Laser Photobiomodulation in the acute inflammatory response of the calcaneal tendon injury in rats exposed to cigarette smoke

La nicotina retarda el proceso de cicatrización y eleva los niveles de la enzima mieloperoxidasa (MPO), que tiene un papel fundamental en la producción de especies reactivas de oxígeno durante el proceso inflamatorio. La fotobiomodulación con láser (FBM) es uno de los agentes electrofísicos más utilizados en el tratamiento del tendón calcáneo, sin embargo sus efectos sobre la actividad de la MPO carecen de mayor elucidación. Este estudio objetivó evaluar los efectos de la FBM sobre la actividad de la MPO después de lesión del tendón calcáneo en ratones expuestos al humo de cigarrillo. Se utilizaron 34 ratones Wistar, machos, con 90 días de vida. Después de 14 días de exposición al humo de cigarrillo, los animales fueron divididos en tres grupos experimentales: grupo de control (GC, n=12), no sometido a la lesión o tratamiento; grupo sham (GSh, n=10), sometido a la lesión parcial del tendón calcáneo y a la simulación de la FBM láser; y el grupo FBM láser (GFBM, n=12), sometido a la lesión parcial del tendón calcáneo y tratado con FBM láser, en el primer minuto después de la lesión. La FBM disminuyó los niveles de actividad de MPO en el GFBM en comparación con el GSh (GC: 1,38±0,69 pg/ml; GSh: 3,78±1,09pg/ml; GFBM: 2,58±0,93pg/ml, p<0,005). Se concluye que la FBM láser aplicada inmediatamente después de la lesión del tendón calcáneo atenúa la actividad inflamatoria aguda en ratones expuestos al humo de cigarrillo.A nicotina retarda o processo de cicatrização e eleva os níveis da enzima mieloperoxidase (MPO), a qual possui um papel fundamental na produção de espécies reativas de oxigênio durante o processo inflamatório. A fotobiomodulação laser (FBM) é um dos agentes eletrofísicos mais utilizados no tratamento do tendão calcâneo, no entanto, os seus efeitos sobre a atividade da MPO carecem de maior elucidação. Este estudo objetivou avaliar os efeitos da FBM sobre a atividade da MPO, após lesão do tendão calcâneo em ratos expostos à fumaça de cigarro. Foram utilizados 34 ratos Wistar, machos, com 90 dias de vida. Após 14 dias de exposição à fumaça de cigarro, os animais foram divididos em três grupos experimentais: grupo controle (GC, n=12), não submetido à lesão ou tratamento; grupo sham (GSh, n=10), submetido à lesão parcial do tendão calcâneo e a simulação da FBM laser; grupo FBM laser (GFBM, n=12), submetido à lesão parcial do tendão calcâneo e tratados com FBM laser, no primeiro minuto após a lesão. A FBM diminuiu os níveis de atividade da MPO no GFBM em comparação ao GSh (GC: 1,38±0,69 pg/ml; GSh: 3,78±1,09pg/ml; GFBM: 2,58±0,93pg/ml; p<0,005). Conclui-se que a FBM laser aplicada imediatamente após lesão do tendão calcâneo, atenua a atividade inflamatória aguda em ratos expostos à fumaça de cigarro.Nicotine delays the healing process and increases the levels of myeloperoxidase (MPO), an enzyme that plays a key role in the production of reactive oxygen species during the inflammatory process. Laser Photobiomodulation (PBM) is one of the most used electrophysical agents in the treatment of the calcaneal tendon, however, its effects on MPO activity need to be further elucidated. This study aimed to evaluate the effects of laser PBM on MPO activity after inflicting an injury to the calcaneal tendon of rats exposed to cigarette smoke. Thirty-four male Wistar rats with 90 days of age were used. After 14 days of exposure to cigarette smoke, the animals were divided into three experimental groups: control group (CG, n=12), not submitted to injury or treatment; sham group (ShG, n=10), submitted to partial calcaneal tendon injury and laser PBM simulation; and laser PBM group (PBMG, n=12), submitted to partial calcaneal tendon lesion and treated with laser PBM within the first minute after injury. PBM decreased MPO activity levels in PBMG compared to ShG (CG: 1.38±0.69pg/ml; ShG: 3.78±1.09pg/ml; PBMG: 2.58±0.93pg/ml; p<0.005). In conclusion, applying laser PBM immediately after inflicting damage to the calcaneal tendon attenuates acute inflammatory activity in rats exposed to cigarette smoke

