Postgraduate Program in Biotechnology, Oxidative Stress and Antioxidant Laboratory, University of Caxias Do Sul, Caxias Do Sul, Rio Grande Do Sul, Brazil.
Department of Physical Therapy, Health Sciences Institute, Federal University of Bahia-UFBA, Salvador, Brazil.
Lasers Med Sci. 2023 Jul 18;38(1):163. doi: 10.1007/s10103-023-03823-0.
To review the effects of photobiomodulation therapy (PBMT) on pain intensity and disability in people with plantar fasciitis (PF) when compared with control conditions, other interventions, and adjunct therapies. Systematic searches were conducted in five database randomized controlled trials (RCT). We only included randomized controlled trials (RCTs) in adults with PF that compared PBMT to placebo, as well as RCTs that compared PBMT to other interventions; and as an adjunct to other therapies. The methodological quality and certainty were assessed through PEDro Scale and GRADE approach, respectively. The data of comparison were pooled and a meta-analysis was conducted when possible. Nineteen RCTs involving 1089 participants were included in this review. PBMT alone (MD = - 22.02 [- 35.21 to - 8.83]) or with exercise (MD = - 21.84 [- 26.14 to - 17.54]) improved pain intensity in short-term treatment. PBMT was superior to (extracorporeal shock wave therapy) EWST for relief of pain (MD = - 20.94 [- 32.74 to - 9.13]). In the follow-up, PBMT plus exercise had a superior to exercise therapy alone (MD = - 18.42 [- 26.48 to - 10.36]). PBMT may be superior to (ultrasound therapeutic) UST in medium- and long-term follow-ups for disability, but can be not clinically relevant. There is uncertainty that PBMT is capable of promoting improvement in disability. PBMT when used with adjuvant therapy does not enhance outcomes of interest. PBMT improves pain intensity with or without exercise. PBMT has been shown to be superior to ESWT for pain relief, but not superior to other interventions for pain intensity and disability. The evidence does not support PBMT as an adjunct to other electrotherapeutic modalities.
比较光生物调节疗法（PBMT）与对照条件、其他干预措施和辅助治疗对足底筋膜炎（PF）患者疼痛强度和残疾的影响。系统检索了 5 个数据库中的随机对照试验（RCT）。我们仅纳入了比较 PBMT 与安慰剂、PBMT 与其他干预措施以及作为其他治疗辅助的成人 PF 随机对照试验（RCT）。方法：使用 PEDro 量表和 GRADE 方法分别评估方法学质量和确定性。对比较数据进行合并，并在可能的情况下进行荟萃分析。结果：本综述共纳入 19 项 RCT，涉及 1089 名参与者。单独使用 PBMT（MD = -22.02 [–35.21 至–8.83]）或与运动结合（MD = -21.84 [–26.14 至–17.54]）可在短期治疗中改善疼痛强度。与体外冲击波疗法（extracorporeal shock wave therapy，EWST）相比，PBMT 更能缓解疼痛（MD = -20.94 [–32.74 至–9.13]）。在随访中，PBMT 联合运动比单独运动疗法（MD = -18.42 [–26.48 至–10.36]）更有效。在中、长期随访中，PBMT 联合运动比单独使用超声治疗（ultrasound therapeutic，UST）更能改善残疾，但无临床意义。目前尚不能确定 PBMT 是否能够改善残疾。当 PBMT 与辅助治疗联合使用时，不会提高治疗效果。PBMT 可改善疼痛强度，无论是否联合运动。PBMT 已被证明在缓解疼痛方面优于 ESWT，但在疼痛强度和残疾方面并不优于其他干预措施。目前证据不支持 PBMT 作为其他电疗方法的辅助手段。
