Low level laser therapy (Classes I, II and III) for treating rheumatoid arthritis

Lucie Brosseau; Vivian Welch; George A Wells; Rob de Bie; Arne Gam; Katherine Harman; Michelle Morin; Beverley Shea; Peter Tugwell

doi:10.1002/14651858.CD002049.pub2

Terapia con láser de baja intensidad (clases I, II y III) para el tratamiento de la artritis reumatoide

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Referencias

Referencias de los estudios incluidos en esta revisión

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estudios excluidos
otras referencias

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Referencias de los estudios excluidos de esta revisión

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estudios incluidos
otras referencias

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Referencias adicionales

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estudios excluidos

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Characteristics of studies

Characteristics of included studies [ordered by study ID]

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estudios excluidos

Bliddal 1987

Methods	Randomized Double‐blind Placebo Sample size at entry 17 Patients being their own control Study duration: 3 weeks and follow‐up at 4 weeks
Participants	Patients with active RA and symmetrical involvement of the metacarpophalangeal joint of the index. No change in other therapy was accepted during the study. F/M: 16/2 Median age: 57 years Median duration of RA: 10 years Class II: 11 Class III: 7
Interventions	Patients were randomized to therapy on the MP joint of the right and left index with laser or placebo. Therapy was given on 3 alternate days a week for 3 consecutive weeks followed by an observation time of 4 weeks. Laser: He‐Ne Wavelength: 633nm Output power: 10mW Spot size : 0.5cm^2 Dosage:6J/cm^2 Irradiation time: 5 min Placebo: Placebo apparatus containing a red 12 V, 10 W bulb and a relflecting mirror giving as far as possible the same red light through an identical optic fibre and pen
Outcomes	Pain (VAS) Morning stiffness
Notes	Quality Jadad's 4/5

Goats 1996

Methods	Randomized Double blind (partial) Placebo controlled Sample size at entry: LAser: 25; placebo: 10 Study duration: 6 months
Participants	Patients with RA affecting 2 or more of tibio‐femoral, talocrural, subtalar, midtarsal or MCP joints No steroids, immunosuppressants or intra‐articular injections in the last 2 months Mean age (yrs): Laser 57 yrs, placebo 64 yrs Sex % F: Laser 80%; placebo: 80% Disease duration (mean): Laser 7.54 yrs, Placebo: 9.80 yrs
Interventions	Gr1: Laser: Ga‐As‐Al Class: 3B Wavelength: 850 nm Output power: 940 mW Power density: Frequency: 5 Hz Duty cycle: 80% Spot size : 0.125 cm^2 Divergence: Dosage: 8.1 J/cm^2 to each aspect of the joint (24.3 J/cm^2 for each right and left tibiofemoral joint, 16.2 J/cm^2 for each right and left MTP) Area treated: Tibiofemoral, talocrural, subtalar, midtarsal and metatarsophalangeal joints Irradiation time: 4 minutes per joint Schedule: 2 times/week for 4 weeks Total sessions: 8 Calibrated: no Placebo: Dummy laser probe, subjects wore eye protection that dimmed visible radiation Measurements: 0, 1, 3, and 6 months after start of treatment Gr2:Gr 2 : Placebo (identical in external appearance but having no output).
Outcomes	Pain (VAS 10 cm) McGill Pain questionnaire ESR CRP HAQ Hemoglobin Platelets Knee ROM Ankle ROM Suprapatellar swelling (cm) Morning stiffness duration (hours) Walking speed (sec) Ritchie index Rheumatoid factor
Notes	Quality Jadad's: 2/5

Hall 1994

Methods	Randomized Triple blind Sample size at entry: Laser 20; placebo : 20 Study duration: 6 months
Participants	Patients with RA, Steinbrocker functional class II or III, and active synovitis of some or all of the MCP and PIP joints No changes to NSAIDs in last 30 days, DMARDS last 3 months, joints incapable of response for mechanical reasons Setting: outpatient clinics Mean age (yrs): Laser: 67.1; Placebo: 60.9 Sex % F: Laser 85%; Placebo 85% Disease duration: Laser: 146.4 months, Placebo: 111.6 months Duration of hand symptoms: Laser 52.5 months; placebo: 54.5 months
Interventions	Laser: Ga‐As‐Al Wavelength: 820 nm Output power: Actual 40 mW (Rated 50 mW) Power density: Frequency: 5 Hz Duty cycle: 80% Spot size : 0.1 cm^2 Divergence: 6 degrees Dosage:3.6 J/cm^2 per radiant exposure for each joints Area treated: 90 seconds per joint on the radial, ulnar, dorsal, ventral aspects of 1st to 5th MCP and PIP joints of the most affected hand Irradiation time: 18 minutes per treatment Schedule: 4 weeks Total sessions: 12 Calibrated:no Placebo: Dummy laser probe (identical apparatus)
Outcomes	Pain (10 cm VAS) Health Assessment Questionnaire (HAQ) Grip strength (mmHg) Hemoglobin (g/dL) CRP (g/mL) Ritchie Index Platelets (x10/L) Duration of morning stiffness (minutes) MCP swelling (cm) PIP swelling (cm) MCP ROM (degrees) PIP ROM (degrees) Thermographic index
Notes	Quality Jadad's: 3/5

Johannsen 1994

Methods	Randomized Double‐blind Placebo controlled Sample size at entry: Laser: 10 Placebo: 12 Study duration 4 weeks
Participants	Participants with RA, Steinbrocker functional class I or II With no changes to steroids, NSAID or analgesics in last month and no changes to DMARDs within the last 3 months Median age : Laser 59 yrs, Placebo 62 yrs Sex % F: Laser: 90; placebo: 83 Disease duration not measured
Interventions	Laser: GaAsAl Wavelength: 830 nm Output power: 21 mW Power density: NA Frequency: NA Duty cycle: NA Spot size: 0.07 cm2 spot size Divergence: NA Dosage: 23.2 J per treatment with 2.9J on 4 points on 2 joints Area treated: 2 most painful metacarpal phalangeal joints (MCP) on worst affected hand Schedule: 3 times/week for 4 weeks Total sessions: 12 Calibration: yes Placebo: Same apparatus giving red visible light
Outcomes	Joint tenderness Pain (range 0 to 12) Erythrocyte sedimentation rate (ESR) C Reactive Protein (CRP) Pinch strength Flexibility‐ tip to palm distance (cm) Grip strength (kg) Improvement in morning stiffness
Notes	Quality Jadad's: 5/5

Palmgren 1989

Methods	Randomized Double‐blind Placebo controlled Sample size at entry: Laser : 19; placebo : 16 Study duration: 4 weeks
Participants	Patients with classic RA, Steinbrocker functional class between I and III No changes to basic medication during study Patients with unstable disease excluded Mean age (yrs) : Laser, M: 66.0, Laser, F: 61.1; Placebo M: 68.0, Placebo F: 57.5 Sex % F: Laser 74%; Placebo: 88% Disease duration: Laser: 13.4 yrs; Placebo: 15.5 yrs
Interventions	Laser: GaAlAs Wavelength: 820 nm Output power: 15 mW Power density: NA Frequency: NA Duty cycle: NA Spot size: 0.1256 cm2 Divergence: 6 degrees Dosage: 5.5 J/cm2 Irradiation time: 60 s on each lateral side of each joint Area treated: 2nd to 5th MCP and proximal interphalangeal (PIP) joints of the most affected hand Schedule: 3 times/week for 4 weeks Total sessions: 12 Placebo: Similar but disconnected diode
Outcomes	Joint swelling ESR Fibrinogen (mmol/L) Leukocytes (10^9/L) Lymphocytes (%) Hemoglobin (mmol/L) Grip strength Flexibility ‐ tip to palm distance (mm) Duration morning stiffness (hrs)
Notes	Quality Jadad's: 3/5

Walker 1987

Methods	Partially blinded Placebo controlled Sample size at entry: Laser : 38; Placebo : 34 Study duration 10 weeks
Participants	Participants with RA, defined by the American Rheumatism Association (ARA) Median age: Laser 61.5 yrs, Placebo 60.0 yrs Sex % F: Laser 60%, Placebo 79% Disease duration (median yrs): Laser 6 yrs, Placebo 11 yrs
Interventions	Laser: He‐Ne Class: I Wavelength: 632.5 nm Output power: 1 mW Power density: 47.7 per cm^2 Frequency: 20 Hz Duty cycle: 50% Spot size: 4 mm^2 Divergence: 30 degrees Dosage: 3.6 mJ/cm^2 Area treated: Radial, median, saphenous nerves for 20 s bilaterally and painful joints for 3 x 10 s along the circumference Schedule: 3 times/week for 10 weeks Total sessions: 30 Placebo: Sham apparatus with no light, subjects closed eyes
Outcomes	Pain (10 cm visual analogue scale)
Notes	Quality Jadad's: 1/5