Efeito in vitro do LED (Light Emitting Diode) de 470 nm em fibroblastos de quelóide

Purpose: To quantify keloid fibroblasts after irradiation with 470nm blue LED, in vitro. Methods: Fibroblasts from keloid and adjacent skin have been obtained from 6 patients. Cells have been cultivated and maintained in DMEM culture medium. In Petri dishes, they were irradiated with energy doses of 6J, 12J and 18J. After 24 h, counting was done by the average of the triplicates for each sample. Results: There were no significant differences in the number of irradiated keloid fibroblasts at the studied doses (p=0.261). In adjacent skin fibroblasts, differences were observed (p=0.025) concerning the doses of 18 J and 6 J (p=0.03). Conclusions: There was a reduction in the number of adjacent skin fibroblasts irradiated with 470nm blue LED at the energy dose of 18 J compared to the ones irradiated at the energy dose of 6 J. There were no changes in keloid fibroblasts counting at any of the doses applied, 24 h after irradiation.Objetivo: Quantificar fibroblastos de quelóide após irradiação com LED azul de 470nm, in vitro. Métodos: Foram obtidos fibroblastos de quelóide e pele adjacente, de seis pacientes. As células foram cultivadas e mantidas em meio de cultura DMEM. Em placas de Petri, receberam irradiação com doses de energia de 6J, 12J e 18J. Após 24 horas a contagem foi feita pela média da triplicata para cada amostra. Resultados: Não houve diferença na quantidade de fibroblastos de quelóide irradiados nas doses estudadas (p=0,261). Observou-se diferença nos fibroblastos de pele adjacente (p=0,025), com relação às doses de 18 J e 6 J (p=0,03). Conclusões: Houve redução dos fibroblastos de pele adjacente irradiados com LED azul de 470 nm na dose de energia de 18 J em relação à dose de 6 J. Não houve alteração na quantidade de fibroblastos de quelóide nas doses aplicadas após 24 horas da irradiação.Universidade Federal de São Paulo (UNIFESP) Department of SurgeryUNIFESP Head Department of SurgeryUNIFESP, Department of SurgeryUNIFESP, Head Department of SurgerySciEL

Hip and knee weakness and ankle dorsiflexion restriction in individuals following lateral patellar dislocation: A case-control study

OBJECTIVE: To explore the relationship between ankle dorsiflexion range of motion (ROM) and hip and knee muscle strength between patients with a history of patellar dislocation (PD) to healthy controls. DESIGN: Case-control study. SETTING: Orthopedical specialty outpatient clinic at a tertiary hospital. PARTICIPANTS: Eighty-eight individuals were recruited; 44 individuals aged 16 years or older, of both sexes, with a history of at least one episode of atraumatic unilateral or bilateral PD requiring emergency care (14 men; 30 women; mean age 20 years) and 44 healthy (control) individuals (11 men; 33 women; mean age 21 years) matched for age, weight, and height to PD cases. INTERVENTION: Assessment of hip and knee strength and ankle dorsiflexion ROM. OUTCOME MEASURES: Ankle dorsiflexion ROM was assessed through the lunge test with a goniometer. Hip and knee muscle strength was evaluated through isometric hand-held dynamometry. Differences between healthy and control individuals were assessed using Student t Tests and Mann-Whitney U Test. RESULTS: Patellar dislocation individuals presented with a reduced ankle dorsiflexion ROM [mean difference (MD): 9 degrees; effect size (ES): 1.39; P < 0.001] and generalized hip and knee weakness (MD range: 4.74 kgf to 31.4 kgf; ES range: 0.52-2.35; P < 0.05) compared with healthy subjects. CONCLUSION: Individuals with a history of PD have reduced ankle dorsiflexion ROM and hip and knee muscle strength compared with healthy controls

