Category: Pain Rehabilitation; Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development)
Objective(s) : The aim of this systematic review was to evaluate the effectiveness of high intensity laser therapy (HILT) on pain and function in individuals with spinal disorders.
Data Sources : Six Electronic databases were searched up to the end of February 2018. In addition, the reference lists of all included studies were searched for any relevant studies.
Study Selection : Studies were eligible for inclusion if they met the following criteria: randomised controlled trials (RCTs) assessing the effectiveness of HILT in adult individuals (<18 years old) with spinal disorders, studies must have at least one primary outcome measure of pain and function, and all included studies must be written in English language.
Data Extraction : PRISMA guidelines were followed to prepare this review. The review was registered in PROSPERO under number CRD42018090019. PEDro scale and GRADE system were performed to assess the quality of studies. A meta-analysis was conducted to calculate the overall effect size.
Data Synthesis : A total of ten RCTs met the inclusion criteria, with four studies of the efficacy of HILT on neck pain (NP) and six on low back pain (LBP). Forest plots showed that HILT with exercise was significantly more effective than placebo HILT with exercise in terms of pain reduction (SMD -1.11; 95% CI -1.42 to -0.80; P<0.00001; I2 0%) and functional improvement (SMD -1.03; 95% CI -1.33 to -0.72; P<0.00001; I2 0%). Meta-analyses also showed that HILT alone or HILT with conventional physiotherapy (CPT) significantly provided better outcomes than CPT alone.
Conclusions : HILT is considered as a complementary modality for pain reduction and function improvement in individuals with spinal disorders. However, the quality of the body of evidence was rated from ‘very low’ to ‘low’ quality.