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Therapeutic Modalities

Low level laser therapy for tendinopathy: evidence of a dose-response pattern

Summary:

This review assessed the effects of low-level laser therapy (LLLT) on pain from tendinopathy. The authors concluded that LLLT can reduce pain in subacute and chronic tendinopathy if a valid treatment procedure and location-specific dose is used. Differences among the studies were not examined and only the short-term outcomes were assessed. The authors’ conclusions may not be reliable.

Conclusion:

Thirteen RCTs with sixteen treatment comparisons were included (n approximately 789).

Nine RCTs using optimal laser treatment dose and power density found that LLLT reduced pain in patients with sub-acute and chronic tendinopathy compared with control (WMD 32%, 95% CI: 23, 41).

Nine RCTs using optimal laser treatment dose and power density and 4 RCTs not using optimal treatment parameters found that LLLT reduced pain compared with control (WMD 22%, 95% CI: 5.9, 36.1). There was a statistically significant difference between RCTs using optimal laser treatment dose and power density and those RCTs not using optimal treatment parameters (P<0.001).

The funnel plots suggested there was potential for some publication bias.

Author & Journal:Bjordal JM, et al, Phys Therapy Rev 2001;6:91-99
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The evaluation of extracorporeal shockwave therapy in naturally occurring osteoarthritis of the stifle joint in dogs.

Summary:

Extracorporeal shockwave therapy (ESWT) has expanded from the original uses of human urinary calculi treatment to veterinary orthopaedic applications. This paper investigates the feasibility and efficacy of treating dogs with osteoarthritis of the stifle joint with ESWT.

Conclusion:

The subjective data provided by client questionnaire did not show significant difference between groups.

Author & Journal:Dahlberg J, et al, Vet Comp Orthop Traumatol 18(3): 147-52, 2005
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In vivo tissue temperature comparison of cryotherapy with and without external compression.

Summary:

To compare the tissue-cooling efficiency of external cryotherapy with and without adjunctive compression.

Conclusion:

Externally applied instant cold packs in a dog model caused local tissue hypothermia that peaked by 20 minutes, persisted for at least 1 hour, and was significantly augmented by adjunctive compression. Further research is needed to evaluate the clinical efficacy and safety of these interventions in the management of acute soft-tissue injuries.

Author & Journal:Barlas D, et al, Ann Emerg Med 28:436-439, 1996
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