Clinical Effectiveness of Low-Level Laser Therapy as an Adjunct to Eccentric Exercise for the Treatment of Achilles' Tendinopathy: A Randomized Controlled Trial

Tumilty S, McDonough S, Hurley DA, Baxter GD. Clinical effectiveness of low-level laser therapy as an adjunct to eccentric exercise for the treatment of Achilles' tendinopathy: a randomized controlled trial. Arch Phys Med Rehabil 2012;93:733-9. Objective: To investigate the effectiveness of low-level laser therapy (LLLT) as an adjunct to a program of eccentric exercises for the treatment of Achilles' tendinopathy. Design: Randomized controlled trial with evaluations at baseline and 4, 12, and 52 weeks. Setting: Primary care clinic. Participants: Participants with midportion Achilles' tendinopathy were randomly assigned to 2 groups (LLLT n=20: mean age +/- SD, 45.6 +/- 9.1 y; placebo n=20: mean age +/- SD, 46.5 +/- 6.4y). The 12-week evaluation was completed by 36 participants (90%), and 33 participants (82.5%) completed the 52-week evaluation. Intervention: Both groups of participants performed eccentric exercises over a 3-month period. In addition, they received either an active or placebo application of LLLT 3 times per week for the first 4 weeks; the dose was 3J per point. Main Outcome Measures: The primary outcome was the Victorian Institute of Sport Assessment-Achilles' questionnaire (VISA-A) score at 12 weeks; secondary outcome was a visual analog scale for pain. Outcomes were measured at baseline and 4, 12, and 52 weeks. Results: Baseline characteristics exhibited no differences between groups. At the primary outcome point, there was no statistically significant difference in VISA-A scores between groups (P>.05). The difference in VISA-A scores at the 4-week point significantly favored the placebo group (F-1=6.411, sum of squares 783.839; P=.016); all other outcome scores showed no significant difference between the groups at any time point. Observers were blinded to groupings. Conclusions: The clinical effectiveness of adding LLLT to eccentric exercises for the treatment of Achilles' tendinopathy has not been demonstrated using the parameters in this study.