Exploring the efficacy of low-level laser therapy and exercise for knee osteoarthritis

Background: Knee Osteoarthritis (KOA) is a prevalent, chronic disorder with excessive functional, social and economic burdens. The goal of treatment is to alleviate the symptoms and slow the progression. Documenting the effects of exercise and LLLT as co-modalities in the management of KOA allows practitioners to implement this management tool as part of KOA rehabilitation, resulting in the earlier discharge from a supervised rehabilitation setting.Objective: The purpose of this study was to determine the effect of low-level laser therapy (LLLT) in the treatment of knee osteoarthritis (KOA). A randomised controlled trial (RCT) was conducted on 111 participants (aged between 40-75 years) diagnosed with KOA. Participants were randomised into an exercise (n=39), LLLT (n=40), or a combined exercise-LLLT (n=32) group.Methods: The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scale was used to assess pain and functionality. Knee range of motion was assessed using a goniometer, and the one-minute timed sit–to-stand test measured physical functionality at four time points: (T1) baseline, (T2) post 12-session intervention, (T3) one-month post intervention and (T4) three-month’s post intervention. Knee circumference was measured using a measuring tape.Results: WOMAC pain and functionality scale and knee circumference scores decreased in all three groups (P<0.05), but the combined exercise-LLLT group demonstrated better outcomes than the LLLT or exercise alone groups respectively. The combined exercise-LLLT group showed better acute and long-term benefits with participants experiencing a 3.5 centimetre decrease in knee circumference, 24 point improvement in the WOMAC pain and functionality scale, and a four repetition increase in physical functionality.Conclusion: The findings suggest that LLLT is a viable tool for managing KOA when used in conjunction with physical exercise. Keywords: photobiomodulation, physical therapy, degenerative joint diseas

Biocultural determinants of overweight and obesity in the context of nutrition transition in Senegal: a holistic anthropological approach

Senegal is experiencing a rising obesity epidemic, due to the nutrition transition occurring in most African countries, and driven by sedentary behaviour and high-calorie dietary intake. In addition, the anthropological local drivers of the social valorization of processed high-calorie food and large body sizes could expose the population to obesity risk. This study aimed to determine the impact of these biocultural factors on the nutritional status of Senegalese adults. A mixed methods approach was used, including qualitative and quantitative studies. Between 2011 and 2013, fourteen focus group discussions (n=84) and a cross-sectional quantitative survey (n=313 women; n=284 men) of adults in three different socio-ecological areas of Senegal (rural: n=204; suburban: n=206; urban: n=187) were conducted. Dietary intake (Dietary Diversity Scores), physical activity (International Physical Activity Questionnaire), body weight norms (Body Size Scale), weight and health statuses (anthropometric measures and blood pressure) were measured. Middle-aged and older Senegalese women were found to value overweight/obesity more than younger Senegalese in all regions. In addition, young urban/suburban adults had a tendency for daily snacking whilst urban/suburban adults tended to be less physically active and had higher anthropometric means. A binary logistic regression model showed that being female, older, living in urban/suburban areas and valuing larger body size were independently associated with being overweight/obese, but not high-calorie diet. Univariate analyses showed that lower physical activity and higher socioeconomic status were associated with being overweight/obese. Finally, overweight/obesity, which is low in men, is associated with hypertension in the total sample. The nutrition transition is currently underway in Senegal's urban/suburban areas, with older women being more affected. Since several specific biocultural factors jointly contribute to this phenomenon, the study's findings suggest the need for local public health interventions that target women and which account for the anthropological specificities of the Senegalese population