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

• Published in: Archives of physical medicine and rehabilitation Vol. 79; no. 11; p. 1415
• Main Authors: de Bie, R A, de Vet, H C, Lenssen, T F, van den Wildenberg, F A, Kootstra, G, Knipschild, P G
• Format: Journal Article
• Language: English
• Published: United States 01-11-1998
• Subjects: Adult; Ankle Injuries - therapy; Bandages; Double-Blind Method; Female; Humans; Laser Therapy; Male; Pain - etiology; Pain Management; Sprains and Strains - physiopathology; Sprains and Strains - therapy
• ISSN: 0003-9993
• DOI: 10.1016/S0003-9993(98)90237-4

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.
Randomized, double-blind, controlled clinical trial with a follow-up of 1 year. Patients, therapists, assessors, and analysts were blinded to the assigned treatment.
An ambulatory care setting.
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.
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.
Pain and function as reported by the patient.
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.
Neither high- nor low-dose laser therapy is effective in the treatment of lateral ankle sprains.