关于低强度光疗法（LLLT）治疗膝骨关节炎症状最佳波长的系统综述和网络荟萃分析。

IF 3.4 3区医学 Q2 GERIATRICS & GERONTOLOGY

Aging Clinical and Experimental Research Pub Date : 2024-10-05 DOI:10.1007/s40520-024-02853-0

Tianxiang Fan, Yang Li, Arnold Y. L. Wong, Xiao Liang, Yarou Yuan, Peng Xia, Zhi Yao, Deli Wang, Marco Y. C. Pang, Changhai Ding, Zhaohua Zhu, Ye Li, Siu Ngor Fu

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引用次数: 0

摘要

研究目的比较各种波长的低强度光疗法（LLLT）在减轻膝关节骨性关节炎（KOA）患者膝关节疼痛、功能障碍和僵硬方面的疗效，并比较 LLLT 与假治疗在减轻膝关节疼痛、功能障碍和僵硬方面的疗效：方法：检索了 PubMed、Web of Science、EMBASE 和 Cochrane Library 从开始到 2023 年 12 月 12 日的资料。纳入的随机对照试验评估了不同波长的 LLLT 对缓解 KOA 患者疼痛的效果。进行了常规荟萃分析和网络荟萃分析，并计算了标准化平均差（SMD）和95%置信区间（CI）：有 13 项研究符合纳入标准，涉及 673 名 KOA 患者。总体而言，LLLT 在缓解疼痛（SMD = 0.96，95% CI 0.31-1.61）方面优于假 LLLT，但在改善功能（SMD = 0.21，95% CI - 0.11 至 0.53）或僵硬（SMD = 0.07，95% CI - 0.25 至 0.39）方面则不尽相同。累积排名曲线下表面（SUCRA）值排名显示，LLLT 对减轻 KOA 疼痛最有效的波长是 904-905 nm（SUCRA，86.90%），其次是多波长（MWL）（SUCRA，56.43%）和 785-850 nm（SUCRA，54.97%）。与假 LLLT 相比，L2（SMD = 1.42，95% CI = 0.31-2.53）和 L1（SMD = 0.82；95% CI = 0.11-1.50）可显著减轻 KOA 疼痛。然而，与假LLLT相比，MWL（SMD = 0.83; 95% CI = - 0.06至1.72）显示出相似的KOA疼痛减轻效果。证据的确定性表明，整体 LLLT 与假 LLLT 相比、904-905 nm 与假 LLLT 相比，证据质量较低，而 MWL 与假 LLL 相比、785-850 nm 与假 LLLT 相比，证据质量非常低：结论：虽然 904-905 nm 波长的激光疗法在减轻 KOA 疼痛方面具有潜在优势，但总体证据质量较低。与假 LLLT 相比，904-905 nm 或 785-850 nm 波长的 LLLT 能明显更好地减轻 KOA 疼痛，但还需要进一步的高质量研究来验证这些发现。

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A systematic review and network meta-analysis on the optimal wavelength of low-level light therapy (LLLT) in treating knee osteoarthritis symptoms

Objectives

To compare the efficacy of the various wavelengths of low-level light therapy (LLLT) in alleviating knee pain, dysfunction, and stiffness in patients with knee osteoarthritis (KOA), and to compare the effectiveness of LLLT versus sham treatment in reducing knee pain, dysfunction, and stiffness.

Methods

PubMed, Web of Science, EMBASE, and Cochrane Library were searched from inception to 12 December 2023. Randomized controlled trials that assessed the effects of different wavelengths of LLLT on alleviating pain of patients with KOA were included. A conventional meta-analysis and network meta-analysis were preformed, and standardized mean differences (SMD) with 95% confidence interval (CI) were calculated.

Results

Thirteen studies involving 673 participants with KOA met inclusion criteria. Overall, LLLT was superior to sham LLLT for relieving pain (SMD = 0.96, 95% CI 0.31–1.61) but not for improving function (SMD = 0.21, 95% CI − 0.11 to 0.53) or stiffness (SMD = 0.07, 95% CI − 0.25 to 0.39). Surface under the cumulative ranking curve (SUCRA) value ranking showed the most effective wavelength of LLLT in reducing KOA pain was 904–905 nm (SUCRA, 86.90%), followed by multi-wavelengths (MWL) (SUCRA, 56.43%) and 785–850 nm (SUCRA, 54.97%). Compared to sham LLLT, L2 (SMD = 1.42, 95% CI = 0.31–2.53) and L1 (SMD = 0.82; 95% CI = 0.11–1.50) showed a significant reduction in KOA pain. However, MWL (SMD = 0.83; 95% CI = − 0.06 to 1.72) showed similar KOA pain reduction compared to sham LLLT. The certainty of evidence showed that the quality of evidence regarding the effectiveness of overall LLLT versus sham, and 904–905 nm versus sham were low, while the quality of evidence for MWL versus sham, and 785–850 nm versus sham was very low.

Conclusion

While the 904–905 nm wavelength showed potential benefits in reducing KOA pain, the overall quality of the evidence was low. LLLT with 904–905 nm or 785–850 nm wavelengths yielded significantly better reduction in KOA pain compared to sham LLLT, but further high-quality research is warranted to validate these findings.

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来源期刊

Aging Clinical and Experimental Research 医学-老年医学

CiteScore

7.90

自引率

5.00%

发文量

283

审稿时长

1 months

期刊介绍： Aging clinical and experimental research offers a multidisciplinary forum on the progressing field of gerontology and geriatrics. The areas covered by the journal include: biogerontology, neurosciences, epidemiology, clinical gerontology and geriatric assessment, social, economical and behavioral gerontology. “Aging clinical and experimental research” appears bimonthly and publishes review articles, original papers and case reports.