Department of Rehabilitation, Physical Therapy Science & Sports, Rudolf Magnus Institute of Neurosciences, University Medical Center Utrecht, Utrecht, The Netherlands.
Department of General Practice, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Rehabilitation Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
Arch Phys Med Rehabil. 2018 Aug;99(8):1650-1659.e15. doi: 10.1016/j.apmr.2017.06.002. Epub 2017 Jun 16.
To systematically review the literature on the effectiveness of low-level laser therapy for patients with carpal tunnel syndrome.
The Cochrane Library, PubMed, Embase, CINAHL, and Physiotherapy Evidence Database were searched for relevant systematic reviews and randomized controlled trials (RCTs) up to April 8, 2016.
Two reviewers independently applied the inclusion criteria to select potential studies.
Two reviewers independently extracted the data and assessed the methodologic quality.
A best-evidence synthesis was performed to summarize the results of the 2 systematic reviews and 17 RCTs that were included. Strong evidence was found for the effectiveness of low-level laser therapy compared with placebo treatment in the very short term (0 to ≤5wk). After 5 weeks, the positive effects of low-level laser therapy on pain, function, or recovery diminished over time (moderate and conflicting evidence were found at 7- and 12-wk follow-up, respectively).
In the very short term, low-level laser therapy is more effective as a single intervention than placebo low-level laser therapy in patients with carpal tunnel syndrome, after which the positive effects of low-level laser therapy tend to subside. Evidence in the midterm and long term is sparse.
系统评价低水平激光治疗腕管综合征患者的有效性。
截至 2016 年 4 月 8 日,检索 Cochrane 图书馆、PubMed、Embase、CINAHL 和物理治疗证据数据库,以寻找相关的系统评价和随机对照试验(RCT)。
两名评审员独立应用纳入标准选择潜在研究。
两名评审员独立提取数据并评估方法学质量。
对纳入的 2 项系统评价和 17 项 RCT 进行最佳证据综合。与安慰剂治疗相比,低水平激光治疗在极短时间(0 至≤5 周)内的有效性具有较强证据。5 周后,低水平激光治疗对疼痛、功能或恢复的积极作用随时间逐渐减弱(分别在 7 周和 12 周随访时发现中度和相互矛盾的证据)。
在极短时间内,低水平激光治疗作为单一干预措施比腕管综合征患者的安慰剂低水平激光治疗更有效,此后低水平激光治疗的积极作用往往会消退。中期和长期的证据很少。