***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND AND OBJECTIVES A prospect i ve , double-blind , r and omized , and controlled trial was conducted in patients with knee osteoarthritis ( OA ) to evaluate the efficacy of infrared low-power Gallium-Arsenide ( Ga-As ) laser therapy ( LPLT ) and compared two different laser therapy regimes . STUDY DESIGN / MATERIAL S AND METHODS Ninety patients were r and omly assigned to three treatment groups by one of the nontreating authors by drawing 1 of 90 envelopes labeled ' A ' ( Group I : actual LPLT consisted of 5 minutes , 3 J total dose + exercise ; 30 patients ) , ' B ' ( Group II : actual LPLT consisted of 3 minutes , 2 J total dose + exercise ; 30 patients ) , and ' C ' ( Group III : placebo laser group + exercise ; 30 patients ) . All patients received a total of 10 treatments , and exercise therapy program was continued during study ( 14 weeks ) . Subjects , physician , and data analysts were unaware of the code for active or placebo laser until the data analysis was complete . All patients were evaluated with respect to pain , degree of active knee flexion , duration of morning stiffness , painless walking distance and duration , and the Western Ontario and Mc Master Universities Osteoarthritis Index ( WOMAC ) at week 0 , 6 , 10 , and 14 . RESULTS Statistically significant improvements were indicated in respect to all parameters such as pain , function , and quality of life ( QoL ) measures in the post-therapy period compared to pre-therapy in both active laser groups ( P < 0.01 ) . Improvements in all parameters of the Group I and in parameters , such as pain and WOMAC of the Group II , were more statistically significant when compared with placebo laser group ( P < 0.05 ) . CONCLUSIONS Our study demonstrated that applications of LPLT in different dose and duration have not affected results and both therapy regimes were a safe and effective method in treatment of knee OA OBJECTIVE the aim of the present study was to evaluate the efficacy of low level laser therapy ( LLLT ) in patients with rheumatoid arthritis ( RA ) with carpal tunnel syndrome ( CTS ) . MATERIAL AND METHODS a total of 19 patients with the diagnosis of CTS in 19 h and s were included and r and omly assigned to two treatment groups ; LLLT ( Group 1 ) ( 10 h and s ) with dosage 1.5 J/ per point and placebo laser therapy group ( Group 2 ) ( 9 h and s ) . A Galium-Aluminum-Arsenide diode laser device was used as a source of low power laser with a power output of 50 mW and wavelength of 780 nm . All treatments were applied once a day on week days for a total period of 10 days . Clinical assessment s were performed at baseline , at the end of the treatment and at month 3 . Tinel and Phalen signs were tested in all patients . Patients were evaluated for such clinical parameters as functional status scale ( FSS ) , visual analogue scale ( VAS ) , symptom severity scale ( SSS ) and grip-strength . However , electrophysiological examination was performed on all h and s. Results were given with descriptive statistics and confidence intervals between group means at 3 months adjusted for outcome at baseline and for the difference between unadjusted group proportions . RESULTS clinical and electrophysiological parameters were similar at baseline in both groups . Improvements were significantly more pronounced in the LLLT group than placebo group . A comparison between groups showed significant improvements in pain score and functional status scale score . Group mean differences at 3 months adjusted at baseline were found to be statistically significant for pain score and functional status scale score . The 95 % significant confidence intervals were [ -15 - ( -5 ) ] and [ -5 - ( -2 ) ] respectively . There were no statistically significant differences in other clinical and electrophysiological parameters between groups at 3 months . CONCLUSIONS our study results indicate that LLLT and placebo laser therapy seems to be effective for pain and h and function in CTS . We , therefore , suggest that LLLT may be used as a good alternative treatment method in CTS patients with RA OBJECTIVE The objective of the study was to investigate clinical effects of low-level laser therapy ( LLLT ) in patients with acute neck pain with radiculopathy . DESIGN Double-blind , r and omized , placebo-controlled study . SETTING The study was carried out between January 2005 and September 2007 at the Clinic for Rehabilitation at the Medical School , University of Bel grade , Serbia . PATIENTS AND INTERVENTION Sixty subjects received a course of 