Abstract
Objective: To assess the effectiveness of therapeutic phototherapy including laser, light-emitting diode, and supraluminous diode energy, in the management of osteoarthritis in aging and older adults.
Methods: A systematic review of PubMed and CINAHL was completed using the following search terms and their associated abbreviations: laser, supraluminous diode (SLD), or light-emitting diode (LED) combined with therapy, intervention, or treatment. We included randomized controlled trials published between January 1, 2008, and December 31, 2018, written in English, and included human subjects who had a central tendency for age greater than or equal to 50 years.
Results: Twenty-two randomized controlled trials met our search criteria. Multiple pathologies were evaluated including knee osteoarthritis (n = 20), total hip arthroplasty (n = 1), and hand osteoarthritis (n = 1). Of these 22 studies, 2 compared laser to control, 8 compared laser to sham or placebo, 1 compared laser to therapeutic exercise, 1 compared laser with exercise to control, 3 compared laser paired with exercise to exercise only, 4 compared laser with exercise to placebo with exercise, 3 compared laser to other modalities, 3 compared laser with other modalities to other modalities, 1 compared laser with other modalities to exercise with other modalities, 1 compared laser with exercise and glucosamine/chondroitin sulfate (GCS) to GCS and exercise as well as placebo and exercise, 1 compared laser intensities, and 2 compared laser used with ultrasound (US) to placebo as well as combination laser/US with exercise to placebo and only the combination laser/US unit. As demonstrated by this variability, a meta-analysis was not appropriate. Studies on knee osteoarthritis varied slightly in their results, but the majority of groups that received laser showed significant improvements in pain, function, and quality of life when compared with placebo or control. High-intensity laser demonstrated larger improvements when compared with low-level laser therapy. Histological studies found significant changes in some of the markers associated with tissue healing favoring the laser treatment groups.
Conclusion: The studies included all used a form of laser in their light therapy treatment protocols. There is some evidence that light therapy may provide statistically significant improvements in pain, function, and quality of life; however, results varied from study to study. Further research is needed to better evaluate the parameters associated with laser when used to treat conditions associated with osteoarthritis that affect aging and older adults.