Effect of High Intensity Laser on Shoulder Impingement.

Not Applicable

Active, not recruiting

• Conditions: Shoulder Impingement Syndrome; Shoulder Pain; High Intensity Laser

• Registration Number: NCT06732570
• Lead Sponsor: Cairo University

Brief Summary

Treatment for shoulder impingement is conservative initially, Rehabilitation programs generally consist of exercise therapy and manual therapy that provide relief from symptoms of impingement. High-intensity laser therapy used recently and was found to be effective in the short term in the treatment of pain and disability in patients with impingement.

This study aims to

* Investigate the effect of high intensity power laser therapy on sonographic measurement in the adolescent suffering from shoulder impingement syndrome.

* Investigate the effect of high intensity power laser therapy on pain in the adolescent suffering from shoulder impingement syndrome.

* Investigate the effect of high intensity power laser therapy on shoulder function in the adolescent suffering from shoulder impingement syndrome.

RESEARCH QUESTION:

Does using high intensity power laser affects shoulder dysfunction in adolescent with shoulder impingement syndrome?

Detailed Description

Shoulder symptoms are often persistent and recurrent and represents approximately one fifth of all musculoskeletal disability payment. One of the most common causes of shoulder pain is the occurrence of tendinopathy resulting from the impingement of rotator cuff tendons under the coracoacromial arch which refer to impingement syndrome.

Treatment for shoulder impingement is conservative initially, Rehabilitation programs generally consist of exercise therapy that provide relief from symptoms of impingement, Exercise therapy has been shown to be effective in the reducing pain and improving function also it was stated that the exercise therapy lead to improving shoulder musculoskeletal risk factors in competitive athletes with Specific exercise was superior to non-specific exercise. Strong recommendation may be made to include manual therapy as an adjunct intervention with exercise.

The manual therapy technique of joint mobilizations which are commonly used by physiotherapists for reducing pain and disability in patients with shoulder musculoskeletal disorders, Manual therapy which involves realigning collagen, enhancing fiber slip, reducing adhesion, and re-establishing correct gleno-humeral joint kinematics, can relieve pain by stimulating peripheral mechanical receptors, suppressing nociceptors, boosting synovial fluid nutrition, and reducing adhesion. It has been stated that impingement patients treated with manual therapy in combination with supervised exercise showed improvement in pain and function.

High-intensity laser therapy (HILT) is a treatment method that added to therapeutic interventions recently. HILT improves the microcirculation and tissue regeneration with photomechanic effects in deep tissues. Biostimulation, anti-inflammatory, and analgesic properties contribute to an effective improvement in painful bone-muscle-joint pathologies, including shoulder problems. Adding therapeutic interventions to laser therapy is usual in clinical practice. HILT was found to be effective in the short term in the treatment of pain and disability in patients with Sub-acromial pain syndrome.

Ultrasonography is recommended as the first line imaging tool to evaluate sports injuries; it has been used as the preferred technique for evaluating the subacromial space.

Algometers are devices that can be used to identify the pressure and/or force eliciting a pressure-pain threshold. . This technique is a well-known and well-validated method to induce acute experimental pain.

Null Hypothesis:

High intensity laser therapy will not affect the sonographic measurement in adolescents with shoulder impingement syndrome.

High intensity laser therapy will not affect the pain in adolescents with shoulder impingement syndrome.

High intensity power laser therapy will not affect the shoulder function in adolescents suffering from shoulder impingement syndrome.

Basic assumptions:

It will be assumed that:

* All evaluation and treatment procedures will be performed in the same environment for all patients

* All volunteers will attend the treatment program regularly.

* All volunteers will be cooperative, following the instructions given to them, and exert their maximum effort during the study.

* The results of the study will be helpful for physical therapists dealing with similar cases.

Study Timeline

• Study Start: 2024-02-18
• Status Verified: 2024-12
• Study First Submitted: 2024-12-06
• Study First Submitted QC: 2024-12-12
• Last Update Submitted: 2024-12-12
• Study First Posted: 2024-12-13
• Last Update Posted: 2024-12-13
• Primary Completion: 2026-06-30
• Study Completion: 2026-12-30

Recruitment & Eligibility

• Status: ACTIVE_NOT_RECRUITING
• Sex: All
• Target Recruitment: 40

Inclusion Criteria

1. Age was ranged between 12-18 years old.
2. Unilateral pain in the anterolateral region of the shoulder.
3. Has painful arc.
4. 2 out of 3 impingement tests positive (Hawkins, Jobe and Neer).
5. Pain with palpation of the supraspinatus tendon insertion.

Exclusion Criteria

1. Previous shoulder complex, cervical and thoracic fractures, or surgeries.
2. Either cervical pain or arm radiculopathy.
3. History of shoulder dislocation.
4. Traumatic onset of the pain.
5. No corticosteroid injections could have been received within 2 months prior to the study

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Acromio-humeral distance (AHD) and Coraco-humeral distance (CHD).	measurements will be done pre and post 5 weeks (15 sessions, three sessions per week) of interventions.	Musculoskeletal Ultrasound (TOSHIBA Aplio 500, japan. Linear probe 12-15 MHZ) will be used to measure both distance (AHD\& CHD) with the injured shoulder in two angles 0- and 60-degrees abduction from scapular plane (40° front of the frontal plane). The subjects were instructed to sit upright in the chair and to place their feet on the floor with knees and hips 90 degrees flexion. the examiner took one ultrasound image at angle 0-degree abduction as thepatient's arm rest beside the body with the palm toward the body and the other image from 60 abduction from scaption. acromio-humeral distance calculated by measuring the linear distance from the most lateral edge of the acromion to the most proximal portion of the humeral head. Then for calculation of the coraco-humeral distance the ultrasound transducer was placed over the most anterior aspect of the shoulder, observing the coracoid process and the humeral head on the screen, taking the shortest distance between them (in centimeters).
pain.	measurements will be done pre and post 5 weeks (15 sessions, three sessions per week) of interventions.	pain: BASLINE push pull force gauge algometer (White Plains, New York 10602 USA) will be used to assess patient pain. An algometer can be used to objectively measure the first point of pressure required to produce symptoms at the most painful points in the long head of biceps tendon, under acromion area and deltoid with the patient relaxed and the affected shoulder will be uncovered from clothes.
Function.	measurements will be done pre and post 5 weeks (15 sessions, three sessions per week) of interventions.	Shoulder Pain and Disability Index (SPADI) was developed to measure current shoulder pain and disability in an outpatient setting. The SPADI contains 13 items that assess two domains; a 5-item subscale that measures pain and an 8-item subscale that measures disability which take less than five minutes to complete. The examiner will describe to the patient the two scale parts, the pain scale that is summed up to a total of 50 while the disability scale sums up to 80. The total SPADI score is expressed as a percentage. A score of 0 indicates best, 100 indicates worst. A higher score shows more disability. In scoring SPADI, any question missed should be taken out of the total score of each subscale. i.e if 1 question is omitted in the pain section, the total score is divided by 40.

Trial Locations

Locations (1)

Cairo University; 🇪🇬 Giza, Egypt