Efficacy of laser versus iontophoresis in the management of shoulder impingement syndrome in youth handball players

Abstract

Saud O. Alsuwat*, Mohamed B. Ibrahim, Ahmad S. Ghorab, Nesma E.M Barakat

Background: Repetitive overhead throwing is the main cause of shoulder impingement syndrome (SIS), a common overuse condition among young handball players. It results in decreased performance, discomfort, and restricted range of motion. Although there is little comparison data in young athletes, non-invasive physiotherapeutic treatments like Iontophoresis and High-Intensity Laser Therapy (HILT) are being employed more and more to treat this disease. Objective: The purpose of this study was to evaluate how well HILT and Iontophoresis worked for young handball players with SIS in terms of pain relief, shoulder function, and joint mobility.

Methods: The participants in this randomized controlled experiment were young handball players between the ages of 14 and 18. Two equal groups of [40] participants having a clinical diagnosis of subacromial impingement syndrome were chosen at random. For around 10 to 15 minutes each session, three times a week for four weeks, Group A got HILT utilizing a Class IV laser device applied across the subacromial region at a wavelength of 1064 nm, with an energy density ranging from 10 to 12 J/cm². Dexamethasone sodium phosphate (0.4%) was the active ingredient in Group B's iontophoresis, which was administered transdermally three times a week for four weeks using a low-intensity direct current for 20 minutes each session. A systematic physiotherapy program that included proprioceptive training, strengthening exercises, and range-of-motion exercises was administered to both groups. The Visual Analog Scale (VAS) for pain, the Shoulder Pain and Disability Index (SPADI) for functional limitations, a bubble inclinometer for shoulder joint range of motion, and a hand-held dynamometer for muscle strength evaluation were used to measure outcome measures both before and after treatment.

Results: Both groups showed significant improvements in pain, function, and shoulder mobility post-treatment. However, the HILT group demonstrated significantly superior outcomes across all measured variables. Pain reduction was faster and more sustained, shoulder range of motion improved more significantly, and muscle strength gains were more pronounced in the HILT group compared to the Iontophoresis group.

Conclusion: When treating SIS in young handball players, high-intensity laser therapy has more therapeutic advantages than iontophoresis, which makes it a useful supplement to sports rehabilitation regimens. Long term impacts, the involvement of female athletes, and the results of return to sport should all be investigated in future research