I'm a bit late in responding to this I know, was just cleaning out my 
mail box:

>>Subject: Enquiry re electrical equipment for private practice

>>I have recently started a small private practice outside Newcastle in NSW
>>Australia. I am wondering what colleagues consider the most useful
>>electrical equipment, in particular, laser versus ultrasound.
>>Linda Watts


>Anna 21/4/99 8:18 pm [log in to unmask]
>Hello Linda,
>
>I would go for the US and perhaps a neuromuscular stimulator.
>there is evidence that low level laser is no more effective than placebo.

There are now over 1,000 published studies on laser therapy 

I could show you 10 good published double blind trials with a positive 
outcome that would be hard to match with any other electrotherapy 
modality.

Yes, many failed to show a positive result but does not mean it does not 
work it just means that for the condition treated at the parameters 
chosen it did not work. 

Here is an old analysis and things have got better since:

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* * * * * * 

Phys Ther 1992 Jul;72(7):483-91 

The efficacy of laser therapy for musculoskeletal and skin disorders: 
a criteria-based meta-analysis of randomized clinical trials.


Beckerman H, de Bie RA, Bouter LM, De Cuyper HJ, Oostendorp RA

Department of Rehabilitation Medicine, Free University Hospital, 
Amsterdam, The Netherlands. 

The efficacy of laser therapy for musculoskeletal and skin disorders has 
been assessed on the basis of the results of 36 randomized clinical 
trials (RCTs) involving 1,704 patients. For this purpose, a 
criteria-based meta-analysis that took into account the methodological 
quality of the individual trials was used. The studies with a positive 
outcome were generally of a better quality than the studies with a 
negative outcome. No clear relationship could be demonstrated between the 
laser dosage applied and the efficacy of laser therapy, or between the 
dosage and the methodological score. In general, the methodological 
quality of these studies appeared to be rather low. Consequently, no 
definite conclusions can be drawn about the efficacy of laser therapy for 
skin disorders. The efficacy of laser therapy for musculoskeletal 
disorders seems, on average, to be larger than the efficacy of a placebo 
treatment. More specifically, for rheumatoid arthritis, posttraumatic 
joint disorders, and myofascial pain, laser therapy seems to have a 
substantial specific therapeutic effect. Further RCTs, avoiding the most 
prevalent methodological errors, are needed in order to enable the 
benefits of laser therapy to be more precisely and validly evaluated. 




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* * * * * * 


J Clin Laser Med Surg 1998 Oct;16(5):245-8 

It's all in the parameters: a critical analysis of some well-known 
negative studies on low-level laser therapy.

Tuner J, Hode L

Swedish Laser Medical Society, Stockholm, Sweden. 
OBJECTIVE: Scientific studies include references to historical studies on 
low-level laser therapy (LLLT) in general and to old studies on the 
specific subject in particular. Some studies are quoted often. It is fair 
to take a second look at these, since few people seem to have read them 
carefully, and others have read them only in the abstract form. This 
paper critically reviews the parameter pitfalls found in many of the 
classic "negative" studies. SUMMARY BACKGROUND DATA: A study of 1,200 
papers on LLLT has resulted in 85 positive and 35 negative double-blind 
studies. The negative studies have been scrutinized carefully in an 
effort to pinpoint possible reasons for the failures. In the following, 
the majority are double-blind studies, but some non-blinded and animal 
studies have been included to give typical examples of pitfalls.


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