High-Intensity Laser Therapy Versus Multimodal Physiotherapy in Subacromial Impingement Syndrome

May 8, 2026 updated by: Tulay Yildirim

Short-Term Effects of High-Intensity Laser Therapy Compared With Multimodal Physiotherapy in Subacromial Impingement Syndrome: A Randomized Controlled Trial

This randomized controlled trial aimed to compare the short-term effectiveness of high-intensity laser therapy (HILT) and a multimodal physiotherapy program in patients with subacromial impingement syndrome (SIS). Ninety-four participants were allocated to either HILT or combined physiotherapy, and both groups received an identical supervised exercise program. Primary outcome measures included shoulder pain assessed using the visual analogue scale (VAS). Secondary outcomes included shoulder function, disability, and quality of life. Outcomes were evaluated at baseline, post-treatment, and short-term follow-up.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Subacromial impingement syndrome (SIS) is one of the most common causes of shoulder pain and functional limitation. Conservative treatment strategies, particularly exercise-based rehabilitation, are recommended as first-line therapy. High-intensity laser therapy (HILT) has recently gained attention because of its potential analgesic and anti-inflammatory effects; however, its comparative effectiveness against multimodal physiotherapy remains unclear.

This single-centre, assessor-blinded randomized controlled trial was conducted at the Department of Physical Medicine and Rehabilitation, Inonu University Hospital, Malatya, Türkiye. Adults aged 18-65 years with clinically and radiologically confirmed SIS were enrolled. Participants were allocated to either a high-intensity laser therapy group or a combined conventional physiotherapy group. Both groups additionally participated in an identical supervised exercise program.

The HILT group received class IV Nd:YAG laser therapy (1064 nm), whereas the control group received hot pack therapy, transcutaneous electrical nerve stimulation, and therapeutic ultrasound. Treatment duration was three weeks.

The primary outcome measure was pain intensity assessed using the visual analogue scale (VAS). Secondary outcomes included the Constant-Murley Score, Shoulder Pain and Disability Index (SPADI), and Short Form-36 quality-of-life assessment. Outcomes were evaluated at baseline, post-treatment, and short-term follow-up.

The study was approved by the Inonu University Clinical Research Ethics Committee (Approval No: 2015/123). The trial was retrospectively submitted for registration at ClinicalTrials.gov.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
94

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:Inclusion Criteria:

  • Adults aged 18 to 65 years
  • Clinically and radiologically confirmed subacromial impingement syndrome
  • Shoulder pain lasting at least 1 month and less than 6 months
  • At least one positive impingement test (Neer, Hawkins-Kennedy, painful arc, or Jobe test)
  • MRI findings consistent with stage I-II rotator cuff changes

Exclusion Criteria:

  • Previous shoulder surgery or trauma
  • Inflammatory rheumatic disease
  • Recent myocardial infarction
  • Active infection
  • Previous physiotherapy or corticosteroid injection within the last 6 months
  • Pregnancy
  • Calcific tendinitis
  • Adhesive capsulitis
  • Cervical radiculopathy
  • Neurological disorders affecting the shoulder
  • Full-thickness rotator cuff tear
  • Contraindications to electrotherapy or laser therapy

Exclusion Criteria:

-

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: High-Intensity Laser Therapy
Participants received class IV Nd:YAG high-intensity laser therapy three times weekly for three weeks in addition to a supervised exercise program.
Device: High-Intensity Laser Therapy
Class IV Nd:YAG laser therapy (1064 nm wavelength) administered to the shoulder region for treatment of subacromial impingement syndrome.
Active Comparator: Multimodal Physiotherapy
Participants received hot pack therapy, transcutaneous electrical nerve stimulation, and therapeutic ultrasound combined with a supervised exercise program.
Other: Multimodal Physiotherapy
Combined physiotherapy program consisting of hot pack therapy, transcutaneous electrical nerve stimulation, and therapeutic ultrasound.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Shoulder Pain Intensity Assessed by Visual Analogue Scale (VAS)
Time Frame: Baseline, 3 weeks, and 7 weeks
Pain intensity at rest, during movement, and at night assessed using a 10-cm visual analogue scale.
Baseline, 3 weeks, and 7 weeks

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Shoulder Function Assessed by Constant-Murley Score
Time Frame: Baseline, 3 weeks, and 7 weeks
Shoulder functional status assessed using the Constant-Murley Score.
Baseline, 3 weeks, and 7 weeks
Shoulder Disability Assessed by SPADI
Time Frame: Baseline, 3 weeks, and 7 weeks
Shoulder Pain and Disability Index (SPADI) used to assess disability related to shoulder pain.
Baseline, 3 weeks, and 7 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Tulay Yildirim

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Tulay Yildirim, MD, Inonu University Faculty of Medicine

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
January 1, 2016

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
December 1, 2017

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 1, 2017

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
May 8, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
May 8, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
May 14, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
May 14, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
May 8, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • IUFM-PMR-2015-123
  • 2015/123 (Other Identifier: Inonu University Clinical Research Ethics Committee)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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