Nazari Ahmad, Moezy Azar, Nejati Parisa, Mazaherinezhad Ali
Department of Sports Medicine, School of Medicine, Hazrat Rasool Hospital, Iran University of Medical Sciences, Sattarkhan Ave, Niayesh St, Tehran, 14455613131, Iran.
Lasers Med Sci. 2019 Apr;34(3):505-516. doi: 10.1007/s10103-018-2624-4. Epub 2018 Sep 3.
Knee osteoarthritis (KOA) is one of the most common musculoskeletal disorders causing pain and functional impairment. The purpose of the study is to compare the effects of high-intensity laser therapy (HILT), conventional physical therapy (CPT), and exercise therapy (ET) on pain and function in patients with KOA. The study was designed as an assessor-blind randomized controlled trial. Ninety-three patients (aged between 50 and 75 years) with proved KOA were included and randomly allocated into three groups, and received 12 sessions of HILT, CPT, or ET. The outcomes were pain intensity measured by visual analog scale (VAS), knee flexion range of motion (FROM), timed up and go test (TUG), 6-min walk test (6MWT), and functionality of knee measured by the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) questionnaire. Statistical analyses were done to compare the amounts at the baseline, immediately after treatment and after 12 weeks. HILT was significantly more effective than the other groups in decreasing the VAS, increasing FROM and improving the scores of WOMAC (total and function subscale) both after treatment and after 12 weeks. The effect of HILT and CPT on the TUG, 6MWT, and WOMAC pain subscale was not significantly different after treatment, and both were better than ET. HILT was significantly better than the others after follow-up, particularly more effective on the stiffness subscale of WOMAC. HILT combined with exercise therapy, as a useful therapeutic approach, could have positive influences on KOA patients.
膝骨关节炎(KOA)是导致疼痛和功能障碍的最常见肌肉骨骼疾病之一。本研究的目的是比较高强度激光治疗(HILT)、传统物理治疗(CPT)和运动疗法(ET)对KOA患者疼痛和功能的影响。该研究设计为评估者盲法随机对照试验。纳入93例确诊为KOA的患者(年龄在50至75岁之间),随机分为三组,分别接受12次HILT、CPT或ET治疗。观察指标包括用视觉模拟量表(VAS)测量的疼痛强度、膝关节屈曲活动范围(FROM)、计时起立行走测试(TUG)、6分钟步行测试(6MWT)以及用西安大略和麦克马斯特大学骨关节炎指数(WOMAC)问卷测量的膝关节功能。进行统计分析以比较基线、治疗后即刻和12周后的各项指标。在治疗后及12周后,HILT在降低VAS、增加FROM以及改善WOMAC(总分及功能子量表)评分方面均显著优于其他组。治疗后,HILT和CPT对TUG、6MWT以及WOMAC疼痛子量表的影响无显著差异,且二者均优于ET。随访后,HILT明显优于其他组,尤其是对WOMAC僵硬子量表的改善更有效。HILT联合运动疗法作为一种有效的治疗方法,可能对KOA患者产生积极影响。