Characteristics of excluded studies [ordered by study ID]

Ir a:

estudios incluidos

Study	Reason for exclusion
Agambar 1992	Only abstract available
Ammer K 2003	Literature Review
Asada K 1989	No control group
Barabas 1989	Foreign language
Day R 1999	Literature Review
De Bie 1998	Literature Review
Fulga C 1998	Patients with juvenile RA; no control group
Goldman 1980	Insufficient statistical data
Heussler 1993	Insufficient statistical data
Matulis 1983	No control group
Miyagi 1989	Foreign language
Oyamada 1988	Although reported as double‐blind in the abstract, a reply from the authors indicated that this trial was not randomized
Sidorov VD 1999	Abstract only available in English; Article was in Russian
Sidorov VD 2000	Abstract only available in English; Article was in Russian
Taghawinejad 1985	Foreign language
Tsurko 1983	Insufficient statistical data
Walker 1983	Duplicate of Walker 1987

Data and analyses

Open in table viewer

Comparison 1. Laser vs Placebo‐ End of treatment (approx 10 wks)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Pain (Visual Analogue Scale 10 cm) Show forest plot	3	147	Mean Difference (IV, Fixed, 95% CI)	‐1.10 [‐1.82, ‐0.39]
Open in figure viewer Analysis 1.1 Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 1 Pain (Visual Analogue Scale 10 cm).
2 Pain (0‐12 scale) Show forest plot	1	22	Mean Difference (IV, Fixed, 95% CI)	‐1.0 [‐1.77, ‐0.23]
Open in figure viewer Analysis 1.2 Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 2 Pain (0‐12 scale).
3 McGill Pain questionnaire Show forest plot	1	35	Mean Difference (IV, Fixed, 95% CI)	1.5 [‐1.22, 4.22]
Open in figure viewer Analysis 1.3 Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 3 McGill Pain questionnaire.
4 Ritchie Index Show forest plot	1	40	Mean Difference (IV, Fixed, 95% CI)	2.60 [‐4.50, 9.70]
Open in figure viewer Analysis 1.4 Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 4 Ritchie Index.
5 Health Assessment Questionnaire (HAQ) Show forest plot	2	75	Mean Difference (IV, Fixed, 95% CI)	0.93 [‐2.01, 3.87]
Open in figure viewer Analysis 1.5 Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 5 Health Assessment Questionnaire (HAQ).
6 MCP ROM (degrees) Show forest plot	1	40	Mean Difference (IV, Fixed, 95% CI)	‐0.5 [‐15.99, 14.99]
Open in figure viewer Analysis 1.6 Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 6 MCP ROM (degrees).
7 PIP ROM (degrees) Show forest plot	1	40	Mean Difference (IV, Fixed, 95% CI)	4.0 [‐6.60, 14.60]
Open in figure viewer Analysis 1.7 Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 7 PIP ROM (degrees).
8 Knee ROM Show forest plot	1	70	Mean Difference (IV, Fixed, 95% CI)	‐18.03 [‐31.80, ‐4.27]
Open in figure viewer Analysis 1.8 Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 8 Knee ROM.
8.1 Right knee ROM	1	35	Mean Difference (IV, Fixed, 95% CI)	‐12.90 [‐31.98, 6.18]
8.2 Left knee ROM	1	35	Mean Difference (IV, Fixed, 95% CI)	‐23.60 [‐43.47, ‐3.73]
9 Ankle ROM Show forest plot	1	70	Mean Difference (IV, Fixed, 95% CI)	4.60 [‐0.33, 9.53]
Open in figure viewer Analysis 1.9 Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 9 Ankle ROM.
9.1 Right ankle ROM	1	35	Mean Difference (IV, Fixed, 95% CI)	5.90 [‐1.21, 13.01]
9.2 Left ankle ROM	1	35	Mean Difference (IV, Fixed, 95% CI)	3.40 [‐3.43, 10.23]
10 Flexibility‐ tip to palm distance (cm) Show forest plot	2	57	Mean Difference (IV, Fixed, 95% CI)	‐1.28 [‐1.72, ‐0.85]
Open in figure viewer Analysis 1.10 Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 10 Flexibility‐ tip to palm distance (cm).
11 Morning stiffness duration (min) Show forest plot	3	110	Mean Difference (IV, Fixed, 95% CI)	‐27.45 [‐51.95, ‐2.95]
Open in figure viewer Analysis 1.11 Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 11 Morning stiffness duration (min).
12 Morning stiffness not improved Show forest plot	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	0.76 [0.49, 1.19]
Open in figure viewer Analysis 1.12 Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 12 Morning stiffness not improved.
13 Rheumatoid factor positive Show forest plot	1	35	Risk Ratio (M‐H, Fixed, 95% CI)	0.9 [0.61, 1.34]
Open in figure viewer Analysis 1.13 Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 13 Rheumatoid factor positive.
14 Grip strength Show forest plot	3	97	Mean Difference (IV, Fixed, 95% CI)	0.62 [‐0.36, 1.60]
Open in figure viewer Analysis 1.14 Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 14 Grip strength.
14.1 Grip strength (mmHg)	2	75	Mean Difference (IV, Fixed, 95% CI)	7.71 [0.15, 15.27]
14.2 Grip strength (kg)	1	22	Mean Difference (IV, Fixed, 95% CI)	0.5 [‐0.49, 1.49]
15 Suprapatellar swelling ‐ right knee (cm) Show forest plot	1	35	Mean Difference (IV, Fixed, 95% CI)	‐2.94 [‐6.31, 0.43]
Open in figure viewer Analysis 1.15 Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 15 Suprapatellar swelling ‐ right knee (cm).
16 Suprapatellar swelling‐ left knee (cm) Show forest plot	1	35	Mean Difference (IV, Fixed, 95% CI)	‐2.69 [‐6.33, 0.95]
Open in figure viewer Analysis 1.16 Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 16 Suprapatellar swelling‐ left knee (cm).
17 MCP swelling (cm) Show forest plot	1	40	Mean Difference (IV, Fixed, 95% CI)	0.20 [‐0.78, 1.18]
Open in figure viewer Analysis 1.17 Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 17 MCP swelling (cm).
18 PIP swelling (cm) Show forest plot	2	75	Mean Difference (IV, Fixed, 95% CI)	0.53 [‐1.12, 2.18]
Open in figure viewer Analysis 1.18 Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 18 PIP swelling (cm).
19 Walking speed (sec) Show forest plot	1	35	Mean Difference (IV, Fixed, 95% CI)	‐1.87 [‐7.08, 3.34]
Open in figure viewer Analysis 1.19 Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 19 Walking speed (sec).
20 Fibrinogen Show forest plot	1	35	Mean Difference (IV, Fixed, 95% CI)	1.5 [‐0.00, 3.00]
Open in figure viewer Analysis 1.20 Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 20 Fibrinogen.
21 Leukocytes Show forest plot	1	35	Mean Difference (IV, Fixed, 95% CI)	1.60 [0.62, 2.58]
Open in figure viewer Analysis 1.21 Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 21 Leukocytes.
22 Lymphocytes Show forest plot	1	35	Mean Difference (IV, Fixed, 95% CI)	3.0 [‐6.57, 12.57]
Open in figure viewer Analysis 1.22 Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 22 Lymphocytes.
23 ESR (mm/hr) Show forest plot	3	92	Mean Difference (IV, Fixed, 95% CI)	‐10.09 [‐15.04, ‐5.15]
Open in figure viewer Analysis 1.23 Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 23 ESR (mm/hr).
24 CRP (g/mL) Show forest plot	2	57	Mean Difference (IV, Fixed, 95% CI)	2.55 [‐14.11, 19.21]
Open in figure viewer Analysis 1.24 Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 24 CRP (g/mL).
25 Hemoglobin Show forest plot	2	70	Mean Difference (IV, Fixed, 95% CI)	0.47 [0.01, 0.93]
Open in figure viewer Analysis 1.25 Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 25 Hemoglobin.
26 Platelets Show forest plot	1	35	Mean Difference (IV, Fixed, 95% CI)	20.35 [‐64.36, 105.06]
Open in figure viewer Analysis 1.26 Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 26 Platelets.

Open in table viewer

Comparison 2. Laser vs Placebo‐ End of follow‐up (approx 20 wks)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Pain Show forest plot	2	54	Mean Difference (IV, Fixed, 95% CI)	0.06 [‐1.24, 1.36]
Open in figure viewer Analysis 2.1 Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 1 Pain.
1.1 Pain (10 cm visual analogue scale)	2	54	Mean Difference (IV, Fixed, 95% CI)	0.06 [‐1.24, 1.36]
2 McGill Pain questionnaire Show forest plot	1	28	Mean Difference (IV, Fixed, 95% CI)	1.39 [‐2.23, 5.01]
Open in figure viewer Analysis 2.2 Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 2 McGill Pain questionnaire.
3 Health Assessment Questionnaire (HAQ) Show forest plot	2	54	Mean Difference (IV, Fixed, 95% CI)	1.10 [‐2.80, 4.99]
Open in figure viewer Analysis 2.3 Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 3 Health Assessment Questionnaire (HAQ).
4 Ritchie Index Show forest plot	1	26	Mean Difference (IV, Fixed, 95% CI)	3.30 [‐5.74, 12.34]
Open in figure viewer Analysis 2.4 Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 4 Ritchie Index.
5 PIP ROM (degrees) Show forest plot	1	26	Mean Difference (IV, Fixed, 95% CI)	2.0 [‐16.30, 20.30]
Open in figure viewer Analysis 2.5 Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 5 PIP ROM (degrees).
6 Knee ROM Show forest plot	1	56	Mean Difference (IV, Fixed, 95% CI)	‐11.47 [‐31.26, 8.31]
Open in figure viewer Analysis 2.6 Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 6 Knee ROM.
6.1 Right knee ROM	1	28	Mean Difference (IV, Fixed, 95% CI)	‐13.60 [‐41.44, 14.24]
6.2 Left knee ROM	1	28	Mean Difference (IV, Fixed, 95% CI)	‐9.30 [‐37.43, 18.83]
7 Ankle ROM Show forest plot	1	56	Mean Difference (IV, Fixed, 95% CI)	‐1.20 [‐11.69, 9.28]
Open in figure viewer Analysis 2.7 Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 7 Ankle ROM.
7.1 Right ankle ROM	1	28	Mean Difference (IV, Fixed, 95% CI)	1.80 [‐12.59, 16.19]
7.2 Left ankle ROM	1	28	Mean Difference (IV, Fixed, 95% CI)	‐4.60 [‐19.91, 10.71]
8 MCP ROM (degrees) Show forest plot	1	26	Mean Difference (IV, Fixed, 95% CI)	10.0 [‐6.86, 26.86]
Open in figure viewer Analysis 2.8 Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 8 MCP ROM (degrees).
9 Morning stiffness duration (min) Show forest plot	2	54	Mean Difference (IV, Fixed, 95% CI)	12.16 [‐31.00, 55.31]
Open in figure viewer Analysis 2.9 Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 9 Morning stiffness duration (min).
10 Walking speed (sec) Show forest plot	1	28	Mean Difference (IV, Fixed, 95% CI)	‐1.91 [‐12.60, 8.78]
Open in figure viewer Analysis 2.10 Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 10 Walking speed (sec).
11 Grip strength Show forest plot	1	26	Mean Difference (IV, Fixed, 95% CI)	‐29.0 [‐61.44, 3.44]
Open in figure viewer Analysis 2.11 Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 11 Grip strength.
11.1 Grip strength (mmHg)	1	26	Mean Difference (IV, Fixed, 95% CI)	‐29.0 [‐61.44, 3.44]
11.2 Grip strength (kg)	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
12 Suprapatellar swelling‐ left knee (cm) Show forest plot	1	28	Mean Difference (IV, Fixed, 95% CI)	‐2.89 [‐14.38, 8.60]
Open in figure viewer Analysis 2.12 Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 12 Suprapatellar swelling‐ left knee (cm).
13 Suprapatellar swelling ‐ right knee (cm) Show forest plot	1	28	Mean Difference (IV, Fixed, 95% CI)	‐3.29 [‐14.66, 8.08]
Open in figure viewer Analysis 2.13 Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 13 Suprapatellar swelling ‐ right knee (cm).
14 MCP swelling (cm) Show forest plot	1	26	Mean Difference (IV, Fixed, 95% CI)	‐0.40 [‐1.23, 0.43]
Open in figure viewer Analysis 2.14 Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 14 MCP swelling (cm).
15 PIP swelling (cm) Show forest plot	1	26	Mean Difference (IV, Fixed, 95% CI)	0.90 [‐1.88, 3.68]
Open in figure viewer Analysis 2.15 Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 15 PIP swelling (cm).
16 Thermographic index Show forest plot	1	26	Mean Difference (IV, Fixed, 95% CI)	0.60 [‐0.11, 1.31]
Open in figure viewer Analysis 2.16 Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 16 Thermographic index.
17 Rheumatoid factor positive Show forest plot	1	20	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.60, 1.68]
Open in figure viewer Analysis 2.17 Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 17 Rheumatoid factor positive.
18 ESR (mm/hr) Show forest plot	1	28	Mean Difference (IV, Fixed, 95% CI)	‐2.0 [‐26.94, 22.94]
Open in figure viewer Analysis 2.18 Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 18 ESR (mm/hr).
19 CRP (g/mL) Show forest plot	2	54	Mean Difference (IV, Fixed, 95% CI)	‐4.21 [‐20.25, 11.83]
Open in figure viewer Analysis 2.19 Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 19 CRP (g/mL).
20 Hemoglobin Show forest plot	2	54	Mean Difference (IV, Fixed, 95% CI)	0.98 [‐0.21, 2.16]
Open in figure viewer Analysis 2.20 Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 20 Hemoglobin.
21 Platelets Show forest plot	2	54	Mean Difference (IV, Fixed, 95% CI)	32.68 [‐37.76, 103.11]
Open in figure viewer Analysis 2.21 Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 21 Platelets.

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Comparison 3. Treatment length‐ subgroup analysis for end of treatment results

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Pain (10 cm VAS or 0‐12 scale) Show forest plot	4		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
Open in figure viewer Analysis 3.1 Comparison 3 Treatment length‐ subgroup analysis for end of treatment results, Outcome 1 Pain (10 cm VAS or 0‐12 scale).
1.1 Treatment for 4 weeks	3	97	Mean Difference (IV, Fixed, 95% CI)	‐0.83 [‐1.46, ‐0.20]
1.2 Treatment for 10 weeks	1	72	Mean Difference (IV, Fixed, 95% CI)	‐1.54 [‐2.47, ‐0.61]

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Comparison 4. Treatment length‐ subgroup analysis for end of follow up results

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Pain (10 cm VAS or 0‐12 scale) Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
Open in figure viewer Analysis 4.1 Comparison 4 Treatment length‐ subgroup analysis for end of follow up results, Outcome 1 Pain (10 cm VAS or 0‐12 scale).
1.1 Treatment for 4 weeks	2	54	Mean Difference (IV, Fixed, 95% CI)	0.06 [‐1.24, 1.36]
1.2 Treatment for 10 weeks	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]

Open in table viewer

Comparison 5. Methodologic quality: low (<3) vs high (=> 3)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Pain at end of treatment Show forest plot	4	169	Mean Difference (IV, Fixed, 95% CI)	‐1.05 [‐1.58, ‐0.53]
Open in figure viewer Analysis 5.1 Comparison 5 Methodologic quality: low (<3) vs high (=> 3), Outcome 1 Pain at end of treatment.
1.1 Low quality (<3)	2	107	Mean Difference (IV, Fixed, 95% CI)	‐1.39 [‐2.23, ‐0.56]
1.2 High quality (=> 3)	2	62	Mean Difference (IV, Fixed, 95% CI)	‐0.84 [‐1.51, ‐0.16]

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Comparison 6. Laser vs Placebo ‐ Joint vs Nerve ‐ end of treatment

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Pain (10 cm VAS or 0‐12 scale) Show forest plot	4		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
Open in figure viewer Analysis 6.1 Comparison 6 Laser vs Placebo ‐ Joint vs Nerve ‐ end of treatment, Outcome 1 Pain (10 cm VAS or 0‐12 scale).
1.1 Joint application	3	97	Mean Difference (IV, Fixed, 95% CI)	‐0.83 [‐1.46, ‐0.20]
1.2 Nerve application	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.3 Joint and nerve application	1	72	Mean Difference (IV, Fixed, 95% CI)	‐1.54 [‐2.47, ‐0.61]

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Comparison 7. Laser vs Placebo ‐ Joint vs Nerve ‐ end of follow up

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Pain (10 cm VAS or 0‐12 scale) Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
Open in figure viewer Analysis 7.1 Comparison 7 Laser vs Placebo ‐ Joint vs Nerve ‐ end of follow up, Outcome 1 Pain (10 cm VAS or 0‐12 scale).
1.1 Joint application	2	54	Mean Difference (IV, Fixed, 95% CI)	0.06 [‐1.24, 1.36]
1.2 Nerve application	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.3 Joint and nerve application	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]

