Effect of High Intensity Laser on Shoulder Impingement Syndrome in Adolescents
试验速览
- 阶段
- 不适用
- 状态
- 进行中（未招募）
- 入组人数
- 40
- 试验地点
- 1
- 主要终点
- Acromio-humeral distance (AHD) and Coraco-humeral distance (CHD).
研究概览
简要总结
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?
详细描述
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.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 12 Years 至 18 Years（Child, Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age was ranged between 12-18 years old.
- •Unilateral pain in the anterolateral region of the shoulder.
- •Has painful arc.
- •2 out of 3 impingement tests positive (Hawkins, Jobe and Neer).
- •Pain with palpation of the supraspinatus tendon insertion.
排除标准
- •Previous shoulder complex, cervical and thoracic fractures, or surgeries.
- •Either cervical pain or arm radiculopathy.
- •History of shoulder dislocation.
- •Traumatic onset of the pain.
- •No corticosteroid injections could have been received within 2 months prior to the study
结局指标
主要结局
Acromio-humeral distance (AHD) and Coraco-humeral distance (CHD).
时间窗: 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.
时间窗: 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.
时间窗: 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.
次要结局
未报告次要终点
研究者
Abd Elkhalek Mansour Ahmed
physical therapist, Al Azhar university hospital, MSC, DPT
Cairo University