Assess the effectiveness of low-level laser therapy on pain reduction and improvement in function in the hands of patients with rheumatoid arthritis. A randomized double-blind controlled trial was carried out on 82 patients with rheumatoid arthritis. The experimental group was submitted to the application of laser therapy, whereas the control group received a placebo laser. Aluminum gallium arsenide laser was used, at a wavelength of 785 nm, dose of 3 J/cm(2) and mean power of 70 mW. The groups were homogenous at the beginning of the study with regard to the main variables (p > 0.05). There were no statistically significant differences between groups in most of the measurements taken at the end of the intervention including the primary variables; the following variables were the exceptions: favoring the experimental group-inflammation of the interphalangeal joint of the right thumb (p = 0.012) and perimetry of the interphalangeal joint of the left thumb (p = 0.013); and favoring the control group-flexion of the proximal interphalangeal joint of the right fifth finger (p = 0.021), perimetry of the third proximal interphalangeal joint of the right hand (p = 0.044), grip strength in the left hand (p = 0.010), and the work domain of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire (p = 0.010). We conclude that low-level aluminum gallium arsenide laser therapy is not effective at the wavelength, dosage, and power studied for the treatment of hands among patients with rheumatoid arthritis.

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Self-efficacy refers to a person's beliefs in their ability to organize, perform actions and face challenges in order to achieve aims and motivation. 1,2 It is not a matter of possessing certain capacities but is a belief that one has them or that one can acquire them through personal efforts (outcome expectancy). The strength of individuals' self-efficacy has an effect on how much effort and perseverance they will apply to achieve an aim. 3 Rheumatoid arthritis is a chronic autoimmune inflammatory disease characterized by pain and destruction of synovial joints that may lead to disability. 4 Epidemiological studies have estimated that the prevalence of rheumatoid arthritis in the adult population is 1%. It affects women three times as much as men and its incidence is highest among people aged between 35 and 65 years. 5 Several studies have found that among patients with rheumatoid arthritis, greater self-efficacy is a predictor for healthy behaviors, such as physical activity, healthy eating and strategies for dealing with pain. 6-9 Greater self-efficacy has also been correlated with lower daily pain, better emotional states, less stiffness, better functional capacity, better physical and mental wellbeing, less depression and better adherence to medication and other health recommendations. 10 It has also been associated with better health outcomes, including physical activity recommendations for rheumatoid arthritis patients. 6,7,11 In a recent review of the literature, negative correlations were found between self-efficacy and disability, pain, fatigue and duration of disease. 12 Studies have also suggested that self-efficacy is associated with the health outcomes of people with rheumatoid arthritis. In these studies, it was observed that the higher the self-efficacy was (which can be changed through educational programs), the higher the association that the patients had with better health status.

The Brazilian Portuguese version of the Michigan Hand Outcomes Questionnaire was translated and culturally adapted successfully, and it showed excellent internal consistency, reproducibility and construct validity.

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