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Published in: Lasers in Medical Science 2/2014

01-03-2014 | Original Article

Effect of low-level laser therapy in patients with chronic knee osteoarthritis: a single-blinded randomized clinical study

Authors: Ahmad Alghadir, Mohammed Taher Ahmed Omar, Abeer Bashier Al-Askar, Naser Khwietm Al-Muteri

Published in: Lasers in Medical Science | Issue 2/2014

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Abstract

The aim of this study was to investigate the effect of low-level laser therapy (LLLT) on pain relief and functional performance in patients with chronic knee osteoarthritis (OA). Forty patients with knee OA were randomly assigned into active laser group (n = 20) and placebo laser group (n = 20). The LLLT device used was a Ga–As diode laser with a power output of 50 mW, a wavelength of 850 nm, and a diameter beam of 1 mm. Eight points were irradiated and received dosage of 6 J/point for 60 s, with a total dosage of 48 J/cm2 in each session. The placebo group was identical but treated without emission of energy. LLLT was applied two times per week over the period of 4 weeks. Outcome measurements included pain intensity at rest and at movement on visual analog scale, knee function using Western Ontario McMaster Universities Osteoarthritis Index scale, and ambulation duration. These measurements were collected at baseline and post-intervention. The results showed significant improvements in all assessment parameters in both groups compared to baseline. Active laser group showed significant differences in pain intensity at rest and movement, knee function, and ambulation duration when compared with the placebo group. Therefore, LLLT seemed to be an effective modality for short-term pain relief and function improvement in patients with chronic knee OA.
Literature
1.
go back to reference Gupta S, Hawker GA, Laporte A, Croxford R, Coyte PC (2005) The economic burden of disabling hip and knee osteoarthritis (OA) from the perspective of individuals living with this condition. Rheumatology (Oxford) 44:1531–7CrossRef Gupta S, Hawker GA, Laporte A, Croxford R, Coyte PC (2005) The economic burden of disabling hip and knee osteoarthritis (OA) from the perspective of individuals living with this condition. Rheumatology (Oxford) 44:1531–7CrossRef
2.
go back to reference Felson DT, Lawrance RC, Dieppe PA et al (2000) Osteoarthritis: new insight. Part I: the disease and its risk factors. Ann Intern Med 133:635–646PubMedCrossRef Felson DT, Lawrance RC, Dieppe PA et al (2000) Osteoarthritis: new insight. Part I: the disease and its risk factors. Ann Intern Med 133:635–646PubMedCrossRef
3.
go back to reference Al-Shammari SA, Khoja TA, Alballa SR, Kremlin M (1995) Obesity and clinical osteoarthritis of the knee in primary health care, Riyadh, Saudi Arabia. Med Sci Res 23:255–6 Al-Shammari SA, Khoja TA, Alballa SR, Kremlin M (1995) Obesity and clinical osteoarthritis of the knee in primary health care, Riyadh, Saudi Arabia. Med Sci Res 23:255–6
4.
go back to reference Al-Arfaj A, Al-Boukai AA (2002) Prevalence of radiographic knee osteoarthritis in Saudi Arabia. Clin Rheumatol 21:142–145PubMedCrossRef Al-Arfaj A, Al-Boukai AA (2002) Prevalence of radiographic knee osteoarthritis in Saudi Arabia. Clin Rheumatol 21:142–145PubMedCrossRef
5.
6.
go back to reference Agunwa W (1989) Low incidence of osteoporosis of hips in contrast with osteoarthritis of knees among rural Saudis. Why? Ann Rheum Dis 48:351–352 Agunwa W (1989) Low incidence of osteoporosis of hips in contrast with osteoarthritis of knees among rural Saudis. Why? Ann Rheum Dis 48:351–352
7.
go back to reference Silverstein FE, Faich G, Goldstein JL et al (2000) Gastrointestinal toxicity with celecoxib vs nonsteroidal anti-inflammatory drugs for osteoarthritis and rheumatoid arthritis. JAMA 284:1247–1255PubMedCrossRef Silverstein FE, Faich G, Goldstein JL et al (2000) Gastrointestinal toxicity with celecoxib vs nonsteroidal anti-inflammatory drugs for osteoarthritis and rheumatoid arthritis. JAMA 284:1247–1255PubMedCrossRef
8.
