Effects Of High-intensity Laser Therapy Research Articles

A systematic review and meta-analysis of randomized controlled trials on the effectiveness of high-intensity laser therapy in the management of neck pain.

The purpose of this systematic review was to evaluate the effects of high-intensity laser therapy (HILT) on pain, disability, and range of movement in patients with neck pain. Randomized controlled trials (RCTs) of HILT for neck pain disorders were searched across databases such as PubMed, Web of Science, Scopus, CINAHL, Science Direct, Cochrane Library, the PEDro database, and Google Scholar (updated January 7, 2024). The main outcome was pain intensity, with neck disability and cervical range of motion as secondary outcomes. Researchers reviewed article titles and abstracts from different databases using the Rayyan web app. Study quality was assessed using the Cochrane risk of bias tool, and evidence-based recommendations were developed using the GRADE approach. A meta-analysis was conducted to calculate the pooled effect in terms of mean differences (MD) for the outcomes of interest, along with a 95% confidence interval (95% CI). Twenty studies met the selection criteria and were potentially eligible for inclusion in the meta-analysis. At the end of the treatment, there was a statistically significant (p < 0.01) pooled MD of -14.1mm for pain intensity (17 RCTs) with the VAS (95% CI:-18.4,-9.7), 3.9° (95% CI:1.9,6.7) for cervical extension (9 RCTs), and -8.3% (95% CI:-14.1,-4.1) for disability diminish (12 RCTs) with the neck disability index in favor of HILT. Only the results for pain intensity are in line with the minimal clinically important differences (MCID) reported in the literature. Overall, the evidence was deemed significant but with low certainty, attributed to observed heterogeneity and some risk of bias among the RCTs. HILT demonstrates effectiveness in reducing neck pain and disability while enhancing cervical extension when added to other physical therapy interventions, especially therapeutic exercise, based on a moderate level of evidence. This review highlights that the most favorable results are obtained when HILT is employed to address myofascial pain, cervical radiculopathy and chronic neck pain.PROSPERO registration number: CRD42023387394 (Registration date, 14/01/2023).

Effectiveness of a high-intensity laser for improving hemiplegic shoulder dysfunction: a randomized controlled trial

Hemiplegic shoulder pain (HSP) is a common complication that occurs after stroke and has been reported in up to 84% of hemiplegic patients. One of the recommended treatment options for shoulder pain is high-intensity laser therapy (HILT). This study aimed to determine the effectiveness of high-intensity laser therapy on pain, function and hand grip strength in patients with hemiplegic shoulder dysfunction. Forty-four hemiplegic patients were randomly divided into two groups: Group 1 (study group, n = 22) received 3 HILT sessions a week for three weeks in combination with three sessions of therapeutic exercise per week for three weeks, and Group 2 (control group, n = 22) received a conventional exercise program for HSP three times a week for three weeks. Shoulder pain was evaluated using the McGill pain questionnaire (MPQ), the functional outcome of the shoulder was evaluated with the University of California–Los Angeles functional scale (UCLA), and handgrip strength was evaluated with a hydraulic hand dynamometer. The increase in the UCLA scores and the decrease in the MPQ scores after treatment were significant in the study group (p < 0.001) as well as in the control group (p < 0.05) in comparison with the pretreatment between-group comparison. Additionally, the increase in hand grip strength was significant in both groups after treatment (p < 0.001). The study group showed significant improvement over the control group with respect to the UCLA score, handgrip strength, and MPQ score (p < 0.001). HILT combined with therapeutic exercise provides greater improvement than therapeutic exercise alone in terms of hemiplegic shoulder pain, dysfunction, and handgrip strength.

Effect of High-intensity Laser Therapy on Carpal Tunnel Syndrome Patients: A Systematic Review and Meta-analysis.

To provide a strong foundation for the use of high-intensity laser therapy (HILT) in carpel tunnel syndrome (CTS,) we conducted a systematic review and meta-analysis to investigate the outcomes of short- and long-term follow-up studies. Systematic review and meta-analysis. Sample sizes of included studies ranged from 16 to 98 patients (total N = 308). Overall, a significant difference between the treatment and control groups were found across majority of the measures. Studies using a four-week follow-up period, however, only found significantly greater benefits for HILT in visual analogue scale (VAS) compared to placebo (p = 0.0191), Transcutaneous electrical nerve stimulation (TENS) (p = 0.0026), and low-intensity laser therapy-20 J/cm2 (p < 0.0002), and exercise (p < 0.0001). For improvement in VAS score over a long treatment period, HILT was also preferred over control group (p < 0.0071). Insufficient evidence exists to determine effect of HILT on nerve conduction examinations. The only statistically significant differences observed in examinations were in relation to sensory nerve action potential (p = 0.0083) and sensory nerve conduction velocity (SNCV) (p = 0.0468). Moderate evidence exists regarding efficacy of HILT compared to placebo, HILT + wrist splint, and exercise in a short period of follow-up time but evidence on long-term follow-up is limited.

