The Addition of Exercise to High-Intensity Laser Therapy Improves Treatment Effectiveness on Pain and Muscle Strength in Patients with Subacromial Pain Syndrome: A Randomized Trial

Abstract

Objective To assess the efficacy of adding exercise to high-intensity laser therapy (HILT) in improving treatment effectiveness for clinical outcomes in patients with subacromial pain syndrome.

Methods Thirty patients with subacromial pain syndrome were randomly assigned to the HILT-only group (n=15) or HILT&Exercise group (n=15). The primary outcome was shoulder function and disability. Secondary outcomes were pain, range of motion, proprioception (joint position sense), and muscle strength.

Results Shoulder function and disability, pain, range of motion, joint position sense, and some muscle strength improved in both groups (p<0.05). There was no significant time-group interaction for the Constant-Murley Score, Shoulder Pain and Disability Index, rest pain, range of motion, and joint position sense (p>0.05). Time-group showed significant effects for activity pain and strength in favor of the HILT&Exercise group. Middle trapezius, lower trapezius, and supraspinatus strength increased after HILT plus exercise (p<0.05), activity pain, upper trapezius, serratus anterior, and subscapularis strength improved more compared to HILT (p<0.05).

Conclusions We found no clinically important differences between HILT and HILT-plus exercise in shoulder function and disability, rest pain, mobility, and proprioception, in patients with subacromial pain syndrome. The addition of exercise to HILT was superior to HILT for improving activity pain and muscle strength.

Zusammenfassung

Ziel Bewertung der Wirksamkeit des Hinzufügens von Bewegung zur hochintensiven Lasertherapie (HILT) zur Verbesserung der Behandlungswirksamkeit für klinische Ergebnisse bei Patienten mit subakromialem Schmerzsyndrom.

Methoden Dreißig Patienten mit subakromialem Schmerzsyndrom wurden randomisiert in die HILT-Gruppe (n=15) oder der HILT&Übung-Gruppe (n=15) zugeteilt. Die primären Messpunkte warren Schulterfunktion und Behinderung. Sekundäre Messpunkte waren Schmerzen, Bewegungsumfang, Propriozeption (Gelenkpositionsgefühl) und Muskelkraft.

Ergebnisse Schulterfunktion und -behinderung, Schmerzen, Bewegungsumfang, Gelenkpositionsgefühl und Muskelkraft verbesserten sich in beiden Gruppen (p<0,05). Es gab keine signifikante Zeitgruppeninteraktion für Constant-Murley Score, Shoulder Pain and Disability Index, Ruheschmerz, Bewegungsumfang und Gelenkpositionsgefühl (p>0,05). Die Zeitgruppe zeigte signifikante Effekte bei Aktivitätsschmerz und Kraft zugunsten der HILT&Übung-Gruppe. Die Kraft des mittleren Trapezmuskels, des unteren Trapezmuskels und des Supraspinatus nahm nach HILT plus Übung zu (p<0,05), Aktivitätsschmerz, die Kraft des oberen Trapezmuskels, des vorderen Serratus und des M. subscapularis verbesserte sich stärker im Vergleich zu HILT (p<0,05).

Schlussfolgerungen Wir fanden keine klinisch bedeutsamen Unterschiede zwischen HILT- und HILT-plus-Übungen bei Schulterfunktion und -behinderung, Ruheschmerz, Mobilität und Propriozeption bei Patienten mit subakromialem Schmerzsyndrom. Das Hinzufügen von Bewegung zu HILT war bei der Verbesserung von Aktivitätsschmerzen und Muskelkraft gegenüber HILT überlegen.

Keywords

Shoulder pain - shoulder impingement syndrome - physical therapy - phototherapy - light therapy

Schlüsselwörter

Schulterschmerzen - Schulter-Impingement-Syndrom - physikalische Therapie - Phototherapie - Lichttherapie

Publication History

Received: 23 November 2022

Accepted: 08 June 2023

Article published online:
03 July 2023

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