Effects of low-level laser therapy in combination with physiotherapy in the management of rotator cuff tendinitis
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Rotator cuff tendinitis is one of the main causes of shoulder pain. The objective of this study was to evaluate the possible additive effects of low-power laser treatment in combination with conventional physiotherapy endeavors in these patients. A total of 50 patients who were referred to the Physical Medicine and Rehabilitation Clinic with shoulder pain and rotator cuff disorders were selected. Pain severity measured with visual analogue scale (VAS), abduction, and external rotation range of motion in shoulder joint was measured by goniometry, and evaluation of daily functional abilities of patients was measured by shoulder disability questionnaire. Twenty-five of the above patients were randomly assigned into the control group and received only routine physiotherapy. The other 25 patients were assigned into the experimental group and received conventional therapy plus low-level laser therapy (4 J/cm2 at each point over a maximum of ten painful points of shoulder region for total 5 min duration). The above measurements were assessed at the end of the third week of therapy in each group and the results were analyzed statistically. In both groups, statistically significant improvement was detected in all outcome measures compared to baseline (p < 0.05). Comparison between two different groups revealed better results for control of pain (reduction in VAS average) and shoulder disability problems in the experimental group versus the control (3.1 ± 2.2 vs. 5 ± 2.6, p = 0.029 and 4.4 ± 3.1 vs. 8.5 ± 5.1, p = 0.031, respectively ) after intervention. Positive objective signs also had better results in the experimental group, but the mean range of active abduction (144.92 ± 31.6 vs. 132.80 ± 31.3) and external rotation (78.0 ± 19.5 vs. 76.3 ± 19.1) had no significant difference between the two groups (p = 0.20 and 0.77, respectively). As one of physical modalities, gallium-arsenide low-power laser combined with conventional physiotherapy has superiority over routine physiotherapy from the view of decreasing pain and improving the patient’s function, but no additional advantages were detected in increasing shoulder joint range of motion in comparison to other physical agents.
KeywordsLow-level laser therapy Gallium-arsenide Physiotherapy Rotator cuff tendinitis Shoulder pain
We greatly acknowledge the staff of Tabriz Shohada Rehabilitation Ward, especially Ms. Firozeh Shirzad, occupational therapist, and Mr. Ghader Jhaffari, physiotherapist, for their kindly help in performing the study.
Integrity of research and reporting conflict of interest
The authors declare that they have no conflicts of interest.
This research has been reviewed by the appropriate ethics committee and has therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated that all persons gave their informed consent prior to their inclusion in the study. The authors also certify that they have no affiliation with or financial involvement in any organization or entity with a direct financial interest in the subject matter or materials discussed in the manuscript.
- 2.Finnoff JT (2007) Musculoskeletal problems of upper limb. In: Braddom RL (ed) Physical Medicine and Rehabilitation, 3rd edn. Saunders Elsevier, Philadelphia, pp 825–832Google Scholar
- 4.Saliba E, Foreman-Saliba S (2003) Low-power lasers. In: Prentice WE (ed) Therapeutic modalities for sports medicine and athletic training, 5th edn. McGraw Hill, North Carolina, pp 342–360Google Scholar
- 5.Baxter GD (2004) Low-intensity laser therapy for pain relief. In: Baxter GD (ed) Therapeutic Lasers: Theory and Practice, 4th edn. Churchill Livingstone, London, pp 150–187Google Scholar
- 8.Abrisham SM, Kermani-Alghoraishi M, Ghahramani R, Jabbari L, Jomeh H, Zare M (2011) Additive effects of low-level laser therapy with exercise on subacromial syndrome: a randomised, double-blind, controlled trial. Clin Rheumatol May 4 [Epub ahead of print] doi: 10.1007/s10067-011-1757-7
- 15.Weber DC, Hoppe KM (2007) Physical agents modalities. In: Braddom RL (ed) Physical Medicine and Rehabilitation, 3rd edn. Saunders Elsevier, Philadelphia, pp 464–467Google Scholar
- 16.Manal TJ, Snyder-Meckler L (2007) Electrical stimulation for pain modulation. In: Robinson AJ, Snyder-Meckler L (eds) Clinical Electrophysiology: Electrotherapy and Electrophysiologic Testing, 3rd edn. Lippincott Williams & Wilkins, New York, pp 151–196Google Scholar
- 17.Baxter GD (2004) Safety and good treatment practice. In: Baxter GD (ed) Therapeutic Lasers: Theory and Practice, 4th edn. Churchill Livingstone, London, pp 53–55Google Scholar
- 19.Gur A, Karakoc M, Nas K, Cevik R, Sarac J, Ataoglu S (2002) Effects of low-power laser and low dose amitriptyline therapy on clinical symptoms and quality of life in fibromyalgia: a single-blind, placebo-controlled trial. Rheumatol Int 22(5):188–193. doi: 10.1007/s00296-002-0221-z PubMedCrossRefGoogle Scholar
- 20.Gur A, Sarac AJ, Cevik R, Altindag O, Sarac S (2004) Efficacy of 904-nm gallium arsenide low-level laser therapy in the management of chronic myofascial pain in the neck: a double-blind and randomize-controlled trial. Lasers Surg Med 35(3):229–235. doi: 10.1002/lsm.20082 PubMedCrossRefGoogle Scholar
- 24.Green S, Buchbinder R, Hetrick S (2003) Physiotherapy interventions for shoulder pain. Cochrane database Syst Rev 2:CD 004258. doi: 10.1002/14651858.CD004258