Effectiveness of high-intensity laser therapy in the treatment of patients with frozen shoulder: a systematic review and meta-analysis.

The purpose of this study is to evaluate the effects of high-intensity laser therapy (HILT) in patients with frozen shoulder. PRISMA guidelines were adhered to, and a systematic search was conducted in the PubMed, Web of Science, Scopus, CINAHL, Science Direct, and PEDro databases (last update: September 4, 2023; search period: December 2022-September 2023). The inclusion criteria encompassed RCTs comparing HILT with other physical therapy interventions in frozen patients with frozen shoulders, with or without sham HILT, assessing pain intensity, shoulder ROM, and disability outcomes. The quality of the RCTs was assessed with the Cochrane Risk of Bias tool, and evidence was assessed using the GRADE approach. Five trials met the eligibility criteria and were included in the review and meta-analysis, which pooled results from the visual analog scale (VAS), goniometry, and the shoulder pain and disability index (SPADI). Mean differences (MDs) for pain intensity and disability show a pooled effect in favor of HILT both for VAS (MD = - 2.23cm, 95% CI: - 3.25, - 1.22) and SPADI (MD = - 10.1% (95% CI = - 16.5, - 3.7), changes that are statistical (p < 0.01) and clinical. The MD for flexion (MD = 9.0°; 95% CI: - 2.36°, 20.3°; p = 0.12), abduction (MD = 3.4°; 95% CI: - 6.9°, 13.7°; p = 0.51), and external rotation (MD = - 0.95°; 95% CI: - 5.36°, 3.5°; p = 0.67) does not show statistical and clinical differences between groups after treatment. PI and disability changes were graded as important due to their clinical and statistical results. HILT into a physical therapy plan reduce pain and disability, but it does not outperform conventional physical therapy in improving shoulder ROM. It is suggested that future RCTs compare the effects of HILT and LLLT to assess their possible differences in their analgesic effects.

Effectiveness of High-intensity Laser Therapy for Pain and Function in Knee Osteoarthritis: A Randomized Controlled Trial

Background: High-intensity laser therapy (HILT) is still a controversial physical therapy modality for individuals with knee osteoarthritis (OA). Objectives: This study aimed to evaluate the effect of HILT on pain and function in patients with knee OA. Methods: This randomized controlled trial included 56 patients with knee OA referred to Amin Hospital affiliated with Isfahan University of Medical Sciences, Isfahan, Iran, from April 19 to August 30, 2022. Patients were randomized into two groups (HILT and control), receiving isometric exercises targeting the quadriceps muscle, meloxicam 15 mg tablet, and Rahamin ointment for two weeks. The HILT group also received high-intensity laser irradiation three times a week for two weeks. The primary outcome was pain assessed using a Visual Analog Scale (VAS), and the secondary outcome was the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) and its subscales (pain, stiffness, and physical function). Outcomes were evaluated at baseline, immediately, and three months after the last treatment session. Results: After adjusting for age, sex, and baseline values, immediately and three months after treatment, VAS pain scores were significantly lower in the HILT group than in controls (P &lt; 0.001), with a large effect (standardized mean difference (SMD) = -1.22, 95% confidence interval (CI): -1.81; -0.62 and SMD = -1.31, 95% CI: -1.90; -0.70, respectively). The results were similar for WOMAC's pain subscale. Despite the difference in WOMAC stiffness score was not significant between the two groups immediately after treatment (P = 0.135), this score was significantly lower in the HILT group than in the control group (SMD = -0.98, 95% CI: -1.56; -0.40, P = 0.002) three months after treatment. Furthermore, WOMAC physical function scores were significantly lower with HILT immediately and three months after treatment (P &lt; 0.001). The same was true for the total WOMAC score. Conclusions: High-intensity laser therapy significantly improved pain and the WOMAC score in patients with knee OA immediately and three months after the last treatment session compared to the control group.