go back to reference Jordan KM, Arden NK, Doherty M et al (2003) Standing committee for international clinical studies including therapeutic trials ESCISIT: EULAR recommendations 2003: an evidence based approach to the management of knee osteoarthritis: report of a task force of the standing committee for international clinical studies including therapeutic trials (ESCISIT). Ann Rheum Dis 62(12):1145–1155PubMedCentralPubMedCrossRef Jordan KM, Arden NK, Doherty M et al (2003) Standing committee for international clinical studies including therapeutic trials ESCISIT: EULAR recommendations 2003: an evidence based approach to the management of knee osteoarthritis: report of a task force of the standing committee for international clinical studies including therapeutic trials (ESCISIT). Ann Rheum Dis 62(12):1145–1155PubMedCentralPubMedCrossRef
9.
go back to reference Adedoyin RA, Olaogun MOB, Fagbeja OF (2002) Effects of interferential current stimulation in management of osteoarthritis knee pain. Physiother 88:493–9CrossRef Adedoyin RA, Olaogun MOB, Fagbeja OF (2002) Effects of interferential current stimulation in management of osteoarthritis knee pain. Physiother 88:493–9CrossRef
10.
go back to reference Sherma L, Dunlop DD, Cahue S et al (2003) Quadriceps strength and osteoarthritis progression in malaligned and lax knees. Osteoarthr Cartil 11:252–9CrossRef Sherma L, Dunlop DD, Cahue S et al (2003) Quadriceps strength and osteoarthritis progression in malaligned and lax knees. Osteoarthr Cartil 11:252–9CrossRef
11.
go back to reference Kazanoglu E, Basaran S, Guzel R, Guler-Uysal F (2003) Short term efficacy of ibuprofen Phonphoresis versus continuous ultrasound therapy in knee osteoarthritis. Swiss Med Wakly 133:333–338 Kazanoglu E, Basaran S, Guzel R, Guler-Uysal F (2003) Short term efficacy of ibuprofen Phonphoresis versus continuous ultrasound therapy in knee osteoarthritis. Swiss Med Wakly 133:333–338
12.
go back to reference Jackson BD, Wluka AE, Teichtahl AJ et al (2004) Reviewing knee osteoarthritis—a biomechanical perspective. J Sci Med Sport 7(3):347–357PubMedCrossRef Jackson BD, Wluka AE, Teichtahl AJ et al (2004) Reviewing knee osteoarthritis—a biomechanical perspective. J Sci Med Sport 7(3):347–357PubMedCrossRef
13.
go back to reference Hegedus B, Viharos L, Gervain M, Galfi M (2009) The effect of low-level laser in knee osteoarthritis: a double blind, randomized, placebo-controlled trial. Photomed Laser Surg 27(4):577–584PubMedCentralPubMedCrossRef Hegedus B, Viharos L, Gervain M, Galfi M (2009) The effect of low-level laser in knee osteoarthritis: a double blind, randomized, placebo-controlled trial. Photomed Laser Surg 27(4):577–584PubMedCentralPubMedCrossRef
14.
go back to reference Ozdemir F, Birtane M, Kokino S (2001) The clinical efficacy of low power laser therapy on pain and function in cervical osteoarthritis. Clin Rheumatol 20:181–4PubMedCrossRef Ozdemir F, Birtane M, Kokino S (2001) The clinical efficacy of low power laser therapy on pain and function in cervical osteoarthritis. Clin Rheumatol 20:181–4PubMedCrossRef
15.
go back to reference Simunovic Z, Trobonjaca T, Trobonjaca Z (1998) Treatment of medial and lateral epicondylitis—tennis and golfer's elbow—with low laser therapy: a multicenter double-blind, placebo-controlled study on 324 patients. J Clin Laser Med Surg 16:145–51PubMed Simunovic Z, Trobonjaca T, Trobonjaca Z (1998) Treatment of medial and lateral epicondylitis—tennis and golfer's elbow—with low laser therapy: a multicenter double-blind, placebo-controlled study on 324 patients. J Clin Laser Med Surg 16:145–51PubMed
16.
go back to reference Gur A, Karakoc M, Cevik R, Nas K, Sarac AJ (2003) Efficacy of low power laser therapy and exercise on pain and functions in chronic low back pain. Lasers Surg Med 32(3):233–238PubMedCrossRef Gur A, Karakoc M, Cevik R, Nas K, Sarac AJ (2003) Efficacy of low power laser therapy and exercise on pain and functions in chronic low back pain. Lasers Surg Med 32(3):233–238PubMedCrossRef
17.
