Effect of Dynamic versus Static Low-Level Laser Therapy on Adhesive Capsulitis: A Randomized Controlled Trial

Mirna M. Niazy; Osama F. Al Balah; Hind M. Alsharief

doi:10.15391/prrht.2025-10(4).02

Authors

Mirna M. Niazy Faculty of Physical therapy, Ahram Canadian University, Giza, Egypt https://orcid.org/0009-0000-9079-9407
Osama F. Al Balah Medical Application of Laser department, National Institute of Laser Enhanced Science, Giza, Egypt https://orcid.org/0000-0002-0268-5432
Hind M. Alsharief Faculty of Physical Therapy, Heliopolis University, Cairo, Egypt https://orcid.org/0009-0001-8560-1053

DOI:

https://doi.org/10.15391/prrht.2025-10(4).02

Keywords:

Adhesive capsulitis, Frozen shoulder, Low-level laser therapy, Photobiomodulation, Range of motion, Physical therapy, Rehabilitation, Pain management, Dynamic therapy, Shoulder function

Abstract

Purpose. Adhesive capsulitis significantly impacts quality of life and functional capacity. While low-level laser therapy (LLLT) has shown promise in treatment, the optimal application method remains debated. Objective: to compare the effectiveness of LLLT applied with dynamic versus static limb positioning in treating adhesive capsulitis.

Material & Methods. Forty patients with adhesive capsulitis were randomly assigned to dynamic LLLT with active shoulder range of motion (ROM) (Group A, n=20) or static LLLT (Group B, n=20). Both groups received conventional treatment. Primary outcomes included a Visual Analogue Scale (VAS) for pain, grip strength, and shoulder ROM (flexion and abduction), which was measured pre-and post-treatment.

Results. Dynamic LLLT showed significantly greater improvements in pain reduction (56.80% vs. 39.18%, p=0.001) and grip strength (152.88% vs. 118.70%, p=0.001) compared to static application. Both groups demonstrated significant improvements in shoulder ROM, though the differences between groups were not statistically significant (p>0.05).

Conclusions. Dynamic LLLT application appears superior to static application for pain reduction and grip strength improvement in adhesive capsulitis treatment, while both methods show comparable effectiveness for ROM improvement.

References

Ahmad, M. A., Hamid, M. S. A., & Yusof, A. (2022). Effects of low-level and high-intensity laser therapy as adjunctive to rehabilitation exercise on pain, stiffness and function in knee osteoarthritis: A systematic review and meta-analysis. Physiotherapy, 114, 85–95. https://doi.org/10.1016/j.physio.2021.03.011

Brosseau, L., Welch, V., Wells, G., Tugwell, P., de Bie, R., Gam, A., Harman, K., Morin, M., & Shea, B. (2004). Low level laser therapy (Classes I, II and III) for treating osteoarthritis. Cochrane Database of Systematic Reviews, (3), CD002046. https://doi.org/10.1002/14651858.CD002046.pub2

El-Gendy, M. H., Abdulla, Y. M., & Abd Elmonaem, G. (2021). Effect of low-level laser therapy and manual exercises on shoulder impingement syndrome: a systematic review. International Journal of Physiotherapy Research, 9(4), 3913–3920. https://doi.org/10.16965/ijpr.2021.143

Farivar, S., Malekshahabi, T., & Shiari, R. (2014). Biological effects of low level laser therapy. Journal of Lasers in Medical Sciences, 5(2), 58–62. https://doi.org/10.22037/JLMS.V5I2.5540

Gulia, A. K., Arya, A. K., Munde, S. L., Kumar, S., Malik, J. S., & Prasad, N. (2019). Comparison of intra-articular corticosteroid and low-level laser therapy in idiopathic adhesive capsulitis of the shoulder. International Journal of Orthopaedics, 5(2), 996–1000. https://doi.org/10.22271/ortho.2019.v5.i2o.1466

Horsley, I., Herrington, L., Hoyle, R., Prescott, E., & Bellamy, N. (2016). Do changes in hand grip strength correlate with shoulder rotator cuff function? Shoulder & Elbow, 8(2), 124–129. https://doi.org/10.1177/1758573215626103

