M.-Y. Li1, Y.-C. Ji1, M.-N. Lee1, Y.-F. Shih1, W.T.-J. Wang1, S.-J. Lee1
1National Yang-Ming University, Physical Therapy and Assistive Technology, Taipei, Taiwan

Background: 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.

Purpose: 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 four 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 being pain and function, the literature using visual analog scale (VAS) for pain, 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: 146 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, 6 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(s): LLLT combined exercise therapy, comparing to exercise alone, brought greater improvements in pain, function, knee extensor strength and knee ROM.

Implications: Physical therapists could apply LLLT in addition to exercise therapy to relieve pain and improve function for patients with knee osteoarthritis.

Funding, acknowledgements: The authors received no financial support for the research, authorship, and/or publication of this article.

Keywords: Knee osteoarthritis, Exercise therapy, Low level laser therapy

Topic: Musculoskeletal: lower limb

Did this work require ethics approval? No
Institution: National Yang-Ming University
Committee: National Yang-Ming University Institutional Review Board
Reason: The study is a systematic review with meta-analysis.

All authors, affiliations and abstracts have been published as submitted.

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