Effects of High-Intensity Laser Therapy on Pain Sensitivity and Motor Performance in Patients with Thumb Carpometacarpal Joint Osteoarthritis: A Randomized Controlled Trial

Abstract

Objective To examine the effects of high-intensity laser therapy (HILT) on pain sensitivity and motor performance in patients with thumb carpometacarpal (CMC) osteoarthritis (OA). Design Prospective, triple-blinded, randomized, placebo-controlled trial. Setting Private practice, Malaga, Spain. Subjects Forty-three patients (mean ± SD age = 71 ± 12 years) with a diagnosis of thumb CMC OA grade 1–2 were randomized to the control group (N = 21) or experimental group (N = 22). Methods The experimental group (ExpG) received high-intensity laser therapy (HILT), and the control group (ConG) received a placebo treatment. The outcome measures were pain intensity (visual analog scale) and key pinch strength measurements (dynamometer). All outcome measures were collected at baseline, immediately following the intervention, at four weeks, and at 12 weeks following the intervention. Results Analysis of variance revealed a group × time interaction (F = 40.8, P < 0.001) for pain intensity, with those patients receiving LT experiencing a greater reduction in pain compared with those receiving placebo therapy at the end of the intervention (P < 0.001), as well as at 12 weeks after the intervention. Although mean values in the ExpG were higher than in the ConG for key pinch at assessment, these differences were not statistically significant. Conclusions HILT effectively diminishes pain intensity when used as an isolated treatment for patients with thumb CMC OA, but the effect of treatment decreases after 12 weeks.

High-Intensity Laser Therapy for Musculoskeletal Disorders: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

“…Following the removal of duplicates, 162 articles were identified as eligible, of which 102 were eliminated after reading of the title and abstract. Finally, after reading the full text, 48 RCTs were included [ 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 ] in the qualitative synthesis. The studies by Angelova et al [ 59 ], Boyraz et al [ 15 ], Akaltun et al [ 58 ], and Hojjati et al [ 32 ] were excluded from the pooled quantitative analysis because of reporting average values of outcomes without measures of dispersion; hence, deriving data from their report was not possible.…”

Osteoarthritis year in review 2020: rehabilitation and outcomes

“…We found evidence to support the use of joint mobilization 66,67 for knee OA, and dry needling 36 in hip OA. In contrast, there was conflicting evidence for the use of laser therapy 26,32 for thumb OA, ECSW therapy 23,24,29,62 and kinesiotape 33,63,64 for hand and knee OA, therapeutic ultrasound 27,59 , and PEMF 25 for knee OA, and neurodynamic mobilizations 34 for hand OA. These findings reinforce existing guidelines 3 that suggest these interventions should only be considered as an adjunct, not standalone, treatments for persons with OA.…”

“…The 38 identified RCTs investigated various individual (aerobic 35,51,57 , (aquatic 42,43 , neuromuscular 39,47 , resistancebased, 38,44,45 ) and combined 37,41,46 exercise-therapies/physical activities, technologies (telerehab 48,50 , video games 40 ) and behaviour change approaches 49 to improve adherence to exercise and PA, modalities (cryotherapy 54,68 , electrical current therapy 53 , ESWT 62 , interferential current 61 , laser 32 , pneumatic compression 58 , transcutaneous electrical nerve stimulation 60 and therapeutic ultrasound 59 ), manual (acupressure 65 , mobilization with movement 66,67 , neurodynamic mobilizations 34 ), needling 36,52 , taping 33,63,64 , or combined 55,56,69 therapies.…”

Clinical effects of proprioceptive thumb exercise for individuals with carpometacarpal joint osteoarthritis: A randomized controlled trial

“…1 The symptoms of this diagnosis are progressive over time. 2 The most common reported symptoms include thumb pain at rest and/or during activity, decreased pinch strength, decreased thumb motion, and limitations in functional performance. 2 Pain relief and restoration of function are the primary objectives of rehabilitation.…”

“…2 The most common reported symptoms include thumb pain at rest and/or during activity, decreased pinch strength, decreased thumb motion, and limitations in functional performance. 2 Pain relief and restoration of function are the primary objectives of rehabilitation. [3][4][5][6] Recommended evidence-based interventions for thumb CMCJ OA include a multifaceted approach based on thumb immobilization or support, educational programs, physical interventions, therapeutic exercise programs and manual therapy for reducing pain and improving function.…”