Open in table viewer

Comparison 8. Laser vs Placebo‐ Wavelength analysis ‐ End of treatment

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Pain Show forest plot	4		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
Open in figure viewer Analysis 8.1 Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 1 Pain.
1.1 Wavelength < 660 nm	1	72	Mean Difference (IV, Fixed, 95% CI)	‐1.54 [‐2.47, ‐0.61]
1.2 Wavelength 820, 830 nm	2	62	Mean Difference (IV, Fixed, 95% CI)	‐0.84 [‐1.51, ‐0.16]
1.3 Wavelength 650‐950 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	‐0.78 [‐2.68, 1.12]
2 McGill Pain questionnaire Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
Open in figure viewer Analysis 8.2 Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 2 McGill Pain questionnaire.
2.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.2 Wavelength 820, 830 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.3 Wavelength 650‐950 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	1.5 [‐1.22, 4.22]
3 Ritchie Index Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
Open in figure viewer Analysis 8.3 Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 3 Ritchie Index.
3.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.2 Wavelength 820, 830 nm	1	40	Mean Difference (IV, Fixed, 95% CI)	2.60 [‐4.50, 9.70]
3.3 Wavelength 650‐950 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
4 Health Assessment Questionnaire (HAQ) Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
Open in figure viewer Analysis 8.4 Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 4 Health Assessment Questionnaire (HAQ).
4.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.2 Wavelength 820, 830 nm	1	40	Mean Difference (IV, Fixed, 95% CI)	1.25 [‐2.09, 4.59]
4.3 Wavelength 650‐950 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	‐0.18 [‐6.39, 6.03]
5 MCP ROM (degrees) Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
Open in figure viewer Analysis 8.5 Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 5 MCP ROM (degrees).
5.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
5.2 Wavelength 820, 830 nm	1	40	Mean Difference (IV, Fixed, 95% CI)	‐0.5 [‐15.99, 14.99]
5.3 Wavelength 650‐950 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
6 PIP ROM (degrees) Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
Open in figure viewer Analysis 8.6 Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 6 PIP ROM (degrees).
6.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.2 Wavelength 820, 830 nm	1	40	Mean Difference (IV, Fixed, 95% CI)	4.0 [‐6.60, 14.60]
6.3 Wavelength 650‐950 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
7 Left knee Range of motion Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
Open in figure viewer Analysis 8.7 Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 7 Left knee Range of motion.
7.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.2 Wavelength 820, 830 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.3 Wavelength 650‐950 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	‐23.60 [‐43.47, ‐3.73]
8 Right knee ROM Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
Open in figure viewer Analysis 8.8 Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 8 Right knee ROM.
8.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
8.2 Wavelength 820, 830 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
8.3 Wavelength 650‐950 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	‐12.90 [‐31.98, 6.18]
9 Left ankle ROM Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
Open in figure viewer Analysis 8.9 Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 9 Left ankle ROM.
9.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
9.2 Wavelength 820, 830 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
9.3 Wavelength 650‐950 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	3.40 [‐3.43, 10.23]
10 Right ankle ROM Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
Open in figure viewer Analysis 8.10 Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 10 Right ankle ROM.
10.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
10.2 Wavelength 820, 830 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
10.3 Wavelength 650‐950 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	7.90 [0.79, 15.01]
11 Flexibility‐ tip to palm distance (cm) Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
Open in figure viewer Analysis 8.11 Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 11 Flexibility‐ tip to palm distance (cm).
11.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
11.2 Wavelength 820, 830 nm	2	57	Mean Difference (IV, Fixed, 95% CI)	‐1.28 [‐1.72, ‐0.85]
11.3 Wavelength 650‐950 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
12 Morning stiffness duration (min) Show forest plot	3		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
Open in figure viewer Analysis 8.12 Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 12 Morning stiffness duration (min).
12.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
12.2 Wavelength 820, 830 nm	2	75	Mean Difference (IV, Fixed, 95% CI)	‐30.65 [‐55.71, ‐5.58]
12.3 Wavelength 650‐950 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	40.80 [‐75.05, 156.65]
13 Morning stiffness not improved Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
Open in figure viewer Analysis 8.13 Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 13 Morning stiffness not improved.
13.1 Wavelength < 660 nm	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
13.2 Wavelength 820, 830 nm	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	0.76 [0.49, 1.19]
13.3 Wavelength 650‐950 nm	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
14 Rheumatoid factor positive Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
Open in figure viewer Analysis 8.14 Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 14 Rheumatoid factor positive.
14.1 Wavelength < 660 nm	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
14.2 Wavelength 820, 830 nm	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
14.3 Wavelength 650‐950 nm	1	35	Risk Ratio (M‐H, Fixed, 95% CI)	0.9 [0.61, 1.34]
15 Grip strength (mmHg, KPa, kg) Show forest plot	3		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
Open in figure viewer Analysis 8.15 Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 15 Grip strength (mmHg, KPa, kg).
15.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
15.2 Wavelength 820, 830 nm	3	97	Mean Difference (IV, Fixed, 95% CI)	0.62 [‐0.36, 1.60]
15.3 Wavelength 650‐950 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
16 Suprapatellar swelling ‐ right knee (cm) Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
Open in figure viewer Analysis 8.16 Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 16 Suprapatellar swelling ‐ right knee (cm).
16.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
16.2 Wavelength 820, 830 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
16.3 Wavelength 650‐950 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	‐2.94 [‐6.31, 0.43]
17 Suprapatellar swelling‐ left knee (cm) Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
Open in figure viewer Analysis 8.17 Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 17 Suprapatellar swelling‐ left knee (cm).
17.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
17.2 Wavelength 820, 830 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
17.3 Wavelength 650‐950 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	‐2.69 [‐6.33, 0.95]
18 MCP swelling (cm) Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
Open in figure viewer Analysis 8.18 Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 18 MCP swelling (cm).
18.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
18.2 Wavelength 820, 830 nm	1	40	Mean Difference (IV, Fixed, 95% CI)	0.20 [‐0.78, 1.18]
18.3 Wavelength 650‐950 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
19 PIP swelling (cm) Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
Open in figure viewer Analysis 8.19 Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 19 PIP swelling (cm).
19.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
19.2 Wavelength 820, 830 nm	2	75	Mean Difference (IV, Fixed, 95% CI)	0.53 [‐1.12, 2.18]
19.3 Wavelength 650‐950 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
20 Walking speed (sec) Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
Open in figure viewer Analysis 8.20 Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 20 Walking speed (sec).
20.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
20.2 Wavelength 820, 830 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
20.3 Wavelength 650‐950 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	‐1.87 [‐7.08, 3.34]
21 Fibrinogen Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
Open in figure viewer Analysis 8.21 Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 21 Fibrinogen.
21.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
21.2 Wavelength 820, 830 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	1.5 [‐0.00, 3.00]
21.3 Wavelength 650‐950 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
22 Leukocytes Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
Open in figure viewer Analysis 8.22 Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 22 Leukocytes.
22.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
22.2 Wavelength 820, 830 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	1.60 [0.62, 2.58]
22.3 Wavelength 650‐950 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
23 Lymphocytes Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
Open in figure viewer Analysis 8.23 Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 23 Lymphocytes.
23.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
23.2 Wavelength 820, 830 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	3.0 [‐6.57, 12.57]
23.3 Wavelength 650‐950 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
24 ESR (mm/hr) Show forest plot	3		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
Open in figure viewer Analysis 8.24 Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 24 ESR (mm/hr).
24.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
24.2 Wavelength 820, 830 nm	2	57	Mean Difference (IV, Fixed, 95% CI)	‐11.12 [‐16.21, ‐6.04]
24.3 Wavelength 650‐950 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	8.27 [‐13.18, 29.72]
25 CRP (g/mL) Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
Open in figure viewer Analysis 8.25 Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 25 CRP (g/mL).
25.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
25.2 Wavelength 820, 830 nm	1	22	Mean Difference (IV, Fixed, 95% CI)	‐120.0 [‐190.13, ‐49.87]
25.3 Wavelength 650‐950 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	9.88 [‐7.27, 27.03]
26 Hemoglobin Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
Open in figure viewer Analysis 8.26 Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 26 Hemoglobin.
26.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
26.2 Wavelength 820, 830 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	0.60 [0.11, 1.09]
26.3 Wavelength 650‐950 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	‐0.69 [‐2.12, 0.74]
27 Platelets Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
Open in figure viewer Analysis 8.27 Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 27 Platelets.
27.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
27.2 Wavelength 820, 830 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
27.3 Wavelength 650‐950 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	20.35 [‐64.36, 105.06]

