Khalilizad Majid, Hosseinzade Danial, Marzban Abbas Abadi Mobin
Sport and Reconstruction Surgery, Clinical Research Development Unit of Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol, Iran.
Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
J Lasers Med Sci. 2024 Aug 4;15:e34. doi: 10.34172/jlms.2024.34. eCollection 2024.
High-intensity laser therapy (HILT) and low-level laser therapy (LLLT) combined with exercise therapy (ET) have emerged as effective treatment options for musculoskeletal pain. However, there have remained uncertainties regarding the magnitude of their effects in reducing pain and improving function in patients with knee osteoarthritis. Hence, we performed a systematic review and network meta-analysis of available evidence in the literature to answer this query. A literature search was carried out in Embase, PubMed, and Scopus databases without any language restrictions from 1 January 1990 to 31 December 2023. We examined randomized controlled trial (RCT) studies that investigated the efficiency of HILT or LLLT plus knee osteoarthritis ET in pain and functional improvement of the knee. We performed a network meta-analysis and provided the standardized mean difference (SMD) with a 95% confidence interval (CI) by pooling the continuous data on the visual analogue scale (VAS) pain score and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) function score using a random-effects model. In total, 11 eligible RCTs were included. Our analysis revealed significant improvements in the VAS pain and WOMAC function scores on weeks 4 and 8 after interventions in groups treated with LLLT+ET and HILT+ET compared with placebo+ET. Moreover, HILT+ET showed a greater reduction in the VAS pain score (SMD=-1.41; 95% CI: -2.05 to -0.76) and improvement in the WOMAC function score (SMD=-2.20; 95% CI: -3.21 to -1.19) than LLLT+ET in week 8. Based on our findings, both HILT+ET and LLLT+ET treatments effectively reduced pain and improved function, but HILT+ET showed a more significant improvement in both outcomes compared to LLLT+ET.
高强度激光疗法（HILT）和低强度激光疗法（LLLT）联合运动疗法（ET）已成为治疗肌肉骨骼疼痛的有效选择。然而，对于它们在减轻膝关节骨关节炎患者疼痛和改善功能方面的效果程度仍存在不确定性。因此，我们对文献中的现有证据进行了系统评价和网络荟萃分析，以回答这个问题。我们在Embase、PubMed和Scopus数据库中进行了文献检索，检索时间范围为1990年1月1日至2023年12月31日，无任何语言限制。我们审查了随机对照试验（RCT）研究，这些研究调查了HILT或LLLT加膝关节骨关节炎ET在膝关节疼痛和功能改善方面的有效性。我们进行了网络荟萃分析，并通过使用随机效应模型汇总视觉模拟量表（VAS）疼痛评分和西安大略和麦克马斯特大学骨关节炎指数（WOMAC）功能评分的连续数据，提供了标准化平均差（SMD）及其95%置信区间（CI）。总共纳入了11项符合条件的RCT。我们的分析显示，与安慰剂+ET组相比，接受LLLT+ET和HILT+ET治疗的组在干预后第4周和第8周时，VAS疼痛评分和WOMAC功能评分有显著改善。此外，在第8周时，HILT+ET在VAS疼痛评分降低方面（SMD=-1.41；95%CI：-2.05至-0.76）和WOMAC功能评分改善方面（SMD=-2.20；95%CI：-3.21至-1.19）比LLLT+ET更显著。根据我们的研究结果，HILT+ET和LLLT+ET治疗均能有效减轻疼痛并改善功能，但与LLLT+ET相比，HILT+ET在这两个结果方面的改善更为显著。