go back to reference Haker EH, Lundeberg TC (1991) Lateral epicondylalgia: report of non effective mid laser treatment. Arch Phys Med Rehabil 72:984–8PubMed Haker EH, Lundeberg TC (1991) Lateral epicondylalgia: report of non effective mid laser treatment. Arch Phys Med Rehabil 72:984–8PubMed
18.
go back to reference Vecchio P, Cave M, King V, Adebajo AO, Smith M, Hazleman BL (1993) A double-blind study of the effectiveness of low-level laser treatment of rotator cuff tendinitis. Br J Rheumatol 32:740–2PubMedCrossRef Vecchio P, Cave M, King V, Adebajo AO, Smith M, Hazleman BL (1993) A double-blind study of the effectiveness of low-level laser treatment of rotator cuff tendinitis. Br J Rheumatol 32:740–2PubMedCrossRef
19.
go back to reference Goats G, Flett E, Hunter JA, Stirling A (1996) Low intensity laser and phototherapy for rheumatoid arthritis. Physiotherapy 82:311–20CrossRef Goats G, Flett E, Hunter JA, Stirling A (1996) Low intensity laser and phototherapy for rheumatoid arthritis. Physiotherapy 82:311–20CrossRef
20.
go back to reference Krasheninnikoff M, Ellitsgaard N, Rogvi-Hansen B, Zeuthen A (1994) No effect of power laser in lateral epicondylitis. Scand J Rheumatol 23(5):260–263PubMedCrossRef Krasheninnikoff M, Ellitsgaard N, Rogvi-Hansen B, Zeuthen A (1994) No effect of power laser in lateral epicondylitis. Scand J Rheumatol 23(5):260–263PubMedCrossRef
21.
go back to reference Bjordal JM, Johnson MI, Lopes-Martins RA (2007) Short-term efficacy of physical interventions in osteoarthritic knee pain: a systematic review and meta-analysis of randomized placebocontrolled trials. BMC Musculoskeletal Disord 8:51–64CrossRef Bjordal JM, Johnson MI, Lopes-Martins RA (2007) Short-term efficacy of physical interventions in osteoarthritic knee pain: a systematic review and meta-analysis of randomized placebocontrolled trials. BMC Musculoskeletal Disord 8:51–64CrossRef
22.
go back to reference Brosseau L, Welch V, Wells G et al (2003) Low level laser therapy (Classes I, II, and III) for treating osteoarthritis. Cochrane Database Syst Rev, Oxford Brosseau L, Welch V, Wells G et al (2003) Low level laser therapy (Classes I, II, and III) for treating osteoarthritis. Cochrane Database Syst Rev, Oxford
23.
go back to reference Altman R, Asch E, Bloch D et al (1986) Development of criteria for the classification and reporting of osteoarthritis of the knee. Arthritis Rheum 29(8):1039–1049PubMedCrossRef Altman R, Asch E, Bloch D et al (1986) Development of criteria for the classification and reporting of osteoarthritis of the knee. Arthritis Rheum 29(8):1039–1049PubMedCrossRef
25.
go back to reference Schulz KF, Grimes DA (2002) Allocation concealment in randomized trials: defending against deciphering. Lancet 359:614–8PubMedCrossRef Schulz KF, Grimes DA (2002) Allocation concealment in randomized trials: defending against deciphering. Lancet 359:614–8PubMedCrossRef
26.
go back to reference Portney LG, Watkins MP (2000) Foundations of clinical research: applications to Practice, 2nd edn. Prentice Hall, Upper Saddle River, New Jersey Portney LG, Watkins MP (2000) Foundations of clinical research: applications to Practice, 2nd edn. Prentice Hall, Upper Saddle River, New Jersey
27.
go back to reference Bolognese JA, Schnitzer TJ, Ehrich EW (2003) Response relationship of VAS and Likert scales in osteoarthritis efficacy measurement. Osteoarthr Cartil 11(7):499–507PubMedCrossRef Bolognese JA, Schnitzer TJ, Ehrich EW (2003) Response relationship of VAS and Likert scales in osteoarthritis efficacy measurement. Osteoarthr Cartil 11(7):499–507PubMedCrossRef
28.
