Long-Term Effect of Pulsed Nd:YAG Laser in the Treatment of Children with Juvenile Rheumatoid Arthritis: A Randomized Controlled Trial.

OBJECTIVE: The aim of this study was to evaluate the long-term impact of a pulsed neodymium-doped yttrium aluminum garnet (Nd:YAG) laser [high-intensity laser therapy (HILT)] in the treatment of juvenile rheumatoid arthritis (JRA).

MATERIALS AND METHODS: A sample of 30 children participated in this study (15 in the laser group and 15 in the placebo group), with a mean age of 10.53 ± 1.25 years. Children who were randomly assigned to the laser group received HILT thrice per week for 4 weeks, plus the exercise program. HILT scanned each knee with 600 J in two phases and 15 J to 10 points for a total of 750 J for each knee. The placebo laser group received placebo HILT plus the same exercise program. The outcomes measured in this study were the pain level by the visual analog scale (VAS) and gait parameters by the GAITRite® system. Statistical analysis was performed by ANOVA with repeated measures to compare the differences between the baseline, post-treatment, and 12-week follow-up measurements for both groups. The level of significance was set at p < 0.05.

RESULTS: The VAS results significantly decreased post-treatment in the laser group relative to the placebo group and were still improved at the 12-week follow-up. Gait parameters significantly increased in the laser group after 4 weeks of treatment and after 12 weeks compared to the placebo group.

CONCLUSIONS: HILT, when combined with an exercise program, appears to be more effective in children with JRA than a placebo laser procedure with exercises.