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Effectiveness of high-intensity laser therapy in the treatment of patients with frozen shoulder: a systematic review and meta-analysis

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Abstract

The purpose of this study is to evaluate the effects of high-intensity laser therapy (HILT) in patients with frozen shoulder. PRISMA guidelines were adhered to, and a systematic search was conducted in the PubMed, Web of Science, Scopus, CINAHL, Science Direct, and PEDro databases (last update: September 4, 2023; search period: December 2022–September 2023). The inclusion criteria encompassed RCTs comparing HILT with other physical therapy interventions in frozen patients with frozen shoulders, with or without sham HILT, assessing pain intensity, shoulder ROM, and disability outcomes. The quality of the RCTs was assessed with the Cochrane Risk of Bias tool, and evidence was assessed using the GRADE approach. Five trials met the eligibility criteria and were included in the review and meta-analysis, which pooled results from the visual analog scale (VAS), goniometry, and the shoulder pain and disability index (SPADI). Mean differences (MDs) for pain intensity and disability show a pooled effect in favor of HILT both for VAS (MD =  − 2.23 cm, 95% CI: − 3.25, − 1.22) and SPADI (MD =  − 10.1% (95% CI =  − 16.5, − 3.7), changes that are statistical (p < 0.01) and clinical. The MD for flexion (MD = 9.0°; 95% CI: − 2.36°, 20.3°; p = 0.12), abduction (MD = 3.4°; 95% CI: − 6.9°, 13.7°; p = 0.51), and external rotation (MD =  − 0.95°; 95% CI: − 5.36°, 3.5°; p = 0.67) does not show statistical and clinical differences between groups after treatment. PI and disability changes were graded as important due to their clinical and statistical results. HILT into a physical therapy plan reduce pain and disability, but it does not outperform conventional physical therapy in improving shoulder ROM. It is suggested that future RCTs compare the effects of HILT and LLLT to assess their possible differences in their analgesic effects.

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Acknowledgements

Exercise and Rehabilitation Sciences Institute Andres Bello University; School of Physical Therapy Andres Bello University; Federal University of São Carlos; Coordination for the Improvement of Higher Education Personnel (CAPES). This research was conducted jointly by Andrés Bello University and University Federal of São Carlos.

Funding

This study was partially funded by the Higher Education Personnel Improvement Coordination (CAPES, finance code 001, Brazil). Role of funding sources: The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Authors and Affiliations

  1. Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, 7591538, Santiago, Chile

    Hernán Andrés de la Barra Ortiz

  2. Physiotherapeutic Resources Research Laboratory, Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Paulo, Brazil

    Hernán Andrés de la Barra Ortiz, Nivaldo Parizotto, Mariana Arias & Richard Liebano

  3. Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT, USA

    Richard Liebano

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The idea for the research was performed by Hernán Andrés de la Barra Ortiz. All authors contributed to the study’s conception and design. Material preparation, data collection, and analysis were performed by Hernán Andrés de la Barra Ortiz, Mariana Arias, Nivaldo Parizotto, and Richard Liebano. The first draft of the manuscript was written by Hernán Andrés de la Barra Ortiz, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Hernán Andrés de la Barra Ortiz.

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This systematic review was registered with the number CRD42023387386 at the International prospective register of systematic reviews (PROSPERO). Registration date, January 14, 2023.

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de la Barra Ortiz, H.A., Parizotto, N., Arias, M. et al. Effectiveness of high-intensity laser therapy in the treatment of patients with frozen shoulder: a systematic review and meta-analysis. Lasers Med Sci 38, 266 (2023). https://doi.org/10.1007/s10103-023-03901-3

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