The effectiveness of high-intensity laser therapy compared to conventional physical therapy in improving the functional ability of patients with peripheral neuropathic conditions: a systematic review

Abstract

Background: Peripheral neuropathy condition affects the peripheral nervous system. It can have a significant impact on a person’s ability to function and can result in difficulty feeling, moving, and balancing. This makes daily tasks more challenging, increases fall risk, and compromises independence. Thus, peripheral neuropathy should be addressed and managed to minimise its negative effects on the patient’s functional ability. High- intensity laser therapy was approved by the U.S. Food and Drug Administration in 2004 as a new treatment approach to physical therapy. However, its potential effect on peripheral neuropathy remains unclear. Aim: This review aims to determine whether high-intensity laser therapy can improve peripheral neuropathy patients' functional ability, accomplished by comparing the effectiveness of high-intensity laser therapy to conventional physical therapy. Methods: Five randomised controlled trials studies were identified using a comprehensive search strategy limited to the English language. Two independent reviewers critically appraised the selected studies, and four studies were advanced to data extraction. As the included studies were clinically heterogeneous, narrative synthesis was conducted. Result: Patients with mild to moderate carpal tunnel syndrome and subacute Bell's palsy showed improvement in their functional ability with high-intensity laser therapy, based on valid and reliable outcome measurements. Conclusion: Patients with peripheral neuropathy can improve functional ability with high- intensity laser therapy without side effects and complications, but it is still too early to determine whether it is a non-invasive treatment to treat peripheral neuropathy effectively. Moreover, even though all included studies had a moderate risk of bias, they showed significant heterogeneity. Consequently, larger sample sizes and well-designed randomized control studies are needed in future studies to evaluate a variety of laser applications, their parameters, treatment regions, and comparator groups. Long-term studies are also needed to determine which high-intensity laser therapy parameters are most effective for different types of peripheral neuropathy.