Table 2.
Characteristics of the included studies outcomes, light source parameters and combination treatment, in peripheral nervous system disorders in clinical studies
| Author | Disease category | Disorder | Sex/Age | Combination therapy | Laser/(LED) | Treatment duration | Key outcomes |
|---|---|---|---|---|---|---|---|
| Aghamohammadi et al., 2012 [42] | Pain | Trigeminal neuralgia | NM / 30–70 | Ganglion block | 890 nm |
6 months 12 sessions |
Decreased the severity of pain, dose of carbamazepine; Increased the period of a pain-free state |
| Ebrahimi et al., 2018 [43] | Pain | Trigeminal neuralgia | M, F / NM | Carbamazepine | 810 nm, 6.36 J/cm2 |
3 weeks (3/week) |
Decreased pain severity with time |
| Stergioulas 2007 [44] | Pain | Lateral epicondylitis | M, F / 45.2 ± 2.86 | Exercises | 904 nm, 2.4 J/cm2 |
8 weeks 12 sessions |
A significant decrease of pain at rest, palpation and pain on isometric testing, middle finger test and pain during grip strength test; A significant increase in the wrist range of motion |
| Celik et al., 2019 [45] | Pain | Lateral epicondylitis | M, F / 48.2 ± 9.4 | Exercises | 904 nm, 2.4 J/cm2 |
4 weeks (3/week) |
Improved elbow extension, shoulder flexion strength, VAS, movement and handgrip strength |
| Ali et al., 2021 [46] | Pain | lateral epicondylitis | M, F / 44.9 ± 7.3 | Ultrasound | 808, 915 nm, 5 J/cm2 | 12 sessions | Improved the VAS, DASH score and hand grip-strength |
| Amanat et al., 2013 [47] | Pain | Orofacial pain | M, F / 47.22 | Antidepressants, Anxiolytics, Muscle relaxants, Carbamazepine | 980 nm, 12.73 J/cm2 |
3 weeks (3/week) |
There was no significant additional level of efficacy for the laser in the management of common orofacial pain based on VAS outcomes |
| Ceylan et al., 2004 [48] | Pain | Myofascial pain syndrome | M, F / 34.05 ± 8.25 | Naproxen sodium, Phenbrobomate | 904 nm, 1.44 J/cm2 | 10 days | Increased the VAS values, 5-HIAA and 5-HT + 5-HTP excretion; Reduced pain |
| Sumen et al., 2015 [49] | Pain | Myofascial pain syndrome | M, F / 41.66 ± 9.26 | Exercises | 670 nm, 4 J/cm2 |
2 weeks (5/week) |
It was found that pain (according VAS Index) was significantly lower in combination therapy group in comparison to exercise only |
| El-sharkawy et al., 2018 [50] | Pain | Myofascial pain syndrome | M, F / NM | Ultrasound, Hot pack, Exercise | 905, 808 nm, 16 J/cm2 |
4 weeks (3/week) |
Increased the quality of life, pressure pain threshold for temporomandibular join, masseter and anterior temporalis muscles |
| Mansourian et al., 2019 [51] | Pain | Myofascial pain syndrome | M, F / 18–60 | Fluoxetine, Clonazepam | 810 nm, 2 J/cm2 |
5 weeks (2/week) |
Improved pain and limitation in lateral movements |
| Gur et al., 2003 [52] | Pain | Chronic low back pain | M, F / 35.2 ± 10.51 | Exercise | 1 J/cm2 |
4 weeks (5/week) |
Laser therapy seemed to be an effective method in reducing pain and functional disability. However, does not bring any additional benefits to exercise therapy |
| Djavid et al., 2007 [53] | Pain | Chronic low back pain | M, F / 38 | Exercise | 810 nm, 27 J/cm2 |
6 weeks (2/week) |
No greater effect of laser therapy plus exercise compared with exercise for any outcome; Reduced pain; Increased lumbar range of movement on the Schober Test and active flexion; Reduced disability |
| Ammar 2015 [54] | Pain | Chronic low back pain | M, F / 42.1 ± 12.8 | Exercise | 850 nm |
6 weeks (2/week) |
Improved functional disability, pain and lumbar ROM |
| Koldaş Doğan et al., 2017 [55] | Pain | Chronic low back pain | M, F / 52.14 ± 12.13 | Hot pack |
850 nm, 10 J/cm2 650, 785, 980 nm, 3 J/cm2 |
3 weeks (5/week) |
Improved pain severity, patient’s and physician’s global assessment, ROM and MODQ scores; Laser therapy provided more improvements in lateral flexion measurements and disability of the patients |
