Assessment of the effectiveness of low-level laser therapy on the hands of patients with rheumatoid arthritis: a randomized double-blind controlled trial

Meireles, Sandra Mara; Jones, Anamaria; Jennings, Fábio; Suda, Alina Lica; Parizotto, Nivaldo Antônio; Natour, Jamil

doi:10.1007/s10067-009-1347-0

Cited by 42 publications

(50 citation statements)

References 19 publications

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“…Table 3 , and irradiation times from 1 to 900 sec. The numbers of irradiation points are also included in Table 3; the number of irradiation points for the specific joint was described in only five studies, [32][33][34]37,51 whereas most of the studies only described the number of irradiation points for one session or did not describe the number of irradiations.…”

Section: Included Studiesmentioning

confidence: 99%

“…Then, except for 7 trials, 39,40,[42][43][44][45]47 the remaining 15 trials simultaneously combined other interventions with laser therapy. Some trials used drugs such as analgesics, NSAIDs, antidepressants, and tranquilizers, [32][33][34][35][36]38,48,52 and other trials used exercises 2,37,41,46,50,51 or hot packs 49 as cointerventions during laser therapy. Table 3 , and irradiation times from 1 to 900 sec.…”

Section: Included Studiesmentioning

confidence: 99%

“…Patient properties, irradiation locations, session schedules, and co-interventions of the included trials are listed in Table 2. There is one trial for rheumatoid arthritis, 32 eight trials for osteoarthritis, [33][34][35][36][37][38][39][40] five trials for temporomandibular disorders, [41][42][43][44][45] five trials for low back pain, 2,46-49 two trials for shoulder pain, 50,51 and two trials for neck pain. 40,52 All patients in these trials suffered from pain in their joint regions and their joint regions were irradiated by lasers.…”

Section: Included Studiesmentioning

confidence: 99%

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Meta-Analysis of Pain Relief Effects by Laser Irradiation on Joint Areas

Jang

Lee

2012

Photomedicine and Laser Surgery

105

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Background: Laser therapy has been proposed as a physical therapy for musculoskeletal disorders and has attained popularity because no side effects have been reported after treatment. However, its true effectiveness is still controversial because several clinical trials have reported the ineffectiveness of lasers in treating pain. Methods: In this systematic review, we investigate the clinical effectiveness of low-level laser therapy (LLLT) on joint pain. Clinical trials on joint pain satisfying the following conditions are included: the laser is irradiated on the joint area, the PEDro scale score is at least 5, and the effectiveness of the trial is measured using a visual analogue scale (VAS). To estimate the overall effectiveness of all included clinical trials, a mean weighted difference in change of pain on VAS was used. Results: MEDLINE is the main source of the literature search. After the literature search, 22 trials related to joint pain were selected. The average methodological quality score of the 22 trials consisting of 1014 patients was 7.96 on the PEDro scale; 11 trials reported positive effects and 11 trials reported negative effects. The mean weighted difference in change of pain on VAS was 13.96 mm (95% CI, 7.24-20.69) in favor of the active LLLT groups. When we only considered the clinical trials in which the energy dose was within the dose range suggested in the review by Bjordal et al. in 2003 and in World Association for Laser Therapy (WALT) dose recommendation, the mean effect sizes were 19.88 and 21.05 mm in favor of the true LLLT groups, respectively. Conclusions: The review shows that laser therapy on the joint reduces pain in patients. Moreover, when we restrict the energy doses of the laser therapy into the dose window suggested in the previous study, we can expect more reliable pain relief treatments.

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Section: Included Studiesmentioning

confidence: 99%

Section: Included Studiesmentioning

confidence: 99%

Section: Included Studiesmentioning

confidence: 99%

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Meta-Analysis of Pain Relief Effects by Laser Irradiation on Joint Areas

Jang

Lee

2012

Photomedicine and Laser Surgery

105

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“…However, the mechanism of pain and inflammation reduction by LILT 26) reported that LILT is not beneficial at the wavelength, dosage, and power studied for the treatment of hands among patients with RA. However, in this study inflammation of the interphalangeal joint was significantly reduced.…”

Section: Discussionmentioning

confidence: 99%

Anti-inflammatory Effects of Low Intensity Laser Therapy on Adjuvant-induced Rheumatoid Arthritis in Rat