Helium-neon laser in viability of random skin flap in rats

objetivo: O presente estudo teve como objetivo verificar a eficacia do laser helio-neonio (He-Ne) na viabilidade do retalho cutaneo randomico em ratos. Metodos: Foram utilizados 48 ratos, da linhagem Wistar-EPM-1, distribuidos em 4 grupos de 12 animais cada. O retalho cutaneo randomico foi realizado com as medidas de 10 x 4 cm, com uma barreira plastica interposta entre o mesmo e o leito doador. O Grupo 1 (controle) foi submetido a simulacao de tratamento da radiacao laser He-Ne. O Grupo 2 foi submetido a radiacao laser He-Ne, utilizando a tecnica pontual com contato sobre o retalho. O Grupo 3 ao redor do retalho e o Grupo 4 sobre e ao redor do retalho. Os grupos experimentais foram submetidos a radiacao laser com densidade de energia de 3J/cm2 imediatamente apos a operacao e nos outros 4 dias subsequentes. As porcentagens da area de necrose de todos os grupos foram avaliadas no setimo dia pos-operatorio com o metodo do gabarito de papel. Resultados: O Grupo 1 obteve media de area de necrose de 48,86 por cento, o Grupo 2 -38,67 por cento, o Grupo 3 - 35,34 por cento e o Grupo 4 - 22,61 por cento. Apos a analise estatistica, os resultados mostraram que todos os grupos experimentais obtiveram valores estatisticamente significantes em comparacao ao grupo controle, e que o Grupo 4 foi o grupo com menor area de necrose comparado a todos os grupos deste estudo (p<0,001). Conclusao: A radiacao laser He-Ne foi eficaz no aumento da, viabilidade do retalho cutaneo randomico em ratosBV UNIFESP: Teses e dissertaçõe

Prevalence of musculoskeletal injuries and a proposal for neuromuscular training to prevent lower limb injuries in Brazilian Army soldiers: an observational study

Abstract Background The activities carried out by soldiers in the army involve great physical demands and require intense trainings to perform combat-specific tasks. Musculoskeletal injury is a potential threat to the health and physical integrity of the soldier. This study aimed to evaluate the prevalence of lower limb musculoskeletal injuries among soldiers and to propose a training protocol to prevent the most frequent injuries. Methods This observational (cross-sectional) study recruited a sample of 103 soldiers who required medical attention, from a total 202 new battalion soldiers. The medical records (paper and online) had a form of running text. All data collected were recorded by the registered physicians of the battalion medical post. The records were analyzed by the following variables: medical diagnosis, injury site, mechanism, type of treatment, time loss, existence of previous injury, and recurring injury. Results A total of 112 musculoskeletal injuries were diagnosed in 71 soldiers, and other types of diseases/injuries were diagnosed in the other soldiers. Joint pain accounted for 55.4% of the diagnoses. The knee was the most affected site, while trauma and overload were the most common mechanisms of injury. Drug treatment was used most frequently, accounting for 58% of the cases. The majority of the sample obtained a temporary leave of absence for 1 to 6 days or not at all. Previous injuries and recurrence were not presented as risk factors for injury. With the data received, a protocol for the prevention of injuries to the lower limbs was proposed. Conclusion This study indicated that the most frequent site of injury is the knee, and joint pain is the most common diagnosis. These results may support the necessity to develop a neuromuscular training protocol to prevent lower limb injuries, which we suggest to be applied in future studies

Effect of photobiomodulation associated with exercise on pain and functionality of patients with knee osteoarthritis: a pilot study

