Physiotherapy Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
Sonoskills Institute, Roermond, Netherlands.
Physiother Theory Pract. 2022 Nov;38(13):2514-2525. doi: 10.1080/09593985.2021.1934926. Epub 2021 Jun 29.
Subacromial impingement syndrome (SAIS) is a common cause of shoulder pain. The effects of physiotherapy modalities including low-level laser (LLL) and high power laser (HPL) on the SAIS have mostly been evaluated by the subjective outcome variables accompanied with the controversial findings and none of them has compared a combination of these two modalities, yet.
The present study was conducted to evaluate the effects of low-level laser (LLL) and high power laser (HPL) combined with kinesiology taping (KT), on the pain, function, and musculoskeletal ultrasound (MSKUS) parameters in the SAIS.
Thirty patients with SAIS were randomly divided into the LLL-KT, HPL-KT, and sham-KT groups, respectively. Patients received seven treatment sessions. Visual analogue scale (VAS), shoulder pain and disability index (SPADI), MSKUS parameters were measured before and 48 hours after the treatment cessation.
Pain intensity significantly reduced in the LLL-KT (-2.43 (0.97)), HPL-KT (-3.43 (1.99)), and sham-KT (-2.43 (1.62)) ( < .01). All the SPADI subscales are significantly reduced in all the groups ( < .05), except for the pain in the sham-KT ( = .06). Significant improvements were only observed in the diameters of biceps ( < .05), supraspinatus tendon thickness in short and long axes ( < .05), occupation ratio ( = .004), and echogenicity ( = .03) in the HPL-KT. Although the acromiohumoral distance (AHD) significantly increased in all the groups including the sham-KT ( < .01), supraspinatus tendon thickness significantly decreased ( < .05), and echogenicity increased ( = .003) just in the HPL-KT.
Kinesiology taping method alone is an effective intervention. Nevertheless, adding the analgesic and anti-inflammatory effects of both LLL and HPL to KT seems to result in better improvement of the pain, function, and MSKUS parameters in the SAIS. Findings of this study suggested that the HPL is more beneficial than the LLL or KT alone for management of the patients with SAIS.
肩峰下撞击综合征（SAIS）是肩部疼痛的常见原因。包括低水平激光（LLL）和高强度激光（HPL）在内的物理治疗方式对 SAIS 的影响主要通过主观结果变量进行评估，但这些研究结果存在争议，而且还没有比较这两种方式联合应用的研究。
本研究旨在评估低水平激光（LLL）和高强度激光（HPL）联合运动贴扎（KT）对 SAIS 患者疼痛、功能和肌肉骨骼超声（MSKUS）参数的影响。
将 30 名 SAIS 患者随机分为 LLL-KT、HPL-KT 和 sham-KT 组，每组患者分别接受 7 次治疗。治疗停止后 48 小时内，使用视觉模拟评分（VAS）、肩部疼痛和残疾指数（SPADI）和 MSKUS 参数进行测量。
LLL-KT 组（-2.43（0.97））、HPL-KT 组（-3.43（1.99））和 sham-KT 组（-2.43（1.62））疼痛强度均显著降低（<0.01）。所有 SPADI 子量表在所有组中均显著降低（<0.05），除 sham-KT 组（=0.06）外。仅在 HPL-KT 组观察到二头肌直径（<0.05）、肩袖肌腱短轴和长轴厚度（<0.05）、占有率（=0.004）和回声强度（=0.03）显著改善。尽管在包括 sham-KT 在内的所有组中肩峰肱骨关节距离（AHD）均显著增加（<0.01），但在 HPL-KT 组中，肩袖肌腱厚度显著降低（<0.05），回声强度增加（=0.003）。
单独使用运动贴扎法是一种有效的干预措施。然而，将 LLL 和 HPL 的镇痛和抗炎作用添加到 KT 中似乎可以更好地改善 SAIS 的疼痛、功能和 MSKUS 参数。本研究结果表明，与单独使用 LLL 或 KT 相比，HPL 更有利于 SAIS 患者的治疗。
