Evaluation of the efficiency of low-power laser shower in management of knee osteoarthritis

Low-level laser therapy (LLLT) is a non-pharmacological modality with a proven effect of reducing inflammation in vivo. This case interventional study aimed to evaluate the efficiency of LLLT shower to relieve the pain and physical functions of participants with knee osteoarthritis (KOA) grades 2 and 3. Forty adult participants were included in the study; however, according to the Kellgren-Lawrence classification, participants with KOA (grades 2 and 3) were consented to receive LLLT sessions (Gallium-aluminum arsenide laser), 1-min exposure time over three areas; one on popliteal fossa at back of the knee, and the other two para patella areas at front of the knee for twelve sessions (3 times a week). Pre and post 4 weeks of sessions, pain intensity on the visual analog scale, tenderness score, goniometry of knee range of motion, Western Ontario and McMaster Universities Arthritis Index, Lequesne Index, and timed up and go test were recorded. Before and after the therapeutic sessions, blood samples were withdrawn for laboratory analyses (blood ESR and serum IL-1β, IL-4, IL-6, and enkephalin). The obtained results declared that all clinical characteristics of knee osteoarthritis including pain on the visual analog scale (VAS), number of tender points (NTP), tenderness score (TS), angle of knee flexion, heel to hip distance, Western Ontario, and McMaster Universities Arthritis Index (WOMAC) score, Lequesne Index, and timed up and go test showed a significant improvement. This improvement was confirmed by the marked upregulation in the level of pain killer (serum enkephalin) and the anti-inflammatory cytokine (serum IL-4); also, a marked downregulation was recorded in the pro-inflammatory cytokine (IL-1β and IL-6) and blood ESR levels. The marked improvement in the clinical characteristics reflected that LLLT was effective in relieving pain and physical functions of knee osteoarthritis patients (grades 2 and 3); this could be mechanized through the upregulation of the anti-inflammatory agents as well as enkephalin levels.