Open in table viewer

Comparison 9. Subgroup Dosage Analysis

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Pain VAS <= 3 J/cm2 Show forest plot	2	94	Mean Difference (IV, Fixed, 95% CI)	‐1.22 [‐1.81, ‐0.63]
Open in figure viewer Analysis 9.1 Comparison 9 Subgroup Dosage Analysis, Outcome 1 Pain VAS <= 3 J/cm2.
2 Pain VAS > 3 J/cm2 Show forest plot	2	75	Mean Difference (IV, Fixed, 95% CI)	‐0.47 [‐1.59, 0.65]
Open in figure viewer Analysis 9.2 Comparison 9 Subgroup Dosage Analysis, Outcome 2 Pain VAS > 3 J/cm2.
3 ESR low dose Show forest plot	1	22	Mean Difference (IV, Fixed, 95% CI)	‐20.0 [‐28.69, ‐11.31]
Open in figure viewer Analysis 9.3 Comparison 9 Subgroup Dosage Analysis, Outcome 3 ESR low dose.
4 ESR high dose Show forest plot	2	70	Mean Difference (IV, Fixed, 95% CI)	‐5.34 [‐11.35, 0.68]
Open in figure viewer Analysis 9.4 Comparison 9 Subgroup Dosage Analysis, Outcome 4 ESR high dose.
5 CRP low dose Show forest plot	1	22	Mean Difference (IV, Fixed, 95% CI)	‐120.0 [‐190.13, ‐49.87]
Open in figure viewer Analysis 9.5 Comparison 9 Subgroup Dosage Analysis, Outcome 5 CRP low dose.
6 CRP high dose Show forest plot	1	35	Mean Difference (IV, Fixed, 95% CI)	9.88 [‐7.27, 27.03]
Open in figure viewer Analysis 9.6 Comparison 9 Subgroup Dosage Analysis, Outcome 6 CRP high dose.
7 HAQ high dose Show forest plot	2	75	Mean Difference (IV, Fixed, 95% CI)	0.93 [‐2.01, 3.87]
Open in figure viewer Analysis 9.7 Comparison 9 Subgroup Dosage Analysis, Outcome 7 HAQ high dose.
8 Hemoglobin high dose Show forest plot	2	70	Mean Difference (IV, Fixed, 95% CI)	0.47 [0.01, 0.93]
Open in figure viewer Analysis 9.8 Comparison 9 Subgroup Dosage Analysis, Outcome 8 Hemoglobin high dose.
9 Morning stiffness (hours) high dose Show forest plot	3	110	Mean Difference (IV, Fixed, 95% CI)	‐27.45 [‐51.95, ‐2.95]
Open in figure viewer Analysis 9.9 Comparison 9 Subgroup Dosage Analysis, Outcome 9 Morning stiffness (hours) high dose.
10 Grip strength (kg) low Show forest plot	1	22	Mean Difference (IV, Fixed, 95% CI)	0.5 [‐0.49, 1.49]
Open in figure viewer Analysis 9.10 Comparison 9 Subgroup Dosage Analysis, Outcome 10 Grip strength (kg) low.
11 Grip strength (kg) high Show forest plot	2	75	Mean Difference (IV, Fixed, 95% CI)	7.71 [0.15, 15.27]
Open in figure viewer Analysis 9.11 Comparison 9 Subgroup Dosage Analysis, Outcome 11 Grip strength (kg) high.
12 MCP swelling (cm) low Show forest plot	2	75	Mean Difference (IV, Fixed, 95% CI)	0.53 [‐1.12, 2.18]
Open in figure viewer Analysis 9.12 Comparison 9 Subgroup Dosage Analysis, Outcome 12 MCP swelling (cm) low.
13 Flexibility tip to palm (cm) low Show forest plot	1	22	Mean Difference (IV, Fixed, 95% CI)	‐1.25 [‐1.68, ‐0.82]
Open in figure viewer Analysis 9.13 Comparison 9 Subgroup Dosage Analysis, Outcome 13 Flexibility tip to palm (cm) low.
14 Flexibility tip to palm high dose Show forest plot	1	35	Mean Difference (IV, Fixed, 95% CI)	‐6.0 [‐11.25, ‐0.75]
Open in figure viewer Analysis 9.14 Comparison 9 Subgroup Dosage Analysis, Outcome 14 Flexibility tip to palm high dose.

Open in table viewer

Comparison 10. Laser vs Placebo‐ contralateral control (End of treatment)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Number of patients improved in pain relief Show forest plot	1	34	Risk Ratio (M‐H, Fixed, 95% CI)	13.0 [0.79, 214.05]
Open in figure viewer Analysis 10.1 Comparison 10 Laser vs Placebo‐ contralateral control (End of treatment), Outcome 1 Number of patients improved in pain relief.
2 Number of patients improved in morning stiffness Show forest plot	1	34	Risk Ratio (M‐H, Fixed, 95% CI)	4.0 [0.50, 32.20]
Open in figure viewer Analysis 10.2 Comparison 10 Laser vs Placebo‐ contralateral control (End of treatment), Outcome 2 Number of patients improved in morning stiffness.

Analysis 1.1

Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 1 Pain (Visual Analogue Scale 10 cm).

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Analysis 1.2

Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 2 Pain (0‐12 scale).

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Analysis 1.3

Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 3 McGill Pain questionnaire.

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Analysis 1.4

Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 4 Ritchie Index.

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Analysis 1.5

Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 5 Health Assessment Questionnaire (HAQ).

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Analysis 1.6

Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 6 MCP ROM (degrees).

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Analysis 1.7

Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 7 PIP ROM (degrees).

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Analysis 1.8

Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 8 Knee ROM.

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Analysis 1.9

Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 9 Ankle ROM.

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Analysis 1.10

Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 10 Flexibility‐ tip to palm distance (cm).

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Analysis 1.11

Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 11 Morning stiffness duration (min).

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Analysis 1.12

Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 12 Morning stiffness not improved.

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Analysis 1.13

Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 13 Rheumatoid factor positive.

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Analysis 1.14

Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 14 Grip strength.

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Analysis 1.15

Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 15 Suprapatellar swelling ‐ right knee (cm).

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Analysis 1.16

Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 16 Suprapatellar swelling‐ left knee (cm).

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Analysis 1.17

Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 17 MCP swelling (cm).

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Analysis 1.18

Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 18 PIP swelling (cm).

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Analysis 1.19

Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 19 Walking speed (sec).

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Analysis 1.20

Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 20 Fibrinogen.

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Analysis 1.21

Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 21 Leukocytes.

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Analysis 1.22

Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 22 Lymphocytes.

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Analysis 1.23

Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 23 ESR (mm/hr).

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Analysis 1.24

Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 24 CRP (g/mL).

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Analysis 1.25

Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 25 Hemoglobin.

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Analysis 1.26

Comparison 1 Laser vs Placebo‐ End of treatment (approx 10 wks), Outcome 26 Platelets.

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Analysis 2.1

Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 1 Pain.

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Analysis 2.2

Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 2 McGill Pain questionnaire.

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Analysis 2.3

Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 3 Health Assessment Questionnaire (HAQ).

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Analysis 2.4

Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 4 Ritchie Index.

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Analysis 2.5

Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 5 PIP ROM (degrees).

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Analysis 2.6

Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 6 Knee ROM.

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Analysis 2.7

Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 7 Ankle ROM.

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Analysis 2.8

Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 8 MCP ROM (degrees).

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Analysis 2.9

Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 9 Morning stiffness duration (min).

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Analysis 2.10

Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 10 Walking speed (sec).

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Analysis 2.11

Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 11 Grip strength.

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Analysis 2.12

Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 12 Suprapatellar swelling‐ left knee (cm).

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Analysis 2.13

Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 13 Suprapatellar swelling ‐ right knee (cm).

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Analysis 2.14

Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 14 MCP swelling (cm).

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Analysis 2.15

Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 15 PIP swelling (cm).

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Analysis 2.16

Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 16 Thermographic index.

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Analysis 2.17

Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 17 Rheumatoid factor positive.

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Analysis 2.18

Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 18 ESR (mm/hr).

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Analysis 2.19

Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 19 CRP (g/mL).

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Analysis 2.20

Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 20 Hemoglobin.

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Analysis 2.21

Comparison 2 Laser vs Placebo‐ End of follow‐up (approx 20 wks), Outcome 21 Platelets.

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Analysis 3.1

Comparison 3 Treatment length‐ subgroup analysis for end of treatment results, Outcome 1 Pain (10 cm VAS or 0‐12 scale).

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Analysis 4.1

Comparison 4 Treatment length‐ subgroup analysis for end of follow up results, Outcome 1 Pain (10 cm VAS or 0‐12 scale).

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Analysis 5.1

Comparison 5 Methodologic quality: low (<3) vs high (=> 3), Outcome 1 Pain at end of treatment.

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Analysis 6.1

Comparison 6 Laser vs Placebo ‐ Joint vs Nerve ‐ end of treatment, Outcome 1 Pain (10 cm VAS or 0‐12 scale).

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Analysis 7.1

Comparison 7 Laser vs Placebo ‐ Joint vs Nerve ‐ end of follow up, Outcome 1 Pain (10 cm VAS or 0‐12 scale).

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Analysis 8.1

Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 1 Pain.

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Analysis 8.2

Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 2 McGill Pain questionnaire.

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Analysis 8.3

Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 3 Ritchie Index.

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Analysis 8.4

Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 4 Health Assessment Questionnaire (HAQ).

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Analysis 8.5

Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 5 MCP ROM (degrees).

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Analysis 8.6

Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 6 PIP ROM (degrees).

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Analysis 8.7

Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 7 Left knee Range of motion.

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Analysis 8.8

Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 8 Right knee ROM.

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Analysis 8.9

Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 9 Left ankle ROM.

