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Effects of Laser Therapy on Rheumatoid Arthritis: A Systematic Review and Meta-analysis
Wen-Chun Chia1, Ching-Hsiang Chang, Wen-Hsuan Hou
1From the Department of General Medicine, Cathy General Hospital, Taipei, Taiwan (W-CC, C-HC); Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan (W-HH); Center of Evidence-based Medicine, Department of Education, Taipei Medical University Hospital, Taipei, Taiwan (W-HH); Master Program in Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan (W-HH); and Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan (W-HH).
Objective:
The aim of the study was to examine the effects of laser therapy on rheumatoid arthritis.
Design:
A search of controlled trials was conducted in different medical electronic databases. The primary outcome was immediate pain relief after treatment. Secondary outcomes were level of functional disability, morning stiffness duration, and 3-mo follow-up for pain.
Results:
Ten trials met the inclusion criteria. Rheumatoid arthritis treatment with laser therapy significantly improved immediate pain relief (standardized mean difference = -0.839, 95% confidence interval = -1.336 to -0.343) and overall functional score (standardized mean difference = -0.309, 95% confidence interval = -0.587 to -0.031). There was no significant improvement in morning stiffness duration (standardized mean difference = -0.519, 95% confidence interval = -1.176 to 0.138), and 3-mo follow-up for pain (standardized mean difference = -1.125, 95% confidence interval = -2.311 to 0.061). There was no publication bias (Egger regression, P = 0.277). However, heterogeneity was noted despite the removal of an outlier (Q = 18.646, I2 = 57.096). Results of subgroup analyses suggested that high-intensity laser therapy and nerve irradiation are better suited for immediate pain relief. Meta-regression analyses showed no significant linear relationship between the treatment effect with laser wavelength or number of treatment sessions.
Conclusions:
Laser therapies provide significant immediate pain relief and improve function for rheumatoid arthritis patients, but without significant improvement in morning stiffness duration and 3-mo follow-up for pain.Systematic review registration number: CRD42020192906.
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