The effect of high-intensity versus low-level laser therapy in the management of plantar fasciitis: randomized participant blind controlled trial

Abstract

Objectives: To evaluate and compare the efficacy of high-intensity laser therapy (HILT) and low-level laser therapy (LLLT) for plantar fasciitis. Design: A participant blind randomized controlled trial with parallel group design and an active comparator with follow-up at four weeks. Settings: Outpatient, University hospital. Subjects: Unilateral plantar fasciitis participants ( n = 102) were randomly assigned into two groups. Recruitment period was from January 2017 to April 2019. Interventions: Interventions included eight sessions of laser therapy over three weeks and single session of patient education. The HILT group ( n = 51) received HILT and the LLLT group ( n = 51) received LLLT. Main measures: Primary outcomes: visual analogue scale; secondary outcomes: pressure algometry, sonography of plantar fascia thickness (time frame: baseline to three-week and four-week follow-up) and numeric rating scale (0%–100%) for opinion of participants on effect of treatment (time frame: three weeks). Data presented: mean (SD) or n (%). Results: There was no statistically significant difference between the groups according to visual analogue scale (pain in general reduction in three weeks: 2.57(3.45) vs. 2.88(3.28) cm), pressure algometry (pain threshold difference between healthy and affected heel reduction in three weeks: 1.80(6.39) vs. 1.77(2.85) kg) and sonography measurements (plantar fascia thickness difference between healthy and affected heel reduction in three weeks: 0.19(0.56) vs. 0.30(0.57) mm). There was a statistically significant difference between the groups in participants’ opinion in favor to HILT group (efficacy of treatment better than 50%: 26(51%) vs. 37(73%)). Conclusion: No statistically significant difference between groups was observed.

Utilization of the 1064 nm Wavelength in Photobiomodulation: A Systematic Review and Meta-Analysis

“…[22][23][24][25][26][27][28] Thirteen of the studies were single-blinded controlled trials involving blinding either the practitioner or the assessor. 8,[29][30][31][32][33][34][35][36][37][38][39][40] No adverse events were reported in any studies except for one study involving patients diagnosed with hemophilic arthropathy, in which one patient experienced paresthesia at the application site and three others had nondescript adverse events, none of which were serious.…”

“…In one trial involving patients with plantar fasciitis (PF), those treated with 1064 nm high-powered PBMT exhibited better outcomes than those treated with low-powered PBMT. 8,40 Another study involving PF patients did not result in any improvements after high-or low-powered PBMT. 40 The PF studies may be limited by the ability to identify the target site to aim at the laser given that PF pain has the potential to be referred to as neuronal pain.…”

“…8,40 Another study involving PF patients did not result in any improvements after high-or low-powered PBMT. 40 The PF studies may be limited by the ability to identify the target site to aim at the laser given that PF pain has the potential to be referred to as neuronal pain. 42 The third study comparing high-powered 1064 nm PBMT to lowpowered PBMT showed benefits for both approaches in the treatment of chronic lower back pain.…”

The Effectiveness of High Intensity Laser Therapy (HILT) in the treatment of Achilles and Patellar Tendinopathy: a Systematic Review

“…A form of HILT, pulsed Nd:YAG laser therapy, has been used for a variety of diseases. Effectiveness of pulsed Nd:YAG laser therapy in pain control has been shown in ankle pain [5], subacromial impingement syndrome [3], low back pain [6,7], knee osteoarthritis [8,9], plantar fasciitis [10,11] and Lateral elbow tendinopathy (LET) [12][13][14][15]. A number of previous studies have investigated the efficacy of HILT in LET, a condition similar to AT and PT.…”

Effectiveness of high-intensity laser therapy added to a physical therapy program for the treatment of myofascial pain syndrome - a systematic review and meta-analysis

“…Each RCT reported pain reduction with HILT when used as part of a physical therapy HILT alone [40,41]. This contrasts with other HILT studies in plantar fasciitis and subacromial impingement that do not report analgesic differences between the same treatments but rather improvements in the HILT groups at the end of treatment [42,43]. Based on these findings, it can be said that HILT intervention is associated with a decrease in pain (intragroup changes); however, it is known how its analgesic effects compare with other interventions, whose effects are unclear.…”