Evaluation of the effect of high-intensity laser therapy (HILT) on function, muscle strength, range of motion, pain level, and femoral cartilage thickness in knee osteoarthritis: randomized controlled study.

This study was designed as a double-blind randomized placebo-controlled study. The aim of this study was to evaluate the effects of high-intensity laser therapy (HILT) on pain, range of motion, function, muscle strength, and femoral cartilage thickness in patients with knee osteoarthritis. Sixty patients who were admitted between November 2021 and April 2022 and diagnosed with knee osteoarthritis based on anamnesis, physical examination, and imaging methods were included in the study. The patients observed during the research were randomly divided into two groups with 30 patients in each group. Hotpack, transcutaneous electrical nerve stimulation (TENS), exercise (5days a week for a total of 15 sessions), and HILT (analgesic mode with a power of 10.0 w, energy density of 12 j/cm2, and 2min for every 25 cm2, biostimulant mode with a power of 5.0 W, energy density of 120 j/cm2, and 10min for each 25 cm2; total 9 sessions 3days a week) were applied for 3weeks for the first group, and hot pack, TENS, exercise (5days a week for a total of 15 sessions), and sham laser treatment (0 W total 9 sessions 3days a week) was applied for 3weeks for the second group. The patients were evaluated with the determined scales before the treatment, at the end of the treatment, and at the third month. A goniometer was used to measure joint range of motion measurement, a visual analog scale (VAS) for pain, WOMAC Osteoarthritis Index to assess pain and function, Biodex System 3 isokinetic device for knee flexion-extension muscle strength measurement, and ultrasonography to measure femoral cartilage thickness. There was no statistically significant difference in VAS, range of motion, WOMAC, muscle strength, and femoral cartilage thickness measurement between the groups, whether before treatment, after treatment or at the third-month follow-up (p > 0.05). There was a statistically significant decrease in pain intensity, an increase in flexion range of motion, WOMAC, and femoral cartilage thickness in both groups (p < 0.005). A statistically significant increase was found in the average peak torque flexion muscle strength measurements at isokinetic 60°/s angular velocities in the post-treatment and third-month checkup compared to the pre-treatment analysis in both groups (p < 0.05). In conclusion, there was no statistically significant difference between HILT + exercise and placebo laser + exercise observed. However, the exercise program performed under the supervision of a physiotherapist has been shown to be effective in improving all parameters.

Effect of high-intensity laser therapy versus shockwave therapy on selected outcome measures in osteoporotic long-term hemiparetic patients: a randomized control trial

BackgroundThis study aimed to compare the effects of high-intensity laser therapy (HILT) and extracorporeal shock wave therapy (ESWT) in treating consequences of osteoporosis in hemiparetic patients.MethodsA randomized controlled trial was conducted on hemiplegic patients with osteoporosis. They were randomly classified into three equal groups (n = 40 in each group). The control group received medication and traditional physiotherapy programs for stroke patients. The high-intensity laser (HIL) group received the same intervention as the control group in addition to high-intensity laser therapy. The shock wave (SW) group received the same intervention as the control group in addition to shock wave therapy. The three groups received an intervention that lasted 3 sessions/week for 12 weeks). All groups were assessed before and after therapy for the degree of pain, fall risk, and quality of life.ResultsA statistically significant difference (p < 0.05) was found concerning VAS, which had a significant difference in favor of HILT and ESWT groups compared to the control group; however, no significant difference was determined between HIL and SW groups. Regarding the overall stability index, SFBBS, and QUALEFFO-41, there was a significant difference in favor of HIL and SW groups compared to the control group, and a significant difference was found in HIL when compared to SW.ConclusionThe current study indicates that the combined traditional physical therapy and HILT and ESWT have clinical significance in improving osteoporotic long-term hemiparetic patients with more favor to HILT.Trial registration: The study was registered as a clinical trial at ClinicalTrial.gov ID (NCT05616611).

High-intensity laser therapy on pain relief in symptomatic knee osteoarthritis: A systematic review and meta-analysis.

