Is high intensity laser therapy more effective than other physical therapy modalities for treating knee osteoarthritis? A systematic review and network meta-analysis

Menglai Wu; Lijiang Luan; Adrian Pranata; Jeremy Witchalls; Roger Adams; Jaquelin Bousie; Jia Han

doi:10.3389/fmed.2022.956188

Is high intensity laser therapy more effective than other physical therapy modalities for treating knee osteoarthritis? A systematic review and network meta-analysis

Front Med (Lausanne). 2022 Sep 15:9:956188. doi: 10.3389/fmed.2022.956188. eCollection 2022.

Authors

Menglai Wu¹, Lijiang Luan², Adrian Pranata³, Jeremy Witchalls⁴, Roger Adams^{4

5}, Jaquelin Bousie⁶, Jia Han⁷

Affiliations

¹ School of Sports and Health, Shanghai University of International Business and Economics, Shanghai, China.
² School of Exercise and Health, Shanghai University of Sport, Shanghai, China.
³ Department of Nursing and Allied Health, School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia.
⁴ Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia.
⁵ School of Physiotherapy, University of Sydney, Sydney, NSW, Australia.
⁶ Faculty of Health, University of Canberra, Canberra, ACT, Australia.
⁷ College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China.

Abstract

Background: The use of physical therapy modalities, especially high intensity laser therapy (HILT), for individuals with knee osteoarthritis (KOA) is still controversial.

Objective: To compare the effects of HILT to other physical therapy modalities on symptoms and function in individuals with KOA.

Methods: Six databases (PubMed, Embase, Cochrane Library, Web of Science, EBSCO, and PEDro) were searched in March 2022. Included studies were randomized controlled trials involving HILT conducted on individuals with KOA. The end-trial weighted mean difference (WMD) and standard deviations (SD) with 95% confidence intervals (CI) were analyzed.

Results: Ten studies with 580 participants were obtained, of which nine were included in the final network meta-analysis. In terms of relieving pain, HILT demonstrated the highest probability of being among the most effective treatments, with surface under the cumulative ranking (SUCRA) = 100%, and compared to a control (placebo laser or exercise or a combination of both) on the visual analog scale (VAS) for pain it demonstrated significant benefits (WMD 1.66, 95% CI 1.48-1.84). For improving self-reported function, as measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total scores, the HILT SUCRA value led with 98.9%. When individuals with KOA were treated by HILT, the improvement in stiffness was statistically significant (WMD 0.78, 95% CI 0.52-1.04) but the amount of improvement was smaller than the minimal clinically important difference (MCID).

Conclusion: The current evidence suggests that HILT may be more effective than other physical therapy modalities for improving pain and function in individuals with KOA. For improving stiffness, however, it may not be clinically effective.

Systematic review registration: [https://www.researchregistry.com], identifier [1148].

Keywords: high intensity laser therapy; knee osteoarthritis; network meta-analysis; physical therapy; systematic review.

Publication types

Systematic Review