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Zhang Y, Ji Q. Current advances of photobiomodulation therapy in treating knee osteoarthritis. Front Cell Dev Biol 2023; 11:1286025. [PMID: 38033853 PMCID: PMC10687633 DOI: 10.3389/fcell.2023.1286025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 11/07/2023] [Indexed: 12/02/2023] Open
Abstract
Knee osteoarthritis (KOA) is manifested by low-grade joint inflammation, irreversible cartilage degeneration, subchondral bone remodeling and osteophyte formation. It is one of the most prevalent degenerative diseases in the elderly. KOA usually results in chronic joint pain, physical impairment even disability bringing a huge socioeconomic burden. Unfortunately, there is so far no effective interventions to delay the progression and development of KOA. There is a pressing need for explorations and developments of new effective interventions. Photobiomodulation therapy (PBMT), also known as low-level light therapy (LLLT), has attracted widespread attention in treating KOA because it is drug-free, non-invasive, safe and useful with rarely reported side effects. It provides the biological stimulatory effects primarily by enhancing the activity of mitochondrial cytochrome c oxidase. This stimulation, in turn, fosters cell proliferation and tissue regeneration. In addition to this, the paper provides a concise overview of the light parameters and the effectiveness of PBMT when applied in the treatment of KOA patients in clinical settings. It also delves into the experimental evidence supporting the modulatory effects of PBMT and its potential underlying mechanisms in addressing synovitis, cartilage degeneration, and pain resolution.
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Affiliation(s)
| | - Quanbo Ji
- Department of Orthopedics, The General Hospital of Chinese PLA, Beijing, China
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Chen FR, Manzi JE, Mehta N, Gulati A, Jones M. A Review of Laser Therapy and Low-Intensity Ultrasound for Chronic Pain States. Curr Pain Headache Rep 2022; 26:57-63. [PMID: 35133560 DOI: 10.1007/s11916-022-01003-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE OF REVIEW Chronic pain management therapies have expanded quickly over the past decade. In particular, the use of laser therapy and ultrasound in the management of chronic pain has risen in recent years. Understanding the uses of these types of therapies can better equip chronic pain specialists for managing complicated chronic pain syndromes. The purpose of this review was to summarize the current literature regarding laser radiation and ultrasound therapy used for managing chronic pain syndromes. RECENT FINDINGS In summary, there is stronger evidence supporting the usage of laser therapy for managing chronic pain states compared to low-intensity ultrasound therapies. As a monotherapy, laser therapy has proven to be beneficial in managing chronic pain in patients with a variety of pain syndromes. On the other hand, LIUS has less clear benefits as a monotherapy with an uncertain, optimal delivery method established. Both laser therapy and low-intensity ultrasound have proven beneficial in managing various pain syndromes and can be effective interventions, in particular, when utilized in combination therapy.
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Affiliation(s)
- Frank R Chen
- Department of Anesthesiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Joseph E Manzi
- Department of Interventional Pain Medicine, New-York Presbyterian Hospital, Weill Cornell Medical Center, 1300 York Ave, New York, NY, 10065, USA
| | - Neel Mehta
- Department of Interventional Pain Medicine, New-York Presbyterian Hospital, Weill Cornell Medical Center, 1300 York Ave, New York, NY, 10065, USA
| | - Amitabh Gulati
- Department of Chronic Pain Management, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Mark Jones
- Department of Interventional Pain Medicine, New-York Presbyterian Hospital, Weill Cornell Medical Center, 1300 York Ave, New York, NY, 10065, USA. .,Pain Medicine of the South, Knoxville, TN, 37934, USA.
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Fakhari S, Pishghahi A, Pourfathi H, Farzin H, Bilehjani E. A Comparison Between Low-Level Laser Therapy and Intra-articular Ozone Injection in Knee Osteoarthritis Treatment: A Randomized Clinical Trial. J Lasers Med Sci 2021; 12:e44. [PMID: 34733767 DOI: 10.34172/jlms.2021.44] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 02/02/2021] [Indexed: 01/05/2023]
Abstract
Introduction: Knee osteoarthritis (KOA) is a common degenerative joint disease, causing deformity, pain and a limited joint range of motion. Modification of the lifestyle and an exercise training program are the cornerstone of treatment. Alternative therapies such as laser or ozone are commonly used, but there is not any comparative study of low-level laser therapy (LLLT) versus ozone therapy. The aim of the study was to compare the efficacy and safety of the LLLT versus ozone in patients with KOA. Methods: In this single-blinded randomized clinical trial, 60 patients with KOA were assigned to LLLT or ozone groups (n=30). The First basic pain severity, the Western Ontario and McMaster Universities Arthritis Index (WOMAC) score and physical function were determined. Then in the LLLT group, the patients were provided with 12 sessions of LLLT. In the ozone group, 6 sessions of intra-articular injection of ozone were organized (in each session a mixture of 10 mL of bupivacaine 0.25% with 15 mL of ozone 30 μg/mL). In the middle and at the end of the intervention period, we reassessed the joint pain and physical function and the degree of improvement compared between the two groups. Results: In the middle and at the end of the treatment period in both groups, the joint pain decreased significantly. The same as pain, the self-administrated WOMAC score and the range of joint motion improved significantly in both groups. All of these variables exposed more improvement in the ozone group patients. Conclusion: The study showed that both LLLT and ozone are acceptable non-invasive methods in the non-surgical treatment of KOA. Compared to LLLT, the ozone was more effective. These methods must be considered in any patient who is not suitable for surgical interventions or does not experience enough improvement in symptoms following long periods of common exercise training programs.
