Laser therapy for OA
Each month, we will review a published article that relates to OA. Most articles will be specifically about canine OA diagnosis and treatment, but we will also dig into the translational research, meaning we will occasionally review an article from a human or equine medical journal if the topic is relevant to canine OA. Articles we review may be hot off the press, or might be “oldies but goodies.” As always, you can find a long list of references, including the monthly articles of interest, here.
CARE Article of Interest—September 2020
Title: Preliminary clinical experience of low-level laser therapy for the treatment of canine OA- associated pain: A retrospective investigation on 17 dogs.
Authors: Barale L, Monticelli P, Raviola M, Adami C.
Journal: Open Veterinary Journal
Background: Laser therapy (aka photobiomodulation) is often used to treat OA in veterinary patients, but the evidence to support this treatment is weak. At the time of this publication, there was one single prior publication investigating laser therapy for dogs with elbow OA (Looney et. al, Can Vet J 2018). This study found that with the laser and protocol studied (980 nm, 5-12 W, CW, 1-2.4W/cm2, 10-19 J/cm2, non-contact mode, scanning method; treatment 2x week for 3 weeks then once a week for 3 weeks), laser-treated dogs (n=11) showed significantly (p=0.001) greater reduction in lameness compared to sham (n=9) treated dogs. NSAID dose was also able to be decreased in 9 of the 11 laser treated dogs. The authors of the current study (Barale et. al) aimed to report the clinical outcomes following a different laser therapy protocol in dogs with OA.
Study Design: Retrospective case series, n=17 dogs with OA of the hips, elbows, stifle or LS.
Intervention: Laser treatment to effected joint and associated muscle using an 808nm, 1W, 1W/cm2 device(LaserVet 1000, GlobusVet), treatment 1x/ week for 6 weeks. Dose: Joints 5 J/cm2, 500-1000 Hz; Muscles 4.2 J/cm2, 3,000-5,000 Hz.
Outcome Measure: VAS (veterinarian assessed), CBPI
Results: Both VAS and CBPI decreased significantly (p<0.05) at 2, 4, and 6 weeks after starting therapy compared to baseline values.
Limitations: Retrospective study, no control (sham) group, veterinarians and owners were not blinded to treatment therefore may have been biased, and lack of objective outcome measures.
Conclusion/ Summary: Authors conclude that while this study did demonstrate positive effects of this protocol for managing OA, “more prospective clinical trials are needed to prove the usefulness of laser to treat OA-associated pain and to refine case-specific protocols.” It is very important to recognize that this study investigated a very specific protocol (laser wavelength, power, pulse frequency, dosing, application…) and therefore these results cannot be directly extrapolated to other, different devices and protocols. However, between this study and that of Looney et al, practitioners are encouraged to consider refining their current protocols, if possible, to deliver treatment based on this emerging evidence or to conduct their own prospective clinical trials with different protocols.