【論文摘要】Effectiveness of Low Level Laser Therapy in Addition to Exercise Therapy for Patients With Knee Osteoarthritis: A Systematic Review and Meta-Analysis

【論文摘要】探討運動治療合併低能量雷射治療對於退化性膝關節炎之效果：系統性回顧及統合分析

李孟螢(Meng-Ying Li) ； 紀俞丞(Yu-Cheng Ji) ； 李民農(Min-Nung Lee) ； 施怡芬(Yi-Fen Shih) ； 王子娟(Wendy Tzyy-JiuanWang) ； 李淑貞(Shwn-Jen Lee)

《物理治療》 46卷2期 (2021/06) Pp. 173-174

https://doi.org/10.6215/FJPT.202106.P71

摘要

Background and Purpose: Exercise therapy being the most validated treatment for knee osteoarthritis individuals, it's effects may be reduced because of the pain induced during the process. Though the low-level laser therapy (LLLT) may reduce the pain and play a role in improving the compliance of the patients and thus amplify the effects of the exercise, there has been a lack of consistent evidence supports. The aim of the study was to investigate the effects of the combined treatment of LLLT and exercise comparing to exercise alone through systematic review and meta-analysis. Methods: A comprehensive and structured literature search was performed through 4 databases searching. The English literature comparing the effects of LLLT combined exercise therapy to exercise alone on knee osteoarthritis patients before May, 2020 were included. The target outcome was pain and function, and the literature using visual analog scale (VAS) for pain and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for function were included. The literature investigating knee extensor strength and knee ROM improvements were also included. Results: One hundred and forty-six studies were eligible for the inclusion criteria. After titles and abstracts review, 114 studies were excluded due to duplication and irrelevant content. Low quality articles were also excluded after reading the content. Finally, six randomized controlled trials were analyzed. The meta-analysis showed that LLLT combined exercise therapy did not have significant difference in VAS pain intensity comparing to exercise alone (effect size = -0.546, p = 0.051). The stiffness subscale analysis of WOMAC didn't show significant difference (effect size = -0.281, p = 0.059), either. However, the combined therapy showed significant improvements than exercise alone in pain subscale in WOMAC (effect size = -0.321, p = 0.031), function subscale in WOMAC (effect size = -0.500, p = 0.005), knee extensor strength (effect size = 0.677, p ＜ 0.001), and knee ROM (effect size = 1.236, p = 0.016). Conclusion: LLLT combined exercise therapy, comparing to exercise alone, brought greater improvements in pain, function, knee extensor strength, and knee ROM. Clinical Relevance: Physical therapists could apply LLLT in addition to exercise therapy to relieve pain and improve function for patients with knee osteoarthritis.