Effectiveness of High-Intensity Laser Therapy in Patients with Lateral Epicondylitis on the Level of Disability, Pain, Grip Strength and Quality of Life: A Systematic Review and Meta-Analysis

Abstract

The systematic review and meta-analysis aim to evaluate the clinical effectiveness of High-Intensity Laser Therapy (HILT) in managing Lateral Epicondylitis (LE). The electronic databases (Pubmed, Europepmc, NCBI-NIH, Medline, Science direct, and google scholar) were searched. Studies that meet the following criteria are included in the review: 1) experimental studies, 2) participants were diagnosed with LE, 3) at least one of the treatment groups included HILT, and 4) at least one research outcome was on level of disability of elbow, level of perceived pain, handgrip strength, or quality of life. The last search was conducted in May 2021. Six studies (n=321) were included in the review. Overall, HILT significantly reduced pain comparing with the active controls (weighted mean difference: -0.65; 95% CI-0.98 to -0.33; p=0). Also, effect of HILT on improving participants’ quality of life in physical domain was significantly better than that of the active controls. (Standardized mean difference: 0.486; 95% CI=0.066 to 0.906; p=0.023). Though all included studies revealed that HILT had a higher therapeutic effect than the comparators in aspects of grip strength and level of disability, no significant difference was detected. These outcomes show a “weak” strength of evidence in quality assessment. In conclusion, although HILT showed a positive impact on LE, the number of studies on HILT was limited and the risk of selection, performance and detection bias was revealed. Therefore, further well-designed studies are warranted