The efficacy of low-level laser therapy for shoulder tendinopathy: a systematic review and meta-analysis of randomized controlled trials
Haslerud S, Magnussen LH, Joensen J, Lopes-Martins RA, Bjordal JM
Physiotherapy research international : the journal for researchers and clinicians in physical therapy · 63 citas
Etiquetas de revisión
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Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 2014-12-02 · Physiother Res Int · vol. 20 · número 2 · págs. 108–125
- Editorial
- Wiley
- Citado
- 112 citas · más que el 63% de estudios similares · 0.9× el promedio de su campo
- Referencias
- 56 trabajos
- Acceso
- De pago
- Áreas de investigación
- Shoulder Injury and Treatment · Laser Applications in Dentistry and Medicine · Tendon Structure and Treatment
- Palabras clave
- Meta-analysis, Tendinopathy, Physical therapy, Medicine, Randomized controlled trial, Low level laser therapy, MEDLINE, Physical medicine and rehabilitation, Internal medicine, Laser therapy, Surgery, Tendon, Laser
- MeSH
- shoulder joint, humans, pain measurement, treatment outcome, tendinopathy, randomized controlled trials as topic, low-level light therapy
5 autores
- Sturla Haslerud🇳🇴 · autor de correspondenciaHøgskolen i Bergen; University of Bergen
- Liv Heide Magnussen🇳🇴Høgskolen i Bergen; University of Bergen
- Jón Joensen🇳🇴Høgskolen i Bergen; University of Bergen
- Rodrigo Álvaro Brandão Lopes‐Martins🇧🇷Universidade de Mogi das Cruzes
- Jan Magnus Bjordal🇳🇴Høgskolen i Bergen; University of Bergen
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background and purpose
Low-level laser therapy (LLLT) is proposed as a treatment for tendinopathies. This is the first systematic review focusing solely on LLLT treatment effects in shoulder tendinopathy.
Methods
A systematic review with meta-analysis and primary outcome measures pain relief on 100-mm visual analogue scale (VAS) and relative risk for global improvement. Two independent assessors rated the included studies according to the PEDro scale. Intervention quality assessments were performed of LLLT dosage and treatment procedures according to World Association for Laser Therapy guidelines. The included trials were sub-grouped by intervention quality and use of other physiotherapy interventions.
Results
Seventeen randomized controlled trials (RCTs) met the inclusion criteria, and 13 RCTs were of high and 4 RCTs of moderate methodological quality. Significant and clinically important pain relief was found with weighted mean differences (WMD) over placebo, for LLLT as monotherapy at 20.41 mm (95% CI: 12.38 to 28.44) and as adjunct to exercise therapy at 16.00 mm (95% CI: 11.88 to 20.12). The WMD when LLLT was used in a multimodal physiotherapy treatment regime reached statistical significance over placebo at 12.80 (95% CI: 1.67-23.94) mm pain reduction on VAS. Relative risks for global improvement were statistically significant at 1.96 (95% CI: 1.25-3.08) and 1.51 (95% CI: 1.12-2.03), for laser as monotherapy or adjunctive in a physiotherapy regime, respectively. Secondary outcome measures of shoulder function were only significantly in favour of LLLT when used as monotherapy. Trials performed with inadequate laser doses were ineffective across all outcome measures.
Conclusion
This review shows that optimal LLLT can offer clinically relevant pain relief and initiate a more rapid course of improvement, both alone and in combination with physiotherapy interventions. Our findings challenge the conclusions in previous multimodal shoulder reviews of physiotherapy and their lack of intervention quality assessments.
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