研究目的
This systematic review aimed to investigate the efficacy of LLLT in the healing of DFUs and to identify the type of LLLT and the application parameters commonly recommended for clinical practice in the treatment of DFU over the past 10 years.
研究成果
Low-level laser therapy is effective in the treatment of DFU and was shown to be safe, since no adverse effects were reported. The data provided indicate that the benefits of LLLT are due to reduction in the size of ulcers and promotion of complete healing. However, the available literature did not allow us to identify the ideal parameterization and also its effects on blood circulation and the inhibition or stimulation of bacterial growth in infected ulcers. Therefore, more research of higher quality and with better methodological design is necessary.
研究不足
In addition to a relatively small number of studies, the methodological quality in some cases was unsatisfactory. The diversity of parameters used was a limiting factor for interpretation of the data obtained. Moreover, our meta-analysis was performed with only 3 studies and thus requires caution in its interpretation.
1：Experimental Design and Method Selection:
A systematic search was performed in PubMed, BVS, PEDro, Scopus, Web of Science, and CINAHL up to March 31, 2019, and included studies in Portuguese, English, or Spanish published between 2008 and
2：The following controlled and uncontrolled terms were used:
20 'low-level laser therapy' OR 'LLLT' OR 'low-level light therapy' OR 'low-power laser therapy' AND 'diabetic foot' OR 'diabetic foot ulcer' and its corresponding terms in Portuguese and Spanish. The bibliographies of all relevant articles were examined for additional studies that were not identified in the search. The gray literature was not searched.
3：Sample Selection and Data Sources:
Studies that investigated the effects of LLLT on the treatment of DFU were considered for inclusion in this review. Their titles and abstracts were analyzed for full-text evaluation and subsequently examined for inclusion in the systematic review and meta-analysis. Studies were eligible for inclusion if they met the following criteria: randomized clinical trials (RCTs); participants with DFU; treatment of DFU involving LLLT; specific results on the healing of DFU, that is, healing rate, ulcer size reduction, and size reduction rate. Studies that did not use LLLT and were not RCTs were excluded including in vitro studies and research using animals.
4：List of Experimental Equipment and Materials:
Not explicitly mentioned.
5：Experimental Procedures and Operational Workflow:
Two independent investigators conducted the study selection process and reviewed each relevant article. Disagreements were arbitrated by a third investigator. After evaluating and reaching a consensus on eligible studies, 2 authors independently extracted the data using a standardized data extraction form.
6：Data Analysis Methods:
The data were analyzed using the R 3.5.2 statistical package. Heterogeneity among studies was verified by the Cochran’s Q test and the I2 value. Continuous data were combined by the weighted mean difference with 95% confidence interval and the fixed-effects (Mantel-Haenszel).
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