Low-energy Laser Applications in Patients With Juvenile Idiopathic Arthritis
Condition: Juvenile Idiopathic Arthritis; Rheumatic Diseases; Chronic Knee Pain; Fatigue; Muscle Weakness; Polyarticular JCA
MeSH terms: Arthritis; Rheumatic Diseases; Arthritis, Juvenile; Muscle Weakness; Collagen Diseases
Study type: Interventional

Summary: 
      This study endeavored to evaluate the auxiliary effect of low-energy laser therapy (LLT) on
      pain, muscle performance, fatigue, and functional ability in children with juvenile
      idiopathic arthritis (JIA). Sixty patients with JIA were randomly allocated to the LLT group
      (n = 30, received LLT in addition to the standard exercise program) or the control group (n =
      30, received standard exercise program only). Both groups were assessed for pain intensity,
      muscle performance, fatigue perception, and functional status.
    

Detailed description: 
      Sixty patients with JIA were recruited from the Physical Therapy Outpatient Clinic of College
      of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, and the Pediatric
      Rheumatology Clinic, King Khalid Hospital, Al-Kharj, Saudi Arabia. The study included
      patients who had a confirmed diagnosis of Polyarticular JIA (according to the criteria set
      forth by the International League of Associations for Rheumatology), aged 8-16 years,
      identified being stable cases, and did not participate in a regular exercise program (in the
      past six months). Patients who had fixed deformities, a history of joint surgery, or whose
      radiological investigations revealed erosive changes of bone, ankylosing, or fractures were
      excluded.

      Outcome measures

        1. Pain intensity: measures through the Visual Analogue Scale

        2. Muscle performance: represented by the peak concentric torque of the right and left
           quadriceps muscle and measured through an Isokinetic Dynamometer.

        3. Fatigue perception: tested by the Pediatric Quality of Life Inventory Multidimensional
           Fatigue Scale (PedsQL-MFS)

        4. Functional status: the functional status was quantified using the cross-cultural
           validated version of the Childhood Health Assessment Questionnaire (CHAQ).

      Patients in the control and LLT group received a 40-minute exercise program, three times a
      week, for three months in succession. Patients in the LLT group additionally underwent an
      articular application of LLT on the knee joint, each session before exercises (eight points
      on each knee, 30 seconds irradiation for each point, with a total irradiation dose of eight
      minutes per session. The treatment was conducted by two experienced pediatric physical
      therapists.
    

Intervention name(s): Physical Exercise; Physical Exercise plus Low-energy Laser Therapy
Intervention type(s): Other; Other
Intervention description(s): The control group received a standard exercise program for 40 minutes, three times a week for three successive months. The program encompassed aerobic, weight-bearing, proprioceptive, flexibility, and strengthening exercises.; The LLT group received the same program in addition to the application of LLT on both knees, each session before exercises.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: A prospective, dual-arm, randomized controlled trial with a 6-month follow-up
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment