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Efficacy of low-level laser versus high-intensity laser therapy in the management of adhesive capsulitis: a randomized clinical trial
Ordahan B, Yigit F, Mulkoglu C
Saudi Journal of Medicine and Medical Sciences 2023 Jul-Sep;11(3):201-207
clinical trial
9/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: Yes; 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: Low-level laser therapy (LLLT) and high-intensity laser therapy (HILT) are effective in alleviating pain and improving functionality in patients with adhesive capsulitis (AC); however, no study has compared the efficacy of these two laser treatments. OBJECTIVE: To compare the effectiveness of LLLT and HILT in improving the shoulder joint range of motion and functional status and in reducing pain level in patients with AC. Trial DESIGN: Prospective, randomized, parallel group, patient- and assessor-blinded. METHODS: A total of 45 patients (aged 18 to 65 years) with complaint of shoulder pain were evaluated for inclusion criteria, which included being aged 18 to 65 years and a diagnosis of AC based on physical examinations. Using computer-generated random numbers, eligible patients were randomized into two groups: HILT plus stretching exercise and LLLT plus stretching exercise groups. Both HILT and LLLT were performed three times/week for 3 weeks. Functional status and pain of the patients were evaluated with Shoulder Pain and Disability Index (SPADI) and Visual Analog Scale (VAS), while shoulder joint range of motion was measured with goniometry. All assessments were done before and 3 weeks after treatment. RESULTS: A total of 40 patients (20 in each group) completed the study. At baseline, there was no statistically significant difference in the demographic and clinical characteristics between both groups. Both the LLLT and HILT groups showed significant improvement in the VAS and SPADI scores 3 weeks after treatment; however, the improvement was significantly higher in the HILT group than the LLLT group. There was no significant improvement in goniometric scores in both groups compared with baseline. No injury or other musculoskeletal complications were recorded during or after the treatments. CONCLUSION: HILT plus stretching exercise treatment was more effective than LLLT plus stretching exercise for improving functional parameters and pain in patients with AC. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05469672. FUNDING: None.

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