Department of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
Lasers Med Sci. 2022 Dec;37(9):3333-3341. doi: 10.1007/s10103-022-03626-9. Epub 2022 Aug 13.
Low-level laser therapy (LLLT) is one of recent modalities for treatment of myofascial neck pain (MNP). Several RCTs have been conducted on its effectiveness. The aim of this comprehensive meta-analysis was to evaluate the effectiveness of LLLT on MNP. Electronic databases were searched for identifying eligible studies comparing the effectiveness of LLLT using any wavelength with placebo or active control in myofascial neck pain up to June 2022. Data related to pain intensity, pain pressure threshold (PPT), range of motion (ROM), and disability was analyzed as a pooled estimate of mean difference or standard mean difference (SMD) with 95% confidence intervals (CIs) using random/fixed-effect model. Funnel plot and Egger's linear regression test were also conducted to examine the risk of publication bias. A total of 13 randomized controlled trials were included in this systematic review and meta-analysis. The data assessing laser effectiveness on different outcomes of 556 patients were considered for meta-analysis. Pooled results revealed that LLLT was significantly effective in pain reduction (MD = - 1.29, 95% CI = - 2.36; - 0.23, P < 0.001). Also, secondary outcomes including PPT (SMD of 2.63, 95% CI = 0.96; 4.30, P < 0.01) and right bending ROM (SMD of 3.44, 95% CI = 0.64; 6.24, P < 0.01) were improved, while disability (MD of - 7.83, 95% CI = - 17.1; 0.08, P = 1.34) did not improve significantly after LLLT. Our meta-data revealed that LLLT may reduce myofascial neck pain and its related outcomes. LLLT is suggested to be used by clinicians along with other therapies such as manual and exercise therapy.
低水平激光疗法(LLLT)是治疗肌筋膜性颈痛(MNP)的新方法之一。已经进行了几项随机对照试验来评估其疗效。本次全面的荟萃分析旨在评估 LLLT 对 MNP 的有效性。电子数据库搜索到的研究将比较 LLLT 与安慰剂或主动对照治疗肌筋膜性颈痛的疗效,截至 2022 年 6 月,研究使用任何波长。分析与疼痛强度、疼痛压力阈值(PPT)、运动范围(ROM)和残疾相关的数据,以平均值差或标准均数差(SMD)的合并估计值表示,置信区间(CI)采用随机/固定效应模型。还进行了漏斗图和 Egger 线性回归检验,以检查发表偏倚的风险。本系统评价和荟萃分析共纳入 13 项随机对照试验。考虑对 556 名患者的不同结局进行激光疗效评估的数据进行荟萃分析。汇总结果显示,LLLT 在减轻疼痛方面具有显著疗效(MD=-1.29,95%CI=-2.36;-0.23,P<0.001)。此外,次要结局包括 PPT(SMD 为 2.63,95%CI=0.96;4.30,P<0.01)和右侧弯曲 ROM(SMD 为 3.44,95%CI=0.64;6.24,P<0.01)均得到改善,而残疾(MD=-7.83,95%CI=-17.1;0.08,P=1.34)在 LLLT 后并未显著改善。我们的荟萃分析数据表明,LLLT 可能减轻肌筋膜性颈痛及其相关结局。建议临床医生将 LLLT 与手动和运动疗法等其他疗法一起使用。