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Comparison of low level and high power laser combined with Kinesiology Taping on shoulder function and musculoskeletal sonography parameters in subacromial impingement syndrome: a randomized placebo-controlled trial
Zaki Z, Ravanbod R, Schmitz M, Abbasi K
Physiotherapy Theory and Practice 2022;38(13):2514-2525
clinical trial
8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: 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. OBJECTIVES: 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. METHODS: 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. RESULTS: 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)) (p < 0.01). All the SPADI subscales are significantly reduced in all the groups (p < 0.05), except for the pain in the sham-KT (p = 0.06). Significant improvements were only observed in the diameters of biceps (p < 0.05), supraspinatus tendon thickness in short and long axes (p < 0.05), occupation ratio (p = 0.004), and echogenicity (p = 0.03) in the HPL-KT. Although the acromiohumoral distance (AHD) significantly increased in all the groups including the sham-KT (p < 0.01), supraspinatus tendon thickness significantly decreased (p < 0.05), and echogenicity increased (p = 0.003) just in the HPL-KT. CONCLUSIONS: 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.

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