HILT vs ESWT in Supraspinatus Tendinitis

Comparador Ativo: Group A: HILT + Conventional PT

Dispositivo: High-Intensity Laser Therapy

High-Intensity Laser Therapy (HILT) is an advanced electrotherapy modality that uses high-power laser energy to penetrate deep musculoskeletal tissues and stimulate biological healing processes. The device emits laser wavelengths ranging between 808-1064 nm with high peak power output, allowing deeper tissue penetration compared to conventional low-level laser therapy. HILT provides analgesic, anti-inflammatory, and biostimulatory effects through increasing local blood circulation, enhancing cellular metabolism, stimulating collagen synthesis, and promoting tissue regeneration. The treatment is non-invasive, safe, and commonly used in musculoskeletal rehabilitation, particularly for tendinopathies and chronic pain conditions.

Outro: Conventional Physical Therapy

The conventional physical therapy program consisted of a combination of therapeutic exercises and physical therapy modalities aimed at reducing pain, improving shoulder range of motion, enhancing muscle strength, and restoring functional performance. The program included hot pack application, Transcutaneous Electrical Nerve Stimulation (TENS), stretching exercises, range of motion exercises, strengthening exercises for the rotator cuff and scapular stabilizers, as well as a home exercise program. Treatment sessions were conducted three times per week according to the patient's tolerance and clinical condition

Comparador Ativo: Group B: ESWT + Conventional PT

Outro: Conventional Physical Therapy

The conventional physical therapy program consisted of a combination of therapeutic exercises and physical therapy modalities aimed at reducing pain, improving shoulder range of motion, enhancing muscle strength, and restoring functional performance. The program included hot pack application, Transcutaneous Electrical Nerve Stimulation (TENS), stretching exercises, range of motion exercises, strengthening exercises for the rotator cuff and scapular stabilizers, as well as a home exercise program. Treatment sessions were conducted three times per week according to the patient's tolerance and clinical condition

Dispositivo: Extracorporeal Shock Wave Therapy

Extracorporeal Shock Wave Therapy (ESWT) is a non-invasive therapeutic modality that delivers high-energy acoustic waves to injured musculoskeletal tissues. The device generates focused or radial shock waves that stimulate tissue healing, neovascularization, pain reduction, and cellular repair mechanisms. ESWT is widely used in the management of tendinopathies, calcific disorders, and chronic musculoskeletal pain. Treatment parameters typically include energy flux density, frequency, number of impulses, and treatment sessions. The therapy is considered safe and effective, with minimal side effects

Comparador Ativo: Group C: Conventional Physical Therapy Only

Outro: Conventional Physical Therapy

The conventional physical therapy program consisted of a combination of therapeutic exercises and physical therapy modalities aimed at reducing pain, improving shoulder range of motion, enhancing muscle strength, and restoring functional performance. The program included hot pack application, Transcutaneous Electrical Nerve Stimulation (TENS), stretching exercises, range of motion exercises, strengthening exercises for the rotator cuff and scapular stabilizers, as well as a home exercise program. Treatment sessions were conducted three times per week according to the patient's tolerance and clinical condition

Pain intensity measured using Visual Analogue Scale (VAS).

Pain intensity will be assessed using the Visual Analogue Scale (VAS), where 0 indicates no pain and 10 indicates worst imaginable pain.

Shoulder Pain and Disability Measured by the Shoulder Pain and Disability Index (SPADI)

Shoulder pain and disability will be assessed using the Shoulder Pain and Disability Index (SPADI). The SPADI score ranges from 0 to 100, with higher scores indicating greater pain and disability.

Upper Extremity Function Measured by the Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH)

Upper extremity function will be assessed using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. DASH scores range from 0 to 100, with higher scores indicating greater disability.

Shoulder Range of Motion Measured Using a Digital Goniometer

Shoulder range of motion (flexion, abduction, and external rotation) will be measured in degrees using a digital goniometer. Higher values indicate greater shoulder mobility.

Quality of Life Measured by the Short Form-36 Health Survey (SF-36)

Quality of life will be assessed using the Short Form-36 Health Survey (SF-36). Scores range from 0 to 100, with higher scores indicating better health-related quality of life.