| Mohammad Ezz El Dien et al., 2007 [56] | Pain | Primary periarthritis shoulder | M, F / 49.2 ± 5.9 | Electromagnetic field, Exercise | 880 nm, 1 J/cm2 |
2 months (3/week) |
Improved all shoulder parameters (pain, tenderness, range of motion and function) |
| Otadi et al., 2012 [57] | Pain | Shoulder tendonitis | F / 49.48 ± 8.5 | Ultrasound, Exercise | 830 nm, 1 J/cm2 |
10 sessions (3/week) |
Improved VAS, TSS, CMS and the muscle strengths |
| Eslamian et al., 2012 [58] | Pain | Rotator cuff tendinitis | M, F / 50.16 ± 12.10 | Physiotherapy | 830 nm, 4 J/cm2 |
10 sessions (3/week) |
Improved pain (reduction in VAS average) and shoulder disability problems; Improved the patient’s function; No additional advantages were detected in increasing shoulder joint range of motion in comparison to other physical agents |
| Dogan et al., 2010 [59] | Pain | Subacromial impingement syndrome | M, F / 53.59 ± 11.34 | Cold pack | 850 nm, 5 J/cm2 |
14 sessions (5/week) |
Improved pain severity, range of motion except internal and external rotation and SPADI scores |
| Abrisham et al., 2011 [60] | Pain | Subacromial syndrome | M, F / 52.2 ± 5.7 | Exercise | 890 nm, 2–4 J/cm2 |
2 weeks (5/week) |
Significant post-treatment improvements were achieved in all parameters, in all movements; There was a substantial difference between the groups in VAS scores; Improved the shoulder ROM |
| Pekyavas et al., 2016 [61] | Pain | Subacromial impingement syndrome | NM / 51.1 ± 14.3 |
Manual therapy, Kinesio taping, Exercise |
1064 nm |
15 sessions (3/week) |
Minimized pain and disability; Increased ROM and SPADI |
| Alfredo et al., 2021 [62] | Pain | Subacromial impingement syndrome | NM / 51.9 ± 8.7 | Exercise | 904 nm |
8 weeks (3/week) |
Improved shoulder function; Reduced pain intensity and medication intake |
| Ökmen et al., 2017 [63] | Pain | Chronic shoulder pain | M, F / 53 | Exercise | 1064 nm, 100 J/cm2 |
2 weeks (7/week) |
Compared to the values of PRT and PST at months 1, 3, and 6, VAS, SPADI, and NHP values were lower |
| Teixeira et al., 2022 [64] | Pain | Chronic neck/shoulder pain | M, F / 32.78 ± 9.99 | Magnetic field | 905, 875, 640 nm |
3 weeks (2/week) |
Reduced pain intensity (reduction in VAS) in all time points tested; There was no difference in the ROM outcomes |
| Kolu et al., 2018 [65] | Pain | Chronic lumbar radiculopathy | M, F / 53.40 ± 10.57 |
Hot pack, Exercise |
12, 120 J/cm2 |
2 weeks (5/week) |
Decreased pain variation and functionality (VAS and ODI) |
| Stasinopoulos et al., 2009 [66] | Pain | Lateral elbow tendinopathy | NM / 18 ≤ | Exercise | 904 nm, 130 mW/cm2 |
4 weeks (3/week) |
Decline in pain; Increase in function compared with baseline has been observed |
| Liu et al., 2014 [67] | Pain | Patellar tendinopathy | M / 18–23 | Exercise | 810 nm, 1592 mW/cm2 |
4 weeks (6/week) |
Reduced pain (VAS); Improved function capacity of knee, muscle strength and endurance |
| Stergioulas et al., 2008 [68] | Pain | Chronic achilles tendinopathy | M, F / 30.1 ± 4.8 | Exercise | 820 nm, 60 mW/cm2 |
8 weeks 12 sessions |
Combination therapy accelerates clinical recovery as tested by VAS; Power densities below 100 mW/cm2 seems to be important for obtaining good results |
| Saayman et al., 2011 [69] | Pain | Cervical facet dysfunction | F / 18–40 | Chiropractic joint manipulation therapy | 830 nm, 151 mW/cm2 |
3 weeks (2/week) |
The combination therapy was more effective than either of the 2 on their own; Pain disability in everyday life, lateral flexion, and rotation was the main outcomes |
| Gu et al., 2017 [70] | Pain | Cervical spondylosis | M, F / 35—71 | Ozone therapy | NM | NM | Decreased preoperative neck and shoulder pain (VAS score) at 1 month period |
| Venosa et al., 2019 [71] | Pain | Cervical spondylosis | M, F / 49.76 | Exercise | 1064 nm | 6 weeks (2/week) | Increased cervical ROM; Reduced pain; There was a significant difference in NDI scores; Analgesic effects; Improved function in patients affected by cervical spondylosis |
