{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T17:16:17Z","timestamp":1788887777617,"version":"build-2803163510"},"reference-count":51,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,9,15]],"date-time":"2022-09-15T00:00:00Z","timestamp":1663200000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003399","name":"Science and Technology Commission of Shanghai Municipality","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003399","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The use of physical therapy modalities, especially high intensity laser therapy (HILT), for individuals with knee osteoarthritis (KOA) is still controversial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare the effects of HILT to other physical therapy modalities on symptoms and function in individuals with KOA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Six databases (PubMed, Embase, Cochrane Library, Web of Science, EBSCO, and PEDro) were searched in March 2022. Included studies were randomized controlled trials involving HILT conducted on individuals with KOA. The end-trial weighted mean difference (WMD) and standard deviations (SD) with 95% confidence intervals (CI) were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ten studies with 580 participants were obtained, of which nine were included in the final network meta-analysis. In terms of relieving pain, HILT demonstrated the highest probability of being among the most effective treatments, with surface under the cumulative ranking (SUCRA) = 100%, and compared to a control (placebo laser or exercise or a combination of both) on the visual analog scale (VAS) for pain it demonstrated significant benefits (WMD 1.66, 95% CI 1.48\u20131.84). For improving self-reported function, as measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total scores, the HILT SUCRA value led with 98.9%. When individuals with KOA were treated by HILT, the improvement in stiffness was statistically significant (WMD 0.78, 95% CI 0.52\u20131.04) but the amount of improvement was smaller than the minimal clinically important difference (MCID).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The current evidence suggests that HILT may be more effective than other physical therapy modalities for improving pain and function in individuals with KOA. For improving stiffness, however, it may not be clinically effective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      [\n                      <jats:ext-link>https:\/\/www.researchregistry.com<\/jats:ext-link>\n                      ], identifier [1148].\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2022.956188","type":"journal-article","created":{"date-parts":[[2022,9,15]],"date-time":"2022-09-15T04:21:40Z","timestamp":1663215700000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":27,"title":["Is high intensity laser therapy more effective than other physical therapy modalities for treating knee osteoarthritis? A systematic review and network meta-analysis"],"prefix":"10.3389","volume":"9","author":[{"given":"Menglai","family":"Wu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lijiang","family":"Luan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Pranata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Witchalls","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Adams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaquelin","family":"Bousie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,9,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"582","DOI":"10.1177\/0269215517691083","article-title":"The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis.","volume":"31","author":"Brosseau","year":"2017","journal-title":"Clin Rehabil."},{"key":"B2","doi-asserted-by":"publisher","first-page":"571","DOI":"10.5435\/JAAOS-21-09-571","article-title":"Treatment of osteoarthritis of the knee: evidence-based guideline, 2nd edition.","volume":"21","author":"Jevsevar","year":"2013","journal-title":"J Am Acad Orthop Surg."},{"key":"B3","first-page":"p. 8","year":"2014","journal-title":"National Institute for Health and Clinical Excellence: Guidance. In: Osteoarthritis: Care and Management in Adults."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1578","DOI":"10.1016\/j.joca.2019.06.011","article-title":"OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis.","volume":"27","author":"Bannuru","year":"2019","journal-title":"Osteoarthr Cartil."},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0172749","article-title":"Cost-effectiveness of adjunct non-pharmacological interventions for osteoarthritis of the knee.","volume":"12","author":"Woods","year":"2017","journal-title":"PLoS One."