Baltzer Axel W A, Ostapczuk Martin S, Stosch Daniel
Associate Practice at Königsallee/Centre for Molecular Orthopaedics, Königsallee 53-55, Düsseldorf, 40212, Germany.
Clinic for Orthopaedics and Trauma Surgery, St. Josef Hospital, Asberger Str. 4, Moers, 47441, Germany.
Lasers Surg Med. 2016 Jul;48(5):498-504. doi: 10.1002/lsm.22480. Epub 2016 Feb 2.
Osteoarthritis (OA) is a common chronic disorder. While research usually focuses on OA of the large joints, OA of the hand receives relatively little attention resulting in a lack of a therapeutic gold standard. Low level laser therapy (LLLT)/photobiomodulation therapy has been successfully used to treat a variety of medical conditions. Nevertheless, its merits in the treatment of (hand) OA remain controversial. The aim of the present study was to examine the longitudinal effect of LLLT on the three major hand OA symptoms-pain, swelling, reduced joint mobility-in patients suffering from Bouchard's and Heberden's OA.
STUDY DESIGN/MATERIALS AND METHODS: Thirty-four patients (32 females) aged 61.21 ± 2.13 years were administered 5-10 LLLT sessions to 85 joints (47 proximal and 38 distal interphalangeal joints). Therapy took place twice a week. Pain (Visual Analogue Scale), ring size (perimeter in mm), and range of motion (extension/flexion) were measured at baseline and after five treatments for all patients, and additionally after seven sessions and 8 weeks after treatment ended for patients who received more than five and seven treatments, respectively. Eighteen patients (37 joints) received only five treatments, 10 patients (29 joints) were administered seven treatments, and six patients (19 joints) were administered 10 LLLT sessions.
LLLT significantly reduced pain and ring size and increased range of motion after five and seven treatments (all P's < 0.001). The effects were very large (all η(2) 's > 0.14). No further significant change occurred between 7 and 10 treatments. The effects achieved after seven sessions persisted for 8 weeks.
LLLT is a safe, non-invasive, efficient and efficacious means to reduce pain and swelling and to increase joint mobility in patients suffering from Heberden's and Bourchard's OA. Further randomized controlled studies are needed to examine medium- to long-term effects as well as the ideal LLLT parameters. Lasers Surg. Med. 48:498-504, 2016. © 2016 Wiley Periodicals, Inc.
骨关节炎（OA）是一种常见的慢性疾病。虽然研究通常聚焦于大关节的骨关节炎，但手部骨关节炎受到的关注相对较少，导致缺乏治疗金标准。低强度激光疗法（LLLT）/光生物调节疗法已成功用于治疗多种医疗状况。然而，其在治疗（手部）骨关节炎方面的优点仍存在争议。本研究的目的是探讨低强度激光疗法对患有布夏尔氏和赫伯登氏骨关节炎患者手部三大主要骨关节炎症状——疼痛、肿胀、关节活动度降低——的纵向影响。
研究设计/材料与方法：34名年龄为61.21±2.13岁的患者（32名女性）接受了5 - 10次低强度激光疗法治疗，共涉及85个关节（47个近端指间关节和38个远端指间关节）。治疗每周进行两次。对所有患者在基线时以及治疗五次后测量疼痛（视觉模拟评分）、戒指尺寸（周长，单位为毫米）和活动范围（伸展/弯曲），对于接受超过五次和七次治疗的患者，分别在治疗七次后以及治疗结束8周后额外进行测量。18名患者（37个关节）仅接受五次治疗，10名患者（29个关节）接受七次治疗，6名患者（19个关节）接受10次低强度激光疗法治疗。
低强度激光疗法在治疗五次和七次后显著减轻了疼痛、减小了戒指尺寸并增加了活动范围（所有P值<0.001）。效果非常显著（所有η²值>0.14）。在治疗七次至十次之间未发生进一步的显著变化。治疗七次后所取得的效果持续了8周。
低强度激光疗法是一种安全、无创、有效且高效的方法，可减轻患有赫伯登氏和布夏尔氏骨关节炎患者的疼痛和肿胀，并增加关节活动度。需要进一步开展随机对照研究以检验中长期效果以及理想的低强度激光疗法参数。《激光外科与医学》48:498 - 504, 2016。©2016威利期刊公司
