Department of Physical Therapy and Rehabilitation, Southeast Colorado Hospital, Springfield, Colorado, 81073, USA.
Department of Health & Rehabilitation Sciences, College of Allied Health Professions, University of Nebraska, Medical Center, Omaha, NE, USA.
Lasers Med Sci. 2024 Sep 25;39(1):240. doi: 10.1007/s10103-024-04190-0.
This systematic review and meta-analysis aims to identify, critically appraise, and summarize the effects of high-intensity laser therapy on subacromial impingement syndrome. Three databases, PubMed, Embase, and Scopus were searched from inception to March 1, 2024. Clinical trials comparing the effects of high-intensity laser therapy to conventional therapy are eligible for inclusion. Two independent reviewers conducted study selection, data extraction, and quality assessment. Methodological quality was assessed using the Physiotherapy Evidence Database scale. Meta-analyses were performed to determine the effects of high-intensity laser therapy. Five randomized controlled trials and one controlled clinical trial were included, with a total of 284 patients with subacromial impingement syndrome. All included studies were evaluated as good or above for quality assessment. Compared to conventional therapy, high-intensity laser therapy demonstrated significantly better outcomes for pain at both post-intervention (SMD = -1.01, 95%CI = -1.85 to -0.17) and three-month post-intervention (SMD = -0.51, 95%CI = -0.90 to -0.13); shoulder and arm function at both post-intervention (SMD = 0.40, 95%CI = 0.14 to 0.66) and three-month post-intervention (SMD = 0.45, 95%CI = 0.06 to 0.84); shoulder abduction active range of motion (SMD = 3.26, 95%CI = 0.49 to 6.03). No significant difference was found for shoulder flexion and external rotation range of motion. This review highlights the promising effects of high-intensity laser therapy for the rehabilitation of subacromial impingement syndrome. Rehabilitation professionals and policymakers should increase their awareness of high-intensity laser therapy as an emerging technology that may facilitate greater outcomes than current widespread standards.
本系统评价和荟萃分析旨在确定、批判性评价和总结高强度激光治疗对肩峰下撞击综合征的影响。从成立到 2024 年 3 月 1 日，我们在 PubMed、Embase 和 Scopus 三个数据库中进行了检索。符合纳入标准的研究为比较高强度激光治疗与常规治疗效果的临床试验。两名独立的评审员进行了研究选择、数据提取和质量评估。使用物理治疗证据数据库量表评估方法学质量。进行荟萃分析以确定高强度激光治疗的效果。纳入了 5 项随机对照试验和 1 项对照临床试验，共有 284 例肩峰下撞击综合征患者。所有纳入的研究在质量评估方面均被评为良好或以上。与常规治疗相比，高强度激光治疗在干预后即刻（SMD=-1.01，95%CI=-1.85 至-0.17）和干预后 3 个月（SMD=-0.51，95%CI=-0.90 至-0.13）时疼痛、干预后即刻（SMD=0.40，95%CI=0.14 至 0.66）和干预后 3 个月（SMD=0.45，95%CI=0.06 至 0.84）时肩臂功能、肩外展主动活动范围（SMD=3.26，95%CI=0.49 至 6.03）均有显著改善；而肩前屈和外旋活动范围无显著差异。本综述强调了高强度激光治疗在肩峰下撞击综合征康复中的良好效果。康复专业人员和政策制定者应提高对高强度激光治疗作为一种新兴技术的认识，这种技术可能会带来比目前广泛应用的标准更好的效果。
