Subacromial Impingement Syndrome, Shoulder Pain, Rotator Cuff Disease
Conditions
Keywords
High-Intensity Laser Therapy, HILT, Physiotherapy, Shoulder Rehabilitation, Exercise Therapy, Randomized Controlled Trial
Brief summary
This randomized controlled trial aimed to compare the short-term effectiveness of high-intensity laser therapy (HILT) and a multimodal physiotherapy program in patients with subacromial impingement syndrome (SIS). Ninety-four participants were allocated to either HILT or combined physiotherapy, and both groups received an identical supervised exercise program. Primary outcome measures included shoulder pain assessed using the visual analogue scale (VAS). Secondary outcomes included shoulder function, disability, and quality of life. Outcomes were evaluated at baseline, post-treatment, and short-term follow-up.
Detailed description
Subacromial impingement syndrome (SIS) is one of the most common causes of shoulder pain and functional limitation. Conservative treatment strategies, particularly exercise-based rehabilitation, are recommended as first-line therapy. High-intensity laser therapy (HILT) has recently gained attention because of its potential analgesic and anti-inflammatory effects; however, its comparative effectiveness against multimodal physiotherapy remains unclear. This single-centre, assessor-blinded randomized controlled trial was conducted at the Department of Physical Medicine and Rehabilitation, Inonu University Hospital, Malatya, Türkiye. Adults aged 18-65 years with clinically and radiologically confirmed SIS were enrolled. Participants were allocated to either a high-intensity laser therapy group or a combined conventional physiotherapy group. Both groups additionally participated in an identical supervised exercise program. The HILT group received class IV Nd:YAG laser therapy (1064 nm), whereas the control group received hot pack therapy, transcutaneous electrical nerve stimulation, and therapeutic ultrasound. Treatment duration was three weeks. The primary outcome measure was pain intensity assessed using the visual analogue scale (VAS). Secondary outcomes included the Constant-Murley Score, Shoulder Pain and Disability Index (SPADI), and Short Form-36 quality-of-life assessment. Outcomes were evaluated at baseline, post-treatment, and short-term follow-up. The study was approved by the Inonu University Clinical Research Ethics Committee (Approval No: 2015/123). The trial was retrospectively submitted for registration at ClinicalTrials.gov.
Interventions
Class IV Nd:YAG laser therapy (1064 nm wavelength) administered to the shoulder region for treatment of subacromial impingement syndrome.
Combined physiotherapy program consisting of hot pack therapy, transcutaneous electrical nerve stimulation, and therapeutic ultrasound.
Sponsors
Tulay Yildirim
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
Outcome assessment was performed by a physician blinded to group allocation. Due to the nature of the interventions, participant and care provider blinding were not feasible.
Intervention model description
Participants were assigned to either high-intensity laser therapy or multimodal physiotherapy, with both groups receiving an identical supervised exercise program.
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
Inclusion Criteria: * Adults aged 18 to 65 years * Clinically and radiologically confirmed subacromial impingement syndrome * Shoulder pain lasting at least 1 month and less than 6 months * At least one positive impingement test (Neer, Hawkins-Kennedy, painful arc, or Jobe test) * MRI findings consistent with stage I-II rotator cuff changes
Exclusion criteria
* Previous shoulder surgery or trauma * Inflammatory rheumatic disease * Recent myocardial infarction * Active infection * Previous physiotherapy or corticosteroid injection within the last 6 months * Pregnancy * Calcific tendinitis * Adhesive capsulitis * Cervical radiculopathy * Neurological disorders affecting the shoulder * Full-thickness rotator cuff tear * Contraindications to electrotherapy or laser therapy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Shoulder Pain Intensity Assessed by Visual Analogue Scale (VAS) | Baseline, 3 weeks, and 7 weeks | Pain intensity at rest, during movement, and at night assessed using a 10-cm visual analogue scale. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Shoulder Disability Assessed by SPADI | Baseline, 3 weeks, and 7 weeks | Shoulder Pain and Disability Index (SPADI) used to assess disability related to shoulder pain. |
| Shoulder Function Assessed by Constant-Murley Score | Baseline, 3 weeks, and 7 weeks | Shoulder functional status assessed using the Constant-Murley Score. |
Contacts
PRINCIPAL_INVESTIGATORTulay Yildirim, MD
Inonu University Faculty of Medicine
Outcome results
None listed