Osteoarthritis is one of the leading causes of global disability and pain. To investigate whether High-Intensity Laser therapy has superior pain-relieving effects in individuals with symptomatic knee osteoarthritis. Searches were conducted using CENTRAL, MEDLINE, CINAHL, EMBASE, Web of Science, PEDro, and related reference lists with language limed to English. Clinical trials investigating the effectiveness of High-Intensity Laser therapy compared to other laser therapies, conventional therapies or exercises on knee osteoarthritis pain were included. The screening and selection of studies, data extraction, and methodological quality assessment were performed by two independent researchers. Studies were quantitatively integrated using the Review Manager Software and qualitative analysis using the criteria recommended by the Cochrane Collaboration. Nine studies meeting the eligibility criteria were identified, among which only one study was identified as excellent methodology quality, six was marked as good quality, and the remaining two studies were regarded as fair or poor quality. All studies reported positive effects of High-Intensity Laser therapy on knee osteoarthritis pain. Two studies (136 people) gave indication that there was moderate evidence that High-Intensity Laser therapy could be a promising new possibility in pain relief among patients with knee osteoarthritis compared with sham laser therapy in a short-term treatment (MD, -2.04, 95% CI, -2.12 to -1.96; Z= 51.01, P< 0.01). Four studies (160 people) showed that High-Intensity Laser therapy could be an effective modality on treating pain compared to conventional physiotherapies in decreasing visual analog scale score (MD, -0.98, 95% CI, -1.19 to -0.76; Z= 9.02, P< 0.01). Three studies (123 people) demonstrated that High-Intensity Laser therapy combined with exercises was more effective than placebo laser or lower-intensity laser combined with exercises in alleviating pain in patients with knee osteoarthritis (MD, -1.54, 95% CI, -1.84 to -1.24; Z= 10.06, P< 0.01). High-Intensity Laser therapy could be a promising and recommended modality in alleviating knee osteoarthritis pain, especially when it was implemented in combination with exercises.

Effect of high-intensity laser therapy in patients with non-specific chronic neck pain: study protocol for a randomized controlled trial

BackgroundChronic non-specific neck pain (CNNP) is a prevalent musculoskeletal disorder known for its significant disability and economic burden, ranking second only to low back pain in musculoskeletal conditions. Physical therapy offers effective interventions for CNNP, including low-level laser therapy (LLLT). High-intensity laser therapy (HILT) is a recent treatment for musculoskeletal pain, but studies that support its use in CNNP are limited. The objective of this study is to assess the effect of high-intensity laser therapy on pain intensity in patients with CNNP, given the existing evidence on LLLT for this condition.MethodsThis is a 2-arm, randomized, placebo-controlled trial with blinded evaluators. The research will be carried out in the laboratory of physical agents at the Andrés Bello University, Campus Casona de las Condes. Eligible participants include the entire internal and external community associated with Andrés Bello University suffering from chronic non-specific NP. Participants will be stratified by sex (4 subgroups) and randomized into 2 study groups: group 1 (HILT and stretching exercises) and group 2 (sham HILT and stretching exercises). Treatments will be performed twice a week for 4 weeks with 3 assessments: before treatment (T0), at the end of treatment (T1), and 12 weeks after treatment (follow-up) (T2). The main outcomes will be pain intensity at rest, pain intensity at movement (active cervical movements: flexion, extension, right and left side bending, and right and left rotation), and pain pressure threshold (average obtained for six evaluation points). Secondary outcome measures will include neck range of motion in the sagittal, coronal, and transverse planes and neck disability.DiscussionIn this study, HILT’s effects on patients with non-specific NP will be compared to those of a sham laser intervention. This RCT will offer new evidence regarding the potential benefits of HILT in terms of pain intensity, range of movement, and disability in people suffering with non-specific NP.Trial registrationClinicalTrials.gov NCT05689788. January 19, 2023.

High-intensity laser therapy combined with targeted hand function training for the treatment of grade 1-2 thumb carpometacarpal osteoarthritis

To explore clinical effect of high-intensity laser therapy(HILT) combined with targeted hand function training on pain and lateral pinch force in grade 1-2 thumb carpometacarpal(CMC) osteoarthritis(OA). From April 2020 and April 2022, 42 female patients with thumb CMC OA grade 1 to 2, aged from 58 to 80 years old with an everage of (68.90±7.58) years old were divided into observation group of 21 patients who received HILT and targeted hand function training for 4 weeks, and 21 patients in control group who received ultrashort wave therapy combined with using of an orthosis for 4 weeks. Visual analogue scale(VAS) was applied to evaluate degree of pain, function of finger was evaluated by dynamometer to measure lateral pinch force at baseline, immediately following intervention at 4 and 12 weeks following intervention. VAS and lateral pinch force at immediately and 12 weeks after intervention betwwen two groups were better than that of before intervention(P<0.05). Compared with control group, the degree of pain in observation group improved more(immediately after intervention t=3.37, P<0.05, 12 weeks after intervention t=9.05, P<0.05), lateral pinch force higher than that of control group (immediately after intervention t=-2.55, P<0.05, 12 weeks after intervention t=9.51, P<0.05). High-intensity laser therapy combined with targeted hand function training is more effective than traditional methods in improving pain and lateral pinch force in grade 1-2 thumb carpometacarpal osteoarthritis.

