review osteoarthritis

Brosseau L, Welch V, Wells G, Tugwell P, de Bie R, Gam A, Harman K, Shea B, Morin M

Physiotherapy Program, School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ontario, Canada. lbrossea@uottawa.ca

The Journal of Rheumatology [2000, 27(8):1961-9]

Of the journal titled as above, I can understand are as follows :

Osteoarthritis (OA) and rheumatoid arthritis  (RA) affect a large proportion of the population. Low level laser therapy  was introduced as an alternative noninvasive treatment for RA and OA about 10 years ago, but its effectiveness is still controversial. We assessed the effectiveness of Low level laser therapy in the treatment of RA and OA. METHODS A systematic review was conducted, following an a priori protocol, according to the methods recommended by the Cochrane Collaboration. Trials were identified by a literature search of Medline, Embase, and the Cochrane Controlled Trials Register. Only randomized controlled trials of Low level laser theraphy for the treatment of patients with a clinical diagnosis of RA or OA were eligible. Thirteen trials were included, with 212 patients randomized to laser and 174 patients to placebo laser, and 68 patients received active laser on one hand and placebo on the opposite hand. Treatment duration ranged from 4 to 10 weeks. Followup was reported by only 2 trials for up to 3 months.

CONCLUSION :low level laser therapy should be considered for short term relief of pain and morning stiffness in RA, particularly since it has few side effects. For OA, the results are conflicting in different studies and may depend on the method of application and other features of the Low level laser therapy. Clinicians and researchers should consistently report the characteristics of the Low level laser therapy device and the application techniques. New trials on Low level laser theraphy should make use of standardized, validated outcomes. Despite some positive findings, this metaanalysis lacked data on how effectiveness of Low level laser therapy is affected by 4 factors: wavelength, treatment duration of Low level laser therapy, dosage, and site of application over nerves instead of joints. There is a need to investigate the effects of these factors on effectiveness of Low level laser therapy for RA and OA in randomized controlled clinical trials.