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

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), I² 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), I² 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), I² 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), I² 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.