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Affiliation(s)
- Solmaz Fakhari
- Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran; Anesthesiology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Pishghahi
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hojjat Pourfathi
- Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran; Anesthesiology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Haleh Farzin
- Pain and Palliative Center, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Eissa Bilehjani
- Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran; Anesthesiology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Vassão PG, de Souza ACF, da Silveira Campos RM, Garcia LA, Tucci HT, Renno ACM. Effects of photobiomodulation and a physical exercise program on the expression of inflammatory and cartilage degradation biomarkers and functional capacity in women with knee osteoarthritis: a randomized blinded study. Adv Rheumatol 2021; 61:62. [PMID: 34656170 DOI: 10.1186/s42358-021-00220-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 10/05/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The knee osteoarthritis (OA) is a joint disease characterized by degradation of articular cartilage that leads to chronic inflammation. Exercise programs and photobiomodulation (PBM) are capable of modulating the inflammatory process of minimizing functional disability related to knee OA. However, their association on the concentration of biomarkers related to OA development has not been studied yet. The aim of the present study is to investigate the effects of PBM (via cluster) with a physical exercise program in functional capacity, serum inflammatory and cartilage degradation biomarkers in patients with knee OA. METHODS Forty-two patients were randomly allocated in 3 groups: ESP: exercise + sham PBM; EAP: exercise + PBM and CG: control group. Six patients were excluded before finished the experimental period. The analyzed outcomes in baseline and 8-week were: the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) and the evaluation of serum biomarkers concentration (IL-1β, IL-6, IL-8, IL-10 e TNF-α, and CTX-II). RESULTS An increase in the functional capacity was observed in the WOMAC total score for both treated groups (p < 0.001) and ESP presents a lower value compared to CG (p < 0.05) the 8-week post-treatment. In addition, there was a significant increase in IL-10 concentration of EAP (p < 0.05) and higher value compared to CG (p < 0.001) the 8-week post-treatment. Moreover, an increase in IL-1β concentration was observed for CG (p < 0.05). No other difference was observed comparing the other groups. CONCLUSION Our data suggest that the physical exercise therapy could be a strategy for increasing functional capacity and in association with PBM for increasing IL-10 levels in OA knee individuals. TRIAL REGISTRATION ReBEC (RBR-7t6nzr).
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Affiliation(s)
- Patricia Gabrielli Vassão
- Department of Biosciences, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136, Santos, SP, 11015-020, Brazil.
| | - Ana Carolina Flygare de Souza
- Department of Human Movement Science, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136, Santos, SP, 11015-020, Brazil
| | - Raquel Munhoz da Silveira Campos
- Department of Biosciences, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136, Santos, SP, 11015-020, Brazil.,Post Graduate Program of Interdisciplinary Health Sciences, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136, Santos, SP, 11015-020, Brazil
| | - Livia Assis Garcia
- Scientific Institute and Technological Department -University Brazil, São Paulo-Itaquera, SP, Brazil
| | - Helga Tatiana Tucci
- Department of Human Movement Science, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136, Santos, SP, 11015-020, Brazil
| | - Ana Claudia Muniz Renno
- Department of Biosciences, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136, Santos, SP, 11015-020, Brazil
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Nambi G. Does low level laser therapy has effects on inflammatory biomarkers IL-1β, IL-6, TNF-α, and MMP-13 in osteoarthritis of rat models-a systemic review and meta-analysis. Lasers Med Sci 2021; 36:475-484. [PMID: 32833088 DOI: 10.1007/s10103-020-03124-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 08/10/2020] [Indexed: 10/23/2022]
Abstract
Osteoarthritis (OA) is a chronic degenerative joint disease and is considered as the most common cause of pain and disability. To the best of our knowledge, it is generally observed that there is a lack of evidence on the effects of low-level laser therapy (LLLT) on inflammatory cytokines in OA. The present review aims to appraise the current evidence of efffects of LLLT on inflammatory cytokines in OA of the knee. Medical databases such as Medline, PubMed, EMBASE, PEDro CINAHL, Web of Science, Cochrane register, and Google reference were searched from its inception to June 2019. Articles that meet the inclusion criteria: subjects (animals-Wistar rats) induced with OA; rats with age group of 50-90 days; weight of 150-300 g; finding the effects of LLLT; reporting inflammatory cytokines; and articles written in English were included. The reviewers assessed the methodological quality of the primary studies. Data of inflammatory cytokines IL-1β, IL-6, TNF-α, and MMP-13 were extracted for analysis. The Q (x2) test and I2 statistics analysis were performed to find the heterogeneity evaluation. Standard mean difference (SMD) and its 95% confidence interval (CI) were used to synthesize the data. Two hundred eleven potential articles were identified and 186 articles were excluded based on the selection criteria. The rest of the 25 articles were read and 8 articles were selected for further study. From the study, it is observed that the laser therapy group had mild to moderate improvement than control group in IL-1β, TNF-α, and MMP-13 (IL-1β; SMD 1.21 [95% CI - 0.278, 2.704], TNF-α; SMD 5.19 [95% CI 2.413, 7.961], and MMP-13 SMD - 1.45 [95% CI - 5.121, 2.211]), while IL-6 [SMD 3.11 (95% CI 0.662, 5.549] did not show any considerable improvement after laser therapy. The present review provides the evidence of LLLT-dependent reduction of IL-1β, TNF-α, and MMP-13, and its ability to modulate proliferation of inflammatory cells, which makes LLLT a suitable treatment for OA. Though the included studies showed a high heterogeneity in treatment parameter, the beneficial effect of LLLT on changes in inflammatory cytokines, such as IL-6, seems to be unaffected.
