Low-level laser therapy in ankle sprains: a randomized clinical trial

R A de Bie; H C de Vet; T F Lenssen; F A van den Wildenberg; G Kootstra; P G Knipschild

doi:10.1016/s0003-9993(98)90237-4

Low-level laser therapy in ankle sprains: a randomized clinical trial

R A de Bie^*
, H C de Vet
, T F Lenssen
, F A van den Wildenberg
, G Kootstra
, P G Knipschild

^*Corresponding author for this work

FHML non-thematic output

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

OBJECTIVE: To test the efficacy of low-level laser therapy on lateral ankle sprains as an addition to a standardized treatment regimen, a trial was conducted in which high-dose laser (5J/cm2), low-dose laser (0.5J/cm2), and placebo laser therapy (0J/cm2) at skin level were compared.

DESIGN: Randomized, double-blind, controlled clinical trial with a follow-up of 1 year. Patients, therapists, assessors, and analysts were blinded to the assigned treatment.

SETTING: An ambulatory care setting.

PATIENTS: After informed consent and verification of exclusion criteria, 217 patients with acute lateral ankle sprains were randomized to three groups from September 1, 1993, through December 31, 1995.

INTERVENTIONS: Twelve treatments of 904nm laser therapy in 4 weeks as an adjunct to a standardized treatment regimen of 4 weeks of brace therapy combined with standardized home exercises and advice. The laser therapy device used was a 904nm Ga-As laser, with 25-watt peak power and 5,000 or 500Hz frequency, a pulse duration of 200nsec, and an irradiated area of 1cm2.

PRIMARY OUTCOME MEASURES: Pain and function as reported by the patient.

RESULTS: Intention-to-treat analysis of the short-term results showed no statistically significant difference on the primary outcome measure, pain (p = .41), although the placebo group showed slightly less pain. Function was significantly better in the placebo group at 10 days (p = .01) and 14 days (p = .03) after randomization. The placebo group also performed significantly better on days of sick leave (p = .02) and at some points for hindrance in activities in daily life and pressure pain, as well as subjective recovery (p = .05). Intention-to-treat analysis showed that total days of absenteeism from work and sports were remarkably lower in the placebo group than in the laser groups, ranging from 3.7 to 5.3 and 6 to 8 days, respectively. The total number of relapses at 1 year in the low-dose laser group (n = 22) was significantly higher (p = .04) than in the other two groups (high laser, n = 13; placebo, n = 13). Subgroup analysis to correct for possible confounders did not alter these findings.

CONCLUSIONS: Neither high- nor low-dose laser therapy is effective in the treatment of lateral ankle sprains.

Original language	English
Pages (from-to)	1415-20
Number of pages	6
Journal	Archives of Physical Medicine and Rehabilitation
Volume	79
Issue number	11
DOIs	https://doi.org/10.1016/s0003-9993(98)90237-4
Publication status	Published - Nov 1998

Keywords

Adult
Ankle Injuries/therapy
Bandages
Double-Blind Method
Female
Humans
Laser Therapy
Male
Pain/etiology
Pain Management
Sprains and Strains/physiopathology

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10.1016/s0003-9993(98)90237-4

Cite this

@article{ff86269ff5494f99b9b4e876b3f4a229,

title = "Low-level laser therapy in ankle sprains: a randomized clinical trial",

abstract = "OBJECTIVE: To test the efficacy of low-level laser therapy on lateral ankle sprains as an addition to a standardized treatment regimen, a trial was conducted in which high-dose laser (5J/cm2), low-dose laser (0.5J/cm2), and placebo laser therapy (0J/cm2) at skin level were compared.DESIGN: Randomized, double-blind, controlled clinical trial with a follow-up of 1 year. Patients, therapists, assessors, and analysts were blinded to the assigned treatment.SETTING: An ambulatory care setting.PATIENTS: After informed consent and verification of exclusion criteria, 217 patients with acute lateral ankle sprains were randomized to three groups from September 1, 1993, through December 31, 1995.INTERVENTIONS: Twelve treatments of 904nm laser therapy in 4 weeks as an adjunct to a standardized treatment regimen of 4 weeks of brace therapy combined with standardized home exercises and advice. The laser therapy device used was a 904nm Ga-As laser, with 25-watt peak power and 5,000 or 500Hz frequency, a pulse duration of 200nsec, and an irradiated area of 1cm2.PRIMARY OUTCOME MEASURES: Pain and function as reported by the patient.RESULTS: Intention-to-treat analysis of the short-term results showed no statistically significant difference on the primary outcome measure, pain (p = .41), although the placebo group showed slightly less pain. Function was significantly better in the placebo group at 10 days (p = .01) and 14 days (p = .03) after randomization. The placebo group also performed significantly better on days of sick leave (p = .02) and at some points for hindrance in activities in daily life and pressure pain, as well as subjective recovery (p = .05). Intention-to-treat analysis showed that total days of absenteeism from work and sports were remarkably lower in the placebo group than in the laser groups, ranging from 3.7 to 5.3 and 6 to 8 days, respectively. The total number of relapses at 1 year in the low-dose laser group (n = 22) was significantly higher (p = .04) than in the other two groups (high laser, n = 13; placebo, n = 13). Subgroup analysis to correct for possible confounders did not alter these findings.CONCLUSIONS: Neither high- nor low-dose laser therapy is effective in the treatment of lateral ankle sprains.",

keywords = "Adult, Ankle Injuries/therapy, Bandages, Double-Blind Method, Female, Humans, Laser Therapy, Male, Pain/etiology, Pain Management, Sprains and Strains/physiopathology",