15 treatments over 3 weeks with active or an inactivated laser as a placebo procedure . LLLT was applied to the skin projection at the anatomical site of the spinal segment involved with the following parameters : wavelength 905 nm , frequency 5,000 Hz , power density of 12 mW/cm(2 ) , and dose of 2 J/cm(2 ) , treatment time 120 seconds , at whole doses 12 J/cm(2 ) . OUTCOME MEASURES The primary outcome measure was pain intensity as measured by a visual analog scale . Secondary outcome measures were neck movement , neck disability index , and quality of life . Measurements were taken before treatment and at the end of the 3-week treatment period . RESULTS Statistically significant differences between groups were found for intensity of arm pain ( P = 0.003 , with high effect size d = 0.92 ) and for neck extension ( P = 0.003 with high effect size d = 0.94 ) . CONCLUSION LLLT gave more effective short-term relief of arm pain and increased range of neck extension in patients with acute neck pain with radiculopathy in comparison to the placebo procedure Abstract A r and omized , double‐blind , placebo‐controlled study of low‐level laser therapy ( LLLT ) in 90 subjects with chronic neck pain was conducted with the aim of determining the efficacy of 300 mW , 830 nm laser in the management of chronic neck pain . Subjects were r and omized to receive a course of 14 treatments over 7 weeks with  either active or sham laser  to tender areas in the neck . The primary outcome measure was change in a 10 cm Visual Analogue Scale ( VAS ) for pain . Secondary outcome measures included Short‐Form 36 Quality ‐of‐Life question naire ( SF‐36 ) , Northwick Park Neck Pain Question naire ( NPNQ ) , Neck Pain and Disability Scale ( NPAD ) , the McGill Pain Question naire ( MPQ ) and Self‐Assessed Improvement ( SAI ) in pain measured by VAS . Measurements were taken at baseline , at the end of 7 weeks ' treatment and 12 weeks from baseline . The mean VAS pain scores improved by 2.7 in the treated group and worsened by 0.3 in the control group ( difference 3.0 , 95 % CI 3.8–2.1 ) . Significant improvements were seen in the active group compared to  placebo for SF‐36‐Physical Score ( SF36 PCS ) , NPNQ , NPAD , MPQVAS and SAI . The results of the SF‐36 – Mental Score ( SF36 MCS ) and other MPQ component scores ( afferent and sensory ) did not differ significantly between the two groups . Low‐level laser therapy ( LLLT ) , at the parameters used in this study , was efficacious in providing pain relief for patients with chronic neck pain over a period of 3 months Summary A r and omized , double blind study of low level laser treatment of chondromalacia of the patella in 40 patients has been undertaken . Chondromalacia was established by arthroscopy and was related to subjective symptoms . Eight treatments were given during five weeks by a physiotherapist with the use of a GAAS pulsed laser , real or sham .  Assessment of the location , quality and intensity of pain , and the influence on mood , gait , sleep , work , and sports was made before and after treatment including an eight to twelve week evaluation . No statistical difference was found between real and sham use of low level laser for the symptoms of chondromalacia of the patella . RésuméOn a réalisé chez 10 malades une étude r and omisée , à double insu , du traitement de la chondropathie de la rotule par  laser  de basse intensité . Le diagnostic avait été confirmé par arthroscopie , en présence d'une symptomatologie subjective . Huit séances de traitement ont été effectuées pendant cinq semaines par un physiothérapeute utilisant un laser alternatif GAAS , réel ou simulé . Une évaluation du siège , du type et de l'intensité de la douleur ainsi que de l'influence de l'humeur , de la marche , du sommeil , du travail et de l'activité sportive a été faite avant et après traitement . Aucune différence statistiquement valable n'a pu être mise en évidence entre l'effet d'un laser réel ou simulé vis à vis des symptômes de la chondropathie rotulienne Objective : To investigate the effectiveness of low‐level laser therapy in the treatment of temporom and ibular disorder and to compare treatment effects in myogenic and arthrogenic cases . Methods : Thirty‐five patients were evaluated by magnetic resonance imaging and r and omly allocated to active treatment ( n=20 ) and placebo treatment ( n=15 ) groups . In addition to a daily exercise program , all patients were treated with fifteen sessions of low‐level laser therapy .  