Low level light therapy/photobiomodulation for diabetic peripheral neuropathy: protocol of a systematic review and meta-analysis

Abstract

IntroductionDiabetic peripheral neuropathy (DPN) is one of the most common complications of diabetes that strongly impact the patients’ quality of life and working ability. Evidence indicated that low level light therapy (LLLT)/photobiomodulation might be effective for neuropathy. However, the effect of LLLT for DPN is not clear. The objective of this systematic review and meta-analysis is to determine the effects and safety of LLLT/photobiomodulation for DPN, in comparison with other methods such as sham light, no treatment, other active treatment and LLLT as an additional treatment compared with another treatment alone.Methods and analysisWe will search eight databases from their inception to the date before the review submission. Randomised controlled trials (RCTs) will be included. Two reviewers will independently extract data using a structured data extraction method and assess the risk of bias in the included studies. Data will be synthesised using standardised mean difference or risk ratio with 95% CIs for continuous and dichotomous data, respectively. The primary outcome will be change in pain and secondary outcomes will include global symptom improvement, functional impairment and disability, impairment of sensation, quality of life, nerve conduction, and adverse events. Sensitivity and subgroup analysis will be employed to explore the influence of possible clinical and methodological characteristics. Publication bias will be assessed using funnel plot. We will conduct meta-analysis with RevMan V.5.4 and evaluate quality of the evidence using GRADE approach.Ethics and disseminationThis study does not require ethics approval. Our findings will be disseminated in the peer-reviewed publications.PROSPERO registration numberCRD42021276056.

Multimodal non-invasive non-pharmacological therapies for chronic pain: mechanisms and progress

“…In clinical studies, light therapy demonstrates analgesic effects in diverse chronic pain conditions beyond osteoarthritis, back and neck pain [143,144]. Recent clinical trials show pain relief with light therapy in fibromyalgia, diabetic neuropathy, chemotherapy-induced peripheral neuropathy, phantom limb pain, post-herpetic neuralgia, and complex regional pain syndrome [145][146][147][148][149][150] (Additional file 1: Fig. S1).…”

Low-power infrared laser on survival, proliferation, and reactive oxygen species levels in Escherichia coli cultures

“…The absorption of radiation by endogenous photoacceptors and, as a consequence, photobiomodulation depends on the wavelength of the radiation emitted from the laser, which influences the penetration of the radiation in the targeted biological tissue. Low-power infrared lasers are considered when therapeutic applications based on photobiomodulation are addressed in deep tissues, such as muscles [15], nerves [16], and tendons [17]. However, most photobiomodulation protocols are based on low-power lasers in continuous-wave emission mode.…”