PICO
Patient/Population
Subacromial impingement
syndrome, aged 30-73.
(n=120)
Intervention
LASER+Exercise
Exercise
LASER
Comparison
LASER+Exercise
Exercise
LASER
Outcomes
Pain
Analgesics intake
Shoulder ROM
Disability
Translatability: (3/3) Easy
Comments: “Low-level laser therapy combined with exercises reduce pain intensity, improve shoulder function and reduces pain intensity and medication intake over 3 months.”
Limitations: no control group to assess the natural course of the disease; no group to combined placebo laser therapy with exercise performance.
Appraisals:
PEDro Scale – (7/10) Blind subjects: No; Blind therapists: No; Intention-to-treat analysis: No. (by PEDro – confirmed)
BTB
Intervention – 1
- LASER (904nm 700Hz)
Dose
- 3J; 6J/cm2 per irradiation point (9 pints total) – 27J total session
Periodicity
- 3 times a week for 8 weeks
Local/Technic:
- three insertion points each in the supraspinatus muscle tendon, on the subacromial bursa, and along the bicipital groove. Before exercise.
Intervention – 2
- Exercise
Dose
- Stretching of each muscle group for 30 seconds, 3 times in a row.
- 10 sets of 10 seconds of each Isometric exercise.
- 3 sets of 15 repetitions of each Isotonic muscle strengthening exercise.
Periodicity
- 3 times a week for 8 weeks
Local/Technic:
A. Muscles stretching – trapezius; pectoralis minor; posterior and inferior shoulder structures
B. Isometric/ Isotónic exercises of the scapular pivot, humeral thruster and scapula stabiliser
1 -(first 6 sessions) – Str etching: A + , Isometric B; in 10 sets of 10 seconds each.
2 – (next 9 sessions) – Stretching : A + Isotonic B; in 3 sets of 15 repetitions with a 1kg load.
3 – (last 9 sessions): Stretching A + . Isotonic exercises B; in 3 sets of 15 repetitions with a 1.5kg load.
Citation:
Alfredo PP, Bjordal JM, Junior WS, Marques AP, Casarotto RA. Efficacy of low-level laser therapy combined with exercise for subacromial impingement syndrome: A randomised controlled trial. Clinical Rehabilitation. 2021;35(6):851-860. doi:10.1177/0269215520980984