Efficacy of high intensity laser therapy in the management of foot ulcers: a systematic review

[Purpose] The aim of this systematic review was to assess the efficacy of high intensity laser therapy (HILT) on wound surface area in patients with foot ulcers. [Methods] Four databases including PubMed, MEDLINE, the Cochrane library, and the Physiotherapy Evidence Database (PEDro) were searched up to the end of April 2018 to identify relevant studies. Studies were included if they met the following criteria: randomised controlled trial (RCT), assessed the efficacy of HILT in patients with foot ulcers, evaluated wound surface area, and written in English language with available full text. The PEDro scale was used to evaluate the quality of studies. [Results] A total of three RCTs met the inclusion criteria, with two studies of the efficacy of HILT in adult patients with diabetic foot ulcers and one in spina bifida children with neuropathic foot ulcers. According to the PEDro scale assessment, all three studies were rated as a fair quality. All studies found that HILT provided significantly better outcomes compared to sham laser or standard medical therapy. [Conclusion] This systematic review suggests that HILT is an effective modality for wound healing in patients with foot ulcers, but further large-scale studies are required to confirm its efficacy.