OBJECTIVES: To investigate the laser effect associated with stretching exercise on pain and functionality in patients with knee osteoarthritis. DESIGN: A randomised controlled trial. SETTING: Special rehabilitation services. SUBJECTS: We enrolled 215 knee osteoarthritis patients (430 knees were treated). INTERVENTION: Group laser+stretch (n = 43), placebo+stretch (n = 43), stretch (n = 43), laser (n = 43) and control (n = 43) were treated with active laser and stretching exercises; placebo laser and stretching exercises; stretching exercises; active laser, and control, respectively. Interventions were conducted 3 times a week for 8 or 11 weeks. MAIN OUTCOME MEASURES: The primary outcome was the change in knee pain and disability. Secondary outcomes included severity of osteoarthritis, mobility, knee range of motion, flexibility, activity, severity of osteoarthritis and medication intake for pain relief. RESULTS: The patients' average age was 63.52 (6.8) years. Pain scores at baseline and post treatment (p < 0.001) were 7.43 (2.10) and 2.79 (1.92) for group laser+stretch, 7.39 (1.98) and 4.47 (2.82) for group placebo+stretch, 6.83 (1.42) and 4.24 (2.43) for group stretch, 6.61 (1.68) and 2.94 (2.65) for group laser, 6.74 (1.75) and 6.47 (2.29) for group control, respectively. Disability score at baseline and post treatment (p = 0.000237) were 12.36 (5.02) and 8.08 (4.64) for group laser+stretch, 12.71 (5.12) and 9.90 (4.95) for group placebo+stretch, 11.83 (2.77) and 7.20 (5.28) for group stretch, 11.58 (5.59) and 8.21 (6.18) for group laser, 11.23 (4.68) and 11.45 (4.83) for group control, respectively. CONCLUSION: Laser therapy combined with stretching exercises improves pain during rest, activities of daily living, stiffness, muscle shortening and range of motion in patients with knee osteoarthritis.

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