Does Low-level Laser Therapy Provide Additional Benefits to Exercise in Patients with Shoulder Musculoskeletal Disorders? A Meta-analysis of Randomised Controlled Trials.

BACKGROUND

Low-level laser therapy as an adjunct to exercise is common in clinical practice; however, existing evidence for its recommendation is low. To determine whether low-level laser therapy provides additional benefits to exercise in patients with various shoulder musculoskeletal disorders.

MATERIAL AND METHODS

An electronic search was conducted on seven databases, including The Cochrane Library, MEDLINE, and CINAH as well as grey literatures, for randomised controlled trials published in English from 1996 to 2018. Selected studies were independently screened and assessed for quality according to the Cochrane Grade of Recommendations, Assessment, Development and Evaluation.

RESULTS

Eleven studies met the inclusion criteria for this review. Moderate evidence indicates that low-level laser therapy provides additional short-term benefit to exercise in improving overall pain (10cm-VAS) (6 RCTs, GRADE quality moderate) (WMD: 1.75; 95% CI: 1.43 to 2.07). However, low evidence indicates that low-level laser therapy provides no additional benefit to exercise for shoulder function [5 RCTs; SWMD: -0.14; 95% CI: -0.79 to 0.25] and range of motions.

CONCLUSIONS

1. Physiotherapists may consider the use of low-laser therapy as an adjunct to exercise in the short run to improve pain in patients with shoulder musculoskeletal disorders. 2. However, low-laser therapy with exercise in the short-term is no more effective than exercise alone in improving shoulder function and range of motions.