Efficacy of Laser Therapy in the Treatment of Shoulder Impingement Syndrome: A Systematic Review and Meta-Analysis

Abstract

Background Laser therapy is used as a noninvasive treatment for musculoskeletal diseases, including shoulder pain, but its efficacy in shoulder impingement syndrome remains controversial. This study aimed to systematically evaluate the efficacy and safety of laser therapy in shoulder impingement syndrome.

Methods The PubMed, Embase, and Cochrane Library databases were searched from its establishment to June 2021. Randomized controlled trials (RCTs) in shoulder impingement syndrome were included. The primary outcome was pain, and the secondary outcomes were function and range of motion. Meta-analysis was performed with RevMan 5.3.

Results A total of 12 RCTs and 669 participants were included. The results showed that laser therapy exhibited significant efficacy in shoulder impingement syndrome, especially in terms of pain release (MD=1.26, 95% CI=0.55–1.97, P=0.0005) and range of motion (MD=4.27, 95% CI=1.93–6.61, P=0.0003). However, the effect of shoulder function was uncertain (SMD=0.43, 95% CI=0–0.85, P=0.05). The subgroup analysis of pain showed that the efficacy of the laser therapy was related to the wavelength of the laser and the number of combined treatments. No adverse events were reported in the included trials.

Conclusions Laser therapy can significantly relieve pain in shoulder impingement syndrome and has no adverse reactions.

Zusammenfassung

Hintergrund und Ziel Die Lasertherapie wird als nicht invasives Verfahren zur Behandlung von Erkrankungen des Bewegungsapparats, u. a. auch Schulterschmerzen, eingesetzt. Allerdings ist die Wirksamkeit der Lastertherapie beim Schulter-Impingement-Syndrom weiterhin umstritten. Ziel der vorliegenden Studie war es, die Wirksamkeit und Sicherheit der Lasertherapie beim Schulter-Impingement-Syndrom systematisch zu prüfen.

Methodik Es erfolgte eine Literaturrecherche in den Datenbanken PubMed, Embase und Cochrane Library von deren Entstehung bis Juni 2021. Randomisierte kontrollierte Studien (RCT) zum Schulter-Impingement-Syndrom wurden in die Übersichtsarbeit eingeschlossen. Der primäre Endpunkt war Schmerz, die sekundären Endpunkte waren Funktion und Bewegungsumfang. Die Metaanalyse wurde mit RevMan 5.3. durchgeführt.

Ergebnisse Insgesamt wurden 12 RCT mit 669 Teilnehmern berücksichtigt. Die Ergebnisse zeigten, dass die Lasertherapie beim Schulter-Impingement-Syndrom signifikant wirksam war, insbesondere im Hinblick auf Schmerzerleichterung (MD=1,26, 95-%-KI=0,55–1.97, P=0.0005) und Bewegungsumfang (MD=4,27, 95-%-KI=1,93–6,61, P=0,0003). Allerdings war eine Wirkung auf die Schulterfunktion nicht eindeutig nachweisbar (SMD=0,43, 95-%-KI=0–0,85, P=0,05). In der Subgruppenanalyse zu Schmerz fand sich ein Zusammenhang zwischen der Wirksamkeit der Lasertherapie und der Wellenlänge sowie der Anzahl der zusammengefassten Behandlungen. In den einbezogenen Studien wurden keine unerwünschten Ereignisse berichtet.

Schlussfolgerung Die Lasertherapie kann Schmerzen in der Schulter signifikant reduzieren.

Key words

Laser therapy - Shoulder impingement syndrome - Systematic review - Meta-analysis

Schlüsselwörter

Lasertherapie - Impingement-Syndrom der Schulter - Schulterenge - systematisches Review - Metaanalyse

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