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Affiliation(s)
- Gopal Nambi
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdul Aziz University, Alkharj, Saudi Arabia.
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Association of photobiomodulation therapy (PBMT) and exercises programs in pain and functional capacity of patients with knee osteoarthritis (KOA): a systematic review of randomized trials. Lasers Med Sci 2021; 36:1341-1353. [PMID: 33392780 DOI: 10.1007/s10103-020-03223-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 12/10/2020] [Indexed: 10/22/2022]
Abstract
Knee osteoarthritis (KOA) is a common degenerative disease in which several treatments and treatment associations have been investigated. This review analyzed the efficacy of the association of photobiomodulation therapy (PBMT) and exercises for people with KOA in randomized controlled clinical trials. PubMed, Scopus, and EMBASE databases were searched using the following terms: "knee osteoarthritis," "laser," "low-level laser," "photobiomodulation," "phototherapy," and "exercise." Seven RCT studies involving humans that examined PBMT treatment in association with were found. Most studies used mainly near-infrared PBMT irradiation, with a fluence ranging from 610 mJ/cm2 to 200 J/cm2, 23.55 J to 2400 J total energy per knee, and number of treatment sessions from 10 to 24. In addition, all the protocols included exercises to increase lower limb muscle strength that were performed alone or in association with other types of exercises. However, only 2 studies, considered as a high quality, showed the additional effect of PBMT (lower doses) on an exercise program (involving warming-up, motor learning, balance coordination and strengthening exercises, and stretching) for improvement of pain and functional capacity in people with KOA. This review demonstrates that there is a controversy on the effects PBMT associated with exercises for pain and functional capacity improvement for people with KOA, because there is a heterogeneity between studies in related to PBMT parameters, as dose, number of therapy sessions and the type of PBMT (either LLLT and HILT), and the exercise protocols proposed.
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Guidelines versus evidence: what we can learn from the Australian guideline for low-level laser therapy in knee osteoarthritis? A narrative review. Lasers Med Sci 2020; 36:249-258. [PMID: 32770424 PMCID: PMC7881962 DOI: 10.1007/s10103-020-03112-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 07/27/2020] [Indexed: 01/13/2023]
Abstract
This narrative review analyses the Australian Guideline (2018) for the treatment of knee osteoarthritis (KOA) developed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. The Guideline recommended against the use low-level laser therapy (LLLT). Why this conclusion was reached is discussed in this review in the context of evidence provided in other systematic reviews, the latest of which was published in 2019 and which provided strong support for LLLT for knee OA. We evaluated the reference list cited for the recommendation “against” LLLT and compared this with reference lists of systematic reviews and studies published before and after the publication date of the Guideline. Eight randomised controlled trials (RCTs) of LLLT were cited in the Guideline the latest of which was published in 2012. There were seventeen additional RCTs, five of which together with one systematic review were located in the year of publication, 2018. The most recent systematic review in 2019 included 22 RCTs in its analysis. Discordance with the levels of evidence and recommendations was identified. Although GRADE methodology is said to be robust for systematically evaluating evidence and developing recommendations, many studies were not identified in the Guideline. In contrast, the latest systematic review and meta-analysis provides robust evidence for supporting the use of LLLT in knee OA. The conflict between guidelines based on opinion and evidence based on meta-analysis is highlighted. Given the totality of the evidence, we recommend that the Australian Guideline should be updated immediately to reflect a “for” recommendation.
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S Jorge AE, O Dantas L, M S Serrão PR, Alburquerque-Sendín F, Salvini TF. Photobiomodulation therapy associated with supervised therapeutic exercises for people with knee osteoarthritis: a randomised controlled trial protocol. BMJ Open 2020; 10:e035711. [PMID: 32482669 PMCID: PMC7264996 DOI: 10.1136/bmjopen-2019-035711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Physical exercise, a cornerstone of the conservative management of knee osteoarthritis (KOA), is exhaustively recommended by important clinical guidelines. A strength therapeutic exercise program (STEP) relieves pain, improves physical function and ultimately ameliorates quality of life (QoL). Furthermore, photobiomodulation (PBM) has been used as an adjunct treatment for people with KOA; however, there are still controversial recommendations regarding its use on this population. Thus, we hypothesised that PBM, when associated with a STEP protocol on patients with KOA, could induce better clinical outcomes than a STEP protocol alone. METHODS AND ANALYSIS The study is a 6-month triple-blind placebo-controlled randomised clinical trial with intention-to-treat analysis. The trial will include 120 people with clinic and radiographic signs of KOA. The intervention consists of a supervised STEP and PBM protocols conducted over an 8-week intervention period. Assessments are performed at baseline, right after treatment, and 3-month and 6-month follow-up periods. The primary clinical outcome is pain intensity according to a 10 cm Visual Analogue Scale. Secondary outcomes are the global Western Ontario & McMaster Universities Osteoarthritis Index; QoL assessed by the 36-item Short-Form health survey questionnaire; and performance-based physical parameters assessed by the 30 s chair stand test; the stair climb test; and the 40 m fast-paced walk test. ETHICS AND DISSEMINATION The trial was approved by the Human Research Ethics Committee of the Federal University of São Carlos, São Paulo, Brazil (REC no 2.016.122). Results will be published in peer-reviewed journals. TRIAL REGISTRATION NUMBER Brazilian Clinical Trials Registry (U1111-1215-6510).
