Effects of High-Intensity Laser Therapy on Functional Outcomes and Spasticity-Related Pain in Subacute and Chronic Stroke Patients with Plantar Flexor Spasticity: A Randomized Sham-Controlled Trial

OBJECTIVE: To evaluate the effects of high-intensity laser therapy (HILT) on gait, spasticity-related pain, and function in subacute and chronic stroke patients with plantar flexor spasticity. DESIGN: A prospective, randomized, sham-controlled, participant- and assessor-blinded trial. Twenty-four patients received HILT or sham laser (3 days/week for 3 weeks) with conventional rehabilitation (6 weeks). The primary outcome was the 10-Meter Walk Test (10MWT); secondary outcomes included pain, spasticity, range of motion (ROM), muscle thickness, and quality of life (QoL). RESULTS: Twenty-two patients completed the study. A significant group-by-time interaction favored HILT for 10MWT (P=0.038) and pain (P<0.001). Between-group comparisons favored HILT for pain at weeks 3 and 6 (P<0.001) but showed no significant gait-speed difference. A post hoc covariate-adjusted analysis favored HILT in gait speed at week 3 (0.063 m/s, 95% CI 0.020-0.105; P=0.006) and week 6 (0.089 m/s, 95% CI 0.003-0.176; P=0.043). ROM and QoL improved similarly in both groups; spasticity and muscle thickness were unchanged. CONCLUSION: In this preliminary trial, HILT was a safe adjunct to rehabilitation, producing a large, durable reduction in spasticity-related pain, with a smaller, covariate-adjusted gait benefit of uncertain clinical magnitude. These findings are preliminary and require confirmation in adequately powered trials.