},{"key":"B6","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1097\/BOR.0000000000000160","article-title":"Physical therapies in the management of osteoarthritis: current state of the evidence.","volume":"27","author":"Bennell","year":"2015","journal-title":"Curr Opin Rheumatol."},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-8-51","article-title":"Short-term efficacy of physical interventions in osteoarthritic knee pain. A systematic review and meta-analysis of randomised placebo-controlled trials.","volume":"8","author":"Bjordal","year":"2007","journal-title":"BMC Musculoskelet Disord."},{"key":"B8","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1089\/pho.2012.3240","article-title":"Meta-analysis of pain relief effects by laser irradiation on joint areas.","volume":"30","author":"Jang","year":"2012","journal-title":"Photomed Laser Surg."},{"key":"B9","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1089\/pho.2017.4425","article-title":"Efficacy of high-intensity laser therapy in treating knee osteoarthritis: a first systematic review.","volume":"36","author":"Wyszynska","year":"2018","journal-title":"Photomed Laser Surg."},{"key":"B10","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1007\/s10103-014-1671-8","article-title":"Effect of high-intensity laser therapy in the management of myofascial pain syndrome of the trapezius: a double-blind, placebo-controlled study.","volume":"30","author":"Dundar","year":"2015","journal-title":"Lasers Med Sci."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1097","DOI":"10.1007\/s10103-015-1716-7","article-title":"Effectiveness of high-intensity laser therapy and splinting in lateral epicondylitis; a prospective, randomized, controlled study.","volume":"30","author":"Dundar","year":"2015","journal-title":"Lasers Med Sci."},{"key":"B12","doi-asserted-by":"publisher","first-page":"947","DOI":"10.1007\/s10103-018-2682-7","article-title":"Comparison of high-intensity laser therapy and combination of ultrasound treatment and transcutaneous nerve stimulation in patients with cervical spondylosis: a randomized controlled trial.","volume":"34","author":"Venosa","year":"2019","journal-title":"Lasers Med Sci."},{"key":"B13","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/j.physio.2021.03.011","article-title":"Effects of low-level and high-intensity laser therapy as adjunctive to rehabilitation exercise on pain, stiffness and function in knee osteoarthritis: a systematic review and meta-analysis.","volume":"114","author":"Ahmad","year":"2022","journal-title":"Physiotherapy."},{"key":"B14","doi-asserted-by":"publisher","first-page":"875","DOI":"10.3233\/BMR-191738","article-title":"Effectiveness of high-intensity laser therapy in the management of patients with knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials.","volume":"33","author":"Song","year":"2020","journal-title":"J Back Musculoskelet Rehabil."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1001","DOI":"10.1016\/j.jclinepi.2014.04.003","article-title":"Network meta-analyses could be improved by searching more sources and by involving a librarian.","volume":"67","author":"Li","year":"2014","journal-title":"J Clin Epidemiol."},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1186\/2046-4053-1-41","article-title":"Sample size and power considerations in network meta-analysis.","volume":"1","author":"Thorlund","year":"2012","journal-title":"Syst Rev."},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0092508","article-title":"The quality of reporting methods and results in network meta-analyses: an overview of reviews and suggestions for improvement.","volume":"9","author":"Hutton","year":"2014","journal-title":"PLoS One."},{"key":"B18","doi-asserted-by":"publisher","first-page":"777","DOI":"10.7326\/M14-2385","article-title":"The PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions: checklist and explanations.","volume":"162","author":"Hutton","year":"2015","journal-title":"Ann Intern Med."},{"key":"B19","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1016\/j.jclinepi.2021.02.003","article-title":"Updating guidance for reporting systematic reviews: development of the PRISMA 2020 statement.","volume":"134","author":"Page","year":"2021","journal-title":"J Clin Epidemiol."},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0222770","article-title":"Agreement between the cochrane risk of bias tool and physiotherapy evidence database (PEDro) scale: a meta-epidemiological study of randomized controlled trials of physical therapy interventions.","volume":"14","author":"Moseley","year":"2019","journal-title":"PLoS One."},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-008562","article-title":"What is the influence of randomisation sequence generation and allocation concealment on treatment effects of physical therapy trials? A meta-epidemiological study.","volume":"5","author":"Armijo-Olivo","year":"2015","journal-title":"BMJ Open."