COMPARATIVE EFFECTS OF THERAPEUTIC ULTRASOUND AND HIGH INTENSITY LASER THERAPY ON NEUROPATHIC PAIN, STRENGTH AND QUALITY OF LIFE IN DIABETIC FOOT

Abstract

Background: Diabetes mellitus is a major global health concern and a leading cause of morbidity, mortality, and long-term disability. One of its most disabling complications, diabetic peripheral neuropathy, adversely affects quality of life through neuropathic pain, sensory loss, gait disturbances, foot ulceration, and increased risk of amputation. Despite the widespread use of physical therapy modalities in neuropathy management, comparative evidence regarding the effectiveness of different adjunctive interventions remains limited, particularly in patients with diabetic foot involvement.

Objective: To compare the effects of therapeutic ultrasound and high-intensity laser therapy, each combined with routine physical therapy, on neuropathic pain, muscle strength, and quality of life in patients with diabetic foot.

Methods: A single-blinded randomized clinical trial (trial registration number NCT06479577) was conducted at Bahawalpur Medical and Dental Hospital. Using a non-probability convenience sampling technique, 44 patients with confirmed diabetic peripheral neuropathy were enrolled and randomly allocated into two groups. One group received therapeutic ultrasound with routine physical therapy, while the other received high-intensity laser therapy with routine physical therapy. Interventions were administered three times per week for eight weeks. Outcome measures included the Michigan Neuropathy Screening Instrument for neuropathic pain and the Foot and Ankle Disability Index for foot-related quality of life, assessed at baseline and after completion of the intervention. Data were analyzed using SPSS version 25.

Results: Baseline characteristics and outcome measures were comparable between groups (p > 0.05). Post-intervention analysis demonstrated statistically significant between-group differences in neuropathic pain, functional status, and muscle strength, favoring the high-intensity laser therapy group (p < 0.05). Within-group analysis showed significant improvements in all outcome measures in both groups (p < 0.05); however, the magnitude of improvement was consistently greater in the high-intensity laser therapy group.

Conclusion: High-intensity laser therapy combined with routine physical therapy was more effective than therapeutic ultrasound with routine physical therapy in reducing neuropathic pain, improving lower-limb strength, and enhancing quality of life in patients with diabetic foot.