Kelle, B., & Kozanoglu, E. (2014). Low-level laser and local corticosteroid injection in the treatment of subacromial impingement syndrome: A controlled clinical trial. Clinical Rehabilitation, 28(8), 762–771. https://doi.org/10.1177/0269215514520772

Khan, K. M., & Scott, A. (2009). Mechanotherapy: how physical therapists’ prescription of exercise promotes tissue repair. British Journal of Sports Medicine, 43(4), 247–252. https://doi.org/10.1136/bjsm.2008.054239

Le, H. V., Lee, S. J., Nazarian, A., & Rodriguez, E. K. (2017). Adhesive capsulitis of the shoulder: Review of pathophysiology and current clinical treatments. Shoulder & Elbow, 9(2), 75–84. https://doi.org/10.1177/1758573216676786

Merry, K., Napier, C., Waugh, C.M., & Scott, A. (2022). Foundational Principles and Adaptation of the Healthy and Pathological Achilles Tendon in Response to Resistance Exercise: A Narrative Review and Clinical Implications. Journal of Clinical Medicine, 11(16), 4722. https://doi.org/10.3390/jcm11164722

Mulyadi, A., Nugraha, L. A. K., Tjandra, K. C., & Kesoema, T. A. (2025). Comparing the effectiveness of high- and low-intensity laser therapy in enhancing conventional treatment for frozen shoulder: A systematic review, meta-analysis, and meta-regression. Electronic Journal of General Medicine, 22(4). https://doi.org/10.29333/ejgm/16418

Nakandala, P., Nanayakkara, I., Wadugodapitiya, S., & Gawarammana, I. (2021). The efficacy of physiotherapy interventions in the treatment of adhesive capsulitis: A systematic review. Journal of Back and Musculoskeletal Rehabilitation, 34(2), 195–205. https://doi.org/10.3233/BMR-200186

Ordahan, B., Yigit, F., & Mülkoglu, C. (2023). Efficacy of low-level laser versus high-intensity laser therapy in the management of adhesive capsulitis: A randomized clinical trial. Saudi Journal of Medicine & Medical Sciences, 11(3), 201–207. https://doi.org/10.4103/sjmms.sjmms_626_22

Page, M. J., Green, S., Kramer, S., Johnston, R. V., McBain, B., Chau, M., & Buchbinder, R. (2014). Manual therapy and exercise for adhesive capsulitis (frozen shoulder). Cochrane Database of Systematic Reviews, 2014(8), CD011275. https://doi.org/10.1002/14651858.CD011275

Pandey, V., & Madi, S. (2021). Clinical guidelines in the management of frozen shoulder: An update! Indian Journal of Orthopaedics, 55(2), 299–309. https://doi.org/10.1007/s43465-021-00351-3

Papalexis, N., Parmeggiani, A., Facchini, G. et al. Current concepts in the diagnosis and treatment of adhesive capsulitis: role of diagnostic imaging and ultrasound-guided interventional procedures. Radiol med 127, 1390–1399 (2022). https://doi.org/10.1007/s11547-022-01566-6

Qureshi, A. S., Hussain, T., Tunio, M. Z., Aleem, M. A., & Abideen, Z. U. (2024). Efficacy comparison of low level laser treatment with muscle energy procedure among diabetic patients suffering from frozen shoulder. Pakistan Journal of Health Sciences, 5(8),160–165. https://doi.org/10.54393/pjhs.v5i08.1885

Stausholm, M. B., Naterstad, I. F., Joensen, J., Lopes-Martins, R. Á. B., Sæbø, H., Lund, H., & Fersum, K. V. (2019). Efficacy of low-level laser therapy on pain and disability in knee osteoarthritis: systematic review and meta-analysis. BMJ Open, 9(10), e031142. https://doi.org/10.1136/bmjopen-2019-031142

Turabi, R., Horsely, I., Birch, H., & Jaggi, A. (2022). Does grip strength correlate with rotator cuff strength in patients with atraumatic shoulder instability? Bulletin of faculty of physical therapy, 27(1), 1-9. https://doi.org/10.1186/s43161-021-00059-3

van der Heijden, G. J. (1999). Shoulder disorders: A state-of-the-art review. Baillière’s Best Practice & Research: Clinical Rheumatology, 13(2), 287–309. https://doi.org/10.1053/berh.1999.0021