Effect of High-Power Laser on Shoulder Mobility in Sub Acromial Impingement Syndrome: Randomized Controlled Trial

Journal of Environmental Treatment Techniques

2020, Volume 8, Issue 3, Pages: 1157-1162

J. Environ. Treat. Tech.

ISSN: 2309-1185

Journal web link: http://www.jett.dormaj.com

Effect of High-Power Laser on Shoulder Mobility in

Sub Acromial Impingement Syndrome: Randomized

Controlled Trial

Walid ahmed Kamal , Mahmood Saber , Khalid Aiad , Mohamed Serag Eldein Mahgoub

Mostafa , Heba A. Bahey El- Deen

Physical Therapist MSC, ministry of interior, Egypt

Professor of laser application in surgery National institute of laser Enhanced science, Cairo University, Giza, Egypt

Professor of orthopedic physical Therapy, Cairo University, Giza, Egypt

Associate professor Basic Sciences department -Faculty of Physical Therapy, Cairo University, Giza, Egypt

Associate Professor of Physical Therapy, Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Jouf University,

Kingdom of Saudi Arabia and Assistant Professor of Physical Therapy, Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Misr

University for Science and Technology, Egypt

Received: 06/05/2020

Accepted: 15/07/2020

Published: 20/09/2020

Abstract

The effect of high-power laser on shoulder mobility in subacromial impingement syndrome had been not investigated yet. Objective of

study was to investigate the effect of high-power laser therapy on shoulder mobility in subacromial impingement syndrome. A Prospective,

Randomized, pre - post- Test, controlled trial was conducted. Setting: Outpatient clinic of Cleopatra Hospital – Egypt. The Study was conducted

between June 2017 and Feb 2018. Participants: Forty Patients who were diagnosed with 1 - 2 stage impingement syndrome pain was randomly

divided into two equal groups. Interventions. Group (A) received a program of Neodymium- yttrium aluminum Garnet Laser 1064 nm wave

Length Hiro 3 high intensity pulsed Laser was used in the study, Power of 8 W, dose of 12 J/cm2 and Total maximum energy of 10000 J were

Applied for 15 min and duration for single impulse 150 `us, fluency 760 mj, two sessions per week over six weeks' period in addition to

exercise Group (B) Received Exercise in the form of Pendulum Ex. For 5 minutes, strengthen Ex for Anterior fiber of deltoid, stretching ex

for sub scapularis muscle and anterior and posterior capsule. Main outcome measure: Visual Analogue Scale (VAS), active shoulder flexion

and abduction, Ultrasonography of supraspinatus tendon thickness. Comparing both groups post-program revealed a statistically significant

reduction in Ultrasonography Dimension of supraspinatus and VAS and significant increase in ROM of shoulder flexion and abduction in favor

to group A in compared to group B (p > 0.05). It’s concluded that high level laser Therapy was yielding more improvement for shoulder

mobility in impingement syndrome.

Keywords: Impingement syndrome, High level Laser Therapy, Shoulder mobility

Introduction¹

SAIS induces edema, swelling, and can become chronic if

appropriate treatment is not implemented, conservative and

surgical treatment methods can be used to minimize discomfort,

increase joint mobility, enhance muscle strength and quality of life

in SAIS. Conservative treatment strategies include analgesic and

non-steroidal anti-inflammatory or corticosteroid medications,

resting, adjustment of routine triggers, approaches to physical

activity, range of movement and strengthening exercises, local

anesthetic subacromial injections [6]. Laser therapy is based on the

belief that laser radiation and possible monochromatic light in

general are capable of changing the function of the cell and tissue

in a way that depends on the characteristics of the light itself, e.g.,

wavelength, coherence [7]. High-intensive laser therapy (HILT)

involving high-intensity laser radiation causing minor and slow

light absorption by chromium spheres, this absorption is not

obtained with concentrated, light by diffuse light in all directions

subacromial impingement syndrome is characterized as an

asymptomatic irritation of the rotator cuff and the subacromial

bursa in the subacromial space [1] the term encompasses a wide

range of disorders, causing an alteration in the relationship

between the [inflammation] soft tissue and the [stiffness] structure,

which is especially critical when the arm is removed in an arc

between 60 degrees and 120 degrees [2]. Sub-acromial

impingement syndrome (SIS) is characterized by extreme pain

spreading across biceps and deltoid from the shoulder, pain rises

at night, and with abduction and interned rotation [3]. Sub-

acromial impingement syndrome is one of the most common

causes of shoulder pain and occurs when the rotator cuff muscles

are squeezed in the sub-acromial space and the acromial arch of

curacao [4]. Numerous predisposing factors play a role in the

development of SIS, with the most prominent risk factors being

poor rotator cuff muscles, irregular scapular muscle function,

articular capsule defects and long-term overhead arm movement,

the muscle imbalances between upper and lower trapezius muscle

activity are related to abnormal scapular motion in patients with

shoulder pain [5].

scattering phenomena, increasing mitochondrial oxidative

reaction and adenosine triphosphate, RNA or DNA photochemical

8]. This study reported that high power laser improves shoulder

mobility in subacromial impingement syndrome. Up to our

knowledge there is no one use ultrasonography as objective

method to assess this improvement and also use different type of

[

Corresponding author: Walid ahmed Kamal, Physical Therapist MSC, ministry of interior, Egypt. Email: walidkamal558@gmail.com.

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