Pain , joint motion , number of joint sounds and tender points were assessed . Results : Significant reduction in pain was observed in both active and placebo treatment groups . Active and passive maximum mouth opening , lateral motion , number of tender points were significantly improved only in the active treatment group . Treatment effects in myogenic and arthrogenic cases were similar . Conclusion : Low‐level laser therapy can be considered as an alternative physical modality in the management of temporom and ibular disorder Background The delivery of acupuncture alongside mainstream interventions and the cost-effectiveness of “ alternative ” treatments remain areas of controversy . Objective The aim of this study was to assess the cost-utility of adding acupuncture to a course of advice and exercise delivered by UK National Health Service ( NHS ) physical therapists to people with osteoarthritis of the knee . Design A cost-utility analysis was performed alongside a r and omized controlled trial . Methods A total of 352 adults ( aged 50 years or older ) were r and omly assigned to receive 1 of 3 interventions . The primary analysis focused on participants receiving advice and exercise ( AE ) or advice and exercise plus true acupuncture ( AE+TA ) . A secondary analysis considered participants receiving advice and exercise plus nonpenetrating acupuncture ( AE+NPA ) . The main outcome measures were quality -adjusted life years ( QALYs ) , measured by the EQ-5D , and UK NHS costs . Results were expressed as the incremental cost per QALY gained over 12 months . Sensitivity analyses included a broader cost perspective to incorporate private out-of-pocket costs . Results NHS costs were higher for AE+TA ( £ 314 [ British pounds sterling ] ) than for AE alone ( £ 229 ) , and the difference in mean QALYs favored AE+TA ( mean difference=0.022 ) . The base-case cost per QALY gained was £ 3,889 ; this value was associated with a 77 % probability that AE+TA would be more cost-effective than AE at a threshold of £ 20,000 per QALY . Cost-utility data for AE+NPA provided cost-effectiveness estimates similar to those for AE+TA . Limitations As with all trial-based economic evaluations , caution should be exercised when generalizing results beyond the study perspectives . Conclusions A package of AE+TA delivered by NHS physical therapists provided a cost-effective use of health care re sources despite an associated increase in costs . However , the economic benefits could not be attributed to the penetrating nature of conventional acupuncture ; therefore , further research regarding the mechanisms of acupuncture is needed . An analysis of alternative cost perspectives suggested that the results are generalizable to other health care setting OBJECTIVES --To define the value of low power laser treatment in small joint rheumatoid arthritis . METHODS --Twenty five women with active disease were recruited . The metacarpophalangeal and proximal interphalangeal joints of one h and were treated with 12 J/cm2 for 30 s with a gallium-aluminium-arsenate laser . The other h and received a sham laser treatment design ed so that neither therapist nor patient could distinguish the active laser from the sham laser . Each patient received 12 treatments over four weeks . The following parameters were measured : pain as assessed by visual analogue scale ; range of joint movements ; grip strength ; duration of early morning stiffness , joint circumference , Jebsen 's h and assessment ; drug usage ; total swollen joint counts ; Arthritis Impact Measurement Scales ; three phase bone scans ; haematological and serological tests . RESULTS --A total of 72 % of patients reported pain relief but this reduction was reported equally in both h and s. No significant changes were seen in other clinical , functional , scintigraphic , or laboratory features . Neither patients nor staff were able to detect which h and was treated with the active laser . CONCLUSION --When this specific laser and dose regimen was used , low power laser treatment had no objective effect on patients with rheumatoid arthritis . It did appear to produce analgesia through a powerful placebo effect The aim of this study was to investigate the analgesic efficacy of low power laser therapy in patients with knee osteoarthritis ( OA ) . The study design was r and omised , placebo-controlled and single blinded . Sixty patients with kne 
    Output:
    
The review shows that laser therapy on the joint reduces pain in patients .
Moreover , when we restrict the energy doses of the laser therapy into the dose window suggested in the previous study , we can expect more reliable pain relief treatments