| Yilmaz et al., 2020 [72] | Pain | Cervical pain | M, F / 18–60 | Exercise | 1064 nm, 5 J/cm2 |
4 weeks (5/week) |
Improved cervical range of motion and quality of life by reducing pain (ROM, VAS and NPADS values) |
| De Carli et al., 2013 [73] | Pain | Temporomandibular joint pain | NM | Piroxicam | 808 nm, 100 J/cm2 | 10 days |
Combination therapy was not more effective than single therapies (evaluated by VAS) |
| Elgohary et al., 2018 [74] | Pain | Temporomandibular joint pain | M, F / 60.75 ± 5.09 | Exercise | 950 nm, 7.6 J/cm2 |
4 weeks (5/week) |
Improvement in VAS, VCS and UW-QOL questionnaire results |
| Brochado et al., 2018 [75] | Pain | Temporomandibular joint pain | M, F / 46.5 ± 14.4 | Manual therapy | 808 nm, 13.3 J/cm2 |
4 weeks (3/week) |
Reduced depression symptoms, anxiety symptoms and physical symptoms; Promoted pain relief; Improved mandibular function and jaw disabilities |
| Ahmad et al., 2018 [76] | Pain | Temporomandibular joint pain | M, F / 37.56 ± 8.26 | Ultrasound, Hot pack, Exercise | 905, 808 nm, 16 J/cm2 |
4 weeks (3/week) |
Decreased limitations in daily functions; Increased pressure pain threshold for masseter and anterior temporalis muscles |
| Panhoca et al., 2019 [77] | Pain | Temporomandibular joint pain | M, F / 23—66 | Ultrasound | 808 nm, 32.832 J/cm2 |
4 weeks (2/week) |
Synergistic treatment was effective in improving the oral health-related quality of life (assessed by the Oral Health Impact Profile) |
| Panhóca et al., 2021 [78] | Pain | Temporomandibular joint pain | M, F / 18—55 | Ultrasound | 808 nm, 684 J/cm2 |
4 weeks (2/week) |
Laser combined with ultrasound are effective in the treatment of pain as assessed by analogue pain scale; Assessment of range of motion and assessment of quality of life |
| Panhóca et al., 2021 [78] | Pain | Temporomandibular joint pain | M, F / 18—55 | Vacuum therapy | 808 nm, 684 J/cm2 |
4 weeks (2/week) |
Laser combined with vacuum are effective in the treatment of pain as assessed by analogue pain scale; Assessment of range of motion and assessment of quality of life |
| Dias et al., 2022 [79] | Pain | Temporomandibular joint pain | M, F / 32.16 ± 8.60 | Orofacial myofunctional therapy | 830 nm, 51 and 34 J/cm2 | 13 sessions | Improved the degree of pain (VAS) and self-perception of the OHQOL |
| Matsutani et al., 2007 [80] | Pain | Fibromyalgia | F / 44 | Exercise | 830 nm 3 J/cm2 | 5 weeks (2/week) | Pain reduction; Higher pain threshold at tender points; Lower mean FIQ scores; Higher SF-36 mean scores |
| da Silva et al., 2018 [81] | Pain | Fibromyalgia | F / ≥ 35 | Exercise |
905 nm, 0.75 J/cm2 (640 nm, 5 J/cm2 and 875 nm, 5.83 J/cm2) |
10 weeks (2/week) |
Improved pain threshold in several tender points; A more substantial effect was noticed for the combined therapy; Pain relief was accomplished by improving VAS and FIQ scores as well as quality of life |
| Germano Maciel et al., 2018 [82] | Pain | Fibromyalgia | F / 30—50 | Exercise | 808 nm, 142.85 J/cm2 |
8 weeks (3/week) |
Reduced pain; Improved function, muscular performance, depression, and quality of life; The benefic effects of functional exercise were not improved by combination with LLLT |
| Aquino Junior et al., 2021 [83] | Pain | Fibromyalgia | F / 30—65 | Ultrasound | 660 nm | 2 to 10 weekly sessions | Combination therapy was more efficient in improvement in the pain of fibromyalgia as tested by FIQ and VAS |
| Paolillo et al., 2015 [84] | Pain | Osteoarthritis | F / 68 ± 6 | Ultrasound, Exercise | 808 nm, 7 J/cm2 | 3 months (1/week) | Grip strength did not differ; Significant decrease of the pain sensitivity |
| Gavish et al., 2021 [85] | Pain | Knee pain | M, F / > 18 | Physiotherapy |
810 nm, 142.5 and 180 J/cm2 (660/850 nm, 3 J/cm2) |
4 weeks (2/week) |
Reduced pain (VAS); Improved the Kujala score |
