High-intensity Laser Therapy Versus Extracorporeal Shock Wave on Tendon Thickness and Occupation Ratio In Patients With Chronic Supraspinatus Tendinopathy (HILT)

This study will be conducted to investigate the difference between high-intensity laser and extracorporeal shock wave on supraspinatus tendon thickness, subacromial space, occupation ratio, shoulder pain intensity, shoulder range of motion (ROM), hand strength, and functional disability in patients with chronic supraspinatus tendinopathy.

Study Overview

• Status: Not yet recruiting
• Conditions: Supraspinatus Tendinopathy
• Intervention / Treatment: Other: High-intensity Laser Therapy; Other: conventional therapy; Other: Extracorporeal Shock Wave

Detailed Description

Supraspinatus tendinopathy is a common cause of shoulder pain and dysfunction due to irritation, inflammation, or degeneration of the supraspinatus tendon in the rotator cuff. It is caused by repetitive overhead movements and is characterized by pain, weakness, and a limited range of motion, especially when reaching or lifting the arm. Recently, studies have demonstrated that HILT is useful for treating a variety of shoulder impairments, including subacromial impingement syndrome, rotator cuff tendinopathy, and adhesive capsulitis.Shock wave is an effective and noninvasive method of reducing pain and increasing ROM and functional status without the need for surgery; it has been successfully utilized to treat tendinopathy over the past 20 years.There is a gap in available literature about comparing the high-intensity laser and extracorporeal shock wave in patients withchronic supraspinatus tendonitis. So this study may add a piece of information to the physiotherapists in the government hospitals and the private clinics about showing the difference between the application of High Intensity laser and extracorporeal shock wave in patients with chronic supraspinatus tendinitis

• Study Type: Interventional
• Enrollment (Estimated): 69
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: mahmoud shaaban, phd; Phone Number: 01001080842; Email: shaabab.m@outlook.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Patients from 18 to 50 years old of both genders.
• Unilateral Chronic Supraspinatus Tendinitis in dominant side
• BMI 18.5-24.9
• Tenderness is found over the supraspinatus as it passes subacromial and anterolateral The patient will report pain with active shoulder elevation in the scapular plane (eg: welders, plate workers, slaughterhouse workers and overhead playing athletes)
• The patient will report pain with resisted isometric abduction.
• The patient will report positive Jobe's test (empty can test)

Exclusion Criteria:

• Post shoulder surgery, traumatic incidents
• Partial tears at surgery
• Massive retracted tears at surgery
• Frozen shoulder Rotator cuff tear
• Glenohumeral or acromioclavicular arthritis
• Implanted pacemaker
• Pregnancy

Study Plan

How is the study designed?

