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Ann Rehabil Med > Epub ahead of print
Agarwal, S, and Sharma: Letter to the Editor: Efficacy and Safety of High Density LED Irradiation Therapy for Patients With Hand Osteoarthritis: A Single-Center Clinical Study
Dear Editor,
We read the article by Kim et al. [1], with attention and would like to congratulate them for their valuable research on efficacy and safety of high density light-emitting diode (LED) irradiation therapy for patients with hand osteoarthritis. However, we would like to provide some feedback on the study presented by authors.
Firstly, we would like to appraise the information outlined in the introduction section concerning hand osteoarthritis, including its prevalence, symptoms, deformity and limitations individuals experience due to the condition. Additionally, the introduction emphasizes the scarcity of literature on hand osteoarthritis, attributing it to a shift in focus towards osteoarthritis affecting larger joints. Our understanding is further deepened by reading the physiology and mechanism of action of photobiomodulation therapies in alleviating symptoms due to arthritis. But we would like to draw attention towards the missing hypothesis in text. In our view, the authors should use two-tailed hypothesis, for which “high-density LED irradiation therapy might have significant difference in improving pain, hand swelling and joint mobility in patients with hand osteoarthritis” would be an alternate hypothesis, and the null hypothesis would be “high-density LED irradiation therapy might not have significant difference in improving pain, hand swelling and joint mobility in patients with hand osteoarthritis.”
Secondly, the stated inclusion and exclusion criteria need to be modified. The amount of time since the disease’s inception and the reference for the selected American College of Rheumatology criteria [2] should have been mentioned in the inclusion criteria. Along with this, patients with any congenital hand deformities, a history of hand injury, patients taking prior physiotherapy sessions and patients contraindicated for LED irradiation (such as in case of epilepsy, active cancer, photosensitizing medications or highly sensitive skin) should have been excluded from the study [3]. Further, the text also lacked the method of sample size calculation and its parameters.
However, we appreciate the number of therapy sessions given per week for 4 weeks along with parameters of irradiation and safety assessment before application has been well mentioned.
Next, we would like to draw attention towards the fact that the methodology did not specify any follow-up time, but it was directly mentioned in results, which initially made the statistical analysis less comprehensible. Explanation of the statistical tests applied, such as paired-t test, one-way ANOVA and chi-square test was unclear. Also the normality of the demographic data in the form of p-values could have been notified for better clarity [4]. However, results were well presented along with graphs and figures. The findings of the study were intriguing, informative, and aligned with other recent evidence, thereby contributing additional insights to the existing literature.
We are interested in hearing the author’s thoughts on these remarks.

CONFLICTS OF INTEREST

No potential conflict of interest relevant to this article was reported.

FUNDING INFORMATION

None.

REFERENCES

1. Kim K, Kim SH, Kim JH, Yong SY, Choi WW, Kim SJ, et al. Efficacy and safety of high density LED irradiation therapy for patients with hand osteoarthritis: a single-center clinical study. Ann Rehabil Med 2024;48:50-6.
crossref pmid pmc pdf
2. Altman R, Alarcón G, Appelrouth D, Bloch D, Borenstein D, Brandt K, et al. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand. Arthritis Rheum 1990;33:1601-10.
crossref pmid
3. Sasaki GH. Advances in light-emitting diodes (LED) technology and therapy. In: DiBernardo BE, Pozner JN, editors. Lasers and non-surgical rejuvenation. Saunders/Elsevier; 2009. p.101-14.

4. Portney LG. Foundations of clinical research: applications to evidence-based practice. 4th ed. F.A. Davis Company; 2020. p.1-696.



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