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

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

Short-term Effectiveness of High-intensity Laser Therapy in De Quervain Tenosynovitis: A Prospective, Randomized, Controlled Study.

The effectiveness of high-intensity laser therapy (HILT) has been demonstrated in some musculoskeletal repetitive strain injury disorders. This study aimed to determine the short-term effectiveness of HILT in de Quervain tenosynovitis (DQT). Sixty-four patients with DQT diagnosis (32 males, 32 females; 18-65 years) were randomly divided into two groups. A short opponens splint was applied to both groups and HILT to the treatment group and sham HILT to the control group once a day, on alternate days, 3 days a week, for 5 weeks. Pre- and post-treatment evaluations were made using a visual analog scale (VAS); Quick Disabilities of the Arm, Shoulder, and Hand questionnaire; Short Form-36 Health Survey; and hand grip strength test. The demographic results (age, gender, duration of complaint, body mass index, occupational group) of both groups were similar (p>0.05). The pre-treatment measured values were similar in both groups (p>0.05). After a 5-week treatment, a significant improvement was observed in all parameters in both groups. Post-treatment, hand grip strength levels were statistically higher in the HILT group than in the sham therapy group, and VAS levels were significantly lower (p<0.001). HILT is a non-invasive and reliable method that increases grip strength and decreases pain in DQT.

Does high-intensity laser therapy speed return to primary function in horses with suspensory ligament desmopathy?

PICO question In horses with a suspensory ligament branch injury, does high-intensity laser therapy (energy output greater than 500 mW) combined with conservative management, compared to conservative management alone, result in a faster return to primary function? Clinical bottom line Category research Treatment. Number and type of study deisgns reviewed The number and type of study designs that were critically appraised were two peer-reviewed studies: a non-randomised controlled clinical trial and a randomised controlled experimental study. Strength of evidence Weak. Outcomes reported The outcomes reported are summarised as follows: the two appraised studies report positive effects of high-intensity laser therapy (HILT) on equine tendon and ligament injuries as measured by pain to palpation, lameness, swelling and ultrasonographic and magnetic resonance imaging (MRI) evaluation of HILT-treated lesions. Conclusion In view of the strength of evidence and the outcomes from the studies the following conclusion is made: the two appraised studies provide only weak evidence to show that horses treated with high-intensity laser therapy (HILT) and conservative management return to primary function sooner than horses treated with conservative management alone. Issues of design, methodology, statistical analysis and reporting reduce the reliability and external validity of these studies. How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.

Effects of High-Intensity Laser Therapy (HILT) on Skin Surface Temperature and Vein Diameter in Healthy Racehorses with Clipped and Non-Clipped Coat.

The aim of this study was to investigate the differences in the effects of high-intensity laser therapy (HILT) on skin surface temperature and vein diameter in the carpal joint region in racehorses with clipped and non-clipped treatment areas. The study included 20 Thoroughbreds split into two equal groups: clipped coat and non-clipped coat. Horses underwent thermographic examination to detect changes in skin surface temperature at the medial surface of the carpal joint, followed by ultrasonographic examination to assess changes in the diameter of the medial palmar vein before and after HILT. The increase in skin surface temperature after HILT was significantly lower in the group with clipped coat than in the non-clipped group. The group with clipped coat showed a greater increase in vessel diameter. There was a significantly weak negative correlation between the changes in average skin surface temperature and vein diameter in both groups. In conclusion, an efficient photothermal effect can be achieved in skin with a non-clipped coat and clipping the treatment area increases photobiostimulation of the tissue, while reducing the photothermal effect. Further research is needed to specify the parameters for the treatment of skin with clipped and non-clipped coat in order to perform effective laser therapy.

