The effect of high-intensity versus low-level laser therapy in the management of plantar fasciitis: randomized participant blind controlled trial

Objectives: To evaluate and compare the efficacy of high-intensity laser therapy (HILT) and low-level laser therapy (LLLT) for plantar fasciitis.

Design: A participant blind randomized controlled trial with parallel group design and an active comparator with follow-up at four weeks.

Settings: Outpatient, University hospital.

Subjects: Unilateral plantar fasciitis participants (n = 102) were randomly assigned into two groups. Recruitment period was from January 2017 to April 2019.

Interventions: Interventions included eight sessions of laser therapy over three weeks and single session of patient education. The HILT group (n = 51) received HILT and the LLLT group (n = 51) received LLLT.

Main measures: Primary outcomes: visual analogue scale; secondary outcomes: pressure algometry, sonography of plantar fascia thickness (time frame: baseline to three-week and four-week follow-up) and numeric rating scale (0%-100%) for opinion of participants on effect of treatment (time frame: three weeks). Data presented: mean (SD) or n (%).

Results: There was no statistically significant difference between the groups according to visual analogue scale (pain in general reduction in three weeks: 2.57(3.45) vs. 2.88(3.28) cm), pressure algometry (pain threshold difference between healthy and affected heel reduction in three weeks: 1.80(6.39) vs. 1.77(2.85) kg) and sonography measurements (plantar fascia thickness difference between healthy and affected heel reduction in three weeks: 0.19(0.56) vs. 0.30(0.57) mm). There was a statistically significant difference between the groups in participants' opinion in favor to HILT group (efficacy of treatment better than 50%: 26(51%) vs. 37(73%)).

Conclusion: No statistically significant difference between groups was observed.