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Affiliation(s)
- Ana E S Jorge
- Department of Physiotherapy, Federal University of Sao Carlos, São Carlos, São Paulo, Brazil
| | - Lucas O Dantas
- Department of Physiotherapy, Federal University of Sao Carlos, São Carlos, São Paulo, Brazil
| | - Paula R M S Serrão
- Department of Physiotherapy, Federal University of Sao Carlos, São Carlos, São Paulo, Brazil
| | - Francisco Alburquerque-Sendín
- Department of Sociosanitary Sciences, Radiology and Physical Medicine, Universidad de Córdoba, Instituto Maiomónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Andalucía, Spain
| | - Tania F Salvini
- Department of Physiotherapy, Federal University of Sao Carlos, São Carlos, São Paulo, Brazil
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Stausholm MB, Naterstad IF, Joensen J, Lopes-Martins RÁB, Sæbø H, Lund H, Fersum KV, Bjordal JM. Efficacy of low-level laser therapy on pain and disability in knee osteoarthritis: systematic review and meta-analysis of randomised placebo-controlled trials. BMJ Open 2019; 9:e031142. [PMID: 31662383 PMCID: PMC6830679 DOI: 10.1136/bmjopen-2019-031142] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
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.
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Affiliation(s)
- Martin Bjørn Stausholm
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | | | - Jon Joensen
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | | | - Humaira Sæbø
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Hans Lund
- Centre for Evidence-Based Practice, Hogskulen pa Vestlandet, Bergen, Norway
| | - Kjartan Vibe Fersum
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Jan Magnus Bjordal
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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Vassão PG, de Souza MC, Silva BA, Junqueira RG, de Camargo MR, Dourado VZ, Tucci HT, Renno AC. Photobiomodulation via a cluster device associated with a physical exercise program in the level of pain and muscle strength in middle-aged and older women with knee osteoarthritis: a randomized placebo-controlled trial. Lasers Med Sci 2019; 35:139-148. [PMID: 31144070 DOI: 10.1007/s10103-019-02807-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 05/10/2019] [Indexed: 12/28/2022]
Abstract
Osteoarthritis (OA) is a chronic joint disease that leads to pain and functional incapacity. The aim of the study is to investigate the effects of the incorporation of photobiomodulation (PBM) (via cluster) into a physical exercise program on the level of pain, lower limb muscle strength, and physical capacity, in patients with knee OA. Sixty-two female volunteers with a diagnosis of knee OA were distributed in 4 groups: exercise associated with placebo PBM group, exercise associated with active PBM group, active PBM group, and placebo PBM group. Sixteen sessions of lower limb strength exercises and PBM via cluster (808 nm, 100 mW, 7 points each side, 56 J total) were performed. The level of pain, physical capacity, and lower limb muscle strength were evaluated with the use of the numeric pain rating scale (NPRS), 6-min walking test (6-MWT) and timed up and go (TUG), and maximal voluntary isometric torque (MVIT) before and after the interventions. Both groups presented a significant decrease in the level of pain when compared with the placebo-treated women. Furthermore, the 6-MWT showed that the trained groups (with or without PBM) demonstrated higher values in the distance walked comparing pre and post-treatment values. The same behavior was found for the MVIT load before and after intervention. TUG was higher for all the treated with exercise groups comparing the pre and post-treatment values. Physical exercise and PBM showed analgesic effects. However, PBM did not have any extra effect along with the effects of exercise in improving the distance walked, the TUG, and the muscle strength.Trial registration: RBR-7t6nzr.
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Affiliation(s)
- Patricia Gabrielli Vassão
- Department of Biosciences, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136, Santos, SP, 11015-020, Brazil.
