Abstract
To examine the effects of laser moxibustion on pain and function in patients with knee osteoarthritis (OA). A double-blind randomized clinical trial (4-week treatment, 20-week follow-up) was conducted. A total of 392 symptomatic knee OA patients with moderate to severe clinically significant knee pain were randomly assigned to laser treatment or sham laser control group (1:1). Twelve sessions of laser moxibustion or sham laser treatments on the acupuncture points at the affected knee(s) were performed 3 times a week for 4 weeks. The primary outcome measurement was change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score from baseline to Week 4. Among the 392 randomized participants, 364 (92.86%) completed the trial. The median WOMAC pain score decreased significantly at Week 4 in the active group than in the sham group (2.1, 95% CI 1.6-2.6, P < 0.01). At Week 24, compared to the sham laser, active laser treatment resulted in significant pain reduction and function improvement (3.0, 95% CI 2.5-3.6, P < 0.01, and 14.8, 95% CI 11.9-17.6, P < 0.01, respectively). The physical component of the quality of life significantly improved in the active group vs the sham controls at Week 4 (3.2, 95% CI 1.3-5.0, P = 0.001) up to Week 24 (5.1, 95% CI 3.3-7.0, P < 0.001). No serious adverse effects were reported. Laser moxibustion resulted in statistically and clinically significant pain reduction and function improvement following a 4-week treatment in patients with knee OA.
Highlights
A laser device that mimics traditional moxibustion without smoke may be effective and safe for treating patients with knee osteoarthritis
The median WOMAC pain score significantly decreased at week 4 in the active group than in the sham group (2.2; 95% CI, 1.7 to 2.8; P < .01)
At week 24, compared to the sham laser, active laser treatment resulted in significant pain reduction and function improvement (3.3; 95% CI, 2.7 to 3.9; P < 0.01, and 15.7; 95% CI, 12.8 to 18.8; P < .01, respectively)
Summary
A laser device that mimics traditional moxibustion without smoke may be effective and safe for treating patients with knee osteoarthritis. Osteoarthritis (OA) is the most common form of arthritis and the leading cause of disability among older adults. Conventional treatment of knee OA mainly aims at alleviation of pain including pharmacological, such as non-steroidal anti-inflammatory drugs (NSAIDs) 7-15 and non-pharmacological managements[11, 13]. NSAIDs are associated with a moderate effect on pain relief. 9,10 evidence on their effectiveness is limited,[9,10,11,12, 14, 15] and often associated with undesirable side effects.[11, 14, 15] Recent review showed that appropriate treatments for knee OA included biomechanical interventions, intra-articular corticosteroids, exercise (land-based and water-based), self-management and education, strength training, and weight management. NSAIDs are associated with a moderate effect on pain relief. 9,10 evidence on their effectiveness is limited,[9,10,11,12, 14, 15] and often associated with undesirable side effects.[11, 14, 15] Recent review showed that appropriate treatments for knee OA included biomechanical interventions, intra-articular corticosteroids, exercise (land-based and water-based), self-management and education, strength training, and weight management. 13
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