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Vol. 21. Num. 4.01 July 2017
Pages 225-304
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Vol. 21. Num. 4.01 July 2017
Pages 225-304
Systematic Review
DOI: 10.1016/j.bjpt.2017.05.008
Effects of monochromatic infrared phototherapy in patients with diabetic peripheral neuropathy: a systematic review and meta-analysis of randomized controlled trials
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Caroline Cabral Robinsona,
Corresponding author
carollinerobinson@gmail.com

Corresponding author at: Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Rua Sarmento Leite 245, Porto Alegre, RS 90050-170, Brazil.
, Patrícia Da Silva Klahrb, Cinara Steina, Maicon Falavignac,d, Graciele Sbruzzie, Rodrigo Della Méa Plentza,b,f
a Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
b Programa de Pós-Graduação em Ciências da Reabilitação, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
c Hospital Moinhos de Vento, Porto Alegre, RS, Brazil
d Instituto de Avaliação de Tecnologias em Saúde, Porto Alegre, RS, Brazil
e Curso de Fisioterapia, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
f Departamento de Fisioterapia, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
Highlights

  • 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.

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Table 1. Characteristics of the included studies.
Table 2. Risk of bias of the included studies.
Table 3. Quality of the evidence.
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Abstract
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.

Keywords:
Diabetes
Foot
Pain
Tactile sensitivity
Physical therapy

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