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高强度激光治疗膝骨关节炎患者的疗效:系统评价和随机对照试验的荟萃分析。

Effectiveness of high-intensity laser therapy in the management of patients with knee osteoarthritis: A systematic review and meta-analysis of randomized controlled trials.

机构信息

College of Pharmacy, University of Florida, Gainesville, FL, USA.

College of Nursing, Chungnam National University, Daejeon, Korea.

出版信息

J Back Musculoskelet Rehabil. 2020;33(6):875-884. doi: 10.3233/BMR-191738.

Abstract

OBJECTIVES

High-intensity laser therapy (HILT) has recently been used to control pain and symptom improvement in knee osteoarthritis. We performed a systematic review and meta-analysis of randomized controlled trials to assess the effectiveness of HILT in patients with knee osteoarthritis.

METHODS

We conducted a search of articles in the MEDLINE, EMBASE, Cochrane CENTRAL, and Web of Science databases up to March 2020 for randomized controlled trials investigating HILT intervention, placebo, or active intervention as comparator groups for alleviating pain in knee osteoarthritis. Two independent reviewers evaluated the methodological quality and extracted pain and functional outcomes using a pre-specified form. A meta-analysis was performed using an inverse-variance random effect model. Heterogeneity was assessed using Higgins I2 with p-values.

RESULTS

Six randomized controlled trials (RCTs) were included in this meta-analysis. For VAS pain, 334 patients from four studies showed that HILT significantly decreased pain compared to the control (MD, -1.18; 95% CI, -1.68 to -0.69). HILT significantly improved WOMAC stiffness (SMD -1.00; 95% CI -1.32, -0.68) and function (SMD, -5.36; 95% CI -7.39 to -3.34) compared to the control.

CONCLUSION

The effectiveness of HILT on pain, stiffness, and function in patients with knee osteoarthritis is promising. However, due to the limited number of studies, further randomized controlled trials with large, well-designed samples are needed.

摘要

目的

高强度激光疗法(HILT)最近已被用于控制膝骨关节炎的疼痛和症状改善。我们进行了系统评价和荟萃分析,以评估 HILT 对膝骨关节炎患者的疗效。

方法

我们检索了 MEDLINE、EMBASE、Cochrane CENTRAL 和 Web of Science 数据库中截至 2020 年 3 月的随机对照试验,以评估 HILT 干预、安慰剂或活性干预作为膝骨关节炎缓解疼痛的对照组。两名独立的审查员使用预先指定的表格评估方法学质量并提取疼痛和功能结果。使用逆方差随机效应模型进行荟萃分析。使用 Higgins I2 评估异质性,并给出 p 值。

结果

共有 6 项随机对照试验(RCT)纳入本荟萃分析。在 4 项研究的 334 名患者中,VAS 疼痛显示 HILT 与对照组相比疼痛明显减轻(MD,-1.18;95%CI,-1.68 至-0.69)。HILT 显著改善 WOMAC 僵硬(SMD-1.00;95%CI,-1.32 至-0.68)和功能(SMD,-5.36;95%CI,-7.39 至-3.34)与对照组相比。

结论

HILT 对膝骨关节炎患者疼痛、僵硬和功能的疗效有一定的潜力。然而,由于研究数量有限,需要进一步进行有大样本、良好设计的随机对照试验。

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