BACKGROUND: Low-level (LLLT) and high-intensity laser therapy (HILT) can be beneficial additions to knee osteoarthritis (KOA) rehabilitation exercises; however, it is still being determined which electrophysical agent is more effective. AIM: To compare the effects of LLLT and HILT as adjuncts to rehabilitation exercises (LL plus EX and HL plus EX) on clinical outcomes in KOA. METHODS: Thirty-four adults with mild-to-moderate KOA were randomly allocated to either LL plus EX or HL plus EX (n = 17 each). Both groups underwent their respective intervention weekly for twelve weeks: LL plus EX (400 mW, 830 nm, 10 to 12 J/cm2, and 400 J per session) or HL plus EX (5 W, 1064 nm, 19 to 150 J/cm2, and 3190 J per session). The laser probe was placed vertically in contact with the knee and moved in a slow-scan manner on the antero-medial/lateral sides of the knee joint. Participants ' Knee Injury and Osteoarthritis Outcome Score (KOOS), Numerical Pain Rating Scale (NPRS), active knee flexion, and Timed Up-and-Go test (TUG) were assessed. RESULTS: Post intervention, both groups showed improvements in their KOOS, NPRS, active knee flexion, and TUG scores compared to baseline (p < 0.01). The mean difference of change in KOOS, NPRS, and active knee flexion scores for the HL plus EX group surpassed the minimal clinically important difference threshold. In contrast, the LL plus EX group only demonstrated clinical significance for the NPRS scores. CONCLUSIONS: Incorporating HILT as an adjunct to usual KOA rehabilitation led to significantly higher improvements in pain, physical function, and knee-related disability compared to LLLT applied in scanning mode.

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