A novel approach utilizing laser acupuncture teletherapy for management of elderly-onset rheumatoid arthritis: A randomized clinical trial

Abstract

Introduction Rheumatoid arthritis (RA) disease is a systemic progressive inflammatory autoimmune disorder. Elderly-onset RA can be assumed as a benign form of RA. Until recently, face-to-face therapeutic sessions between health professionals and patients are usually the method of its treatment. However, during pandemics, including coronavirus disease 2019 (COVID-19), teletherapeutic sessions can extensively increase the patient safety especially in elderly patients who are more vulnerable to these infections. Thus, the aim of this study was to evaluate a novel teletherapy approach for management of elderly patients suffering from RA by utilizing laser acupuncture. Methods A teletherapy system was used for management of elderly patients suffering from RA. Sixty participants were allocated randomly into two groups and the ratio was 1:1. Patients in the first group were treated with laser acupuncture and telerehabilitation sessions, which consisted of aerobic exercise and virtual reality training. Patients in the second group received telerehabilitation sessions, which consisted of aerobic exercise and virtual reality training. Evaluation of patients was done by using the Health Assessment questionnaire (HAQ), the Rheumatoid Arthritis Quality of Life (RAQoL) questionnaire, and the analysis of interleukin-6 (IL-6), serum C-reactive protein (CRP), plasma adenosine triphosphate (ATP) concentration and plasma malondialdehyde (MDA). Results A statistically significant difference was found in CRP, RAQoL, IL-6 and MDA between the pre- and post-treatments in the first group ( p < 0.05) favouring the post-treatment group, while the HAQ showed a statistically significant difference between pre- and post-treatments ( p < 0.05) in both groups. Statistically significant post-treatment differences were also observed between the two groups ( p < 0.05) in RAQoL, CRP, ATP and MDA, favouring the first group. Discussion Laser acupuncture teletherapy could be suggested as a reliable treatment method for elderly patients suffering from RA, as it can provide a safe and effective therapeutic approach. Teletherapy provided safer access to health professionals and patients while giving a high patient satisfaction value with a relatively lower cost (ClinicalTrials.gov Identifier: NCT04684693).

Clinical Efficacy of Acupuncture for the Treatment of Rheumatoid Arthritis: Meta-Analysis of Randomized Clinical Trials

“…In our first selection round, 1823 records were potentially related to our topic, with 61 being considered eligible for a full-text review. Eleven RCTs ultimately met the inclusion criteria for this meta-analysis [ 7 – 17 ]. All the selected RCTs were reported in English and Chinese.…”

“…Three trials simply mentioned randomization methods used in their research and omitted details concerning random sequence generation methods [ 11 , 12 , 17 ]. Only three trials indicated what allocation concealment methods were used to maintain privacy after random allocation [ 7 , 9 , 10 ]. Five trials reported the blinding of personnel and outcome assessment [ 7 – 10 , 13 ].…”

“…Only three trials indicated what allocation concealment methods were used to maintain privacy after random allocation [ 7 , 9 , 10 ]. Five trials reported the blinding of personnel and outcome assessment [ 7 – 10 , 13 ]. All studies had a low risk of bias in incomplete outcome data and selective reporting.…”

“…Three trials reported the quality of life of the patients with RA measured by RAQoL [ 7 , 11 , 12 ]. The results of meta-analysis indicated that laser acupuncture had significantly better effects in ameliorating the quality of life, while compared to the control group (MD = −2.32, 95% CI: −4.40 to −0.25, P =0.028) ( Figure 4 ).…”

“…Three trials reported serum IL-6 [ 7 , 11 , 12 ]. The pooled result indicated that laser acupuncture had significantly better effects in decreasing serum IL-6, while compared to the control group (MD = −29.63, 95% CI: −49.34 to −9.92, P =0.003) ( Figure 7(c) ).…”