go back to reference Carlsson A, Anna M (1983) Assessment of chronic pain. I. Aspects of the reliability and validity of the Visual Analogue Scale. Pain 16:87–101PubMedCrossRef Carlsson A, Anna M (1983) Assessment of chronic pain. I. Aspects of the reliability and validity of the Visual Analogue Scale. Pain 16:87–101PubMedCrossRef
29.
go back to reference Bellamy N, Buchanan WW, Goldsmith CH, Campbell L (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15:1833–1840PubMed Bellamy N, Buchanan WW, Goldsmith CH, Campbell L (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15:1833–1840PubMed
30.
go back to reference Choquette D, Bellamy N, Raynauld JP (1994) A French-Canadian version of the WOMAC osteoarthritis index. Arthritis Rheum 37:S226 Choquette D, Bellamy N, Raynauld JP (1994) A French-Canadian version of the WOMAC osteoarthritis index. Arthritis Rheum 37:S226
31.
go back to reference Faik A, Benbouazza K, Amine B, Maarou W et al (2008) Translation and validation of Moroccan Western Ontario and Mc Master Universities (WOMAC) osteoarthritis index in knee osteoarthritis. Rheumatol Int 28:677–683PubMedCrossRef Faik A, Benbouazza K, Amine B, Maarou W et al (2008) Translation and validation of Moroccan Western Ontario and Mc Master Universities (WOMAC) osteoarthritis index in knee osteoarthritis. Rheumatol Int 28:677–683PubMedCrossRef
32.
go back to reference Guermazi M, Poiraudeau S, Yahia M, Mezganni M, Fermanian J, Habib Elleuch Revel M (2004) Translation, adaptation and validation of the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) for an Arab population: the Sfax modified WOMAC. Osteoarthr Cartil 12:459–468PubMedCrossRef Guermazi M, Poiraudeau S, Yahia M, Mezganni M, Fermanian J, Habib Elleuch Revel M (2004) Translation, adaptation and validation of the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) for an Arab population: the Sfax modified WOMAC. Osteoarthr Cartil 12:459–468PubMedCrossRef
33.
go back to reference Grace EM, Gerecz EM, Kaassam YB et al (1988) 50-foot walking time: a critical assessment of an outcome measure in clinical therapeutic trials of antirheumatic drugs. Br J Rheumatol 27:372–374PubMedCrossRef Grace EM, Gerecz EM, Kaassam YB et al (1988) 50-foot walking time: a critical assessment of an outcome measure in clinical therapeutic trials of antirheumatic drugs. Br J Rheumatol 27:372–374PubMedCrossRef
34.
go back to reference Ay S, Dogans K, Evcik D (2010) Is low level laser therapy effective in acute or chronic low back pain? Clin Rhumatol 29(8):905–910CrossRef Ay S, Dogans K, Evcik D (2010) Is low level laser therapy effective in acute or chronic low back pain? Clin Rhumatol 29(8):905–910CrossRef
35.
go back to reference Fukuda VO, Fukuda TY, Guimarães M et al (2011) Short-term efficacy of low-level laser therapy in patients with knee osteoarthritis: a randomized placebo controlled, double-blind clinical trial. Rev Bras Ortop 46(5):526–33CrossRef Fukuda VO, Fukuda TY, Guimarães M et al (2011) Short-term efficacy of low-level laser therapy in patients with knee osteoarthritis: a randomized placebo controlled, double-blind clinical trial. Rev Bras Ortop 46(5):526–33CrossRef
36.
go back to reference Montes-Molina R, Madroñero-Agreda MA et al (2009) Efficacy of interferential low-level laser therapy using two independent sources in the treatment of knee pain. Photomed Laser Surg 27(3):467–71PubMedCrossRef Montes-Molina R, Madroñero-Agreda MA et al (2009) Efficacy of interferential low-level laser therapy using two independent sources in the treatment of knee pain. Photomed Laser Surg 27(3):467–71PubMedCrossRef
37.
go back to reference Gur A, Cosut A, Sarac AJ, Cevik R, Nas K, Uyar A (2003) Efficacy of different therapy regimes of low-power laser in painful osteoarthritis of the knee: a double-blind and randomized-controlled trial. Lasers Surg Med 33(5):330–8PubMedCrossRef Gur A, Cosut A, Sarac AJ, Cevik R, Nas K, Uyar A (2003) Efficacy of different therapy regimes of low-power laser in painful osteoarthritis of the knee: a double-blind and randomized-controlled trial. Lasers Surg Med 33(5):330–8PubMedCrossRef
38.