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Analysis 8.10

Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 10 Right ankle ROM.

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Analysis 8.11

Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 11 Flexibility‐ tip to palm distance (cm).

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Analysis 8.12

Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 12 Morning stiffness duration (min).

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Analysis 8.13

Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 13 Morning stiffness not improved.

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Analysis 8.14

Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 14 Rheumatoid factor positive.

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Analysis 8.15

Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 15 Grip strength (mmHg, KPa, kg).

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Analysis 8.16

Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 16 Suprapatellar swelling ‐ right knee (cm).

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Analysis 8.17

Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 17 Suprapatellar swelling‐ left knee (cm).

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Analysis 8.18

Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 18 MCP swelling (cm).

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Analysis 8.19

Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 19 PIP swelling (cm).

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Analysis 8.20

Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 20 Walking speed (sec).

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Analysis 8.21

Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 21 Fibrinogen.

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Analysis 8.22

Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 22 Leukocytes.

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Analysis 8.23

Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 23 Lymphocytes.

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Analysis 8.24

Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 24 ESR (mm/hr).

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Analysis 8.25

Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 25 CRP (g/mL).

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Analysis 8.26

Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 26 Hemoglobin.

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Analysis 8.27

Comparison 8 Laser vs Placebo‐ Wavelength analysis ‐ End of treatment, Outcome 27 Platelets.

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Analysis 9.1

Comparison 9 Subgroup Dosage Analysis, Outcome 1 Pain VAS <= 3 J/cm2.

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Analysis 9.2

Comparison 9 Subgroup Dosage Analysis, Outcome 2 Pain VAS > 3 J/cm2.

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Analysis 9.3

Comparison 9 Subgroup Dosage Analysis, Outcome 3 ESR low dose.

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Analysis 9.4

Comparison 9 Subgroup Dosage Analysis, Outcome 4 ESR high dose.

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Analysis 9.5

Comparison 9 Subgroup Dosage Analysis, Outcome 5 CRP low dose.

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Analysis 9.6

Comparison 9 Subgroup Dosage Analysis, Outcome 6 CRP high dose.

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Analysis 9.7

Comparison 9 Subgroup Dosage Analysis, Outcome 7 HAQ high dose.

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Analysis 9.8

Comparison 9 Subgroup Dosage Analysis, Outcome 8 Hemoglobin high dose.

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Analysis 9.9

Comparison 9 Subgroup Dosage Analysis, Outcome 9 Morning stiffness (hours) high dose.

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Analysis 9.10

Comparison 9 Subgroup Dosage Analysis, Outcome 10 Grip strength (kg) low.

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Analysis 9.11

Comparison 9 Subgroup Dosage Analysis, Outcome 11 Grip strength (kg) high.

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Analysis 9.12

Comparison 9 Subgroup Dosage Analysis, Outcome 12 MCP swelling (cm) low.

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Analysis 9.13

Comparison 9 Subgroup Dosage Analysis, Outcome 13 Flexibility tip to palm (cm) low.

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Analysis 9.14

Comparison 9 Subgroup Dosage Analysis, Outcome 14 Flexibility tip to palm high dose.

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Analysis 10.1

Comparison 10 Laser vs Placebo‐ contralateral control (End of treatment), Outcome 1 Number of patients improved in pain relief.

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Analysis 10.2

Comparison 10 Laser vs Placebo‐ contralateral control (End of treatment), Outcome 2 Number of patients improved in morning stiffness.

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Comparison 1. Laser vs Placebo‐ End of treatment (approx 10 wks)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Pain (Visual Analogue Scale 10 cm) Show forest plot	3	147	Mean Difference (IV, Fixed, 95% CI)	‐1.10 [‐1.82, ‐0.39]

2 Pain (0‐12 scale) Show forest plot	1	22	Mean Difference (IV, Fixed, 95% CI)	‐1.0 [‐1.77, ‐0.23]

3 McGill Pain questionnaire Show forest plot	1	35	Mean Difference (IV, Fixed, 95% CI)	1.5 [‐1.22, 4.22]

4 Ritchie Index Show forest plot	1	40	Mean Difference (IV, Fixed, 95% CI)	2.60 [‐4.50, 9.70]

5 Health Assessment Questionnaire (HAQ) Show forest plot	2	75	Mean Difference (IV, Fixed, 95% CI)	0.93 [‐2.01, 3.87]

6 MCP ROM (degrees) Show forest plot	1	40	Mean Difference (IV, Fixed, 95% CI)	‐0.5 [‐15.99, 14.99]

7 PIP ROM (degrees) Show forest plot	1	40	Mean Difference (IV, Fixed, 95% CI)	4.0 [‐6.60, 14.60]

8 Knee ROM Show forest plot	1	70	Mean Difference (IV, Fixed, 95% CI)	‐18.03 [‐31.80, ‐4.27]

8.1 Right knee ROM	1	35	Mean Difference (IV, Fixed, 95% CI)	‐12.90 [‐31.98, 6.18]
8.2 Left knee ROM	1	35	Mean Difference (IV, Fixed, 95% CI)	‐23.60 [‐43.47, ‐3.73]
9 Ankle ROM Show forest plot	1	70	Mean Difference (IV, Fixed, 95% CI)	4.60 [‐0.33, 9.53]

9.1 Right ankle ROM	1	35	Mean Difference (IV, Fixed, 95% CI)	5.90 [‐1.21, 13.01]
9.2 Left ankle ROM	1	35	Mean Difference (IV, Fixed, 95% CI)	3.40 [‐3.43, 10.23]
10 Flexibility‐ tip to palm distance (cm) Show forest plot	2	57	Mean Difference (IV, Fixed, 95% CI)	‐1.28 [‐1.72, ‐0.85]

11 Morning stiffness duration (min) Show forest plot	3	110	Mean Difference (IV, Fixed, 95% CI)	‐27.45 [‐51.95, ‐2.95]

12 Morning stiffness not improved Show forest plot	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	0.76 [0.49, 1.19]

13 Rheumatoid factor positive Show forest plot	1	35	Risk Ratio (M‐H, Fixed, 95% CI)	0.9 [0.61, 1.34]

14 Grip strength Show forest plot	3	97	Mean Difference (IV, Fixed, 95% CI)	0.62 [‐0.36, 1.60]

14.1 Grip strength (mmHg)	2	75	Mean Difference (IV, Fixed, 95% CI)	7.71 [0.15, 15.27]
14.2 Grip strength (kg)	1	22	Mean Difference (IV, Fixed, 95% CI)	0.5 [‐0.49, 1.49]
15 Suprapatellar swelling ‐ right knee (cm) Show forest plot	1	35	Mean Difference (IV, Fixed, 95% CI)	‐2.94 [‐6.31, 0.43]

16 Suprapatellar swelling‐ left knee (cm) Show forest plot	1	35	Mean Difference (IV, Fixed, 95% CI)	‐2.69 [‐6.33, 0.95]

17 MCP swelling (cm) Show forest plot	1	40	Mean Difference (IV, Fixed, 95% CI)	0.20 [‐0.78, 1.18]

18 PIP swelling (cm) Show forest plot	2	75	Mean Difference (IV, Fixed, 95% CI)	0.53 [‐1.12, 2.18]

19 Walking speed (sec) Show forest plot	1	35	Mean Difference (IV, Fixed, 95% CI)	‐1.87 [‐7.08, 3.34]

20 Fibrinogen Show forest plot	1	35	Mean Difference (IV, Fixed, 95% CI)	1.5 [‐0.00, 3.00]

21 Leukocytes Show forest plot	1	35	Mean Difference (IV, Fixed, 95% CI)	1.60 [0.62, 2.58]

22 Lymphocytes Show forest plot	1	35	Mean Difference (IV, Fixed, 95% CI)	3.0 [‐6.57, 12.57]

23 ESR (mm/hr) Show forest plot	3	92	Mean Difference (IV, Fixed, 95% CI)	‐10.09 [‐15.04, ‐5.15]

24 CRP (g/mL) Show forest plot	2	57	Mean Difference (IV, Fixed, 95% CI)	2.55 [‐14.11, 19.21]

25 Hemoglobin Show forest plot	2	70	Mean Difference (IV, Fixed, 95% CI)	0.47 [0.01, 0.93]

26 Platelets Show forest plot	1	35	Mean Difference (IV, Fixed, 95% CI)	20.35 [‐64.36, 105.06]

Comparison 1. Laser vs Placebo‐ End of treatment (approx 10 wks)

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Comparison 2. Laser vs Placebo‐ End of follow‐up (approx 20 wks)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Pain Show forest plot	2	54	Mean Difference (IV, Fixed, 95% CI)	0.06 [‐1.24, 1.36]

1.1 Pain (10 cm visual analogue scale)	2	54	Mean Difference (IV, Fixed, 95% CI)	0.06 [‐1.24, 1.36]
2 McGill Pain questionnaire Show forest plot	1	28	Mean Difference (IV, Fixed, 95% CI)	1.39 [‐2.23, 5.01]