Effectiveness of high-intensity laser therapy in patients with plantar fasciitis: a systematic review with meta-analysis of randomized clinical trials

Effectiveness of high-intensity laser therapy in patients with plantar fasciitis: a systematic review with meta-analysis of randomized clinical trials

A randomized comparative study between high-intensity laser vs low-intensity pulsed ultrasound both combined with exercises for the treatment of knee osteoarthritis.

To compare the effects of high-intensity laser therapy (HILT) plus exercise therapy (ET) vs low-intensity pulsed ultrasound (LIPUS) plus ET in knee osteoarthritis (KOA). A single blinded randomized controlled trial in an outpatient setting. There were 60 participants with grades II and III KOA based on the radiological findings in Kellgren and Lawrence grading scale. Participants were allocated randomly into three groups, study group I (HILT+ET), study group II (LIPUS+ET), and control (ET) group. Participants in the three groups received active range of motion (ROM) exercises, muscle strengthening, and flexibility exercises. Treatment was administered 5 times/wk for two successive weeks. Primary outcomes involved visual analog scale (VAS), secondary outcomes involved knee ROM, proprioceptive accuracy and Western Ontario and McMaster Universities Arthritis Index scale. All outcomes were measured pre- and post-treatment. The mean age of participants was 55.4± 6.34, 55.2± 4.77 and 57 ± 6.39 years in HILT+ET, LIPUS+ET and control group respectively. There were statistically significant time-by-group effects (mixed-design multivariate analysis of variance) on all measured outcomes for all groups (P< .0001). However, HILT+ET yielded better improvement than the other groups (P< .0001). Between-group comparison revealed a significant difference in all measured outcomes between study group 1 vs study group 2, and between each study group vs the control group (P= .0001). The effect of HILT combined with exercises achieved better results in pain, knee ROM, proprioceptive accuracy and functional disability than LIPUS combined with exercises and both are better than exercises only.

High-intensity laser therapy of patients with atrophic scars: results of a comparative prospective interventional cohort study

BACKGROUND: Scars of various sizes and localization are formed in more than 100 million patients annually. Atrophic scarring defects of the skin are verified in more than 80% of patients with acne and in 30% of patients with other injuries. Different skin remodeling technologies have different effectiveness, which actualizes the search for optimal methods of scar correction. The most promising of them are combinations of high-intensity laser radiation.&#x0D; AIMS: Determination of therapeutic effects of high-intensity laser therapy in patients with atrophic skin scars.&#x0D; MATERIALS AND METHODS: A prospective interventional cohort comparative study of the therapeutic effects of high-intensity laser therapy in patients with atrophic skin scars was conducted. In patients with emerging scars, a combination of homogeneous photothermolysis by long-pulse Nd:YAG laser radiation (l=1.064 microns) followed by fractional ablative photothermolysis of CO2 laser (l=10.6 microns) was used, and in patients with mature scars, a combination of homogeneous photothermolysis of long-pulse Nd:YAG laser (l=1.064 microns) and planar laser photodestruction of CO2 laser (l=10.6 microns).&#x0D; 115 patients with the diagnosis of "atrophic scars" (ICD-X, Class XII "Diseases of the skin and subcutaneous tissue", L90.5) were examined, among which groups with emerging (49 patients) and mature (66 patients) scars were identified. Empirical research methods ― clinical, instrumental, and medico-sociological ― have been applied. The analysis of the obtained data was carried out using the methods of descriptive, parametric and multifactorial statistics with the determination of the specific weight of the studied features.&#x0D; RESULTS: The improvement of the clinical status, pronounced remodeling of the skin in the area of atrophic scars, under the influence of various combinations of high-intensity laser therapy was revealed. An increase in the quality of life indicators according to the Skindex-29 and Dermatology Life Quality Index (DLQI) scales was determined, more pronounced in the groups of patients with atrophic scars in comparison with the group of patients with mature scar deformities. Combinations of high-intensity laser therapy have a favorable safety profile, are characterized by a high degree of compliance and satisfaction with the results of treatment. The effectiveness of variant high-intensity laser therapy in patients with atrophic scars is 8690%.&#x0D; CONCLUSIONS: Combinations of high-intensity laser therapy in patients with developing atrophic scars cause dermoplastic and fibromodeling therapeutic effects, in patients with mature ones ― reepithelizing, fibrocorrecting therapeutic effects.

Photothermal Effects of High-Intensity Laser Therapy on the Superficial Digital Flexor Tendon Area in Clinically Healthy Racehorses.

