Staff View: Effects of low-level and high-intensity laser therapy as adjunctive to rehabilitation exercise on pain, stiffness and function in knee osteoarthritis: A systematic review and meta-analysis.

Effects of low-level and high-intensity laser therapy as adjunctive to rehabilitation exercise on pain, stiffness and function in knee osteoarthritis: A systematic review and meta-analysis.

Background When treating knee osteoarthritis (KOA), rehabilitation exercise is often combined with low-level (LLLT) or high-intensity laser therapy (HILT). However, the effectiveness of these combinations is still uncertain. Objective To examine the effects of LLLT or HILT combined with rehabilitati...

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Main Authors:	Ahmad, Mohd Azzuan, A. Hamid, Mohamad Shariff, Yusof, Ashril
Format:	Article
Published:	Elsevier Sci Ltd 2022
Subjects:	Medical technology
Online Access:	http://eprints.um.edu.my/43017/
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spelling	my.um.eprints.430172023-10-04T03:24:41Z http://eprints.um.edu.my/43017/ Effects of low-level and high-intensity laser therapy as adjunctive to rehabilitation exercise on pain, stiffness and function in knee osteoarthritis: A systematic review and meta-analysis. Ahmad, Mohd Azzuan A. Hamid, Mohamad Shariff Yusof, Ashril Medical technology Background When treating knee osteoarthritis (KOA), rehabilitation exercise is often combined with low-level (LLLT) or high-intensity laser therapy (HILT). However, the effectiveness of these combinations is still uncertain. Objective To examine the effects of LLLT or HILT combined with rehabilitation exercise (LLLT + E or HILT + E) on pain, stiffness and function in KOA. Data sources Five databases (PubMed, Web of Science, CINAHL, PEDro and SPORTDiscus) were searched for relevant studies published up to 31 December 2019. Study selection KOA randomised controlled trials, LLLT + E or HILT + E against exercise alone with or without placebo laser, reported clinical outcomes, human studies and English language. Data synthesis Methodological quality was assessed by the PEDro and Cochrane risk-of-bias scales, and the meta-analysis was undertaken using RevMan 5.3. Results Of the 10 retrieved studies, six investigated LLLT + E, three on HILT + E, and one evaluated both. All the studies had high PEDro scores. However, as most of the studies employed a single type of laser therapy, only indirect comparison of LLLT + E and HILT + E was possible. This study found all treatment modalities were effective in reducing KOA symptoms. Interestingly, relative to control, the meta-analysis showed significant improvements in knee pain, stiffness and function for the HILT + E. Conclusion Both LLLT and HILT are beneficial as adjuncts to rehabilitation exercise in the management of KOA. Based on an indirect comparison, the HILT + E seems to have higher efficacy in reducing knee pain and stiffness, and in increasing function. To confirm this finding, a direct comparative investigation of the two types of laser therapy may be necessary. (c) 2021 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved. Elsevier Sci Ltd 2022-03 Article PeerReviewed Ahmad, Mohd Azzuan and A. Hamid, Mohamad Shariff and Yusof, Ashril (2022) Effects of low-level and high-intensity laser therapy as adjunctive to rehabilitation exercise on pain, stiffness and function in knee osteoarthritis: A systematic review and meta-analysis. Physiotherapy, 114. pp. 85-95. DOI https://doi.org/10.1016/j.physio.2021.03.011 <https://doi.org/10.1016/j.physio.2021.03.011>. 10.1016/j.physio.2021.03.011
institution	Universiti Malaya
building	UM Library
collection	Institutional Repository
continent	Asia
country	Malaysia
content_provider	Universiti Malaya
content_source	UM Research Repository
url_provider	http://eprints.um.edu.my/
topic	Medical technology
spellingShingle	Medical technology Ahmad, Mohd Azzuan A. Hamid, Mohamad Shariff Yusof, Ashril Effects of low-level and high-intensity laser therapy as adjunctive to rehabilitation exercise on pain, stiffness and function in knee osteoarthritis: A systematic review and meta-analysis.
description	Background When treating knee osteoarthritis (KOA), rehabilitation exercise is often combined with low-level (LLLT) or high-intensity laser therapy (HILT). However, the effectiveness of these combinations is still uncertain. Objective To examine the effects of LLLT or HILT combined with rehabilitation exercise (LLLT + E or HILT + E) on pain, stiffness and function in KOA. Data sources Five databases (PubMed, Web of Science, CINAHL, PEDro and SPORTDiscus) were searched for relevant studies published up to 31 December 2019. Study selection KOA randomised controlled trials, LLLT + E or HILT + E against exercise alone with or without placebo laser, reported clinical outcomes, human studies and English language. Data synthesis Methodological quality was assessed by the PEDro and Cochrane risk-of-bias scales, and the meta-analysis was undertaken using RevMan 5.3. Results Of the 10 retrieved studies, six investigated LLLT + E, three on HILT + E, and one evaluated both. All the studies had high PEDro scores. However, as most of the studies employed a single type of laser therapy, only indirect comparison of LLLT + E and HILT + E was possible. This study found all treatment modalities were effective in reducing KOA symptoms. Interestingly, relative to control, the meta-analysis showed significant improvements in knee pain, stiffness and function for the HILT + E. Conclusion Both LLLT and HILT are beneficial as adjuncts to rehabilitation exercise in the management of KOA. Based on an indirect comparison, the HILT + E seems to have higher efficacy in reducing knee pain and stiffness, and in increasing function. To confirm this finding, a direct comparative investigation of the two types of laser therapy may be necessary. (c) 2021 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.
format	Article
author	Ahmad, Mohd Azzuan A. Hamid, Mohamad Shariff Yusof, Ashril
author_facet	Ahmad, Mohd Azzuan A. Hamid, Mohamad Shariff Yusof, Ashril
author_sort	Ahmad, Mohd Azzuan
title	Effects of low-level and high-intensity laser therapy as adjunctive to rehabilitation exercise on pain, stiffness and function in knee osteoarthritis: A systematic review and meta-analysis.
title_short	Effects of low-level and high-intensity laser therapy as adjunctive to rehabilitation exercise on pain, stiffness and function in knee osteoarthritis: A systematic review and meta-analysis.
title_full	Effects of low-level and high-intensity laser therapy as adjunctive to rehabilitation exercise on pain, stiffness and function in knee osteoarthritis: A systematic review and meta-analysis.
title_fullStr	Effects of low-level and high-intensity laser therapy as adjunctive to rehabilitation exercise on pain, stiffness and function in knee osteoarthritis: A systematic review and meta-analysis.
title_full_unstemmed	Effects of low-level and high-intensity laser therapy as adjunctive to rehabilitation exercise on pain, stiffness and function in knee osteoarthritis: A systematic review and meta-analysis.
title_sort	effects of low-level and high-intensity laser therapy as adjunctive to rehabilitation exercise on pain, stiffness and function in knee osteoarthritis: a systematic review and meta-analysis.
publisher	Elsevier Sci Ltd
publishDate	2022
url	http://eprints.um.edu.my/43017/
_version_	1781704666031063040
score	13.211869

Effects of low-level and high-intensity laser therapy as adjunctive to rehabilitation exercise on pain, stiffness and function in knee osteoarthritis: A systematic review and meta-analysis.

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