Local low power laser irradiation accelerates the regeneration of the fibular nerve in rats

OBJETIVO: Estudar a influência da irradiação com o laser AsGaAL de baixa potência na regeneração de um nervo periférico, após lesão por esmagamento controlado. MATERIAL E MÉTODOS: O nervo fibular comum direito de 30 ratos Wistar foi submetido a uma lesão por esmagamento com uma pinça de carga regulável (5.000 g, 10 minutos de aplicação), os animais sendo divididos em três grupos (n=10), de acordo com o procedimento pós-operatório (sem irradiação; irradiação simulada; irradiação efetiva). A irradiação com o laser (comprimento de onda: 830 nm; potência do emissor: 100 mW; modo contínuo; dose: 140 J/cm²) era iniciada no primeiro dia pós-operatório e realizada por 21 dias consecutivos. Foram analisados a massa corporal dos animais, o tempo de percurso na passarela de marcha e o índice funcional do fibular (PFI), pela análise das impressões das pegadas, no período pré-operatório e no 21º dia pós-operatório. RESULTADOS: O tempo de marcha e o PFI melhoraram significativamente mais no grupo de irradiação efetiva com o laser, apesar do ganho significante de massa corporal entre os períodos pré e pós-operatório. CONCLUSÃO: A irradiação com o laser AsGaAL de baixa potência com os parâmetros aqui empregados acelerou e melhorou a regeneração do nervo fibular do rato.OBJECTIVE: To study the influence of low power GaAs-Al laser irradiation on the regeneration of a peripheral nerve, following a controlled crush injury. MATERIAL AND METHODS: The right common fibular nerve of 30 Wistar rats was submitted to a crush injury with an adjustable load forceps (5 000 g, 10 minutes of application). The animals were divided into three groups (n=10), according to the postoperative procedure (no irradiation; sham irradiation; effective irradiation). Laser irradiation (830 nm wave-length; 100 mW emission power; continuous mode; 140 J/cm²) was started on the first postoperative day and continued over 21 consecutive days. Body mass, time spent on the walking track and functional peroneal index (FPI) were analyzed based the hind footprints, both preoperatively and on the 21st postoperative day. RESULTS: Walking time and PFI significantly improved in the group that received effective laser irradiation, despite the significant gain in body mass between the pre- and post-operative periods. CONCLUSION: Low Power GaAs-Al laser irradiation, with the parameters used in our study, accelerated and improved fibular nerve regeneration in rats

Bilateral Idiopathic Carpal Tunnel Syndrome: Clinical‐Functional Characterization and Efficacy of Two Combined Postoperative Physiotherapeutic Treatments

Objective To evaluate the efficacy of combined association instrument myofascial mobilization (IASTM) and stretching in patients with idiopathic bilateral carpal tunnel syndrome (CTS) operated on one hand and to analyze the response of the operated (OH) and non‐operated (NH) hand according to the sequence of therapies. Research on these parameters has not yet been found in the literature. Methods Randomized controlled crossover study with 43 participants using the objective and subjective outcome variables. Patients were randomly assigned to two groups: starting with stretching followed by IASTM and starting with IASTM followed by stretching. Then patients underwent surgery on the hand with more severe involvement and physical therapy rehabilitation was started 30 days after for a period of 4 weeks. After the 1‐week interval the participants who started with stretching were referred to IASTM and vice versa, following the same previous patterns. The outpatient reassessments took place at 3 to 6 months. Crossover ANOVA and effect sizes were used as analysis methods. Results Time was the most significant outcome for all variables both during therapies and at 6‐month follow‐up. Regarding response to the combined therapies between OH and NH, there were differences for both OH and NH, with the greatest impact on NH for the palmar grip and VAS variables. The treatment sequences were significant for pain on the NH and mental SF‐12, suggesting that starting with IASTM followed by stretching had a superior outcome for these outcomes. Conclusion The combination of IASTM with stretching, used in the postoperative period of bilateral idiopathic CTS, proved to be supplementary, with significant results and large effect sizes for most of the outcomes assessed, both during the time of application of the therapies and in the 6‐month follow‐up for both hands, and may constitute a viable therapeutic alternative for this population