3 Health Assessment Questionnaire (HAQ) Show forest plot	2	54	Mean Difference (IV, Fixed, 95% CI)	1.10 [‐2.80, 4.99]

4 Ritchie Index Show forest plot	1	26	Mean Difference (IV, Fixed, 95% CI)	3.30 [‐5.74, 12.34]

5 PIP ROM (degrees) Show forest plot	1	26	Mean Difference (IV, Fixed, 95% CI)	2.0 [‐16.30, 20.30]

6 Knee ROM Show forest plot	1	56	Mean Difference (IV, Fixed, 95% CI)	‐11.47 [‐31.26, 8.31]

6.1 Right knee ROM	1	28	Mean Difference (IV, Fixed, 95% CI)	‐13.60 [‐41.44, 14.24]
6.2 Left knee ROM	1	28	Mean Difference (IV, Fixed, 95% CI)	‐9.30 [‐37.43, 18.83]
7 Ankle ROM Show forest plot	1	56	Mean Difference (IV, Fixed, 95% CI)	‐1.20 [‐11.69, 9.28]

7.1 Right ankle ROM	1	28	Mean Difference (IV, Fixed, 95% CI)	1.80 [‐12.59, 16.19]
7.2 Left ankle ROM	1	28	Mean Difference (IV, Fixed, 95% CI)	‐4.60 [‐19.91, 10.71]
8 MCP ROM (degrees) Show forest plot	1	26	Mean Difference (IV, Fixed, 95% CI)	10.0 [‐6.86, 26.86]

9 Morning stiffness duration (min) Show forest plot	2	54	Mean Difference (IV, Fixed, 95% CI)	12.16 [‐31.00, 55.31]

10 Walking speed (sec) Show forest plot	1	28	Mean Difference (IV, Fixed, 95% CI)	‐1.91 [‐12.60, 8.78]

11 Grip strength Show forest plot	1	26	Mean Difference (IV, Fixed, 95% CI)	‐29.0 [‐61.44, 3.44]

11.1 Grip strength (mmHg)	1	26	Mean Difference (IV, Fixed, 95% CI)	‐29.0 [‐61.44, 3.44]
11.2 Grip strength (kg)	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
12 Suprapatellar swelling‐ left knee (cm) Show forest plot	1	28	Mean Difference (IV, Fixed, 95% CI)	‐2.89 [‐14.38, 8.60]

13 Suprapatellar swelling ‐ right knee (cm) Show forest plot	1	28	Mean Difference (IV, Fixed, 95% CI)	‐3.29 [‐14.66, 8.08]

14 MCP swelling (cm) Show forest plot	1	26	Mean Difference (IV, Fixed, 95% CI)	‐0.40 [‐1.23, 0.43]

15 PIP swelling (cm) Show forest plot	1	26	Mean Difference (IV, Fixed, 95% CI)	0.90 [‐1.88, 3.68]

16 Thermographic index Show forest plot	1	26	Mean Difference (IV, Fixed, 95% CI)	0.60 [‐0.11, 1.31]

17 Rheumatoid factor positive Show forest plot	1	20	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.60, 1.68]

18 ESR (mm/hr) Show forest plot	1	28	Mean Difference (IV, Fixed, 95% CI)	‐2.0 [‐26.94, 22.94]

19 CRP (g/mL) Show forest plot	2	54	Mean Difference (IV, Fixed, 95% CI)	‐4.21 [‐20.25, 11.83]

20 Hemoglobin Show forest plot	2	54	Mean Difference (IV, Fixed, 95% CI)	0.98 [‐0.21, 2.16]

21 Platelets Show forest plot	2	54	Mean Difference (IV, Fixed, 95% CI)	32.68 [‐37.76, 103.11]

Comparison 2. Laser vs Placebo‐ End of follow‐up (approx 20 wks)

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Comparison 3. Treatment length‐ subgroup analysis for end of treatment results

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Pain (10 cm VAS or 0‐12 scale) Show forest plot	4		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

1.1 Treatment for 4 weeks	3	97	Mean Difference (IV, Fixed, 95% CI)	‐0.83 [‐1.46, ‐0.20]
1.2 Treatment for 10 weeks	1	72	Mean Difference (IV, Fixed, 95% CI)	‐1.54 [‐2.47, ‐0.61]

Comparison 3. Treatment length‐ subgroup analysis for end of treatment results

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Comparison 4. Treatment length‐ subgroup analysis for end of follow up results

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Pain (10 cm VAS or 0‐12 scale) Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

1.1 Treatment for 4 weeks	2	54	Mean Difference (IV, Fixed, 95% CI)	0.06 [‐1.24, 1.36]
1.2 Treatment for 10 weeks	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 4. Treatment length‐ subgroup analysis for end of follow up results

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Comparison 5. Methodologic quality: low (<3) vs high (=> 3)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Pain at end of treatment Show forest plot	4	169	Mean Difference (IV, Fixed, 95% CI)	‐1.05 [‐1.58, ‐0.53]

1.1 Low quality (<3)	2	107	Mean Difference (IV, Fixed, 95% CI)	‐1.39 [‐2.23, ‐0.56]
1.2 High quality (=> 3)	2	62	Mean Difference (IV, Fixed, 95% CI)	‐0.84 [‐1.51, ‐0.16]

Comparison 5. Methodologic quality: low (<3) vs high (=> 3)

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Comparison 6. Laser vs Placebo ‐ Joint vs Nerve ‐ end of treatment

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Pain (10 cm VAS or 0‐12 scale) Show forest plot	4		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

1.1 Joint application	3	97	Mean Difference (IV, Fixed, 95% CI)	‐0.83 [‐1.46, ‐0.20]
1.2 Nerve application	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.3 Joint and nerve application	1	72	Mean Difference (IV, Fixed, 95% CI)	‐1.54 [‐2.47, ‐0.61]

Comparison 6. Laser vs Placebo ‐ Joint vs Nerve ‐ end of treatment

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Comparison 7. Laser vs Placebo ‐ Joint vs Nerve ‐ end of follow up

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Pain (10 cm VAS or 0‐12 scale) Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

1.1 Joint application	2	54	Mean Difference (IV, Fixed, 95% CI)	0.06 [‐1.24, 1.36]
1.2 Nerve application	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.3 Joint and nerve application	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 7. Laser vs Placebo ‐ Joint vs Nerve ‐ end of follow up

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Comparison 8. Laser vs Placebo‐ Wavelength analysis ‐ End of treatment

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Pain Show forest plot	4		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

1.1 Wavelength < 660 nm	1	72	Mean Difference (IV, Fixed, 95% CI)	‐1.54 [‐2.47, ‐0.61]
1.2 Wavelength 820, 830 nm	2	62	Mean Difference (IV, Fixed, 95% CI)	‐0.84 [‐1.51, ‐0.16]
1.3 Wavelength 650‐950 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	‐0.78 [‐2.68, 1.12]
2 McGill Pain questionnaire Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

2.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.2 Wavelength 820, 830 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.3 Wavelength 650‐950 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	1.5 [‐1.22, 4.22]
3 Ritchie Index Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

3.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.2 Wavelength 820, 830 nm	1	40	Mean Difference (IV, Fixed, 95% CI)	2.60 [‐4.50, 9.70]
3.3 Wavelength 650‐950 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
4 Health Assessment Questionnaire (HAQ) Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

4.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.2 Wavelength 820, 830 nm	1	40	Mean Difference (IV, Fixed, 95% CI)	1.25 [‐2.09, 4.59]
4.3 Wavelength 650‐950 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	‐0.18 [‐6.39, 6.03]
5 MCP ROM (degrees) Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

5.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
5.2 Wavelength 820, 830 nm	1	40	Mean Difference (IV, Fixed, 95% CI)	‐0.5 [‐15.99, 14.99]
5.3 Wavelength 650‐950 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
6 PIP ROM (degrees) Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

6.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.2 Wavelength 820, 830 nm	1	40	Mean Difference (IV, Fixed, 95% CI)	4.0 [‐6.60, 14.60]
6.3 Wavelength 650‐950 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
7 Left knee Range of motion Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

7.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.2 Wavelength 820, 830 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.3 Wavelength 650‐950 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	‐23.60 [‐43.47, ‐3.73]
8 Right knee ROM Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

8.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
8.2 Wavelength 820, 830 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
8.3 Wavelength 650‐950 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	‐12.90 [‐31.98, 6.18]
9 Left ankle ROM Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

9.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
9.2 Wavelength 820, 830 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
9.3 Wavelength 650‐950 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	3.40 [‐3.43, 10.23]
10 Right ankle ROM Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

10.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
10.2 Wavelength 820, 830 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
10.3 Wavelength 650‐950 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	7.90 [0.79, 15.01]
11 Flexibility‐ tip to palm distance (cm) Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

