Background: Osteoarthritis (OA) is the most common form of arthritis and is a major cause of disability and impaired quality of life (QoL). The prevalence of OA is rapidly increasing affecting approximately 15% of the world’s population.Currently, there are no disease modifying treatments available. Non-steroidal anti-inflammatory drugs, the most widely prescribed medications for patients with knee OA (KOA), are associated with serious side effects, including bleeding and gastric ulceration. As a result, both patients and professional societies are looking for alternative therapies, with good effects,and less toxicity, to control pain sufficiently. Low-level laser therapy (LLLT) is a non-invasive treatment modality in the field of physiotherapy for pain management. Nonetheless,the effectiveness of LLLT in the treatment of OA is debatable.
Objectives and Design: A randomised, double-blind, controlled trial was conducted to evaluate the efficacy of LLLT when it is applied on specific acupuncture points (APs) at the knee joint in combination with exercises and advice in patients with KOA.
Participants: Forty-nine patients with KOA were randomly assigned into two groups; active laser group (n= 26) and placebo laser group(n= 23).
Intervention: Using a gallium-aluminium-arsenide laser device,patients received either active or placebo LLLT treatment at five APs (ST 35,Xiyan, ST 36, SP9, and SP10) on the affected knee. All participants received a series of 9 treatment sessions over a period of three weeks by using LLLT(active or placebo) in addition to strengthening exercise and advice.
Outcome Measures: Visual analogue scale (VAS), Saudi knee function scale (SKFS), active range of motion (ROM), knee circumference (KC), and patient satisfaction were assessed at baseline, at the 5th treatment session,at the last (9th) treatment session, after six weeks and then six months after the last treatment session.
Result: There was a statistically (but not clinically) significant improvement in the laser group compared to the placebo group in the primary outcome VAS after six weeks (P=0.014) and after six months of the last session of treatment (P= 0.003). There was a statistically (but not clinically) significant improvement in the laser group compared to the placebo group in the SKFS scores at the last treatment session (P= 0.035), and after six months (P= 0.006); in ROM only after six months (P= 0.019); inpatient satisfaction at the 5th session (P= 0.033) and after six months. No significant difference between both groups was noted in the KC at any time.Within both groups there was statistically significant improvement in most outcomes.
Conclusions: The results demonstrate that the short-period application of LLLT on specific APs associated with exercises and advice is effective in reducing pain and improving the QoL in patients with KOA.
|Date of Award||2014|
|Add any sponsors of the thesis research||Saudi Arabian Cultural Bureau|
|Supervisor||Carlos Wigderowitz (Supervisor) & Rami Abboud (Supervisor)|
Student thesis: Doctoral Thesis › Doctor of Philosophy