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

Abstract

Plantar fasciitis (PF) is a plantar pain condition that often leads to discomfort that hinders both work and daily activities. High-intensity laser therapy (HILT) is a promising technology for managing pain in PF. Consequently, the purpose of this study was to assess the effects of HILT on patients with PF. A search was carried out in PubMed, Web of Science, Scopus, CINAHL, Science Direct, and PEDro databases (last update: July 23, 2023) with the aim of identifying clinical trials that compared HILT with other treatments in patients with PF. The primary outcomes of the study encompassed pain intensity and functionality assessed through various scales and measurements. Nine studies met the selection criteria, and a meta-analysis was conducted to consolidate the findings from VAS and FAOS. The study quality was assessed using the Cochrane risk of bias (RoB) tool, and the GRADE approach was applied for evidence recommendations. The studies included showed a low RoB, with the blinding of assessors being the highest risk. Each RCT reported analgesia (VAS) and an improvement in function (FAOS) for HILT. However, the meta-analysis demonstrated a statistically significant effect in mean differences for pain in first steps (MD = -1.27cm,95% CI:-1.87,-0.67), pain at rest HILT versus LLLT (MD = -2.76cm,95% CI:-3.51,-2.00), and quality of life (MD = 14.42%,95% CI:9.43, 19.4), results consistent with the minimal clinically important difference. The findings suggest that HILT significantly reduces pain in the first steps and has an impact on the quality of life of PF patients, with effects lasting for at least 3 months.

Keywords

• systematic review
• phototherapy
• laser therapy
• high-intensity laser therapy
• plantar fasciitis