Combined Effects of Low-Level Laser Therapy and Aerobic Exercise on Peripheral Arterial Function in Type 2 Diabetes Mellitus: A Randomized Trial

Background: Peripheral arterial disease (PAD) in patients with type 2 diabetes mellitus (T2DM) is a significant factor contributing to impaired mobility and increased cardiovascular risk. While aerobic exercise remains a fundamental part of PAD rehabilitation, low-level laser therapy (LLLT) has been used as a promising adjunct to improve perfusion and promote angiogenesis.
Objective: To examine the combined effect of LLLT and aerobic exercise on peripheral arterial function, pain, and functional walking capacity in T2DM patients with PAD.
Patients and Methods: This randomized controlled trial enrolled 40 patients aged 55–65 years with T2DM and mild-to-moderate PAD. Participants were randomly assigned to two groups: Group A received LLLT (scan; 808 nm, 450 mW) in addition to moderate aerobic exercise, and Group B received aerobic exercise only. The intervention lasted for 12 weeks (3 sessions/week). Outcome measures included the ankle-brachial index (ABI), peak systolic velocity (PSV), pain assessed using a visual analog scale (VAS), and functional treadmill metrics, such as initial claudication distance, absolute claudication distance, time to initial and absolute claudication, and VO₂ max.
Results: Both groups showed significant improvements in ABI, PSV, VAS, and treadmill parameters (p < 0.05). Compared to Group B, Group < strong> A demonstrated significantly greater gains in ABI (20% vs. 13.6%), larger reductions in PSV (52.7% vs. 45.4%), and a bigger decrease in pain intensity (VAS: 48.8% vs. 29.2%). Treadmill performance improved significantly in both groups, with Group A achieving better outcomes in initial claudication distance, absolute claudication distance, and time to initial and absolute claudication (p < 0.05). Although VO₂ max improved in both groups, the difference between the groups was not statistically significant; however, group A showed a greater performance.
Conclusion: The combination of low-level laser therapy and aerobic exercise proved more effective than exercise alone in improving vascular function, relieving pain, and enhancing walking ability in diabetic patients with PAD.