Design Details

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

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: High-intensity Laser Therapy; Twenty-three patients with chronic supraspinatus tendinopathy will receive high-intensity laser and conventional physiotherapy twice a week for six weeks	Other: High-intensity Laser Therapy; the patients will receive HILT with peak power 3kW, intensity 15000W/cm and energy per pulse 350 mj) at supraspinatus tendenopathy.The treatment consisted of 3 phases in each session. the initial phase will be rapid manual scanning (100 cm2/30s) of the anterior joint line of the shoulder with one shot of 850 mj at frequency of 30 Hz. The scanning will be performed parallel to the joint line, with the patient arm internally rotated on the posterior scan and externally rotated on the anterior scan. the intermediate phase will be a fixed scan phase , with one -shot emission of 350mj at a frequency of 20-25Hz. plus conventional therapy; Other: conventional therapy; will receive Conventional physical therapy in form of stretching exercise of posterior shoulder capsule, passive stretching exercise, will be done only 3 times with holding time 30 sec and 10 sec rest period between repetitions , strengthing exercise consists of 3 exercises all have been recommended as essential for any shoulder rehabilitation program. These exercise include shoulder flexion, scaption and horizontal extension. for each exercise, a 10-repetition maximum for 3 sets with 60 sec rest between every set + TENS and hot back.
Experimental: Extracorporeal Shock Wave; Twenty-three patients with chronic supraspinatus tendinopathy will receive extracorporeal shock wave and conventional physiotherapy twice a week for six weeks	Other: conventional therapy; will receive Conventional physical therapy in form of stretching exercise of posterior shoulder capsule, passive stretching exercise, will be done only 3 times with holding time 30 sec and 10 sec rest period between repetitions , strengthing exercise consists of 3 exercises all have been recommended as essential for any shoulder rehabilitation program. These exercise include shoulder flexion, scaption and horizontal extension. for each exercise, a 10-repetition maximum for 3 sets with 60 sec rest between every set + TENS and hot back.; Other: Extracorporeal Shock Wave; patients will be sitting with shoulder abduction at 45 and elbow flexed and the forearm rested on flat surface and shock wave applicator directed in the most tender point near the insertion at the greater tubrosity under acromion with 2000 impulses, and energy flex density of 0.22mj/mm , pulse rate 10/sec and frequency 1-15 Hz plus conventional therapy
Active Comparator: conventional therapy; Twenty-three patients with chronic supraspinatus tendinopathy will receive conventional physiotherapy twice a week for six weeks	Other: conventional therapy; will receive Conventional physical therapy in form of stretching exercise of posterior shoulder capsule, passive stretching exercise, will be done only 3 times with holding time 30 sec and 10 sec rest period between repetitions , strengthing exercise consists of 3 exercises all have been recommended as essential for any shoulder rehabilitation program. These exercise include shoulder flexion, scaption and horizontal extension. for each exercise, a 10-repetition maximum for 3 sets with 60 sec rest between every set + TENS and hot back.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
supraspinatous tendon thickness	supraspinatus tendon thickness will be assess by ultrasonography.The tendon often appears swollen or thickened (frequently > 6 to 7 mm)	up to 6 weeks
supracromial space	supracromial space will be measured by ultrasonography. A normal resting subacromial space generally ranges from 9 to 11 mm. A measurement of less than 6 mm is often pathological	up to 6 weeks
occupation ratio of subacromial space	The ratio comparing the thickness of the supraspinatus tendon to the overall acromiohumeral distance. An increased occupation ratio (i.e., a thickened tendon taking up too much of the space) indicates a higher risk of impingement	up to 6 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
pain intensity	visuala analogue scale will be used to assess pain intesity. it is a line of 100 mm.The ends are labeled with extremes, such as "No pain" at 0 mm and "Worst pain imaginable" at 100 mm.	up to 6 weeks
shoulder range of motion	the range of motion will be measured by electrogoniometer	up to six weeks
upper limb disability	The QuickDASH will be used to assess upper limb function.the QuickDASH is an 11-item questionnaire used to measure physical function and symptoms in people with upper limb disorders. Scores range from 0 (no disability) to 100 (most severe disability).	up to six weeks
supraspinatus muscle strength	supraspinatus muscle strength will be measured by handheld dynamometer	up to six weeks

Collaborators and Investigators

• Sponsor: Cairo University

Study record dates

Study Major Dates

• Study Start (Estimated): June 30, 2026
• Primary Completion (Estimated): April 25, 2027
• Study Completion (Estimated): April 25, 2027

Study Registration Dates

• First Submitted: June 19, 2026
• First Submitted That Met QC Criteria: June 19, 2026
• First Posted (Actual): June 25, 2026

Study Record Updates

• Last Update Posted (Actual): June 25, 2026
• Last Update Submitted That Met QC Criteria: June 19, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: Extracorporeal Shock Wave; High-intensity Laser Therapy; Tendon Thickness; Chronic Supraspinatus Tendinopathy
• Additional Relevant MeSH Terms: Therapeutics; Physical Therapy Modalities; Rehabilitation; Ultrasonic Therapy; Diathermy; Hyperthermia, Induced; Extracorporeal Shockwave Therapy
• Other Study ID Numbers: P.T.REC/012/006491

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No