# Photobiomodulation associated with physical exercise in shoulder impingement syndrome. Systematic review with meta‐analysis

## TL;DR

Combining photobiomodulation with physical exercise helps reduce pain and improve shoulder movement in people with shoulder impingement syndrome.

## Contribution

This study provides evidence that photobiomodulation combined with physical exercise improves shoulder function in patients with shoulder impingement syndrome.

## Key findings

- PBM combined with physical exercise significantly reduces pain intensity in shoulder impingement syndrome.
- PBM improves range of motion compared to control groups.
- Functionality improvements were not statistically significant in the PBM group.

## Abstract

To present the use of PBM associated with physical exercise in the treatment of shoulder impingement syndrome, with its different parameters. The following databases were used: PubMed, Web of Science, Embase, Cochrane, Scopus, and Lilacs. The gray literature included Google Scholar, Open Grey, LIVIVO, and the Brazilian Library of Theses and Dissertations. Ten randomized clinical trials were included. Pain intensity was improved with PBM compared to control [MD = −0.89, 95% CI (−1.38, −0.40), I
2 46%, p = 0.0004]. The 3 different times of assessment (at rest, activity, and at night) of pain intensity were not statistically significant and likewise, the combined effect size [SMD = −0.16; 95% CI (−0.43, 0.12), I
2 63%, p = 0.26]. A significant improvement in ROM was seen in the PBM group compared to the control [MD = 12.24, 95% CI (7.64, 16.84), I
2 85%, p < 0.00001]. The combined effect estimate showed no significant improvement in functionality in the PBM group compared to the control [MD = −1.47, 95% CI (−7.34, 4.41), I
2 58%, p = 0.62]. PBM therapy combined with physical exercise is effective in reducing pain and improving the range of motion in individuals with shoulder impingement syndrome.

The combination of physical exercise and PBM therapy has been demonstrated to be an effective approach in reducing pain and enhancing range of motion and functionality.