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The Efficacy of Laser Therapy for Musculoskeletal and Skin Disorders: A Criteria-Based Meta-analysis of Randomized Clinical Trials

H Beckerman, PT, is Research Associate, Department of Rehabilitation Medicine, Free University Hospital, PO Box 7057, 1007 MB Amsterdam, the Netherlands.
RA de Bie, PT, is Research Associate, Department of Epidemiology and Biostatistics, University of Limburg, Maastricht, the Netherlands.
LM Bouter, PhD, is Professor of Epidemiology, Free University, Institute for Extramural Medical Research, Amsterdam, the Netherlands.
HJ De Cuyper, MD, is Director, Department of Physical Therapy, Gallifort Hospital, Antwerp, Belgium.
RAB Oostendorp, PhD, PT, is Research Director, Dutch Foundation for Research and Postgraduate Education in Physical Therapy, Amersfoort, the Netherlands, and Professor of Biomedical Science/Manual Therapy, Free University of Brussels, Brussels, Belgium.

The efficacy of laser therapy for musculoskeletal and skin disorders has been assessed on the basis of the results of 36 randomized clinical trials (RCTs) involving 1,704 patients. For this purpose, a criteria-based meta-analysis that took into account the methodological quality of the individual trials was used. The studies with a positive outcome were generally of a better quality than the studies with a negative outcome. No clear relationship could be demonstrated between the laser dosage applied and the efficacy of laser therapy, or between the dosage and the methodological score. In general, the methodological quality of these studies appeared to be rather low. Consequently, no definite conclusions can be drawn about the efficacy of laser therapy for skin disorders. The efficacy of laser therapy for musculoskeletal disorders seems, on average, to be larger than the efficacy of a placebo treatment. More specifically, for rheumatoid arthritis, posttraumatic joint disorders, and myofascial pain, laser therapy seems to have a substantial specific therapeutic effect. Further RCTs, avoiding the most prevalent methodological errors, are needed in order to enable the benefits of laser therapy to be more precisely and validly evaluated.

Key Words: Laser therapy • Meta-analysis • Physical therapy • Randomized clinical trials • Review

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