This pattern was not apparent in our review. On the contrary, there were examples of trials that used dosage parameters consistent with WALT guidelines that demonstrated no effect (Dundar et al 2007: 830nm, 7J per point) as well as trials that used doses Professor Bjordal would describe as ‘very low’ (Ozdemir et al 2001: 830nm, 0.9 J per point) that reported very large treatment effects. Additionally, the WALT guidelines suggest that the number of points treated is
a significant dosage parameter. There was very large variation, both between and within the trials reviewed, of the number of points treated (Range 4–50) and hence the total energy delivered during the treatment. The other explanation offered IOX1 nmr by Professor Bjordal for the variability in outcomes was that the therapeutic effect of laser therapy
is characteristically delayed. This phenomenon also was not apparent in our review. Any conclusions about the size of the treatment effect over time were difficult to draw because few trials reported find more both short- and medium-term outcomes, and those that did had mixed results regarding inhibitors immediate and delayed effects. We found evidence in some studies of an immediate analgesic effect and in others an apparent delayed effect and we are not aware of any biologically plausible explanation for this finding. Although not directly related to the discussion on laser therapy, Professor Bjordal also commented on the need to balance benefit and harm in light of our findings regarding pharmacological treatments, and we agree with these comments. The most startling finding regarding pharmacological treatments for neck pain was the lack of quality trials of medication for neck pain. The finding of short-term benefit for orphenadrine/paracetamol, needs consideration in the context of lack of evidence about long term benefit and potential harms. “
“Healthtalkonline documents the experiences of health and illness of over 2000 people. It is based on research
from the Health Experiences Research Group at the University of Oxford. The website is run by the DIPEx Charity and was previously known as www.dipex.org. It includes videos Oxalosuccinic acid and transcripts of interviews with people living with over 40 health conditions as well as interviews with carers of people living with health conditions. There are also links to other resources such as overviews by experts and information designed for health care consumers. Many of the featured conditions or settings are of direct relevance to physiotherapists. Chronic pain, diabetes, breast cancer, lung cancer, stroke, motor neurone disease, Parkinson’s disease, congenital heart disease, rheumatoid arthritis, osteoporosis, pain during pregnancy, and the experience of being a patient in an intensive care unit are all covered by the website. This is an impressive website.