| | - Mayra Cavenague de Souza
- Department of Biosciences, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136, Santos, SP, 11015-020, Brazil
| | - Bruna Arcaim Silva
- Department of Biosciences, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136, Santos, SP, 11015-020, Brazil
| | - Rheguel Grillo Junqueira
- Department of Biosciences, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136, Santos, SP, 11015-020, Brazil
| | - Marcela Regina de Camargo
- Department of Biosciences, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136, Santos, SP, 11015-020, Brazil
| | - Victor Zuniga Dourado
- Department of Human Movement Science, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136, Santos, SP, 11015-020, Brazil
| | - Helga Tatiana Tucci
- Department of Human Movement Science, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136, Santos, SP, 11015-020, Brazil
| | - Ana Claudia Renno
- Department of Biosciences, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136, Santos, SP, 11015-020, Brazil
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Ezzati K, Fekrazad R, Raoufi Z. The Effects of Photobiomodulation Therapy on Post-Surgical Pain. J Lasers Med Sci 2019; 10:79-85. [PMID: 31360374 PMCID: PMC6499566 DOI: 10.15171/jlms.2019.13] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Introduction: One of the major complains after surgery is pain. Recent advances in the prevention and reduction of postoperative pain have provided several modalities. One of them is the use of laser irradiation on the surgical area. Objectives: To evaluate the effects of low level laser therapy (LLLT) on pain and side effects after surgery. Methods: In this research, databases such as: PubMed, Science Direct, Google Scholar, Springer and Cochrane were used and the words of laser therapy, photobiomodulation, therapeutic laser, low level laser therapy, surgery and pain were searched. Articles, including systematic reviews, original articles, case series, and clinical intervention studies related to these words, were studied. The language of all articles was English and consists of papers from 2009 until 2017. Results: A total of 370 papers were studied and 10 articles that met inclusion criteria were selected for this review. Few of these articles were followed up. Surgery included a wide range of surgeries including mastectomy, breast augment post-fracture, episiotomy, tonsillectomy and hernia. The methodological quality score on the PEDro scale was between 5 and 11. 8 trials reported positive effects and 2 trials reported negative effects. In order to study clinical effect size of laser therapy after surgery, only 4 papers met entry criteria and the mean effect sizes were 0.13 to 2.77. Accordingly, the best treatment protocol included a red laser dose of 4 J/cm2 for the post-operative pain of tonsillectomy, which was irradiated through the infra mandibular angle on the tonsils. Conclusion: LLLT may be an appropriate modality for reducing pain after surgery, nevertheless the effect size of this modality is variable. Therefore, further research based on proper protocols for these patients and follow-up of therapeutic course should be designed and implemented.
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Affiliation(s)
- Kamran Ezzati
- Neuroscience Research Center, Poorsina Hospital, Faculty of medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Reza Fekrazad
- Department of Periodontology, Dental Faculty - Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran, Iran
- International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran
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Kholvadia A, Constantinou D, Gradidge PJL. Exploring the efficacy of low-level laser therapy and exercise for knee osteoarthritis. SOUTH AFRICAN JOURNAL OF SPORTS MEDICINE 2019; 31:v31i1a6058. [PMID: 36817986 PMCID: PMC9924591 DOI: 10.17159/2078-516x/2019/v31i1a6058] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background Knee Osteoarthritis (KOA) is a prevalent, chronic disorder with excessive functional, social and economic burdens. The goal of treatment is to alleviate the symptoms and slow the progression. Documenting the effects of exercise and LLLT as co-modalities in the management of KOA allows practitioners to implement this management tool as part of KOA rehabilitation, resulting in the earlier discharge from a supervised rehabilitation setting. Objective The purpose of this study was to determine the effect of low-level laser therapy (LLLT) in the treatment of knee osteoarthritis (KOA). A randomised controlled trial (RCT) was conducted on 111 participants (aged between 40-75 years) diagnosed with KOA. Participants were randomised into an exercise (n=39), LLLT (n=40), or a combined exercise-LLLT (n=32) group. Methods The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scale was used to assess pain and functionality. Knee range of motion was assessed using a goniometer, and the one-minute timed sit-to-stand test measured physical functionality at four time points: (T1) baseline, (T2) post 12-session intervention, (T3) one-month post intervention and (T4) three-month's post intervention. Knee circumference was measured using a measuring tape. Results WOMAC pain and functionality scale and knee circumference scores decreased in all three groups (P<0.05), but the combined exercise-LLLT group demonstrated better outcomes than the LLLT or exercise alone groups respectively. The combined exercise-LLLT group showed better acute and long-term benefits with participants experiencing a 3.5 centimetre decrease in knee circumference, 24 point improvement in the WOMAC pain and functionality scale, and a four repetition increase in physical functionality. Conclusion The findings suggest that LLLT is a viable tool for managing KOA when used in conjunction with physical exercise.
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Evaluation of the therapeutic effects of led (λ627 ± 10 nm) on the initial phase of ankle sprain treatment: a randomised placebo-controlled clinical trial. Lasers Med Sci 2018; 33:1031-1038. [PMID: 29423840 DOI: 10.1007/s10103-018-2460-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 01/29/2018] [Indexed: 12/26/2022]
Abstract
Various therapies for the treatment of sprains have emerged as advances occur in biomedical engineering and photobiology. Therapy with coherent and non-coherent light is a treatment modality for various musculoskeletal injuries. The main certified phototherapy benefits are the reduction of nociceptive processes and the modulation of the inflammatory process, among others. The objective of this study was to analyse the changes caused by the use of light-emitting diodes (LED) (λ627 ± 10 nm) with an energy density of 10 J/cm2 in 40 subjects divided into two groups (20 placebo and 20 LED). All of the volunteers had acute ankle sprains by inversion of grade II treated with the PRICE (protection, rest, ice, compression and elevation) technique and were treated for 6 days with LED therapy and LED therapy turned off (placebo). Pain assessment was performed on the 1st, 3rd and 6th days using the visual analogue scale (VAS) of pain, the McGill Pain Questionnaire and volumetry. The group treated with LED showed statistically decreased pain compared to the placebo group in both the VAS (85.79 vs 55.73%) and McGill questionnaire (83.33 vs 52.52%). The reduction of oedema in the LED group on the 3rd and 6th days after therapy was statistically superior to that in the placebo (p < 0.0001). Based on the results of this study, treatment with LED, using the tested dose, is effective for pain and oedema in the initial phase of ankle sprains.