Kim

2013

J Phys Ther Sci

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Abstract.[Purpose] The purpose of this study was to evaluate the anti-inflammatory and analgesic efficacy of low-intensity laser therapy (LILT) on adjuvant-induced arthritis in a rat model. [Subjects] Thirty Sprague-Dawley rats were randomly divided into 3 groups: normal, placebo, and LILT groups. The arthritis group was treated with low intensity laser therapy using a gallium-aluminum-arsenide diode laser device for 3 weeks. Each group had 10 rats. All treatments were applied once a day, 5 days a week, for a total experimental period of 21 days. The hind paw volume and articular index of the knee joint along with TNF-α and IL-6 levels in the serum were used as outcome measures.[Results] Hind paw volume and the arthritis index of rats in the placebo group were significantly higher than those in the normal group (p<0.05). In the laser treatment group, the hind paw volume, the arthritis index, and TNF-α and IL-6 concentrations were significantly decreased than those in the placebo group. [Conclusion] We concluded that LILT is effective at in alleviating RA symptoms such as edema, arthritic index, and the expression profiles of inflammation cytokines in adjuvant-induced arthritic rats.

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“…Other inclusion criteria were being an adult (>18 years of age) of either gender, and chronicity of the disease greater than one year. The exclusion criteria were severe joint pain affecting global mobility, currently receiving physiotherapy for RA, recent joint injections and a change in corticosteroids or other disease-modifying anti-rheumatic drugs in the 3 months prior to the study (29). Subjects were also excluded if they had poor balance or significant pain that prevented them from performing the nerve mobilization exercises.…”

Section: Methodsmentioning

confidence: 99%

The effect of nerve mobilization exercise in patients with rheumatoid arthritis: a pilot study

Xia²,

Leung³

2017

Reumatismo

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SUMMARYRheumatoid arthritis (RA) is an autoimmune disorder characterized by chronic inflammation of the joints. The neurogenic inflammatory mechanism plays an important role in the inflammatory process of RA, and pathological changes in neural tissues in RA have also been noted. We aim to investigate treatment of the nervous system to relieve joint pain and inflammation in RA. Nerve mobilization, a nervous system-specific therapeutic exercise, was applied on RA patients to determine the effect of nerve mobilization on joint inflammation. Twelve RA patients were recruited from the community and were randomised into an experimental and a control group. In the experimental group, the subjects were taught a set of nerve mobilization exercises while the subjects in the control group were taught a set of gentle joint mobilization exercises. Both groups were instructed to practice the exercises daily. After a 4-week period, their RA pain scale (RAPS) and pain scores were examined, as well as the C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Subjects in the experimental group showed improvements in RAPS and pain scores after 4 weeks of nerve mobilization exercises, while CRP and ESR values remained unaffected. These preliminary data showed that nerve mobilization exercises might be beneficial in controlling joint pain in RA patients. Reumatismo, 2017; 69 (3): 111-118 n INTRODUCTION R heumatoid arthritis (RA) is one of the most prevalent chronic autoimmune diseases. The symptoms of RA are characterized by joint inflammation and deformities that are associated with pain and functional disability (1). The aetiology of RA remains unclear, but an increasing number of investigations have provided evidence that disease perpetuation could be due to a mixture of both immunogenic (1) and neurogenic (2, 3) inflammation. The mechanism of neurogenic inflammation has been described as an inflammation that is initiated by the nervous system (4-6). The neurogenic inflammation is triggered in the tissues by the cutaneous nerves (4, 7-10). The evidence of neurogenic inflammation in RA is supported by a small but significant number of tyrosine hydroxylase-positive sympathetic nerve fibres, which have a negative correlation with the inflammation index, a large number of substance P-positive nerve fibres (11) and immunoreactive sensory nerve fibres with calcitonin gene-related peptide (CGRP) (12). The current treatment algorithms for RA involve the use of both traditional and biological disease-modifying antirheumatic drugs (DMARDs) to control the disease (13). Physical treatments are also beneficial for patients to optimize physical functions, decreasing pain and improving quality of life (14-16). A paradigm is named as neurodynamic, which is a series of movements that produce physiological and mechanical events in the nervous system. They are used in physical testing to gain a response to the mechanical performance and sensitivity of the nervous sys- Key words: CRP; ESR; Nerve mobilisation; Neurogenic inflammation...

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Assessment of the effectiveness of low-level laser therapy on the hands of patients with rheumatoid arthritis: a randomized double-blind controlled trial

Cited by 42 publications

References 19 publications

Meta-Analysis of Pain Relief Effects by Laser Irradiation on Joint Areas

Meta-Analysis of Pain Relief Effects by Laser Irradiation on Joint Areas

Anti-inflammatory Effects of Low Intensity Laser Therapy on Adjuvant-induced Rheumatoid Arthritis in Rat

The effect of nerve mobilization exercise in patients with rheumatoid arthritis: a pilot study

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