| Murakami et al., 1993 [86] | Paresis | Facial palsy | M, F / 41.8 ± 4.7 | Ganglion block | 830 nm | NM | The combination therapy showed a similar overall recovery of facial palsy to ganglion block |
| Yamada et al., 1995 [87] | Paresis | Facial palsy | NM / 45.1 ± 14.0 | Corticosteroid |
830 nm 36.7, 38.2 and 127.4 J/cm2 |
3–10 weeks | Combination therapy is an ideal adjunct treatment in cases that corticosteroid therapy is mineable |
| Ordahan 2017 [88] | Paresis | Bell’s palsy | M, F / 41 ± 9.7 | Exercise | 830 nm, 10 J/cm2 |
6 weeks (3/week) |
Improved functional facial movements through the FDI; Decreased recovery times for patients |
| Naeser et al., 2002 [89] | Neuropathy | Carpal tunnel syndrome | M, F / 53.5 | Transcutaneous electric nerve stimulation |
632.8, 904 nm, 1.81 J/cm2 |
3 to 4 weeks (3/week) |
Significant decreases in MPQ score, median nerve Sensory latency, and Phalen and Tinel signs |
| Dincer et al., 2009 [90] | Neuropathy | Carpal tunnel syndrome | F / 52.2 ± 9.1 | Splinting | 904 nm, 1 J/cm2 |
2 weeks (5/week) |
Reduced symptom severity and pain; Increased patient satisfaction using BQ SSS, BQ FSS, VAS, ENMG testing |
| Yagci et al., 2009 [91] | Neuropathy | Carpal tunnel syndrome | F / 49.47 ± 6.32 | Splinting | 830 nm | 10 sessions | Improved both clinical and NCS parameters (median motor nerve distal latency, median sensory nerve conduction velocities, BQ SSS, and BQ FCS); Provided better outcomes on NCS |
| Fusakul et al., 2014 [92] | Neuropathy | Carpal tunnel syndrome | M, F / 50.70 ± 1.39 | Splinting | 810 nm |
5 weeks (3/week) |
Improved hand grip strength, distal motor latency of the median nerve and electroneurophysiological parameters at 5 and 12-week follow-up |
| Tabatabai et al., 2016 [93] | Neuropathy | Carpal tunnel syndrome | M, F / 48.60 | Transcutaneous electrical nerve stimulation | 808 nm, 6.5 J/cm2 |
2 weeks (5/week) |
Reduced the mean scores of MPQ, VAS, pain severity, and DASH questionnaires |
| Güner et al., 2018 [94] | Neuropathy | Carpal tunnel syndrome | F / 44.33 ± 9.21 | Kinesiotaping | 685 nm, 5 J/cm2 |
3 weeks (5/week) |
Improved VNS daytime, VNS night, FPS, HGS, BQ SSS, BQ FCS parameters at 3th and 12th weeks compared to before treatment; Improved mMA, mSNCV, and mSDL parameters at the 12th week (from ENMG parameters) |
| Bartkowiak et al., 2019 [95] | Neuropathy | Carpal tunnel syndrome | M, F / 46.8 ± 10.8 | Exercise | 830 nm, 9 J/cm2 |
2 weeks (5/week) |
Declined sensory impairments and pain; Improved hand grip strength, VAS, Boston Questionnaire results, CTS SSS and CTS FSS |
5-HIAA 5-hydroxy indole acetic acid 5-HT serotonin, 5-HTTP 5-hydroxy tryptophan, BQ FCS Boston Questionnaire functional capacity scale, BQ FSS Boston Questionnaire functional status scale, BQ SSS Boston Questionnaire symptom severity scale, CMS Constant Murley Score, CTS FSS The carpal tunnel syndrome functional status scale, CTS SSS The carpal tunnel syndrome symptom severity scale, DASH Disabilities of the Arm, Shoulder and Hand, ENMG Electroneuromyography, F Female, FDI facial disability index, FIQ Fibromyalgia Impact Questionnaire, FPS Finger pinch strength, HGS Hand grip strength, LLLT Low level laser therapy, M Male, mMA motor amplitude, MODQ Modified Oswestry Disability Questionnaire, MPQ McGill Pain Questionnaire, mSDL the sensory distal latency, mSNCV the sensory conduction velocity, NCS nerve conduction study, NDI Neck disability index, NHP Nottingham Health Profile, NM not mentioned, NPADS Neck pain and disability scale, ODI Oswestry Disability Index, OHQOL Oral health quality of life, PRT pretreatment, PST posttreatment, ROM range of motion, SF-36 36-item Short-Form Health Survey, SPADI Shoulder Pain and Disability Index, TSS Tenderness Severity Scale, UW-QOL University of Washington Quality of Life questionnaire, VAS visual analogue scale, VCS Vernier caliper scale, VNS visual numeric pain scale