11.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
11.2 Wavelength 820, 830 nm	2	57	Mean Difference (IV, Fixed, 95% CI)	‐1.28 [‐1.72, ‐0.85]
11.3 Wavelength 650‐950 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
12 Morning stiffness duration (min) Show forest plot	3		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

12.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
12.2 Wavelength 820, 830 nm	2	75	Mean Difference (IV, Fixed, 95% CI)	‐30.65 [‐55.71, ‐5.58]
12.3 Wavelength 650‐950 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	40.80 [‐75.05, 156.65]
13 Morning stiffness not improved Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only

13.1 Wavelength < 660 nm	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
13.2 Wavelength 820, 830 nm	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	0.76 [0.49, 1.19]
13.3 Wavelength 650‐950 nm	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
14 Rheumatoid factor positive Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only

14.1 Wavelength < 660 nm	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
14.2 Wavelength 820, 830 nm	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
14.3 Wavelength 650‐950 nm	1	35	Risk Ratio (M‐H, Fixed, 95% CI)	0.9 [0.61, 1.34]
15 Grip strength (mmHg, KPa, kg) Show forest plot	3		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

15.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
15.2 Wavelength 820, 830 nm	3	97	Mean Difference (IV, Fixed, 95% CI)	0.62 [‐0.36, 1.60]
15.3 Wavelength 650‐950 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
16 Suprapatellar swelling ‐ right knee (cm) Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

16.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
16.2 Wavelength 820, 830 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
16.3 Wavelength 650‐950 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	‐2.94 [‐6.31, 0.43]
17 Suprapatellar swelling‐ left knee (cm) Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

17.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
17.2 Wavelength 820, 830 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
17.3 Wavelength 650‐950 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	‐2.69 [‐6.33, 0.95]
18 MCP swelling (cm) Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

18.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
18.2 Wavelength 820, 830 nm	1	40	Mean Difference (IV, Fixed, 95% CI)	0.20 [‐0.78, 1.18]
18.3 Wavelength 650‐950 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
19 PIP swelling (cm) Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

19.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
19.2 Wavelength 820, 830 nm	2	75	Mean Difference (IV, Fixed, 95% CI)	0.53 [‐1.12, 2.18]
19.3 Wavelength 650‐950 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
20 Walking speed (sec) Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

20.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
20.2 Wavelength 820, 830 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
20.3 Wavelength 650‐950 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	‐1.87 [‐7.08, 3.34]
21 Fibrinogen Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

21.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
21.2 Wavelength 820, 830 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	1.5 [‐0.00, 3.00]
21.3 Wavelength 650‐950 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
22 Leukocytes Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

22.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
22.2 Wavelength 820, 830 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	1.60 [0.62, 2.58]
22.3 Wavelength 650‐950 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
23 Lymphocytes Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

23.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
23.2 Wavelength 820, 830 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	3.0 [‐6.57, 12.57]
23.3 Wavelength 650‐950 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
24 ESR (mm/hr) Show forest plot	3		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

24.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
24.2 Wavelength 820, 830 nm	2	57	Mean Difference (IV, Fixed, 95% CI)	‐11.12 [‐16.21, ‐6.04]
24.3 Wavelength 650‐950 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	8.27 [‐13.18, 29.72]
25 CRP (g/mL) Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

25.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
25.2 Wavelength 820, 830 nm	1	22	Mean Difference (IV, Fixed, 95% CI)	‐120.0 [‐190.13, ‐49.87]
25.3 Wavelength 650‐950 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	9.88 [‐7.27, 27.03]
26 Hemoglobin Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

26.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
26.2 Wavelength 820, 830 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	0.60 [0.11, 1.09]
26.3 Wavelength 650‐950 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	‐0.69 [‐2.12, 0.74]
27 Platelets Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

27.1 Wavelength < 660 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
27.2 Wavelength 820, 830 nm	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
27.3 Wavelength 650‐950 nm	1	35	Mean Difference (IV, Fixed, 95% CI)	20.35 [‐64.36, 105.06]

Comparison 8. Laser vs Placebo‐ Wavelength analysis ‐ End of treatment

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Comparison 9. Subgroup Dosage Analysis

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Pain VAS <= 3 J/cm2 Show forest plot	2	94	Mean Difference (IV, Fixed, 95% CI)	‐1.22 [‐1.81, ‐0.63]

2 Pain VAS > 3 J/cm2 Show forest plot	2	75	Mean Difference (IV, Fixed, 95% CI)	‐0.47 [‐1.59, 0.65]

3 ESR low dose Show forest plot	1	22	Mean Difference (IV, Fixed, 95% CI)	‐20.0 [‐28.69, ‐11.31]

4 ESR high dose Show forest plot	2	70	Mean Difference (IV, Fixed, 95% CI)	‐5.34 [‐11.35, 0.68]

5 CRP low dose Show forest plot	1	22	Mean Difference (IV, Fixed, 95% CI)	‐120.0 [‐190.13, ‐49.87]

6 CRP high dose Show forest plot	1	35	Mean Difference (IV, Fixed, 95% CI)	9.88 [‐7.27, 27.03]

7 HAQ high dose Show forest plot	2	75	Mean Difference (IV, Fixed, 95% CI)	0.93 [‐2.01, 3.87]

8 Hemoglobin high dose Show forest plot	2	70	Mean Difference (IV, Fixed, 95% CI)	0.47 [0.01, 0.93]

9 Morning stiffness (hours) high dose Show forest plot	3	110	Mean Difference (IV, Fixed, 95% CI)	‐27.45 [‐51.95, ‐2.95]

10 Grip strength (kg) low Show forest plot	1	22	Mean Difference (IV, Fixed, 95% CI)	0.5 [‐0.49, 1.49]

11 Grip strength (kg) high Show forest plot	2	75	Mean Difference (IV, Fixed, 95% CI)	7.71 [0.15, 15.27]

12 MCP swelling (cm) low Show forest plot	2	75	Mean Difference (IV, Fixed, 95% CI)	0.53 [‐1.12, 2.18]

13 Flexibility tip to palm (cm) low Show forest plot	1	22	Mean Difference (IV, Fixed, 95% CI)	‐1.25 [‐1.68, ‐0.82]

14 Flexibility tip to palm high dose Show forest plot	1	35	Mean Difference (IV, Fixed, 95% CI)	‐6.0 [‐11.25, ‐0.75]

Comparison 9. Subgroup Dosage Analysis

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Comparison 10. Laser vs Placebo‐ contralateral control (End of treatment)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Number of patients improved in pain relief Show forest plot	1	34	Risk Ratio (M‐H, Fixed, 95% CI)	13.0 [0.79, 214.05]

2 Number of patients improved in morning stiffness Show forest plot	1	34	Risk Ratio (M‐H, Fixed, 95% CI)	4.0 [0.50, 32.20]

Comparison 10. Laser vs Placebo‐ contralateral control (End of treatment)

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Referencias

Referencias de los estudios incluidos en esta revisión

Bliddal 1987 {published data only}

Goats 1996 {published data only}

Hall 1994 {published data only}

Johannsen 1994 {published data only}

Palmgren 1989 {published data only}

Walker 1987 {published data only}

Referencias de los estudios excluidos de esta revisión

Agambar 1992 {published data only}

Ammer K 2003 {published data only}

Asada K 1989 {published data only}

Barabas 1989 {published data only}

Day R 1999 {published data only}

De Bie 1998 {published data only}

Fulga C 1998 {published data only}

Goldman 1980 {published data only}

Heussler 1993 {published data only}

Matulis 1983 {published data only}

Miyagi 1989 {published data only}

Oyamada 1988 {published data only}

Sidorov VD 1999 {published data only}

Sidorov VD 2000 {published data only}

Taghawinejad 1985 {published data only}

Tsurko 1983 {published data only}

Walker 1983 {published data only}

Referencias adicionales

Anderson 1993

Badley 1994

Barabas 1988

Bassler 1985

Beckerman 1992

Bolagni 1985

Brosseau 1994

Brosseau 1998

Calderhead 1991

Ceccherelli 1989

Coderre 1993

Detsky 1992

Gam 1993

Greenland 1985

Helewa 1994

Hennekens 1987

Jadad 1996

Karu 1987

King 1990

Kudoh 1989

Lineker 1999

Mantel 1959

Morin 1996

Nishida 1990

OMERACT 1993

Petitti 1994

Prwemstay 1987

Quirion‐DeGirardi 94

Rothstein 1991

Schultz 1985

Seichert 1991

Tugwell 2004

Walker 1996

Young 1988

Characteristics of studies

Characteristics of included studies [ordered by study ID]

Characteristics of excluded studies [ordered by study ID]

Data and analyses

Copiar o descargar referencia

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Instituciones a las que se accedió previamente

Usuarios institucionales

Instituciones a las que se accedió previamente

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