Comparison of the effect of separate and simultaneous application of Tecar therapy and low-level laser therapy on the neurological symptoms of type 2 diabetic patients with peripheral neuropathy of lower limbs.

Objectives: The study aimed to compare the effects of separate and simultaneous application of Tecar therapy and low-level laser therapy on neurological symptoms of type 2 diabetic patients.

Patients and methods: In this randomized control trial conducted between November 2021 and February 2022, 45 patients (30 females, 15 males; mean age: 65.7±7.6 years; range, 51 to 76 years) with type 2 diabetes and peripheral sensory neuropathy of the lower limbs were randomly divided into three groups: Tecar + sham laser (n=15), Tecar + laser (n=15), and laser + sham Tecar (n=15). Outcome measures for both right and left limbs included tibial motor nerve conduction velocity (MNCV), sural nerve amplitude, sole sensation, and ankle-brachial index (ABI) measured before and after 10 sessions and after a three-month follow-up.

Results: In intergroup comparison, the Tecar + laser group significantly improved compared to the laser + sham Tecar group in terms of tibial MNCV in both limbs after 10 sessions and all measured outcomes after three months (p<0.05). In addition, comparison between the Tecar + laser and Tecar + sham laser groups for tibial MNCV (p=0.021 for the right limb and p=0.002 for the left limb) and ABI (p=0.001 for the right limb and p=0.002 for the left limb) in both limbs after three months was significant. In the intragroup comparison, a significant improvement was found in the laser + sham Tecar group for sole sensation (p<0.001) and ABI (p<0.001) of both limbs after three months compared to before the interventions, whereas in the other two groups, significant improvements were found in all four outcomes.

Conclusion: A significant increase was found in neurological outcomes in all three groups after 10 sessions. Moreover, the use of combined Tecar therapy and laser compared to Tecar or laser alone could lead to a more lasting effect in improving the sensory symptoms of type 2 diabetic patients with peripheral neuropathy of the lower limbs.