Mamais Ioannis, Papadopoulos Konstantinos, Lamnisos Demetris, Stasinopoulos Demetrios
Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens.
Department of London Sports Institute, Science and Technology School, Middlesex University of London.
Laser Ther. 2018 Sep 30;27(3):174-186. doi: 10.5978/islsm.27_18-OR-16.
The aim of this umbrella review is to determine the effectiveness of LLLT in the treatment of LET and to provide recommendations based on this evidence.
A comprehensive and systematic review was undertaken using Medline, EBSCO and EMBASE. Systematic reviews or meta-analysis were included if they compared Laser with at least one of the following: (i) placebo, (ii) no treatment, (iii) another treatment, conservative (physical therapy intervention or medical) or operative of LET. Principal outcomes included the assessment of short and long-term effect on functional status, pain, grip strength (pain-free or maximum) and a global measure (overall improvement).
Seven papers met the inclusion criteria for the umbrella review, Five papers were of moderate and two of low methodological quality. All reviews reported benefits associated with laser therapy Vs other intervention or placebo, however the significance of the identified benefits differed between studies and reviews. No review reported negative effects of laser therapy or harm to patients. All reviews noted significant variance between included studies with 2 reviews citing statistically significant heterogeneity. It is essential to consider this in the interpretation of these data.
This umbrella review found poor results for the effectiveness of LLLT in the management of LET. Therefore, further research with well-designed RCTs is required to provide meaningful evidence on the effectiveness (absolute and relative) of LLLT for the management of LET.
本系统性综述的目的是确定低强度激光疗法（LLLT）治疗腕管综合征（LET）的有效性，并基于此证据提供建议。
使用Medline、EBSCO和EMBASE进行全面系统的综述。如果系统评价或荟萃分析将激光与以下至少一种进行比较，则纳入其中：（i）安慰剂，（ii）不治疗，（iii）另一种治疗，保守治疗（物理治疗干预或药物治疗）或LET的手术治疗。主要结局包括评估对功能状态、疼痛、握力（无痛或最大握力）和整体测量指标（总体改善情况）的短期和长期影响。
七篇论文符合系统性综述的纳入标准，五篇论文方法学质量中等，两篇论文方法学质量低。所有综述均报告了激光治疗与其他干预措施或安慰剂相比的益处，然而，不同研究和综述中所确定益处的显著性有所不同。没有综述报告激光治疗的负面影响或对患者的伤害。所有综述均指出纳入研究之间存在显著差异，两篇综述引用了具有统计学意义的异质性。在解释这些数据时必须考虑到这一点。
本系统性综述发现，低强度激光疗法治疗腕管综合征的有效性结果不佳。因此，需要通过设计良好的随机对照试验进行进一步研究，以提供关于低强度激光疗法治疗腕管综合征有效性（绝对和相对有效性）的有意义证据。
