Photobiomodulation Therapy to Reduce Pain and Inflammation in Patients With Gonarthrosis

August 18, 2023 updated by: D'Or Institute for Research and Education

Photobiomodulation Therapy to Reduce Pain and Inflammation in Patients With Gonarthrosis: a Multicenter Randomized, Double-blind, Placebo-controlled Clinical Trial

Osteoarthritis (OA) is one of the main causes of chronic pain and physical disability, which directly impacts the quality of life of patients. The prevalence of OA among adults over 60 years of age is approximately 13% in women and 10% in men. Knee OA (gonarthrosis) has as main risk factors, in addition to age, female gender and obesity. Pharmacological treatment of gonarthrosis is based on approaches to reduce symptoms and/or pain, with joint replacement (arthroplasty) being reserved for more advanced forms of the disease. In general, currently available treatments have only moderate effects and low satisfaction rates among patients. Photobiomodulation Therapy (TFBM) has been used for at least 50 years by health professionals to treat a variety of clinical conditions, especially those associated with chronic pain. TFBM is a treatment using a non-ionizing light source such as Low Intensity Laser (LBI) or Light Emitting Diodes (LED), with near-infrared wavelengths. The aim of this study is to evaluate the intensity of knee pain in the short and medium term after photobiomodulation therapy in patients with gonarthrosis. In this multicenter, randomized, placebo-controlled, double-blind clinical trial, 238 volunteers with gonarthrosis grades II and III according to the Kellgren-Lawrence classification will be recruited to be administered adjuvant treatment with TFBM. The TFBM will be performed in the knee region, twice a week, for five weeks, totaling 10 sessions. Volunteers will be allocated in the intervention group (n=119) or in the placebo group, which will be treated with 10 sessions of inert light (n=119). The hypothesis is that the photobiomodulation therapy will have a positive impact, in the short and medium term, on improving pain, functionality and quality of life of patients with symptomatic gonarthrosis.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Osteoarthritis (OA) is one of the main causes of chronic pain and physical disability, which directly impacts the quality of life of patients. The prevalence of OA among adults over 60 years of age is approximately 13% in women and 10% in men. Knee OA (gonarthrosis) has as main risk factors, in addition to age, female gender and obesity. It can involve all three compartments of the knee and is clinically characterized by pain and progressive impairment of cartilage, bone, synovial membrane and ligaments. Pharmacological treatment of gonarthrosis is based on approaches to reduce symptoms and/or pain, with joint replacement (arthroplasty) being reserved for more advanced forms of the disease. In general, currently available treatments have only moderate effects and low satisfaction rates among patients. Photobiomodulation Therapy (TFBM) has been used for at least 50 years by health professionals to treat a variety of clinical conditions, especially those associated with chronic pain. TFBM is a treatment using a non-ionizing light source such as Low Intensity Laser (LBI) or Light Emitting Diodes (LED), with near-infrared wavelengths. The technique does not emit heat, is painless and non-invasive and does not have significant side effects, and can be used as an adjuvant therapy to control pain associated with gonarthrosis. The aim of this study is to evaluate the intensity of knee pain in the short and medium term after photobiomodulation therapy in patients with gonarthrosis. In this multicenter, randomized, placebo-controlled, double-blind clinical trial, 238 volunteers with gonarthrosis grades II and III according to the Kellgren-Lawrence classification will be recruited to be administered adjuvant treatment with TFBM. The TFBM will be performed in the knee region, twice a week, for five weeks, totaling 10 sessions. Volunteers will be allocated in the intervention group (n=119) or in the placebo group, which will be treated with 10 sessions of inert light (n=119). The evaluations will be made before and after TFBM or placebo and will consist of (i) measurement of pain intensity through the application of questionnaires; (ii) verify the functional mobility of the knee joint and the muscle strength of the lower limb through physical tests; (iii) evaluate the quality of life and levels of anxiety and depression through the application of questionnaires; and (iv) record the consumption of medication for analgesic purposes and the frequency of physical therapy during the trial period. The hypothesis is that the photobiomodulation therapy will have a positive impact, in the short and medium term, on improving pain, functionality and quality of life of patients with symptomatic gonarthrosis. It is also expected to observe a reduction in pain on the Visual Analog Scale of more than 20% after 10 treatment sessions.

