Effects of monochromatic infrared phototherapy in patients with diabetic peripheral neuropathy: a systematic review and meta-analysis of randomized controlled trials.
Braz J Phys Ther 2017;
21:233-243. [PMID:
28571697 PMCID:
PMC5537484 DOI:
10.1016/j.bjpt.2017.05.008]
[Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Revised: 09/13/2016] [Accepted: 09/14/2016] [Indexed: 11/20/2022] Open
Abstract
MIRE is an adjunctive phototherapy source approved by FDA to improve blood perfusion and reduce pain.
MIRE was associated with a modest short-term improvement in plantar tactile sensitivity, not sustained over time.
MIRE resulted in a less decrease in pain relief, possibly associated with initial improvement in plantar sensitivity.
Current quality of evidence is low and further studies are likely to change the estimated effect.
Background
Monochromatic infrared energy (MIRE) or phototherapy has been used to improve plantar sensitivity and pain in lower limbs of patients with diabetic sensorimotor peripheral neuropathy (DSPN), but the available primary results are inconsistent.
Objective
To review systematically the effects of MIRE on plantar sensitivity and neuropathic pain in patients with DSPN.
Methods
Medline, EMBASE, Cochrane CENTRAL, and Google Scholar were searched up to September 2016. Randomized controlled trials addressing the effects of MIRE on plantar sensitivity and neuropathic pain in patients with DSPN were selected. Study inclusion, risk of bias and quality assessment, and data extraction were completed by two independent reviewers.
Results
Of 2549 records identified, six studies met the selection criteria, with 304 patients (594 feet) randomized. MIRE was not associated with improvement in plantar tactile sensitivity (SMD = 0.22, 95%CI −0.07 to 0.51, low quality of evidence). Subgroups of studies with short-term (up to 2 weeks) follow-up showed significant improvement in plantar sensitivity (SMD = 0.41, 95% CI 0.18–0.64). Neuropathic pain increased significantly in patients who received MIRE (MD = 0.49, 95% CI 0.30–0.68, low quality of evidence).
Conclusions
There was limited evidence that MIRE results in short-term improvement of tactile sensitivity probably not sustained over time. Limited evidence also suggested that MIRE does not provide relief for neuropathic pain. As quality of evidence is low, further studies are likely to change the estimated effect.
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