Effectiveness of photobiomodulation for the treatment of ankle sprain

Photobiomodulation, also called low-level laser therapy demonstrated to have a noteworthy overall effect on pain with a high effect size in case of ankle sprain.

This review and meta-analysis investigated the effect of Photobiomodulation treatment on pain, oedema and function in patients with ankle sprains.

An extensive MEDLINE, Web of Science, PubMed, Elton B. Stephens CO (EBSCO), Wiley, ScienceDirect, Physiotherapy Evidence and Cochrane Databases was done to find clinical data about Photobiomodulation for ankle sprains.

Parameters of Photobiomodulation and measured outcomes were extracted, with pain and function as the primary outcomes and oedema as the secondary outcome. The PEDro scale was used to rate the methodological quality of the clinical trials, while the GRADE framework helped to examine the level of evidence.

The review included 6 studies (2=fair quality; 4=good quality) with 598 patients, out of which 5 were part of the meta-analysis. The evidence was moderate for pain and low for oedema and function.

The meta-analysis showed that Photobiomodulation therapy had a noteworthy overall effect on pain with a high effect size [standardized mean difference, SMD -0.88 (-1.76, -0.00), p=0.05], but a non-significant effect on oedema [SMD -0.70 (-1.64, 0.24), p=0.14] and function [SMD -0.22 (-0.69, 0.24), p=0.35].

High heterogeneity (I2) (more than 75%) was recognized in pain and oedema outcomes, while function outcomes showed moderate heterogeneity.

Photobiomodulation is quite effective for individuals with ankle sprains, indicating a high effect size and a reasonable level of evidence for reducing pain intensity. However, the therapy's non-significant effects on function and oedema, coupled with a low level of evidence, limit confidence in these findings. Further large-scale studies are recommended to standardize irradiation parameters and treatment protocols, using higher intensity and fluency.