REVIEW PAPER
Effectiveness of high-intensity laser therapy in the treatment of shoulder impingement syndrome: a systematic review and meta-analysis of randomised clinical trials
1
Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
2
Physiotherapeutic Resources Research Laboratory, Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Paulo, Brazil
Submission date: 2023-08-31
Acceptance date: 2023-11-29
Publication date: 2025-03-20
Corresponding author
Hernán Andrés de la Barra Ortiz
Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, 7591538, Chile
Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, 7591538, Chile
Physiother Quart. 2025;33(1):1-19
KEYWORDS
systematic reviewphototherapyshoulder impingement syndromelaser therapyshoulder painhigh-intensity laser therapy
TOPICS
ABSTRACT
Introduction:
High-intensity laser therapy (HILT) is a recent resource promoted as an alternative to relieve pain and improve function in patients with subacromial impingement syndrome (SAIS). The aim of this review was to assess the effects of HILT on pain in patients with SAIS.
Methods:
Electronic databases, including PubMed, Web of Science, Scopus, CINAHL, Science Direct, Cochrane Library, the PEDro database, and Google Scholar (updated to January 8, 2025), were searched for clinical trials comparing HILT with other physical therapy treatments in patients with SAIS. The main outcomes evaluated were pain intensity, range of motion (ROM), and disability for different scales and instruments. The results of VAS, range of motion, CMS, and SPADI were analysed, evaluating the quality of RCTs with the Cochrane risk of bias (RoB) 2.0 tool and the evidence with the GRADE approach.
Results:
Nineteen studies were included, generally presenting a low RoB, except for outcome data measurement and bias due to deviations from the intended intervention. RCTs reported a reduction in pain and an improvement in functionality in the meta-analysis. VAS MD = –1.56 cm (95% CI: –2.1,1.0); CMS MD = 4.0% (95% CI: 1.7, 6.2). Furthermore, there were significant improvements in flexion and abduction favouring HILT: flexion MD = 12.8° (95% CI: 2.5, 23.1);abduction MD = 15.3° (95% CI: 4.4,26.1). Only changes in pain and ROM were both statistically significant (p < 0.05) and clinically significant.
Conclusions:
This SR supports the effects of HILT on pain, ROM, and disability. It agrees with previous reviews on LLLT, validating both treatment options. Although the evidence was assessed as important, methodological inconsistencies are noted in some RCTs that could affect the certainty.
High-intensity laser therapy (HILT) is a recent resource promoted as an alternative to relieve pain and improve function in patients with subacromial impingement syndrome (SAIS). The aim of this review was to assess the effects of HILT on pain in patients with SAIS.
Methods:
Electronic databases, including PubMed, Web of Science, Scopus, CINAHL, Science Direct, Cochrane Library, the PEDro database, and Google Scholar (updated to January 8, 2025), were searched for clinical trials comparing HILT with other physical therapy treatments in patients with SAIS. The main outcomes evaluated were pain intensity, range of motion (ROM), and disability for different scales and instruments. The results of VAS, range of motion, CMS, and SPADI were analysed, evaluating the quality of RCTs with the Cochrane risk of bias (RoB) 2.0 tool and the evidence with the GRADE approach.
Results:
Nineteen studies were included, generally presenting a low RoB, except for outcome data measurement and bias due to deviations from the intended intervention. RCTs reported a reduction in pain and an improvement in functionality in the meta-analysis. VAS MD = –1.56 cm (95% CI: –2.1,1.0); CMS MD = 4.0% (95% CI: 1.7, 6.2). Furthermore, there were significant improvements in flexion and abduction favouring HILT: flexion MD = 12.8° (95% CI: 2.5, 23.1);abduction MD = 15.3° (95% CI: 4.4,26.1). Only changes in pain and ROM were both statistically significant (p < 0.05) and clinically significant.
Conclusions:
This SR supports the effects of HILT on pain, ROM, and disability. It agrees with previous reviews on LLLT, validating both treatment options. Although the evidence was assessed as important, methodological inconsistencies are noted in some RCTs that could affect the certainty.
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