The Effect of High-intensity Laser Therapy in Patients With Chronic Shoulder Pain

Primary outcomes

1. Change in range of motion from baseline to week 3

   Time frame: 3 weeks

   The range of motion of the joints in the upper extremities will be measured using the universal goniometer before and after the treatment.

2. Change in pain threshold from baseline to week 3

   Time frame: 3 weeks

   The pain threshold will be measured with a digital algometer device. Algometers are devices that can be used to identify the pressure and/or force eliciting a pressure-pain threshold. It has been noted in pressure-pain threshold studies that the rate at which manual force is applied should be consistent to provide the greatest reliability.

3. Change in disability of the upper extremity from baseline to week 3

   Time frame: 3 weeks

   Disability of the upper extremities will be assessed with 'The Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire'. It is a self-administered region-specific outcome instrument developed as a measure of self-rated upper-extremity disability and symptoms. The questionnaire was designed to help describe the disability experienced by people with upper-limb disorders and also to monitor changes in symptoms and function over time. The 30-item questionnaire includes 21 physical function items, 6 symptom items, and 3 social/role function items. Each 30 items are marked from 1 (No Difficulty) to 5 (Unable). DASH are added to form the raw, or actual, score. A minimum score is 30; a maximum is 150. The range of the scores, therefore-from 30 to 150-equals 120. The raw score is then transformed to a zero-to-100 scale with zero reflecting no disability (good function) and 100 reflecting maximum disability.

4. Change in muscle strength from baseline to week 3

   Time frame: 3 weeks

   The muscle strength of shoulder flexion, abduction, adduction, external and internal rotation movements will be evaluated by using the Baseline Push-Pull (New York) dynamometer. Results will be calculated in kg (1 lb = 0.454 kg). The patient's arm will be stabilized and the patient will be asked to show maximum resistance within 2 sec against the dynamometer placed and then hold it for 5 seconds at this position and power. The measurement will be repeated twice and recorded with the average of these two values.

5. Change in health status from baseline to week 3

   Time frame: 3 weeks

   In the evaluation of the health status of the individuals the Short Form-36 (SF-36) questionnaire was used. SF-36 is a questionnaire developed to self-evaluate the quality of life. It consists of 36 items in total and has eight sub-parameters. Subscales are scored between 0 and 100, and higher scores indicate higher quality of life.