Effects of monochromatic infrared phototherapy in patients with diabetic peripheral neuropathy: a systematic review and meta-analysis of randomized controlled trials.
Caroline Cabral Robinson, Patrícia Da Silva Klahr, Cinara Stein and 3 others
PMID 28571697WHAT IT FOUND
Infrared light therapy did not improve plantar sensitivity or neuropathic pain compared to sham.
A small sensitivity benefit appeared only in the first two weeks and was not sustained. The evidence quality is low, and this treatment is not currently supported for diabetic neuropathy.
Key findings
01MIRE did not increase the number of plantar regions sensitive to the 5.07 SWM compared to the control group.
02Subgroup analysis showed the benefit of MIRE in studies with follow-up of two weeks or less, but this effect was not sustained after the two weeks.
03Overall pain symptoms did not differ between MIRE and comparison groups, however high heterogeneity was observed.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The quality of evidence was low due to serious inconsistencies and indirectness. Four studies randomized feet rather than patients, which may inflate the sample size and affect statistical independence. Plantar sensitivity was measured using SWM, which may not be accurate enough to detect subtle changes in sensory nerve function over time. Pain assessment used visual analog scales, which may not capture specific neuropathic pain qualities. One included study was not blinded, which may have introduced placebo effects and bias.
Declared interests
The authors declare no conflicts of interest. The study was funded by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES).
The easy way to misread this
Do not interpret the short-term subgroup finding as evidence of clinical efficacy. The primary analysis showed no benefit, and the effect disappeared after two weeks. The low quality of evidence and lack of sustained effect mean this therapy should not be adopted for diabetic neuropathy.