Effects of photobiomodulation therapy in patients with chronic non-specific low back pain: protocol for a randomised placebo-controlled trial

Tomazoni, Shaiane Silva; Costa, Lucíola da Cunha Menezes; Guimarães, Layana de Souza; Araújo, Amanda Costa; Nascimento, Dafne Port; Medeiros, Flávia Cordeiro; Avanzi, Marina Athayde

doi:10.1136/bmjopen-2017-017202

Cited by 20 publications

(22 citation statements)

References 58 publications

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“…Eighteen of these studies were excluded based on title and abstract. The full text of 34 remaining articles was screened and 15 articles were excluded [1][2][3]6,7,9,10,[23][24][25][26][27][28][29][30] because: the PEDro score of three studies was 6 2,3,28 . Six articles didn't report pain by VAS; it was not possible to estimate ES in two studies 1,6,7,9,10,23,24,27 ; two studies 29,30 were case reports; and two studies did not have at least one another group for comparison.…”

Section: Resultsmentioning

confidence: 99%

The Beneficial Effects of High-Intensity Laser Therapy and Co-Interventions on Musculoskeletal Pain Management: A Systematic Review

et al. 2020

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Introduction: High-intensity laser therapy (HILT) has been used more recently in the therapeutic protocols of pain managements. Adding therapeutic interventions to laser therapy is usual in clinical practice. This study aimed to evaluate the efficacy of HILT and beneficial effects of adding cointerventions to HILT in musculoskeletal pain management. Methods: The following databases were searched up to August 2018: Medline, PubMed, EMBASE, Cochrane, Google Scholar, Springer and ISI. The keywords of pain, HILT, high power laser therapy, laser therapy, photobiomodulation, physical therapy and rehabilitation were searched. The quality of the articles was assessed using the PEDro scale. The primary measure was pain severity expected to be reported in all studies. Effect size was calculated as standardized mean differences divided by the standard deviation of either the treatment or other group. Results: Initially 52 potential studies were found. Eighteen of these studies were excluded based on title and abstract. The full text of 34 remaining articles was screened and 15 of the studies were excluded. All included studies had high quality (PEDro ≥7). Approximately, 94% of included articles (n=18) revealed positive effects of HILT on pain. The effect sizes for HILT and placebo/comparator groups were 0.9-9.11 and 0.21-11.22 respectively. Also, the differences of effect size between two groups were between 0.03 to 5.85. Conclusion: It is early to determine that HILT may be an effective non-invasive agent in the management of musculoskeletal pain, as few studies have shown its clinical efficacy. Adding related co-interventions to HILT may enhance the beneficial effects of laser therapy. The variability of the study methods and outcomes suggests that further long-term follow-up, randomized controlled clinical trials with appropriate methodological design are needed regarding the effectiveness of HILT on pain.

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Section: Resultsmentioning

confidence: 99%

The Beneficial Effects of High-Intensity Laser Therapy and Co-Interventions on Musculoskeletal Pain Management: A Systematic Review

et al. 2020

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“…We strongly recommend the attention of researchers to perform the prospective register of study protocol (and to publish the protocol in peer-reviewed journals when possible), 38,39 to follow the Consolidated Standards of Reporting Trials (CONSORT) guidelines when designing the trials, and the use of the TIDieR checklist (template for intervention description and replication) to confirm if all items required were reported in the manuscript before submission. 40,41 This is a way to reduce reporting bias and assist the authors to follow an adequate, clear, and transparent reporting of data and study design.…”

Section: Scientific Recommendationsmentioning

confidence: 99%

Clinical and scientific recommendations for the use of photobiomodulation therapy in exercise performance enhancement and post-exercise recovery: current evidence and future directions

Leal-Junior

Lopes-Martins

Bjordal

2019

Brazilian Journal of Physical Therapy

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Background: There is about ten years since the first randomized controlled trial looking for the effects of photobiomodulation therapy using low-level laser therapy and/or light emitting diodes therapy in athletic performance enhancement was published. Since then, the knowledge in this field has increasing exponentially. Objective: Given the fast advance in clinical interest, research and development in the use of photobiomodulation therapy for athletic performance enhancement and also to accelerate post-exercise recovery, as pioneers in this research field we felt the need to establish recommendations to ensure the correct use of the therapy, and also to guide the further studies in this area looking for the achievement of highest scientific evidence. It is important to highlight that the establishment of both clinical and scientific recommendations in this masterclass article were based on the most recent systematic reviews with meta-analysis and randomized controlled trials published in this field. It is important to stress that the recommendations of this masterclass article are based on most recent systematic reviews with meta-analysis and RCTs published in this research field. Future guidelines must follow the same direction and must be based only at the highest scientific evidence, avoiding overstatements and extrapolations based on animal experiments and case-studies.

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“…PBMT irradiation sites and parameters were chosen based on a previous study. [27] The treatment will be performed in a single session and the patients will receive a total dose of 220.05 J. Table 1 shows PBMT parameters.…”

Section: Methods and Analysismentioning

confidence: 99%

Effects of photobiomodulation therapy on inflammatory mediators in patients with chronic non-specific low back pain

et al. 2019

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Introduction: Low back pain (LBP) is ranked as one of the most prevalent health conditions. It is likely that some inflammatory mediators could be associated with pain and disability in these patients. Photobiomodulation therapy (PBMT) is a non-pharmacological therapy often used in patients with LBP and one of the possible mechanisms of action of therapy is modulate inflammatory mediators. However, to date there are no studies that evaluated the effects of PBMT on the levels of inflammatory mediators in patients with LBP. The aim of this study is to evaluate the acute effects of PBMT on systemic levels of inflammatory mediators and pain intensity in patients with chronic non-specific low back pain. Methods and analysis: This is a prospectively registered, two-arm randomized placebo-controlled trial with blinded patients, assessors and therapists. Eighteen patients with chronic non-specific LBP will be randomized into 2 groups: placebo or active PBMT. The treatment will be provided in a single session. The primary outcome will be levels of prostaglandin E 2 (PGE 2 ). The secondary outcomes will be levels of necrosis factor alpha (TNF-α), interleukin 6 (IL-6) and pain intensity. Biochemical and clinical outcomes will be measured at baseline and 15 minutes after the single treatment session. Discussion: Despite PBMT be used in musculoskeletal disorders such as LBP, to the best of our knowledge this is the first study that will investigate a possible biological mechanism behind the positive clinical effects of PBMT on non-specific chronic low back pain. Ethics and dissemination: The study was approved by the Regional Research Ethics Committee. The results will be disseminated through publication in peer-reviewed international journal and conferences. Trial registration number: NCT03859505.

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Effects of photobiomodulation therapy in patients with chronic non-specific low back pain: protocol for a randomised placebo-controlled trial

Cited by 20 publications

References 58 publications

The Beneficial Effects of High-Intensity Laser Therapy and Co-Interventions on Musculoskeletal Pain Management: A Systematic Review

The Beneficial Effects of High-Intensity Laser Therapy and Co-Interventions on Musculoskeletal Pain Management: A Systematic Review

Clinical and scientific recommendations for the use of photobiomodulation therapy in exercise performance enhancement and post-exercise recovery: current evidence and future directions

Effects of photobiomodulation therapy on inflammatory mediators in patients with chronic non-specific low back pain

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