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Rayegani SM, Raeissadat SA, Heidari S, Moradi-Joo M. Safety and Effectiveness of Low-Level Laser Therapy in Patients With Knee Osteoarthritis: A Systematic Review and Meta-analysis. J Lasers Med Sci 2017; 8:S12-S19. [PMID: 29071029 DOI: 10.15171/jlms.2017.s3] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction: Low-level laser therapy (LLLT) was introduced as an alternative non-invasive treatment for osteoarthritis, but its effectiveness is still controversial. The main objective of this article was to determine the safety and efficacy of LLLT in patients with knee osteoarthritis (KOA). Methods: In order to gather evidence, main medical databases as well as relevant websites were browsed without time limit. We searched with appropriate keywords and strategies. After quality assessment of studies, study data were extracted by two reviewers. Standard mean difference proposed through inverse variance was used in the meta-analysis using the random-effects model. Twelve values were used for the evaluation of heterogeneity. Results: A total of 823 studies, 14 randomized controlled trials (RCTs) were selected after final review. There was a significant difference between LLLT and placebo in pain at rest (P=0.02), pain at activity (P=0.01), total pain (P=0.03), WOMAC function (P=0.01), WOMAC stiffness (P=0.02) and WOMAC total (P<0.0001) in favor of the LLLT. There was no significant difference between LLLT and Placebo in WOMAC pain (P=0.09) and range of motion (P=0.1). Conclusion: In spite of some positive findings, this meta-analysis lacked data on how LLLT effectiveness is affected with important factors: wavelength, energy density, treatment duration, numbers of sessions the treatment, severity of KOA and site of application.
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Affiliation(s)
- Seyed Mansour Rayegani
- Physical Medicine and Rehabilitation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Ahmad Raeissadat
- Physical Medicine and Rehabilitation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Heidari
- Health Technology Assessment, Social Development & Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Moradi-Joo
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Iran Health Insurance Organization, Tehran, Iran
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Alan H, Yolcu Ü, Koparal M, Özgür C, Öztürk SA, Malkoç S. Evaluation of the effects of the low-level laser therapy on swelling, pain, and trismus after removal of impacted lower third molar. Head Face Med 2016; 12:25. [PMID: 27457369 PMCID: PMC4960798 DOI: 10.1186/s13005-016-0121-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 07/20/2016] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND In current study we aimed to examine the effect of a low-level laser therapy on the pain, mouth opening and swelling of patients whose impacted 3rd molar tooth was extracted in addition measurement volumetrically to the edema with 3dMD face system. METHODS It was surveyed 15 patients who had bilateral symmetric lower 3rd molars. Surgical sides of patients were randomly separated into two groups: the study group and the control group. It was applied extra oral low-level laser therapy (LLLT, 0.3 W, 40 s, 4 J/cm(2)) to the study group (n = 15) after the surgical operation and on the 2nd day. Only routine postoperative recommendation (ice application) was made in the control (n = 15) group. The maximum mouth opening, pain level and facial swelling evaluated. 3dMD Face® (3dMD, Atlanta, GA) Photogrammetric System was used to evaluate volumetric changes of the swelling. RESULTS There was no statistically significant difference in the edema and interincisal opening between the groups and the pain level in the laser group was significantly lower than in the control group on the 7(th) postoperative day. CONCLUSIONS Although there were decreasing trismus, swelling, and pain level, with this LLLT, there was significant difference only in the 7th day pain level in the laser group compared with the control group.
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Affiliation(s)
- Hilal Alan
- Department of Oral and Maxillofacial Surgery, Inonu University, Faculty of Dentistry, Malatya, 44280, Turkey.
| | - Ümit Yolcu
- Department of Oral and Maxillofacial Surgery, Inonu University, Faculty of Dentistry, Malatya, 44280, Turkey
| | - Mahmut Koparal
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Adıyaman University, Adıyaman, Turkey
| | - Cem Özgür
- Department of Oral and Maxillofacial Surgery, Inonu University, Faculty of Dentistry, Malatya, 44280, Turkey
| | - Seyit Ahmet Öztürk
- Department of Ortodontics, Faculty of Dentistry, Inonu University, Malatya, Turkey
| | - Sıddık Malkoç
- Department of Ortodontics, Faculty of Dentistry, Inonu University, Malatya, Turkey
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Huang Z, Ma J, Chen J, Shen B, Pei F, Kraus VB. The effectiveness of low-level laser therapy for nonspecific chronic low back pain: a systematic review and meta-analysis. Arthritis Res Ther 2015; 17:360. [PMID: 26667480 PMCID: PMC4704537 DOI: 10.1186/s13075-015-0882-0] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 11/30/2015] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND In recent decades, low-level laser therapy (LLLT) has been widely used to relieve pain caused by different musculoskeletal disorders. Though widely used, its reported therapeutic outcomes are varied and conflicting. Results similarly conflict regarding its usage in patients with nonspecific chronic low back pain (NSCLBP). This study investigated the efficacy of low-level laser therapy (LLLT) for the treatment of NSCLBP by a systematic literature search with meta-analyses on selected studies. METHOD MEDLINE, EMBASE, ISI Web of Science and Cochrane Library were systematically searched from January 2000 to November 2014. Included studies were randomized controlled trials (RCTs) written in English that compared LLLT with placebo treatment in NSCLBP patients. The efficacy effect size was estimated by the weighted mean difference (WMD). Standard random-effects meta-analysis was used, and inconsistency was evaluated by the I-squared index (I(2)). RESULTS Of 221 studies, seven RCTs (one triple-blind, four double-blind, one single-blind, one not mentioning blinding, totaling 394 patients) met the criteria for inclusion. Based on five studies, the WMD in visual analog scale (VAS) pain outcome score after treatment was significantly lower in the LLLT group compared with placebo (WMD = -13.57 [95 % CI = -17.42, -9.72], I(2) = 0 %). No significant treatment effect was identified for disability scores or spinal range of motion outcomes. CONCLUSIONS Our findings indicate that LLLT is an effective method for relieving pain in NSCLBP patients. However, there is still a lack of evidence supporting its effect on function.