Simple SummaryHigh-intensity laser therapy (HILT) is becoming an increasingly popular form of physiotherapy for tendon injuries. This short communication paper discusses the photothermal effects of HILT on the superficial digital flexor tendon of the hindlimb in clinically healthy racehorses. A thermographic assessment of the surface temperature change in the superficial digital flexor tendon was performed before and immediately after high-intensity laser therapy. The results indicate a statistically significant increase after treatment. These findings may be helpful in determining the optimal HILT parameters needed for treating tendon injuries. The aim of the present study was to assess the photothermal effects of high-intensity laser therapy (HILT) on the superficial digital flexor tendon (SDFT) of the hindlimb in racehorses. It was conducted on 18 clinically healthy thoroughbreds that were subjected to thermographic examination to measure surface temperature changes in the SDFT. This was performed before and immediately after HILT. This revealed statistically significant differences in the temperature of the skin surface overlying the flexor tendons (p < 0.001). The surface temperature of the area examined was higher by an average of 3.5 °C after HILT, compared with the temperature measured before HILT. Our results prove that HILT has a photothermal effect in treating soft tissue. This finding can be helpful in determining the appropriate parameters for monitoring the short- and long-term effects of HILT.

Effectiveness of high-intensity laser therapy added to a physical therapy program for the treatment of myofascial pain syndrome - a systematic review and meta-analysis

Effectiveness of high-intensity laser therapy added to a physical therapy program for the treatment of myofascial pain syndrome - a systematic review and meta-analysis

A Randomised-Controlled Clinical Study Examining the Effect of High-Intensity Laser Therapy (HILT) on the Management of Painful Calcaneal Spur with Plantar Fasciitis.

Calcaneal spur and plantar fasciitis are the most common causes of plantar heel pain. There are many effective physical modalities for treating this musculoskeletal disorder. So far, the are no clear recommendations confirming the clinical utility of high-intensity laser therapy (HILT) in the management of painful calcaneal spur with plantar fasciitis. This study aimed to evaluate the effectiveness of HILT in pain management in patients with calcaneal spur and plantar fasciitis. A group of 65 patients was assessed for eligibility based on the CONSORT guidelines. This study was prospectively registered in the Australian New Zealand Clinical Trial Registry platform (registration number ACTRN12618000744257, 3 May 2018). The main eligibility criteria were: cancer, pregnancy, electronic and metal implants, acute infections, impaired blood coagulation, cardiac arrhythmias, taking analgesic or anti-inflammatory medications, non-experience of heel pain, or presence of other painful foot conditions. Finally, 60 patients were randomly assigned into two groups: study group (n = 30, mean age 59.9 ± 10.1), treated with HILT (7 W, 149.9 J/cm2, 1064 nm, 4496 J, 12 min), and placebo-controlled group (n = 30, mean age 60.4 ± 11.9), treated with sham HILT therapy. Both groups received ultrasound treatments (0.8 W/cm2, 1 MHz frequency, 100% load factor, 5 min). Treatment procedures were performed once a day, five times per week for three weeks (total of 15 treatment sessions). Study outcomes focused on pain intensity and were assessed before (M1) and after (M2) the treatment as well as after 4 (M3) and 12 (M4) weeks using the Visual Analogue Scale (VAS) and the Laitinen Pain Scale (LPS). According to VAS, a statistically significant decrease in the study group was observed between M1 and M2 by 3.5 pts, M1 and M3 by 3.7 pts, and M1 and M4 by 3.2 pts (p < 0.001). On the other hand, the control group showed a statistically significant decrease (p < 0.001) between M1 and M2 by 3.0 pts, M1 and M3 by 3.4 pts, and M1 and M4 by 3.2 pts. According to LPS, a statistically significant decrease in the study group was observed between M1 and M2 by 3.9 pts, M1 and M3 by 4.2 pts, and M1 and M4 by 4.0 pts (p < 0.001). On the other hand, the control group showed a statistically significant decrease between M1 and M2 by 3.2 pts (p = 0.002), M1 and M3 by 4.0 pts (p < 0.001), and M1 and M4 by 3.9 pts (p < 0.001). However, there were no statistically significant differences between the groups in VAS and LPS (p > 0.05). In conclusion, the HILT does not appear to be more effective in pain management of patients with calcaneal spurs and plantar fasciitis than the conservative standard physiotherapeutic procedures.