Over the weekend, I had the opportunity to review Jan Tunér's article entitled, "Is the Blue Cross Meta analysis Reliable?" This again, is an excellent review of the many aspects of Low Intensity Laser Therapy.
Most importantly, it points out the lack of standardization in applying Laser Therapy to various tissues, therefore it is impossible to draw conclusions from many studies.
The article delineates that many lesions vary from the norm and classification of the lesion is critical, in order to characterize any study. Moreover, it points out the importance of wavelength, dosage, duration and other parameters utilized in any treatment. Unless such factors are standardized, the study cannot be deemed reliable and no conclusions with regard to the effectiveness of Laser Therapy can be derived from it. It is important for all Laser Therapists to recognize these differentiations.
Another study commenting on the efficacy of Laser Therapy for musculoskeletal and skin disorders by Beckerman, et al., at the Department of Rehabilitation Medicine, Free University Hospital, Amsterdam, indicates that in a criteria based Meta analysis involving over 1,700 patients, studies with a positive outcome were generally of a better quality than studies with a negative outcome. Further comment discusses the methodological quality of the 36 randomized clinical trials comprising the 1,700 patients included study and indicates that many studies were considered of low quality. Moreover, it found specifically that for rheumatoid arthritis, joint trauma and myofascial pain, laser had a substantial positive therapeutic effect.
The above certainly confirms my opinion that if laser is applied in relatively random fashion, without due attention to wavelength, waveform, frequency, duty cycle, energy density, etc. the information obtained may not be useful. When attention is paid to detail, conclusions have a higher degree of validity.