Low-level laser therapy in acute pain: a systematic review of possible mechanisms of action and clinical effects in randomized placebo-controlled trials
Bjordal JM, Johnson MI, Iversen V, Aimbire F, Lopes-Martins RA, Lopes-Martins RA
Photomedicine and laser surgery · 354 citas
Cómo se estudió
- Diseño
- Revisión sistemática (indexado por PubMed)
- Estudiado en
- Personas, más trabajo en animales o laboratorio
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- Norges Forskningsråd
Según 1 financiador declarado.
Publicación
- Publicado
- 2006-04-01 · Photomed Laser Surg · vol. 24 · número 2 · págs. 158–168
- Editorial
- Mary Ann Liebert, Inc.
- Citado
- 581 citas · más que el 99% de estudios similares · 9.6× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 77 trabajos
- Acceso
- De pago
- Áreas de investigación
- Laser Applications in Dentistry and Medicine · Biofield Effects and Biophysics · Pain Management and Treatment
- Palabras clave
- low-level laser therapy, acute pain, soft tissue injury, inflammatory pain, mechanism of action, dose-response relationship, edema, oxidative stress, prostaglandin E2, cyclooxygenase-2, neutrophil infiltration
- MeSH
- animals, humans, soft tissue injuries, phototherapy, randomized controlled trials as topic, pain management
5 autores
- Jan Magnus Bjordal🇳🇴Høgskolen i Bergen; University of Bergen
- Mark I. Johnson🇬🇧Leeds Beckett University
- Vegard Vereide Iversen🇳🇴University of Bergen
- Flávio Aimbire🇧🇷Universidade do Vale do Paraíba
- Rodrigo Álvaro Brandão Lopes‐Martins🇧🇷Universidade de São Paulo
Resumen
El texto original del estudio, en el idioma en que se publicó.
Objective
The aim of this study was to review the biological and clinical short-term effects of photoradiation in acute pain from soft-tissue injury.
Background data
It is unclear if and how photoradiation can reduce acute pain.
Methods
Literature search of (i) controlled laboratory trials investigating potential biological mechanisms for pain relief and (ii) randomized placebo-controlled clinical trials which measure outcomes within the first 7 days after acute soft-tissue injury.
Results
There is strong evidence from 19 out of 22 controlled laboratory studies that photoradiation can modulate inflammatory pain by reducing levels of biochemical markers (PGE(2), mRNA Cox 2, IL-1beta, TNFalpha), neutrophil cell influx, oxidative stress, and formation of edema and hemorrhage in a dose-dependent manner (median dose 7.5 J/cm(2), range 0.3-19 J/cm(2)). Four comparisons with non-steroidal anti-inflammatory drugs (NSAIDs) in animal studies found optimal doses of photoradiation and NSAIDs to be equally effective. Seven randomized placebo-controlled trials found no significant results after irradiating only a single point on the skin overlying the site of injury, or after using a total energy dose below 5 Joules. Nine randomized placebo-controlled trials (n = 609) were of acceptable methodological quality, and irradiated three or more points and/or more than 2.5 cm(2) at site of injury or surgical incision, with a total energy of 5.0-19.5 Joules. Results in these nine trials were significantly in favor of photoradiation groups over placebo groups in 15 out of 18 outcome comparisons. Poor and heterogeneous data presentation hampered statistical pooling of continuous data. Categorical data of subjective improvement were homogeneous (Q-value = 7.1) and could be calculated from four trials (n = 379) giving a significant relative risk for improvement of 2.7 (95% confidence interval [CI], 1.8-3.9) in a fixed effects model.
Conclusion
photoradiation can modulate inflammatory processes in a dose-dependent manner and can be titrated to significantly reduce acute inflammatory pain in clinical settings. Further clinical trials with adequate photoradiation doses are needed to precisely estimate the effect size for photoradiation in acute pain.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.
Confianza de la comunidad
Cargando…
¿Cuánto confías en los hallazgos de este estudio?
Comentarios
¿Algo está mal aquí?
Señala este estudio si su información, etiquetas o financiación parecen incorrectas. Un editor revisa cada señalamiento.
Información educativa sobre investigación publicada. No es consejo médico ni una recomendación para empezar o dejar nada.