Department of Physiotherapy Basics, Academy of Physical Education, Katowice, Poland.
College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, Canada.
Clin Interv Aging. 2018 Aug 21;13:1445-1455. doi: 10.2147/CIA.S168094. eCollection 2018.
Laser therapy seems to be a beneficial physical agent for chronic low back pain (LBP), and it is commonly used in the clinical rehabilitation practice. However, there are still no indisputable and clearly defined protocols and practical guidelines, and further, the methodology of the previous reports leaves many unsatisfied and raises some reservations.
The aim of this study was to evaluate the effectiveness of low-level laser therapy (LLLT) and high-intensity laser therapy (HILT) in patients with lumbar disc degenerative changes based on the analysis of the short- and long-term results and in comparison with the placebo effect.
This study was a prospective and placebo-controlled clinical trial.
A group of 68 participants were qualified for the therapy and were assigned to four comparative groups in the order they volunteered: HILT of 1,064 nm, 60 J/cm, 10 minutes (HILT); sham (HILT placebo); LLLT of 785 nm, 8 J/cm, 8 minutes; and sham (LLLT placebo). The following tests were used to assess the effectiveness of treatment: 1) the visual analogue scale; 2) the Laitinen Questionnaire Indicators of Pain; 3) the Oswestry Disability Index; 4) the Roland-Morris Disability Questionnaire; 5) Lasegue test; and 6) Schober's test. All measurements were carried out before and after irradiations (3 weeks) and in follow-ups (1 and 3 months).
After applying verum or placebo laser irradiation, therapeutic progress was observed in all comparative groups; however, no statistically significant differences were observed among the procedures.
The high- and low-energy laser therapy methods used in the present article are ineffective in relation to patients with lumbar disc degenerative changes in both the short- and long-term perspectives and do not show a significant advantage over the placebo effect.
激光疗法似乎是一种有益于慢性下腰痛（LBP）的物理治疗方法，在临床康复实践中得到广泛应用。然而，目前仍然没有无可争议且明确界定的方案和实用指南，此外，之前报告的方法学存在许多不足之处，并引起了一些保留意见。
本研究旨在评估低水平激光疗法（LLLT）和高强度激光疗法（HILT）在腰椎间盘退行性改变患者中的有效性，分析短期和长期结果，并与安慰剂效应进行比较。
这是一项前瞻性、安慰剂对照的临床试验。
一组 68 名参与者符合治疗条件，并按志愿顺序被分配到四个比较组：1064nm、60J/cm、10 分钟的 HILT（HILT）；假 HILT（HILT 安慰剂）；785nm、8J/cm、8 分钟的 LLLT；假 LLLT（LLLT 安慰剂）。以下测试用于评估治疗效果：1）视觉模拟量表；2）Laitinen 疼痛指标问卷；3）Oswestry 残疾指数；4）Roland-Morris 残疾问卷；5）Lasegue 测试；6）Schober 测试。所有测量均在照射前和照射后（3 周）以及随访时（1 个月和 3 个月）进行。
在应用真实或安慰剂激光照射后，所有比较组均观察到治疗进展，但治疗方法之间无统计学差异。
本文使用的高、低能量激光治疗方法在短期和长期内对腰椎间盘退行性改变患者均无效，与安慰剂效应相比没有明显优势。
