Rayegani Seyed Mansour, Raeissadat Seyed Ahmad, Heidari Saeed, Moradi-Joo Mohammad
Physical Medicine and Rehabilitation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Health Technology Assessment, Social Development & Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
J Lasers Med Sci. 2017 Summer;8(Suppl 1):S12-S19. doi: 10.15171/jlms.2017.s3. Epub 2017 Aug 29.
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). 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. 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 (=0.02), pain at activity (=0.01), total pain (=0.03), WOMAC function (=0.01), WOMAC stiffness (=0.02) and WOMAC total (<0.0001) in favor of the LLLT. There was no significant difference between LLLT and Placebo in WOMAC pain (=0.09) and range of motion (=0.1). 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.
低强度激光疗法（LLLT）作为骨关节炎的一种替代性非侵入性治疗方法被引入，但它的有效性仍存在争议。本文的主要目的是确定LLLT对膝骨关节炎（KOA）患者的安全性和疗效。为了收集证据，我们无时间限制地浏览了主要医学数据库以及相关网站。我们使用适当的关键词和检索策略进行搜索。在对研究进行质量评估后，由两名审阅者提取研究数据。在使用随机效应模型的荟萃分析中，采用通过逆方差提出的标准平均差。使用12个值评估异质性。经过最终审核，共筛选出823项研究，其中14项随机对照试验（RCT）。LLLT与安慰剂在静息痛（=0.02）、活动痛（=0.01）、总疼痛（=0.03）、WOMAC功能（=0.01）、WOMAC僵硬（=0.02）和WOMAC总分（<0.0001）方面存在显著差异，LLLT更具优势。LLLT与安慰剂在WOMAC疼痛（=0.09）和活动范围（=0.1）方面无显著差异。尽管有一些积极的研究结果，但这项荟萃分析缺乏关于重要因素如何影响LLLT疗效的数据，这些因素包括：波长、能量密度、治疗持续时间、治疗次数、KOA的严重程度和应用部位。
