High-intensity laser plus physical activity beneficial in knee osteoarthritis

In the management of patients with knee osteoarthritis, the combination of high-intensity laser therapy (HILT) plus exercise therapy (ET) yields more favourable effects on several outcomes, such as pain and functional disability, when compared with low-intensity pulsed ultrasound (LIPUS) plus ET, although both combinations are better than physical activity alone, according to a study.

The study included 60 patients with grades II and III knee osteoarthritis based on the radiological findings in Kellgren and Lawrence grading scale. They were randomly assigned to one of the following intervention arms: group I (HILT+ET), group II (LIPUS+ET), and control (ET) group.

Patients (mean age 55.4 years) across the three intervention arms underwent active range of motion (ROM), muscle strengthening, and flexibility exercises. Treatment was administered five times per week for two successive weeks.

Researchers evaluated pain using the visual analogue scale (VAS) as the primary outcome. They also assessed knee ROM, proprioceptive accuracy, and functional activity (Western Ontario and McMaster Universities Arthritis Index scale). All outcomes were measured at baseline and after the intervention.

The mean age of the patients was 55.4 years in the HILT+ET arm, 55.2 years in the LIPUS+ET, and 57 years in the control arm. There were statistically significant time-by-group effects (mixed-design multivariate analysis of variance) on all measured outcomes across the intervention arms (p<0.0001).

However, the HILT+ET arm showed greater magnitude of improvements compared the other two arms (p<0.0001). Between-group comparisons revealed a significant difference in all measured outcomes between HILT+ET vs LIPUS+ET arm, and between each combination arm vs the control arm (p=0.0001).