Objectives:
This study is purposed to investigate the effect and safety of laser therapy for stroke patients by systematic review and meta-analysis of the randomized controlled trials (RCTs).
Methods:
RCTs on the treatment of laser therapy for stroke patients were selected among the literature published from January 2000 to June 2022 in twelve domestic and foreign databases (Pubmed, The Cochrane library, EMBASE, China National Knowledge Infrastructure (CNKI), Wangfang, Oriental Medicine Advanced Searching Integrated System (OASIS), Research Information Sharing Service (RISS), Korean Traditional Knowledge Portal, National Digital Science Library (NDSL), KMbase, koreanstudies and DBpia). The quality of the literature was evaluated using the Cochrane's Risk of Bias tool and RevMan 5.4 was used for the synthesis of results.
Results:
Total 2,598 patients with stroke were finally selected from 18 RCTs. Meta-analysis has shown that in three studies, the ratio of 0-2 in modified Rankin Scale (mRS) score of the laser therapy is higher than that of sham laser therapy but it is not statistically significant. In two studies, Modified Barthel Index score (MBI) in the combined treatment of laser therapy and rehabilitation was statistically significantly higher than that in rehabilitation alone group. In two studies regarding motor function after stroke, total effective rate in the combined treatment of laser therapy and rehabilitation was statistically significantly higher than that in rehabilitation alone group. In three studies, the Fugl-Meyer Assessment for upper extremity (FMA-UE) in the combined treatment of laser therapy and rehabilitation was statistically significantly higher than that in rehabilitation alone group. In two studies regarding shoulder pain after stroke, visual analogue scale (VAS) in the combined treatment of laser therapy and rehabilitation was lower than that in rehabilitation alone group, but it is not statistically significant. In two studies regarding shoulder pain after stroke, calcitonin gene-related peptide (CGRP) in the combined treatment of laser therapy and rehabilitation was statistically significantly higher than that in rehabilitation alone group. In two studies regarding shoulder pain after stroke, endothelin 1 (ET-1) and bradykinin (BK) in the combined treatment of laser therapy and rehabilitation were statistically significantly lower than those in rehabilitation alone group. Overall, the risk of bias was uncertain or low in the quality assessment of the literature.
Conclusions: The purpose of this study was to investigate the effect of laser therapy for stroke patients. Although it is unclear that laser therapy is more effective than sham laser, laser therapy might be more effective in improving symptoms than conventional rehabilitation alone. Laser therapy was effective in significantly improving activities of daily living (MBI), motor function (effective rate), upper motor function (FMA-UE), shoulder pain related factors (CGRP, ET-1, BK). Furthermore, no serious adverse events were founded in laser therapy studies. However, the quality of the selected literature was generally low. Therefore, further studies with high methodological quality on laser therapy for stroke patients would be required in the future.