Bekhet Amira Hassan, Ragab Basma, Abushouk Abdelrahman Ibrahim, Elgebaly Ahmed, Ali Olfat Ibrahim
Faculty of Physical Therapy, Cairo University, Cairo, 11566, Egypt.
Physical Therapy Egypt Research Society, Cairo, Egypt.
Lasers Med Sci. 2017 Aug;32(6):1439-1448. doi: 10.1007/s10103-017-2234-6. Epub 2017 Jun 5.
We performed this meta-analysis to investigate the efficacy of low-level laser therapy (LLLT), a physiotherapy modality with anti-inflammatory and analgesic effects, in the management of mild-to-moderate carpal tunnel syndrome (CTS). We searched PubMed, Web of Knowledge, Scopus, Cochrane Central, and Virtual Health Library for randomized controlled trials (RCTs) that compared the effects of LLLT with or without splinting versus placebo on functional and electromyographic outcomes in CTS. All outcomes were pooled as mean differences (MD) under the inverse variance or random effects model, using the statistical add-in (MetaXL, version 5.0). Eight RCTs (473 patients/631 wrists) were eligible for the final analysis. The overall effect estimates did not favor LLLT therapy group over placebo in all primary outcomes: visual analogue scale (MD -1.11, 95% CI [-2.58, 0.35]), symptom severity scale score (MD -1.41, 95% CI [-5.12, 2.29]), and functional status scale score (MD -1.33, 95% CI [-3.27, 0.61]). However, LLLT was superior to placebo in terms of grip strength (MD 2.19, 95% CI [1.63, 2.76]) and inferior to placebo in terms of sensory nerve action potential (MD -2.74, 95% CI [-3.66, -1.82]). Laser therapy is superior to placebo in terms of improving the grip strength; however, no significant difference was found between both groups in terms of functional status improvement, pain reduction, or motor electrodiagnostic evaluations. Further high-quality trials with longer follow-up periods are required to establish the efficacy of LLLT for CTS treatment.
我们进行了这项荟萃分析，以研究低强度激光疗法（LLLT）——一种具有抗炎和镇痛作用的物理治疗方式——在轻至中度腕管综合征（CTS）治疗中的疗效。我们检索了PubMed、Web of Knowledge、Scopus、Cochrane Central和虚拟健康图书馆，查找比较LLLT联合或不联合夹板与安慰剂对CTS功能和肌电图结果影响的随机对照试验（RCT）。使用统计插件（MetaXL，5.0版），将所有结果合并为反方差或随机效应模型下的平均差（MD）。八项RCT（473例患者/631只手腕）符合最终分析的条件。在所有主要结果中，总体效应估计并不支持LLLT治疗组优于安慰剂组：视觉模拟量表（MD -1.11，95%CI[-2.58，0.35]）、症状严重程度量表评分（MD -1.41，95%CI[-5.12，2.29]）和功能状态量表评分（MD -1.33，95%CI[-3.27，0.61]）。然而，在握力方面LLLT优于安慰剂（MD 2.19，95%CI[1.63，2.76]），在感觉神经动作电位方面LLLT不如安慰剂（MD -2.74，95%CI[-3.66，-1.82]）。激光疗法在改善握力方面优于安慰剂；然而，两组在功能状态改善、疼痛减轻或运动电诊断评估方面未发现显著差异。需要进一步进行高质量、随访期更长的试验来确定LLLT治疗CTS的疗效。
