Abstract:
BACKGROUND:Osteoarthritis (OA) affects a large proportion of the population. Low Level Laser Therapy (LLLT) is a light source that generates extremely pure light, of a single wavelength. The effect is not thermal, but rather related to photochemical reactions in the cells. LLLT was introduced as an alternative non-invasive treatment for OA about 10 years ago, but its effectiveness is still controversial. OBJECTIVES:To assess the effectiveness of LLLT in the treatment of OA. SEARCH STRATEGY:We searched MEDLINE, EMBASE, the Cochrane Musculoskeletal registry, the registry of the Rehabilitation and Related Thereapies field and the Cochrane Controlled Trials Register up to January 30, 2000. SELECTION CRITERIA:Following an a priori protocol, only controlled clinical trials of LLLT for the treatment of patients with a clinical diagnosis of OA were eligible. Abstracts were excluded unless further data could be obtained from the authors. DATA COLLECTION AND ANALYSIS:Two reviewers independently selected trials and abstracted data using predetermined forms. Heterogeneity was tested with Cochran's Q test. A fixed effects model was used throughout for continuous variables, except where heterogeneity existed, in which case, a random effects model was used. Results were analyzed as weighted mean differences (WMD) with 95% confidence intervals (CI), where the difference between the treated and control groups was weighted by the inverse of the variance. Standardized mean differences (SMD) were calculated by dividing the difference between treated and control by the baseline variance. SMD were used when different scales were used to measure the same concept (e.g. pain). Dichotomous outcomes were analyzed with odds ratios. MAIN RESULTS:Five trials were included, with 112 patients randomized to laser, 85 patients to placebo laser. Treatment duration ranged from 4 to 10 weeks. Pain was assessed by four trials. The pooled estimate (random effects) of three trials showed no effect on pain measured using a scale (SMD: -0.2, 95% CI: -1.0, +0.6), but there was statistically significant heterogeneity (p>0,05). Two of the trials showed no effect and one demonstrated very beneficial effects with laser. In another trial, with no scale-based pain outcome, significantly more patients reported pain relief (yes/no) with laser with an odds ratio of 0.05, (95% CI: 0.0 to 1.56). Other outcomes of joint tenderness, joint mobility and strength were not significant. REVIEWER'S CONCLUSIONS:For OA, the results are conflicting in different studies and may depend on the method of application and other features of the LLLT application. Clinicians and researchers should consistently report the characteristics of the LLLT device and the application techniques used. New trials on LLLT should make use of standardized, validated outcomes. Despite some positive findings, this meta-analysis lacked data on how LLLT effectiveness is affected by four important factors: wavelength, treatment duration of LLLT, dosage and site of application over nerves instead of joints. There is clearly a need to investigate the effects of these factors on LLLT effectiveness for OA in randomized controlled clinical trials.
journal_name
Cochrane Database Syst Revjournal_title
The Cochrane database of systematic reviewsauthors
Brosseau L,Welch V,Wells G,deBie R,Gam A,Harman K,Morin M,Shea B,Tugwell Pdoi
10.1002/14651858.CD002046keywords:
subject
Has Abstractpub_date
2000-01-01 00:00:00pages
CD002046issue
2issn
1469-493Xpii
CD002046pub_type
杂志文章,评审abstract:BACKGROUND:Somatoform disorders are characterised by chronic, medically unexplained physical symptoms (MUPS). Although different medications are part of treatment routines for people with somatoform disorders in clinics and private practices, there exists no systematic review or meta-analysis on the efficacy and tolera...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD010628.pub2
更新日期:2014-11-07 00:00:00
abstract:BACKGROUND:Preterm birth is known to constitute the major risk factor for development of germinal matrix-intraventricular hemorrhage (GM-IVH). Head position may affect cerebral hemodynamics and thus may be involved indirectly in development of GM-IVH. Turning the head toward one side may functionally occlude jugular ve...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD012362.pub2
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abstract:BACKGROUND:A number of preclinical studies in both in vitro and in vivo models of Parkinson's disease have demonstrated that coenzyme Q10 can protect the nigrostriatal dopaminergic system. Some clinical trials have looked at the neuroprotective effects of coenzyme Q10 in patients with early and midstage Parkinson's dis...
journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD008150.pub2
更新日期:2011-12-07 00:00:00
abstract:BACKGROUND:Injecting drug users are vulnerable to infection with HIV and other blood borne viruses as a result of collective use of injecting equipment as well as sexual behaviour. OBJECTIVES:To assess the effect of oral substitution treatment for opioid dependent injecting drug users on rates of HIV infections, and h...
journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD004145.pub2
更新日期:2004-10-18 00:00:00
abstract:BACKGROUND:Endometriomata are endometriotic deposits within the ovary. The surgical management of these blood filled cysts is controversial. The laparoscopic approach to the management of endometriomata is favoured for as it offers the advantage of a shorter hospital stay, faster patient recovery and decreased hospital...
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doi:10.1002/14651858.CD004992.pub2
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doi:10.1002/14651858.CD006818.pub2
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doi:10.1002/14651858.CD008256.pub3
更新日期:2016-06-07 00:00:00
abstract:OBJECTIVES:To assess the efficacy of aldose reductase inhibitors in the prevention, reversal or delay in the progression of diabetic peripheral neuropathy. SEARCH STRATEGY:The Cochrane Diabetes Group's database was searched and the citation lists of identified trials and previous reviews checked. Investigators identif...
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abstract:BACKGROUND:The conventional method of induction of labour is with intravenous oxytocin. More recently, induction with prostaglandins, followed by an infusion of oxytocin if necessary, has been used. OBJECTIVES:The objective of this review was to assess the effects of induction of labour with prostaglandins compared wi...
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abstract:BACKGROUND:Between 4% and 25% of school age children complain of recurrent abdominal pain (RAP) of sufficient severity to interfere with daily activities. For the majority of such children no organic cause for their pain can be found on physical examination or investigation. Although most children are likely managed by...
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更新日期:2000-01-01 00:00:00
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journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD008347.pub3
更新日期:2014-12-19 00:00:00
abstract:BACKGROUND:This is an update of a previously published version of the review (Issue 10, 2011).Epithelial ovarian cancer (EOC) is the seventh most common cause of cancer death among women worldwide. Treatment consists of a combination of surgical debulking and platinum-based chemotherapy. Between 55% and 75% of women wh...
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doi:10.1002/14651858.CD007927.pub4
更新日期:2018-10-16 00:00:00
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journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD006058.pub2
更新日期:2009-07-08 00:00:00
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journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD003217.pub5
更新日期:2015-03-04 00:00:00
abstract:BACKGROUND:Several antibiotics have been evaluated in Crohn's disease (CD), however randomised controlled trials (RCTs) have produced conflicting results. OBJECTIVES:To assess the efficacy and safety of antibiotics for induction and maintenance of remission in CD. SEARCH METHODS:We searched MEDLINE, Embase, CENTRAL, ...
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doi:10.1002/14651858.CD012730.pub2
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abstract:BACKGROUND:Chronic inflammatory joint diseases (IJDs) affect 1% to 2% of the population in developed countries. IJDs include rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis (PsA), and other forms of spondyloarthritis (SpA). Tobacco smoking is considered a significant environmental risk facto...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章
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abstract:BACKGROUND:Cystic fibrosis is a life-limiting autosomal recessive genetic illness. A feeling of shortness of breath is common in cystic fibrosis, especially as the disease progresses. Reversing the underlying cause is the priority when treating breathlessness (dyspnoea), but when it is not feasible, palliation (easing)...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章
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pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD006612.pub4
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更新日期:2013-07-01 00:00:00
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journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD004068.pub2
更新日期:2009-01-21 00:00:00
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journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
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更新日期:2008-07-16 00:00:00
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更新日期:2007-01-24 00:00:00