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

Abstract 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. 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±9.1y; 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 (F1 =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.