The effect of low-level red and near-infrared photobiomodulation on pain and function in tendinopathy: a systematic review and meta-analysis of randomized control trials.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 34391447 · doi:10.1186/s13102-021-00306-z
What was done
Systematic review and random-effects meta-analysis of randomized controlled trials assessing red or near-infrared photobiomodulation (PBM) for tendinopathy compared to sham or other interventions. Searches were conducted across PubMed, CINAHL, SCOPUS, Cochrane, Web of Science, and SPORTDiscus up to August 2020. Primary outcomes were pain and function, evaluated using mean difference (MD) and standardized mean difference (SMD).
What was found
Across 17 included trials (n = 835), PBM alone compared to other interventions yielded similar pain reductions (MD -0.09; 95% CI -0.79 to 0.61) and smaller improvements in function (SMD -0.52; 95% CI -0.81 to -0.23). When PBM plus exercise was compared to sham plus exercise, PBM led to greater pain reduction (MD 1.06; 95% CI 0.57 to 1.55) and improved function (MD 5.65; 95% CI 0.25 to 11.04). When PBM plus exercise was compared to other interventions plus exercise, no significant difference in pain was observed (MD 0.31; 95% CI -0.07 to 0.70). Most trials had a low risk of bias, with GRADE certainty rated very low to moderate.
Why it matters
Photobiomodulation provides modest additive benefits for pain and function when paired with exercise compared to exercise with sham, but it does not outperform other active therapies.
Limits
The evidence certainty is rated only very low to moderate. The abstract aggregates diverse tendinopathy disorders without reporting anatomical site-specific outcomes, optimal wavelength and dosage parameters, or long-term follow-up.