HILT or Conventional Combined Physical Therapy, in the Management of Hemiplegic Shoulder Pain

High-intensity Laser Therapy (HILT) or Conventional Combined Physical Therapy in the Management of Hemiplegic Shoulder Pain ; Randomized Controlled Trial

Background: Hemiplegic shoulder pain is one of the most common complications after a stroke. There are many treatment strategies for this complication. High-intensity laser therapy (HILT) is a new treatment option, and we aimed to compare the effectiveness of conventional electrotherapy agents and HILT in this study.

Patients and methods: Participants (N = 42) were randomized into the HILT (n = 21) and TENS+US (n = 21) groups. Group 1 received 3 sessions of HILT per week for 3 weeks in addition to a therapeutic exercise program that performed 5 sessions per week for 3 weeks. Group 2 received conventional physical therapy and a therapeutic exercise program for HSP of 5 sessions per week for 3 weeks. Patients were assessed before and after treatment on the on the 6th week for radiological evaluation with ultrasonography and for clinical parameters with VAS, AMAT, MRS, and FIQ scores.

Inclusion Criteria:

• Diagnosed case of HSP,
• Age ≥18,
• First-ever unilateral stroke,
• Visual analog scale (VAS) ≥30 mm,
• Time since stroke ≥6 months,
• Time since last local intervention treatment >6 months.

Exclusion Criteria:

• A history of shoulder pain prior to stroke;
• An unstable medical condition or uncontrolled systemic diseases (such as respiratory failure, congestive heart failure, liver and kidney dysfunction, or any other disorders affecting neuromuscular function);
• Bilateral hemiplegia;
• Cardiac pacemakers;
• Disturbance of awareness, severe visual and cognitive impairment, Mini-Mental State Examination score: <23 points