What is the evidence for laser therapy in the treatment of osteoarthritis of the knee?
AMSTAR Rating
Summary
Patient Population:
No information on patient population was given.
Intervention:
Low-Level Laser Irradiation Therapy (LLLT). Wavelengths ranged from 632.8-1060 nm, and ave. power from 0.4-10,000 mW/cm2. Dose of energy ranged from 0.0135-293.4 J, and densities from 0.1 – 1200 J/cm2. Irradiation times ranged from 1 – 900 seconds (size and number of points also varied substantially).
Comparison:
There were 22 RCTs identified with PEDro scores ≥5. Average PEDro score of included trials was 7.9 overall. 8 trials enrolled individuals experiencing osteoarthritis (In 5, the knee was specified as the irradiated joint).
Outcome:
- Pain: LLLT vs. placebo – LLLT was associated with a 13.96mm improvement on the VAS (95% CI 7.24, 20.69).
- Publication Bias: The authors produced a funnel plot and interpret it as meaning no significant bias (despite its appearance), but they do not produce a statistic to support this statement.
- Note: LLLT was combined with other interventions such as analgesics, NSAIDs, exercise, etc. in 15 of the studies included in the review. In the discussion the authors note that they did an analysis to assess effect of the presence of a co-intervention on their results. Of these 15 studies, 9 reported LLLT to be ineffective. Of the remaining 7 studies, 2 studies reported LLLT to be ineffective.
