article · Photobiomodulation Photomedicine and Laser Surgery
This study evaluated and compared the effects of high-intensity laser therapy and extracorporeal shock wave therapy as outpatient physical therapy modalities for individuals with knee osteoarthritis. Forty patients with stage II knee osteoarthritis were randomly allocated into two equal groups, alongside a standard conservative physical therapy programme. One group received extracorporeal shock wave therapy once a week for four weeks, while the other received high-intensity laser therapy three times a week for four weeks. Outcomes were assessed before and after the four-week intervention using a visual analogue scale for pain, a six-minute walking test for physical function, and the Western Ontario and McMaster Universities Osteoarthritis Index for disability. Although both interventions led to statistically significant improvements across all measured outcomes, high-intensity laser therapy produced significantly greater improvements in pain relief, functional ability, and disability reduction compared to shock wave therapy.
Knee osteoarthritis is a common, chronic condition that causes pain and limits everyday mobility. Identifying non-invasive physical therapy treatments that provide superior symptom relief helps clinicians design better care plans, potentially offering patients more effective ways to manage pain and recover functional movement without surgical intervention.
The findings provide clinical trial evidence directly relevant to healthcare providers, physiotherapy clinics, and medical device manufacturers. High-intensity laser therapy protocols represent an applied, tested clinical approach ready for adoption in outpatient rehabilitation settings to improve therapeutic offerings for knee osteoarthritis management, though the abstract does not describe any new commercial product or device development.
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<b><i>Objective:</i></b> The aim of this study was to evaluate and compare the effects of extracorporeal shock wave therapy (ESWT) and high-intensity laser therapy (HILT), as outpatient physical therapy modalities, on knee osteoarthritis (KOA) patients. <b><i>Materials and methods:</i></b> The treatment program was completed by 40 individuals with stage II KOA (according to Kellgren and Lawrence) who were randomly allocated to one of two groups. They have had more than grade 3 pain on the visual analog scale (VAS) during activities for the last 3 months, with body-mass index less than 30 and no history of knee operation, fracture, cancer, or other neuromuscular or musculoskeletal diseases that may affect study results. The ESWT group (<i>n</i> = 20, mean age = 40.12 ± 9.45 years) received ESWT, 0.05 mJ/mm<sup>2</sup>, one session/week for 4 weeks, and the HILT group (<i>n</i> = 20, mean age = 46.62 ± 8.68 years) received HILT, 1500 mJ/cm<sup>2</sup> in each session, three sessions/week for 4 weeks. Both groups received conservative physical therapy programs. Before and after 4 weeks of intervention, pain, physical function, and disability were assessed using a VAS, 6-min walking test, and the Western Ontario and McMaster Universities Osteoarthritis Index. <b><i>Results:</i></b> When the pre- and post-treatment mean values of dependent variables of both groups were compared, there were statistically significant improvements in both groups. Significant differences in the measured variables were also discovered in favor of the HILT group compared with the ESWT group. <b><i>Conclusions:</i></b> HILT showed a superior effect compared with ESWT on pain, physical function, and disability in chronic KOA patients. Pan African Clinical Trials Registry number: PACTR202007638955907.
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DOI: 10.1089/photob.2021.0136
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