go back to reference Stelian J, Gil I, Habot B et al (1992) Improvement of pain and disability in elderly patients with degenerative osteoarthritis of the treated with narrow-band light therapy. J Am Geriatr Soc 40:23–6PubMed Stelian J, Gil I, Habot B et al (1992) Improvement of pain and disability in elderly patients with degenerative osteoarthritis of the treated with narrow-band light therapy. J Am Geriatr Soc 40:23–6PubMed
39.
go back to reference Hsieh RL, Lo MT, Liao WC, Lee WC (2012) Short-term effects of 890-nanometer radiation on pain physical activity, and postural stability in patients with Knee osteoarthritis: A double-blind, randomized placebo-controlled study. Arch Phys Med Rehabil 93:757–764PubMedCrossRef Hsieh RL, Lo MT, Liao WC, Lee WC (2012) Short-term effects of 890-nanometer radiation on pain physical activity, and postural stability in patients with Knee osteoarthritis: A double-blind, randomized placebo-controlled study. Arch Phys Med Rehabil 93:757–764PubMedCrossRef
40.
go back to reference Tascioglu F, Armagan O, Tabak Y, Corapci L, Oner C (2004) Low power laser treatment in patients with knee osteoarthritis. Swiss Med Wkly 134:254–258PubMed Tascioglu F, Armagan O, Tabak Y, Corapci L, Oner C (2004) Low power laser treatment in patients with knee osteoarthritis. Swiss Med Wkly 134:254–258PubMed
41.
go back to reference Dominguez-Carrilo LG (2001) Comparación de la electroestimulación transcutánea vs laser de bajonivel en la analgesia de pacientes con gonartrosis. Cir Cir 69(1):13–7 Dominguez-Carrilo LG (2001) Comparación de la electroestimulación transcutánea vs laser de bajonivel en la analgesia de pacientes con gonartrosis. Cir Cir 69(1):13–7
42.
go back to reference Bülow PM, Hensen J, Danneskiold-Samsoe B (1994) Low power Ga–Al–As laser treatment of painful osteoarthritis of the knee. Scand J Rehab Med 26:155–9 Bülow PM, Hensen J, Danneskiold-Samsoe B (1994) Low power Ga–Al–As laser treatment of painful osteoarthritis of the knee. Scand J Rehab Med 26:155–9
43.
go back to reference Reed SC, Jackson RW, Glossop N, Randle J (1994) An in vivo study of the effect of excimer laser irradiation on degenerate rabbit articular cartilage. Arthroscopy 10(1):78–84PubMedCrossRef Reed SC, Jackson RW, Glossop N, Randle J (1994) An in vivo study of the effect of excimer laser irradiation on degenerate rabbit articular cartilage. Arthroscopy 10(1):78–84PubMedCrossRef
44.
go back to reference Bassleer C, Datchy M, Reginster JY (1985) Human articular chondrocytes cultivated in three dimensions: effects of IR laser irradiation. Proceedings of the International Congress on Lasers in Medicine and Surgery, October 15, 1985. Bologna: Monduzzi Editor. pp 381–385 Bassleer C, Datchy M, Reginster JY (1985) Human articular chondrocytes cultivated in three dimensions: effects of IR laser irradiation. Proceedings of the International Congress on Lasers in Medicine and Surgery, October 15, 1985. Bologna: Monduzzi Editor. pp 381–385
45.
go back to reference Skinner SM, Gage JP, Wilce PA, Saw RM (1996) A preliminary study of the effects of laser radiation on collagen metabolism in cell culture. Aust Dent J 41(3):188–192PubMedCrossRef Skinner SM, Gage JP, Wilce PA, Saw RM (1996) A preliminary study of the effects of laser radiation on collagen metabolism in cell culture. Aust Dent J 41(3):188–192PubMedCrossRef
Metadata
Title
Effect of low-level laser therapy in patients with chronic knee osteoarthritis: a single-blinded randomized clinical study
Authors
Ahmad Alghadir
Mohammed Taher Ahmed Omar
Abeer Bashier Al-Askar
Naser Khwietm Al-Muteri
Publication date
01-03-2014
Publisher
Springer London
Published in
Lasers in Medical Science / Issue 2/2014
Print ISSN: 0268-8921
Electronic ISSN: 1435-604X
DOI
https://doi.org/10.1007/s10103-013-1393-3

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