Study Type

Interventional

Enrollment (Estimated)

238

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

  • Brazil
      • Rio De Janeiro, Brazil, 22211-230
        • Hospital Gloria D'Or
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Patients of both sexes, aged between 50 and 75 years;
  • Uni or bilateral symptomatic gonarthrosis grades II or III according to the Kellgren-Lawrence classification confirmed on radiographs with weight bearing in anteroposterior, lateral and axial patella. When the disease is bilateral, the knee indicated by the patient as being the most symptomatic will be included;
  • Complaint of knee pain ≥4 on the Visual Analogue Scale at the time of inclusion in the study;
  • Able to walk independently, with or without walking aids;
  • Cognitive ability to answer questionnaires and perform physical tests;
  • Agreement to participate in the study by signing the Free and Informed Consent Form (TCLE).

Exclusion Criteria:

  • Diagnosis of active malignancy except basal cell carcinoma (BCC);
  • Diseases or neurological conditions that compromise the ability to perform the physical tests;
  • Epilepsy;
  • Skin lesions on the lower limb, close to the TFBM application site;
  • Tattoos on the lower limb, close to the TFBM application site;
  • Unicompartmental or total knee arthroplasty in the knee included in the study;
  • History of direct trauma to the knee included in the study within the last six months;
  • Active systemic inflammatory disease;
  • Rheumatological diseases;
  • Any previous procedure with an intra-articular approach to the knee in the last six months;
  • Anticipation of adopting another form of treatment during the study period, including arthroplasty;
  • Patients undergoing knee shock wave treatment in the knee included in the study;
  • Absence, inability or refusal to sign the informed consent form.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Triple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: FBM
volunteers who will receive adjuvant photobiomodulation therapy (n=119)
Device: Photomodulation Therapy with the Light-Aid system
Patients in the intervention group (FBM) will be submitted to 10 treatment sessions (twice a week/five weeks) with the Light-Aid system (Bright Photomedicine, SP, Brazil), operated in continuous mode, with 100 LEDs of 850nm wave per tip, with application time varying from 4 to 8 minutes. Irradiation parameters will be customized based on pain intensity, skin phototype and Body Mass Index (BMI).
Placebo Comparator: Control
volunteers who will receive placebo treatment with inert light (n=119)
Device: Control
Patients in the placebo group will undergo the same therapeutic protocol as the FBM group using a device with the same appearance as the Light-Aid System, but with inert light emission. In both groups, the treatment will be administered in contact with the skin over the knee, with the patient positioned in dorsal decubitus. The three tips of the device will be positioned horizontally over the anterior region of the knee with the central tip over the patella.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change of knee pain scale by at least 20% in the FBM group assessed using the Visual Analog Scale (VAS).
Time Frame: 18 months
The Visual Analogue Scale (VAS) evaluation is an instrument uses a scale of 0-10 to grade pain intensity, where 0 represents no pain and 10 the worst imaginable pain. The VAS will be applied daily until the 5th week of treatment and weekly from the sixth week to three months after treatment, through an online form sent daily to the patient via cell phone using an integrated application to the RedCap system or similar.
18 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

D'Or Institute for Research and Education

Collaborators

TERGOS PESQUISA E ENSINO S.A

Investigators

  • Principal Investigator: Veronica Vianna, Instituto D'Or de Pesquisa e Ensino

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

August 15, 2023

Primary Completion (Estimated)

December 31, 2024

Study Completion (Estimated)

August 31, 2025

Study Registration Dates

First Submitted

July 27, 2023

First Submitted That Met QC Criteria

July 27, 2023

First Posted (Actual)

August 4, 2023

Study Record Updates

Last Update Posted (Actual)

August 22, 2023

Last Update Submitted That Met QC Criteria

August 18, 2023

Last Verified

August 1, 2023

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • ID 369-22-ORTOP-IDOR-RJ-M-I

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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