O objetivo do estudo foi avaliar o efeito da fotobiomodulação associada a exercícios na dor e na funcionalidade de pacientes com osteoartrite de joelho. Para isso foram recrutados 20 pacientes com osteoartrite do joelho uni ou bilateral, que foram distribuídos em dois grupos: grupo-controle (GC), que realizou aplicação de fotobiomodulação (FBM) placebo e um protocolo de exercício; e grupo fotobiomodulação (GF), que realizou aplicação ativa da FBM e o protocolo de exercício, sendo esse realizado duas vezes por semana durante oito semanas e consistindo de alongamentos passivos dos músculos de membros inferiores, straight leg raise, treinamento proprioceptivo e exercícios para o controle da marcha. A FBM foi aplicada com o aparelho cluster contendo quatro diodos de 670 nm e cinco diodos de 850 nm, com uma potência de saída de 540 mW, sendo a dose utilizada de 4 J/cm2. Os grupos foram avaliados pré e pós-tratamento com os questionários SF-36, Lequesne, Tinetti, e por meio da Escala Visual Analógica de dor (EVA). Os dados foram analisados com o método Anova, seguido do Bonferroni. Os dados indicaram melhoras significativas para o GF ao fim do tratamento para as avaliações da EVA (2±1,25 vs. 0,7±0,82; p=0,009). Embora ambos os grupos tenham obtido melhoras significativas ao longo do tratamento, não foi possível observar diferenças significativas entre eles para o restante das avaliações ao final do tratamento. Portanto, conclui-se que o uso da FBM associada a exercícios apresentou melhora da dor nos pacieOur study evaluated the effect of photobiomodulation associated with exercise on pain and functionality of patients with knee osteoarthritis. Twenty patients with unilateral or bilateral knee osteoarthritis were selected and divided into two groups: Control group (CG), which underwent photobiomodulation (PBM) placebo and exercise protocol; and the photobiomodulation group (PG), which performed an active application of the PBM and the exercise protocol - performed twice a week for eight weeks and consisting of passive stretching of the lower extremity muscles, straight leg raise, proprioceptive training and exercises for gait control. PBM was applied through a cluster apparatus containing four diodes of 670 nm and five diodes of 850 nm, with an output power of 540 mW and with a dose of 4J / cm2. The groups were evaluated before and after treatment with the SF-36, Lequesne and Tinetti questionnaires as well as the Visual Analog Pain Scale. Data were analyzed using the Anova method, followed by the post-hoc Bonferroni test. The data indicated significant improvements in the PG at the end of treatment for Visual Analog Pain Scale (2±1.25 vs. 0.7±0.82, p=0.009). Although both groups achieved significant improvements throughout the treatment, we could not observe significant differences between them for the rest of the evaluations at the end of the treatment. Therefore, the use of PBM associated with exercises showed pain improvement in patients with knee osteoarthritis, although it was not possible to observe significant differences in patients’ functionality.El presente estudio tuvo como objetivo evaluar el efecto de la fotobiomodulación asociada a ejercicios sobre el dolor y la funcionalidad de pacientes con osteoartritis de rodilla. Para ello, se reclutaron a 20 pacientes con osteoartritis de rodilla unilateral o bilateral, que se dividieron en dos grupos: el grupo control (GC), que recibió placebo de fotobiomodulación (FBM) y un protocolo de ejercicio; y el grupo de fotobiomodulación (GF), que recibió la aplicación activa de FBM y el protocolo de ejercicio, el cual se realizó dos veces por semana, durante ocho semanas, y consistió en estiramientos pasivos de los músculos de las extremidades inferiores, straight leg raise, entrenamiento propioceptivo y ejercicios para el control de la marcha. La FBM se aplicó con el dispositivo cluster que contenía cuatro diodos de 670 nm y cinco diodos de 850 nm, con una potencia de salida de 540 mW, y la dosis utilizada fue de 4 J/cm2. Los grupos se evaluaron antes y después del tratamiento por medio de los cuestionarios SF-36, Lequesne, Tinetti y de la Escala Visual Analógica de Dolor (EVA). Los datos se analizaron utilizando el método Anova, seguido del Bonferroni. Los datos apuntaron una mejora significativa en el GF al final del tratamiento mediante las evaluaciones de la EVA (2±1,25 vs. 0,7±0,82; p=0,009). A pesar de que ambos grupos lograron obtener mejoras significativas durante el curso del tratamiento, no fue posible observar diferencias significativas entre ellos en las evaluaciones al final del tratamiento. Por lo tanto, se concluye que el uso de la FBM asociada a ejercicios ocasionó una mejora del dolor en pacientes con osteoartritis de rodilla, aunque no fue posible observar diferencias significativas con respecto a la funcionalidad

THRESHOLD PAIN AFTER PHOTOBIOMODULATION ASSOCIATED TO NEUROMUSCULAR TRAINING IN PATIENTS WITH GRADE 4 KNEE OSTEOARTHRITIS

Fed Univ Sao Paulo UNIFESP, Santos, BrazilFed Univ Sao Paulo UNIFESP, Santos, BrazilWeb of Scienc

EFFECT PHOTOBIOMODULATION IN ADDITION WITH A BALANCE PROTOCOL IN FUNCTIONALITY PATIENTS WITH ADVANCED KNEE OSTEOARTHRITIS

Fed Univ Sao Paulo UNIFESP, Santos, BrazilFed Univ Sao Paulo UNIFESP, Santos, BrazilWeb of Scienc