Proximal Interphalangeal (PIP) flexion and Distal Interphalangeal (DIP) flexion. This significant difference in favor to Group A (Study Group) in compared to Group B (Control Group). Conclusions: Early photobiomodulation therapy (LLLT) can improve pain and range of motion following flexor tendon repair.