comparison of tecar therapy and low-level laser therapy separately and simultaneously on clinical symptoms and health-related quality of life in individuals with type 2 diabetes: a 3-month follow-up study

Background: distal peripheral neuropathy (dpn) is a prevalent issue among patients with type 2 diabetes mellitus. despite the widespread use of low-level laser therapy (lllt) and limited use of tecar therapy in physiotherapy for diabetics, the synergistic effect of these two interventions in a long-term follow-up has not yet been determined. objectives: this study aimed to compare the effects of tecar therapy and lllt separately and simultaneously over a 3-month follow-up period on clinical symptoms and health-related quality of life in individuals with type 2 diabetes and dpn. methods: in this double-blind, randomized clinical trial, forty-five individuals with type 2 diabetes (30 women and 15 men) with dpn were randomly assigned to three groups of 15 people: tecar-on + laser-sham, tecar-on + laser-on, and laser-on + tecar-sham. the patients received ten treatment sessions and were followed up for 3-months after the last session. health-related quality of life was assessed using the whoqol-bref questionnaire, while clinical symptoms, including pain (measured with a visual analog scale), functional balance (evaluated with the timed-up and go test), and neuropathy symptoms (assessed with the michigan questionnaire) were also recorded. results: inter-group comparison after ten sessions revealed that the tecar-on + laser-sham and tecar-on + laser-on groups exhibited significant improvement in neuropathy symptoms compared to the laser-on + tecar-sham group. even after the 3-month follow-up, these two groups showed lasting improvement in all variables compared to the laser-on + tecar-sham group (p < 0.05). the tecar-on + laser-on group demonstrated a more enduring significant effect on pain scores (p = 0.035) compared to the tecar-on + laser-sham group after the 3-month follow-up. in intra-group comparison, all three groups showed significant improvement in clinical symptoms and health-related quality of life after ten treatment sessions compared to before treatment (p < 0.05). moreover, after the 3-month follow-up, both the tecar-on + laser-sham group and the tecar-on + laser-on group demonstrated a more lasting significant effect in all variables compared to before treatment (p < 0.05). for the laser-on + tecar-sham group, a more durable improvement in health-related quality of life (p = 0.000) and neuropathy symptoms (p = 0.011) was reported after the 3-month follow-up compared to before treatment. conclusions: although all three groups exhibited significant improvement in clinical symptoms and health-related quality of life in individuals with type 2 diabetes and dpn after ten treatment sessions, the synergistic use of tecar therapy and lllt after a long-term follow-up period could lead to more durable therapeutic effects in improving these outcomes for individuals with diabetes.