The purpose of this study is to establish the absolute reliability between hand-held dynamometers (HHDs) and concurrent validity between HHDs and isokinetic dynamometers (IDs) in shoulder rotator strength assessment. The Medline, CINAHL, and Central databases were searched for relevant studies up to July 2020. Absolute reliability was determined by test–retest studies presenting standard error of measurement (SEM%) and/or minimal detectable change (MDC%) expressed as percentage of the mean. Studies considering intra-class correlation coefficient (ICC) between IDs and HHDs were considered for concurrent validity. The risk of bias and the methodological quality were evaluated according to COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). Thirteen studies were included in the meta-analysis. Shoulder internal rotator strength assessment MDC% was 0.78%, 95% confidence interval (CI) −5.21 to 3.66, while shoulder external rotators MDC% was 3.29%, CI −2.69 to 9.27. ICC between devices was 0.94, CI (0.91 to 0.96) for shoulder internal rotators and 0.92, IC (0.88 to 0.97) for shoulder external rotators. Very high correlation was found for shoulder rotator torque assessment between HHDs and IDs. The COSMIN checklist classified the selected studies as adequate and inadequate.

Invasive techniques like percutaneous electrolysis have recently surged in popularity for treating musculoskeletal disorders. However, emerging techniques have sparked debates on the current needed to achieve optimal results. The aim of this review was to compare the effects of electrolysis and microelectrolysis on pain intensity in individuals with musculoskeletal pain. This quantitative systematic review has an observational, retrospective, and secondary design. The search included databases such as PubMed, Scopus, Web of Science, EMBSCOhost, Embase, Cochrane Library, PEDro, and Google Scholar (updated on July 1, 2024). Independent reviewers selected eligible studies and assessed their quality using the Cochrane risk of bias 2 tool. The primary outcome was pain intensity, while secondary outcomes included pain pressure threshold and disability. The meta-analysis calculated pooled effects using mean differences or standardized mean differences for these outcomes. Twenty-eight studies were included with an overall low risk of bias (21.4%). Randomization and outcome measurement (21.4%), intervention deviations (28.6%), and outcome measurement (53.6%) were all sources of bias. Statistically-significant reductions in pain intensity and disability (p < 0.01) were observed post-treatment for both microelectrolysis (pain: SMD = −0.92; 95% CI: −1.3, −0.5 and disability: SMD = −0.92; 95% CI: −1.3, −0.5) and electrolysis (pain: SMD = −0.3; 95% CI: −0.6, −0.01 and disability: SMD = −1.8; 95% CI: −3.1, −0.6). For the pain pressure threshold, neither modality outperformed the controls. This review highlights the effectiveness of electrolysis modalities in the treatment of musculoskeletal pain and disability, especially microelectrolysis, which shows a larger effect in terms of pain reduction. Further research is needed to understand their analgesic mechanisms, and US-guided decisions should be based on comprehensive risk-benefit assessments.

We read with interest the systematic review and meta-analysis by Alayat et al

Anxiety disorders are highly prevalent conditions associated with substantial psychosocial burden, and low-level laser therapy auriculotherapy (LLLT-AT) has emerged as a non-invasive intervention with potential neuromodulatory effects for anxiety management. This systematic review aimed to evaluate the effects of LLLT-AT on anxiety symptoms across diverse populations. The review was conducted according to PRISMA 2020 guidelines and prospectively registered in PROSPERO (CRD420251159376). Randomized controlled trials comparing LLLT-AT with sham, placebo, or active interventions were identified through searches in PubMed, Web of Science, Scopus, CINAHL, MEDLINE, ScienceDirect, Cochrane Library, PEDro, and Google Scholar. The literature search was last updated on 2 July 2026. Risk of bias was assessed using RoB 2 and certainty of evidence using GRADE. Six RCTs involving 386 participants were included. Meta-analysis suggested significant reductions in post-treatment anxiety symptoms favoring LLLT-AT compared with control interventions (SMD = −0.65; 95% CI: −1.17 to −0.13), although substantial heterogeneity was identified (I² = 78.9%). Significant reductions were also observed for pain intensity and disability, while adverse eventst analyses demonstrated lower risks of ear pain, hyperemia, and itchy ear following LLLT-AT. However, sensitivity analyses excluding studies with high risk of bias yielded a non-significant effect for anxiety outcomes (SMD = −0.35; 95% CI: −0.94 to 0.25). Interpretation of the findings should be considered cautiously due to substantial heterogeneity and the very low-to-low certainty of evidence for anxiety outcomes. Across all outcomes, the certainty of evidence ranged from very low to low, with very low certainty for anxiety outcomes and low certainty for pain intensity, disability, and adverse eventsoutcomes (ear pain, hyperemia, and itchy ear). LLLT-AT may represent a promising non-invasive complementary intervention for anxiety-related symptoms; however, these findings should be interpreted cautiously given the limited evidence base and substantial heterogeneity. Further high-quality randomized controlled trials with standardized protocols and longer follow-up assessments are required.

