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

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: Completed
• Conditions: Subacromial Impingement Syndrome; Shoulder Pain; Rotator Cuff Disease
• Intervention / Treatment: Device: High-Intensity Laser Therapy; Other: Multimodal Physiotherapy

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: Interventional
• Enrollment (Actual): 94
• Phase: Not Applicable

Participation Criteria

Eligibility Criteria

• 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

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
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

Outcome Measure	Measure Description	Time Frame
Shoulder Pain Intensity Assessed by Visual Analogue Scale (VAS)	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

Outcome Measure	Measure Description	Time Frame
Shoulder Function Assessed by Constant-Murley Score	Shoulder functional status assessed using the Constant-Murley Score.	Baseline, 3 weeks, and 7 weeks
Shoulder Disability Assessed by SPADI	Shoulder Pain and Disability Index (SPADI) used to assess disability related to shoulder pain.	Baseline, 3 weeks, and 7 weeks

Collaborators and Investigators

• Sponsor: Tulay Yildirim
• Investigators: Principal Investigator: Tulay Yildirim, MD, Inonu University Faculty of Medicine

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2016
• Primary Completion (Actual): December 1, 2017
• Study Completion (Actual): December 1, 2017

Study Registration Dates

• First Submitted: May 8, 2026
• First Submitted That Met QC Criteria: May 8, 2026
• First Posted (Actual): May 14, 2026

Study Record Updates

• Last Update Posted (Actual): May 14, 2026
• Last Update Submitted That Met QC Criteria: May 8, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Randomized Controlled Trial; Physiotherapy; Exercise Therapy; Shoulder Rehabilitation; High-Intensity Laser Therapy; HILT
• Additional Relevant MeSH Terms: Shoulder Injuries; Pain; Neurologic Manifestations; Musculoskeletal Diseases; Wounds and Injuries; Joint Diseases; Arthralgia; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Shoulder Pain; Shoulder Impingement Syndrome
• Other Study ID 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