Efficacy of low-level laser therapy on pain and disability in knee osteoarthritis: systematic review and meta-analysis of randomised placebo-controlled trials
Stausholm MB, Naterstad IF, Joensen J, Lopes-Martins RÁB, Sæbø H, Lund H, Fersum KV, Bjordal JM
BMJ open · 114 citas
Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación independiente
- Universidad u hospital
- Universitetet i Bergen
Según 1 financiador declarado.
Publicación
- Publicado
- 2019-10-01 · BMJ Open · vol. 9 · número 10 · pág. e031142
- Editorial
- BMJ
- Citado
- 161 citas · más que el 94% de estudios similares · 3.1× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 62 trabajos
- Acceso
- Acceso abierto (revista) · CC-BY-NC
- Áreas de investigación
- Laser Applications in Dentistry and Medicine · Temporomandibular Joint Disorders · Medical and Biological Ozone Research
- Palabras clave
- Medicine, Placebo, Meta-analysis, Physical therapy, Osteoarthritis, Visual analogue scale, Low level laser therapy, Randomized controlled trial, Clinical trial, Relative risk, MEDLINE, Subgroup analysis, Publication bias, Knee pain, Rheumatology, Internal medicine, Alternative medicine, Laser therapy, Confidence interval, Pathology
- MeSH
- humans, arthralgia, osteoarthritis, knee, treatment outcome, randomized controlled trials as topic, low-level light therapy
8 autores
- Martin Bjørn Stausholm🇳🇴 · autor de correspondenciaUniversity of Bergen
- Ingvill Fjell Naterstad🇳🇴University of Bergen
- Jón Joensen🇳🇴University of Bergen
- Rodrigo Álvaro Brandão Lopes‐Martins🇧🇷Universidade do Vale do Paraíba; Instituto de Desenvolvimento Sustentável Mamirauá
- Humaira Sæbø🇳🇴University of Bergen
- Hans Lund🇳🇴🇧🇪Western Norway University of Applied Sciences; Rode Kruis-Vlaanderen
- Kjartan Vibe Fersum🇳🇴University of Bergen
- Jan Magnus Bjordal🇳🇴University of Bergen
Resumen
El texto original del estudio, en el idioma en que se publicó.
Objectives
Low-level laser therapy (LLLT) is not recommended in major knee osteoarthritis (KOA) treatment guidelines. We investigated whether a LLLT dose-response relationship exists in KOA.
Design
Systematic review and meta-analysis.
Data sources
Eligible articles were identified through PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database and Cochrane Central Register of Controlled Trials on 18 February 2019, reference lists, a book, citations and experts in the field.
Eligibility criteria for selecting studies
We solely included randomised placebo-controlled trials involving participants with KOA according to the American College of Rheumatology and/or Kellgren/Lawrence criteria, in which LLLT was applied to participants' knee(s). There were no language restrictions.
Data extraction and synthesis
The included trials were synthesised with random effects meta-analyses and subgrouped by dose using the World Association for Laser Therapy treatment recommendations. Cochrane's risk-of-bias tool was used.
Results
22 trials (n=1063) were meta-analysed. Risk of bias was insignificant. Overall, pain was significantly reduced by LLLT compared with placebo at the end of therapy (14.23 mm Visual Analogue Scale (VAS; 95% CI 7.31 to 21.14)) and during follow-ups 1-12 weeks later (15.92 mm VAS (95% CI 6.47 to 25.37)). The subgroup analysis revealed that pain was significantly reduced by the recommended LLLT doses compared with placebo at the end of therapy (18.71 mm (95% CI 9.42 to 27.99)) and during follow-ups 2-12 weeks after the end of therapy (23.23 mm VAS (95% CI 10.60 to 35.86)). The pain reduction from the recommended LLLT doses peaked during follow-ups 2-4 weeks after the end of therapy (31.87 mm VAS significantly beyond placebo (95% CI 18.18 to 45.56)). Disability was also statistically significantly reduced by LLLT. No adverse events were reported.
Conclusion
LLLT reduces pain and disability in KOA at 4-8 J with 785-860 nm wavelength and at 1-3 J with 904 nm wavelength per treatment spot.
Prospero registration number
CRD42016035587.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial (CC BY-NC).
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