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Affiliation(s)
- ZeYu Huang
- Department of Orthopedic Surgery, West China Hospital, West China Medical School, Sichuan University, No. 37 Wainan Guoxue Road, Chengdu, Sichuan Province, People's Republic of China.
- Duke Molecular Physiology Institute, Duke University School of Medicine, Duke University, PO Box 104775, Room 51-205, Carmichael Building, 300 North Duke Street, Durham, 27701-2047, NC, USA.
| | - Jun Ma
- Department of Orthopedic Surgery, West China Hospital, West China Medical School, Sichuan University, No. 37 Wainan Guoxue Road, Chengdu, Sichuan Province, People's Republic of China.
| | - Jing Chen
- West China School of Stomatology, Sichuan University, No. 14, Third Section, Renmin Road South, Chengdu, 610041, Sichuan Province, People's Republic of China.
| | - Bin Shen
- Department of Orthopedic Surgery, West China Hospital, West China Medical School, Sichuan University, No. 37 Wainan Guoxue Road, Chengdu, Sichuan Province, People's Republic of China.
| | - FuXing Pei
- Department of Orthopedic Surgery, West China Hospital, West China Medical School, Sichuan University, No. 37 Wainan Guoxue Road, Chengdu, Sichuan Province, People's Republic of China.
| | - Virginia Byers Kraus
- Duke Molecular Physiology Institute, Duke University School of Medicine, Duke University, PO Box 104775, Room 51-205, Carmichael Building, 300 North Duke Street, Durham, 27701-2047, NC, USA.
- Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, NC, 27710, USA.
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Huang Z, Chen J, Ma J, Shen B, Pei F, Kraus V. Effectiveness of low-level laser therapy in patients with knee osteoarthritis: a systematic review and meta-analysis. Osteoarthritis Cartilage 2015; 23:1437-1444. [PMID: 25914044 PMCID: PMC4814167 DOI: 10.1016/j.joca.2015.04.005] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 03/16/2015] [Accepted: 04/02/2015] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To investigate the efficacy of low-level laser therapy (LLLT) treatment of knee osteoarthritis (KOA) by a systematic literature search with meta-analyses on selected studies. DESIGN MEDLINE, EMBASE, ISI Web of Science and Cochrane Library were systematically searched from January 2000 to November 2014. Included studies were randomized controlled trials (RCTs) written in English that compared LLLT (at least eight treatment sessions) with sham laser in KOA patients. The efficacy effective size was estimated by the standardized mean difference (SMD). Standard fixed or random-effects meta-analysis was used, and inconsistency was evaluated by the I-squared index (I(2)). RESULTS Of 612 studies, nine RCTs (seven double-blind, two single-blind, totaling 518 patients) met the criteria for inclusion. Based on seven studies, the SMD in visual analog scale (VAS) pain score right after therapy (RAT) (within 2 weeks after the therapy) was not significantly different between LLLT and control (SMD = -0.28 [95% CI = -0.66, 0.10], I(2) = 66%). No significant difference was identified in studies conforming to the World Association of Laser Therapy (WALT) recommendations (four studies) or on the basis of OA severity. There was no significant difference in the delayed response (12 weeks after end of therapy) between LLLT and control in VAS pain (five studies). Similarly, there was no evidence of LLLT effectiveness based on Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain, stiffness or function outcomes (five and three studies had outcome data right after and 12 weeks after therapy respectively). CONCLUSION Our findings indicate that the best available current evidence does not support the effectiveness of LLLT as a therapy for patients with KOA.
