The Addition of Exercise to High-Intensity Laser Therapy Improves Treatment Effectiveness on Pain and Muscle Strength in Patients with Subacromial Pain Syndrome: A Randomized Trial

Objective To assess the efficacy of adding exercise to high-intensity laser therapy (HILT) in improving treatment effectiveness for clinical outcomes in patients with subacromial pain syndrome.Methods Thirty patients with subacromial pain syndrome were randomly assigned to the HILT-only group (n=15) or HILT & Exercise group (n=15). The primary outcome was shoulder function and disability. Secondary outcomes were pain, range of motion, proprioception (joint position sense), and muscle strength.Results Shoulder function and disability, pain, range of motion, joint position sense, and some muscle strength improved in both groups (p<0.05). There was no significant time-group interaction for the Constant-Murley Score, Shoulder Pain and Disability Index, rest pain, range of motion, and joint position sense (p>0.05). Time-group showed significant effects for activity pain and strength in favor of the HILT & Exercise group. Middle trapezius, lower trapezius, and supraspinatus strength increased after HILT plus exercise (p<0.05), activity pain, upper trapezius, serratus anterior, and subscapularis strength improved more compared to HILT (p<0.05).Conclusions We found no clinically important differences between HILT and HILT-plus exercise in shoulder function and disability, rest pain, mobility, and proprioception, in patients with subacromial pain syndrome. The addition of exercise to HILT was superior to HILT for improving activity pain and muscle strength.