Introduction: De Quervain tenosynovitis (QT), a painful and inflammatory wrist condition, presents challenges in its conservative treatment. Although low-level laser therapy (LLLT) is considered an attractive option, the evidence of its effectiveness requires evaluation. This systematic review aimed to assess the analgesic effects of LLLT in QT patients.Methods: The search used the PubMed, Scopus, Web of Science, Embase, EBSCOhost, Physiotherapy Evidence Database (PEDro), and Google Scholar (last updated on March 10, 2025) databases to identify clinical trials comparing the effects of LLLT to other physical therapy or medical treatments in patients with QT. The primary outcomes evaluated were pain intensity, grip strength, and disability. The Cochrane Risk of Bias Tool 2 (RoB2) assessed study quality, and the meta-analysis used weighted mean difference (WMD) or standardised mean difference (SMD). Evidence-based recommendations for statistically significant outcomes were presented following the GRADE approach.Results: Eight studies were included, with an overall low risk of bias (RoB) (25%). Deviations from intended interventions and outcome measurement were sources of bias. Post-treatment pain intensity was statistically significant for LLLT (WMD = –0.98 cm; 95% CI: –1.91, –0.04; p = 0.04; LLLT group [107],control group [124]). RoB and heterogeneity rated the evidence certainty as very low yet important. Handgrip strength and synovial sheath thickness were not statistically significant between groups (p > 0.05).Conclusions: LLLT reduces pain effectively. Prioritising LLLT or ultrasound (US) over invasive treatments may optimise clinical management and minimise postsurgical complications.

Low-level laser auriculotherapy (LLLT-AT) is a non-invasive intervention increasingly explored for the management of musculoskeletal pain and psycho-emotional symptoms, which frequently coexist in myogenic temporomandibular disorders (TMDs). This randomized, assessor-blinded, placebo-controlled clinical trial evaluated the effectiveness of LLLT-AT as an adjunct to manual therapy in improving pressure pain threshold (PPT) and anxiety in individuals with myogenic TMDs. Forty-four participants with myogenic TMDs and clinically relevant anxiety were randomly allocated to an experimental group receiving LLLT-AT combined with a standardized myofascial release protocol (n =21) or to a control group receiving sham LLLT-AT with the same manual therapy (n =23). Interventions were delivered twice weekly for three weeks. Primary outcomes were PPT, assessed by pressure algometry, and anxiety, measured using the Generalized Anxiety Disorder–7 (GAD-7) scale. Secondary outcomes included maximum mouth opening range of motion (MMOROM) and mandibular functional limitation assessed by the Jaw Functional Limitation Scale–8 (JFLS-8). Outcomes were evaluated at baseline, post-intervention, and at a four-week follow-up. Both groups demonstrated significant within-group improvements in PPT, MMOROM, and JFLS-8 over time (p < 0.05), with no significant between-group differences (p > 0.05). Between-group analyses showed greater reductions in anxiety in the LLLT-AT group at post-intervention (p = 0.02; Hedges’ g = −1.35) and follow-up (p = 0.02; Hedges’ g = −1.68). LLLT-AT did not confer additional mechanical or functional benefits but was associated with greater reductions in anxiety when used as an adjunct to manual therapy.