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Affiliation(s)
- Z. Huang
- Department of Orthopedic Surgery, West China Hospital, West China Medical School, SiChuan University, ChengDu, SiChuan Province, People's Republic of China,Duke Molecular Physiology Institute, Duke University School of Medicine, Duke University, Durham, NC, United States
| | - J. Chen
- West China School of Stomatology, SiChuan University, ChengDu, SiChuan Province, People's Republic of China
| | - J. Ma
- Department of Orthopedic Surgery, West China Hospital, West China Medical School, SiChuan University, ChengDu, SiChuan Province, People's Republic of China
| | - B. Shen
- Department of Orthopedic Surgery, West China Hospital, West China Medical School, SiChuan University, ChengDu, SiChuan Province, People's Republic of China
| | - F. Pei
- Department of Orthopedic Surgery, West China Hospital, West China Medical School, SiChuan University, ChengDu, SiChuan Province, People's Republic of China, Address correspondence and reprint requests to: F. Pei, Department of Orthopedic Surgery, West China Hospital, West China Medical School, Sichuan University, 37# Wainan Guoxue Road, Chengdu, Sichuan Province, People's Republic of China. Tel: 86-189-80601380; Fax: 86-028-85423848. (F. Pei)
| | - V.B. Kraus
- Duke Molecular Physiology Institute, Duke University School of Medicine, Duke University, Durham, NC, United States, Department of Medicine, Division of Rheumatology, Duke University School of Medicine, Duke University, Durham, NC, United States, Address correspondence and reprint requests to: V.B. Kraus, Division of Rheumatology, Duke University School of Medicine, Duke Molecular Physiology Institute, PO Box 104775, Room 51-205, Carmichael Building, 300 N Duke St, Durham, NC 27701-2047, United States. Tel: 1-919-681-6652; Fax: 1-919-684-8907. (V.B. Kraus)
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LASER versus electromagnetic field in treatment of hemarthrosis in children with hemophilia. Lasers Med Sci 2015; 30:2179-87. [PMID: 26306883 DOI: 10.1007/s10103-015-1794-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 08/10/2015] [Indexed: 12/13/2022]
Abstract
Children with hemophilia usually have recurrent joint bleeding that leads to joint damage, loss of range of motion, and restriction of mobility, therefore affecting the quality of life in these children. The purpose of this study was to compare the effects of low-level laser therapy (LLLT) to that of pulsed electromagnetic field (PEMF) in treatment of hemarthrosis in children with hemophilia. Thirty boys with hemophilia A with ages ranging from 9 to 13 years were selected and assigned randomly, using sealed envelopes, into two equal intervention groups. The study group I received the traditional physical therapy program in addition to LLLT, whereas the study group II received the same physical therapy program given to the study group I in addition to PEMF. Both groups received the treatment sessions three times per week for three successive months. Pain, laboratory investigations, swelling, and range of motion (ROM) of the affected knee joint, in addition to physical fitness were evaluated before, at the end of the sixth week and at 12 weeks of the treatment program. Laser group showed significant improvement in all measured variables after the sixth week of treatment when compared with PEMF. By 12 weeks of treatment, there was a significant improvement in pain, ROM, ESR and leucocytes levels in laser group compared with PEMF, while there was no significant difference in knee circumferences and the 6-min walk test (6MWT) between both groups. Both groups showed significant improvement at 12 weeks of treatment compared with that at 6 weeks. Both LLLT and PEMF are effective modalities in reducing pain, swelling, increasing ROM and improving physical fitness. Twelve weeks of treatment of both modalities demonstrated significant improvement than 6 weeks of treatment. Laser therapy induced significant improvement than electromagnetic therapy in treatment of hemarthrosis-related problems in children with hemophilia.
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Ammar TARA. Monochromatic Infrared Photo Energy versus Low Level Laser Therapy in Patients with Knee Osteoarthritis. J Lasers Med Sci 2014; 5:176-182. [PMID: 25653818 PMCID: PMC4281991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Knee osteoarthritis (KO) is the most common joint disease for which there is no optimal treatment. Monochromatic infrared photo energy (MIPE) is a relatively new light modality used to reduce pain and increase circulation. Low Level Laser Therapy (LLLT) is another light modality used to reduce pain in KO. METHODS The aim of this study was to compare the effects of the MIPE and LLLT in improving pain and function in KO. Sixty participants with KO completed the program and were randomly assigned into two groups. Group 1 (experimental, n=30) received MIPE and exercises. Group 2 (control, n=30) received LLLT and exercises. Both groups received two visits per week for six weeks. Outcome included pain intensity measured on a visual analogue scale and physical function measured with the lower extremity functional scale, before and after the 12 therapy sessions (6 weeks after the start of the intervention). RESULTS There were statistically significant improvements in pain intensity and lower extremity functional scale scores (p<0.05) in each group. However, no significant differences were recorded between the groups (p>0.05). CONCLUSION Therefore, MIPE and LLLT reduce pain and improve function in KO; however, there are no differences between the two modalities in reducing pain and increasing physical function in KO.
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Alghadir A, Omar MTA, Al-Askar AB, Al-Muteri NK. Effect of low-level laser therapy in patients with chronic knee osteoarthritis: a single-blinded randomized clinical study. Lasers Med Sci 2013; 29:749-55. [PMID: 23912778 DOI: 10.1007/s10103-013-1393-3] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Accepted: 07/08/2013] [Indexed: 10/26/2022]
Abstract
The aim of this study was to investigate the effect of low-level laser therapy (LLLT) on pain relief and functional performance in patients with chronic knee osteoarthritis (OA). Forty patients with knee OA were randomly assigned into active laser group (n = 20) and placebo laser group (n = 20). The LLLT device used was a Ga-As diode laser with a power output of 50 mW, a wavelength of 850 nm, and a diameter beam of 1 mm. Eight points were irradiated and received dosage of 6 J/point for 60 s, with a total dosage of 48 J/cm(2) in each session. The placebo group was identical but treated without emission of energy. LLLT was applied two times per week over the period of 4 weeks. Outcome measurements included pain intensity at rest and at movement on visual analog scale, knee function using Western Ontario McMaster Universities Osteoarthritis Index scale, and ambulation duration. These measurements were collected at baseline and post-intervention. The results showed significant improvements in all assessment parameters in both groups compared to baseline. Active laser group showed significant differences in pain intensity at rest and movement, knee function, and ambulation duration when compared with the placebo group. Therefore, LLLT seemed to be an effective modality for short-term pain relief and function improvement in patients with chronic knee OA.
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Affiliation(s)
- Ahmad Alghadir
- Department of Rehabilitation Health Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box. 10219, Riyadh, 11433, Saudi Arabia
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