},{"key":"B22","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1177\/183335839902800410","article-title":"PEDro: a database of randomised controlled trials in physiotherapy.","volume":"28","author":"Herbert","year":"2016","journal-title":"Health Inf Manag."},{"key":"B23","doi-asserted-by":"publisher","first-page":"713","DOI":"10.1093\/ptj\/83.8.713","article-title":"Reliability of the PEDro scale for rating quality of randomised controlled trials.","volume":"83","author":"Maher","year":"2003","journal-title":"Phys Ther."},{"key":"B24","author":"Higgins","year":"2011","journal-title":"Cochrane Handbook for Systematic Reviews of Interventions."},{"key":"B25","doi-asserted-by":"publisher","first-page":"594","DOI":"10.1016\/j.jclinepi.2010.08.009","article-title":"Reported quality of randomized controlled trials of physiotherapy interventions has improved over time.","volume":"64","author":"Moseley","year":"2011","journal-title":"J Clin Epidemiol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"1191","DOI":"10.1111\/j.1365-2044.1976.tb11971.x","article-title":"The reliability of a linear analogue for evaluating pain.","volume":"31","author":"Revill","year":"1976","journal-title":"Anaesthesia."},{"key":"B27","doi-asserted-by":"publisher","first-page":"972","DOI":"10.1002\/acr.22538","article-title":"Development of multinational definitions of minimal clinically important improvement and patient acceptable symptomatic state in osteoarthritis.","volume":"67","author":"Bellamy","year":"2015","journal-title":"Arthritis Care Res."},{"key":"B28","doi-asserted-by":"publisher","first-page":"1440","DOI":"10.1093\/rheumatology\/kes043","article-title":"The use and reporting of WOMAC in the assessment of the benefit of physical therapies for the pain of osteoarthritis of the knee: findings from a systematic review of clinical trials.","volume":"51","author":"Woolacott","year":"2012","journal-title":"Rheumatology."},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2018-000685","article-title":"Multidimensional minimal clinically important differences in knee osteoarthritis after comprehensive rehabilitation: a prospective evaluation from the bad Zurzach osteoarthritis study.","volume":"4","author":"Angst","year":"2018","journal-title":"RMD Open."},{"key":"B30","doi-asserted-by":"publisher","first-page":"1989","DOI":"10.1007\/s10067-020-05469-7","article-title":"Efficacy of high intensity laser therapy in knee osteoarthritis: a double-blind controlled randomized study.","volume":"40","author":"Akaltun","year":"2021","journal-title":"Clin Rheumatol."},{"key":"B31","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1007\/s10103-017-2141-x","article-title":"Efficacy of pulsed Nd:YAG laser in the treatment of patients with knee osteoarthritis: a randomized controlled trial.","volume":"32","author":"Alayat","year":"2017","journal-title":"Lasers Med Sci."},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/9163618","article-title":"Effectiveness of high intensity laser therapy for reduction of pain in knee osteoarthritis.","volume":"2016","author":"Angelova","year":"2016","journal-title":"Pain Res Manag."},{"key":"B33","first-page":"69","article-title":"Comparing the immediate and long-term effects of low and high power laser on the symptoms of knee osteoarthritis.","volume":"28","author":"Delkhosh","year":"2018","journal-title":"J Mazandaran Univ Med Sci."},{"key":"B34","doi-asserted-by":"publisher","first-page":"269","DOI":"10.5604\/15093492.1002257","article-title":"Influence of various laser therapy methods on knee joint pain and function in patients with knee osteoarthritis.","volume":"14","author":"Gworys","year":"2012","journal-title":"Ortop Traumatol Rehabil."},{"key":"B35","doi-asserted-by":"publisher","first-page":"1371","DOI":"10.1007\/s10103-014-1529-0","article-title":"High-intensity versus low-level laser therapy in the treatment of patients with knee osteoarthritis: a randomized controlled trial.","volume":"29","author":"Kheshie","year":"2014","journal-title":"Lasers Med Sci."},{"key":"B36","doi-asserted-by":"publisher","first-page":"3197","DOI":"10.1589\/jpts.28.3197","article-title":"The effects of high intensity laser therapy on pain and function in patients with knee osteoarthritis.","volume":"28","author":"Kim","year":"2016","journal-title":"J Phys Ther Sci."},{"key":"B37","first-page":"53","article-title":"Efficacy of high intensity laser therapy in the mild osteoarthritis of the knee: a randomized double-blind controlled trial.","volume":"12","author":"Kim","year":"2009","journal-title":"J Korean Orthop Res Soc."