author = "\{de Bie\}, \{R A\} and \{de Vet\}, \{H C\} and Lenssen, \{T F\} and \{van den Wildenberg\}, \{F A\} and G Kootstra and Knipschild, \{P G\}",

year = "1998",

month = nov,

doi = "10.1016/s0003-9993(98)90237-4",

language = "English",

volume = "79",

pages = "1415--20",

journal = "Archives of Physical Medicine and Rehabilitation",

issn = "0003-9993",

publisher = "W.B. Saunders",

number = "11",

}

TY - JOUR

T1 - Low-level laser therapy in ankle sprains

T2 - a randomized clinical trial

AU - de Bie, R A

AU - de Vet, H C

AU - Lenssen, T F

AU - van den Wildenberg, F A

AU - Kootstra, G

AU - Knipschild, P G

PY - 1998/11

Y1 - 1998/11

N2 - OBJECTIVE: To test the efficacy of low-level laser therapy on lateral ankle sprains as an addition to a standardized treatment regimen, a trial was conducted in which high-dose laser (5J/cm2), low-dose laser (0.5J/cm2), and placebo laser therapy (0J/cm2) at skin level were compared.DESIGN: Randomized, double-blind, controlled clinical trial with a follow-up of 1 year. Patients, therapists, assessors, and analysts were blinded to the assigned treatment.SETTING: An ambulatory care setting.PATIENTS: After informed consent and verification of exclusion criteria, 217 patients with acute lateral ankle sprains were randomized to three groups from September 1, 1993, through December 31, 1995.INTERVENTIONS: Twelve treatments of 904nm laser therapy in 4 weeks as an adjunct to a standardized treatment regimen of 4 weeks of brace therapy combined with standardized home exercises and advice. The laser therapy device used was a 904nm Ga-As laser, with 25-watt peak power and 5,000 or 500Hz frequency, a pulse duration of 200nsec, and an irradiated area of 1cm2.PRIMARY OUTCOME MEASURES: Pain and function as reported by the patient.RESULTS: Intention-to-treat analysis of the short-term results showed no statistically significant difference on the primary outcome measure, pain (p = .41), although the placebo group showed slightly less pain. Function was significantly better in the placebo group at 10 days (p = .01) and 14 days (p = .03) after randomization. The placebo group also performed significantly better on days of sick leave (p = .02) and at some points for hindrance in activities in daily life and pressure pain, as well as subjective recovery (p = .05). Intention-to-treat analysis showed that total days of absenteeism from work and sports were remarkably lower in the placebo group than in the laser groups, ranging from 3.7 to 5.3 and 6 to 8 days, respectively. The total number of relapses at 1 year in the low-dose laser group (n = 22) was significantly higher (p = .04) than in the other two groups (high laser, n = 13; placebo, n = 13). Subgroup analysis to correct for possible confounders did not alter these findings.CONCLUSIONS: Neither high- nor low-dose laser therapy is effective in the treatment of lateral ankle sprains.

AB - OBJECTIVE: To test the efficacy of low-level laser therapy on lateral ankle sprains as an addition to a standardized treatment regimen, a trial was conducted in which high-dose laser (5J/cm2), low-dose laser (0.5J/cm2), and placebo laser therapy (0J/cm2) at skin level were compared.DESIGN: Randomized, double-blind, controlled clinical trial with a follow-up of 1 year. Patients, therapists, assessors, and analysts were blinded to the assigned treatment.SETTING: An ambulatory care setting.PATIENTS: After informed consent and verification of exclusion criteria, 217 patients with acute lateral ankle sprains were randomized to three groups from September 1, 1993, through December 31, 1995.INTERVENTIONS: Twelve treatments of 904nm laser therapy in 4 weeks as an adjunct to a standardized treatment regimen of 4 weeks of brace therapy combined with standardized home exercises and advice. The laser therapy device used was a 904nm Ga-As laser, with 25-watt peak power and 5,000 or 500Hz frequency, a pulse duration of 200nsec, and an irradiated area of 1cm2.PRIMARY OUTCOME MEASURES: Pain and function as reported by the patient.RESULTS: Intention-to-treat analysis of the short-term results showed no statistically significant difference on the primary outcome measure, pain (p = .41), although the placebo group showed slightly less pain. Function was significantly better in the placebo group at 10 days (p = .01) and 14 days (p = .03) after randomization. The placebo group also performed significantly better on days of sick leave (p = .02) and at some points for hindrance in activities in daily life and pressure pain, as well as subjective recovery (p = .05). Intention-to-treat analysis showed that total days of absenteeism from work and sports were remarkably lower in the placebo group than in the laser groups, ranging from 3.7 to 5.3 and 6 to 8 days, respectively. The total number of relapses at 1 year in the low-dose laser group (n = 22) was significantly higher (p = .04) than in the other two groups (high laser, n = 13; placebo, n = 13). Subgroup analysis to correct for possible confounders did not alter these findings.CONCLUSIONS: Neither high- nor low-dose laser therapy is effective in the treatment of lateral ankle sprains.

KW - Adult

KW - Ankle Injuries/therapy

KW - Bandages

KW - Double-Blind Method

KW - Female

KW - Humans

KW - Laser Therapy

KW - Male

KW - Pain/etiology

KW - Pain Management

KW - Sprains and Strains/physiopathology

U2 - 10.1016/s0003-9993(98)90237-4

DO - 10.1016/s0003-9993(98)90237-4

M3 - Article

C2 - 9821903

SN - 0003-9993

VL - 79

SP - 1415

EP - 1420

JO - Archives of Physical Medicine and Rehabilitation

JF - Archives of Physical Medicine and Rehabilitation

IS - 11

ER -

Low-level laser therapy in ankle sprains: a randomized clinical trial

Abstract

Keywords

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