},{"key":"B38","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1089\/photob.2021.0136","article-title":"Effect of high-power laser therapy versus shock wave therapy on pain and function in knee osteoarthritis patients: a randomized controlled trial.","volume":"40","author":"Mostafa","year":"2022","journal-title":"Photobiomodul Photomed Laser Surg."},{"key":"B39","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1007\/s10103-018-2624-4","article-title":"Efficacy of high-intensity laser therapy in comparison with conventional physiotherapy and exercise therapy on pain and function of patients with knee osteoarthritis: a randomized controlled trial with 12-week follow up.","volume":"34","author":"Nazari","year":"2019","journal-title":"Lasers Med Sci."},{"key":"B40","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1515\/plm-2012-0030","article-title":"Laser therapy applications for osteoarthritis and chronic joint pain \u2013 a randomized placebo-controlled clinical trial.","volume":"1","author":"Marquina","year":"2012","journal-title":"Photon Lasers Med."},{"key":"B41","first-page":"114","article-title":"Pain reduction after laser acupuncture treatment in geriatric patients with knee osteoarthritis: a randomized controlled trial.","volume":"48","author":"Helianthi","year":"2016","journal-title":"Acta Med Indones."},{"key":"B42","doi-asserted-by":"publisher","first-page":"S12","DOI":"10.15171\/jlms.2017.s3","article-title":"Safety and effectiveness of low-level laser therapy in patients with knee osteoarthritis: a systematic review and meta-analysis.","volume":"8","author":"Rayegani","year":"2017","journal-title":"J Lasers Med Sci."},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-031142","article-title":"Efficacy of low-level laser therapy on pain and disability in knee osteoarthritis: systematic review and meta-analysis of randomised placebo-controlled trials.","volume":"9","author":"Stausholm","year":"2019","journal-title":"BMJ Open."},{"key":"B44","doi-asserted-by":"publisher","first-page":"A167","DOI":"10.1016\/j.joca.2015.02.932","article-title":"Effect of low-level laser therapy (904nm) and static stretching exercises in patients with knee osteoarthritis: a randomised controlled trial.","volume":"23","author":"Meneses","year":"2015","journal-title":"Osteoarthr Cartil."},{"key":"B45","first-page":"71","article-title":"Therapeutic effects of low level laser therapy (LLLT) in knee osteoarthritis, compared to therapeutic ultrasound.","volume":"3","author":"Rayegani","year":"2012","journal-title":"J Lasers Med Sci."},{"key":"B46","doi-asserted-by":"publisher","first-page":"112","DOI":"10.15171\/jlms.2016.19","article-title":"Effect of laser therapy on chronic osteoarthritis of the knee in older subjects.","volume":"7","author":"Youssef","year":"2016","journal-title":"J Lasers Med Sci."},{"key":"B47","first-page":"15","article-title":"Compared effects and effectiveness in applications of isokinetic exercise, laser, and diclophenac iontophoresis in primary osteoarthritis of knee.","volume":"15","author":"Yavuz","year":"2013","journal-title":"Duzce Med J."},{"key":"B48","article-title":"The effect of exercise therapy on knee osteoarthritis: a randomized clinical trial.","volume":"29","author":"Nejati","year":"2015","journal-title":"Med J Islam Repub Iran."},{"key":"B49","doi-asserted-by":"publisher","first-page":"522","DOI":"10.1177\/0269215520971795","article-title":"Stationary cycling exercise for knee osteoarthritis: a systematic review and meta-analysis.","volume":"35","author":"Luan","year":"2021","journal-title":"Clin Rehabil."},{"key":"B50","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1007\/s10067-018-4263-3","article-title":"Home exercise therapy to improve muscle strength and joint flexibility effectively treats pre-radiographic knee OA in community-dwelling elderly: a randomized controlled trial.","volume":"38","author":"Suzuki","year":"2019","journal-title":"Clin Rheumatol."},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.5812\/ircmj.62600","article-title":"The effects of routine physiotherapy alone and in combination with either tai chi or closed kinetic chain exercises on knee osteoarthritis: a comparative clinical trial study.","volume":"20","author":"Nahayatbin","year":"2018","journal-title":"Iran Red Cres Med J."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.956188\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,15]],"date-time":"2022-09-15T04:21:58Z","timestamp":1663215718000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.956188\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,15]]},"references-count":51,"alternative-id":["10.3389\/fmed.2022.956188"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2022.956188","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,15]]},"article-number":"956188"}}