Our results show that despite reduced muscle force, the combination of obesity and postmenopause may be associated with greater resistance to muscle fatigue.
This study evaluated the synergistic effects of ultrasound (US) and low-level laser therapy (LLLT) with or without therapeutic exercises (TE) in women with knee osteoarthritis. Forty-two Caucasian women with knee osteoarthritis were allocated into three groups: (1) the placebo group who did not perform TE, but the prototype without emitting light or ultrasonic waves was applied, (2) the US + LLLT group in which only the prototype was applied and (3) the TE + US + LLLT group that performed TE before the prototype was applied. However, 35 women completed the full clinical trial. Pressure pain thresholds (PPT) using an algometer and functional performance during the sit-to-stand test were carried out. The average PPT levels increased for US + LLLT (41 ± 9 to 54 ± 15 N, p < 0.01) and TE + US + LLLT (32 ± 8 to 45 ± 9 N, p < 0.01) groups. The number of sit-to-stands was significantly higher for all groups. However, the change between pre-treatment and post-treatment (delta value) was greater for the US + LLLT (4 ± 1) and TE + US + LLLT groups (5 ± 1) than for the placebo group (2 ± 1) with a significant intergroup difference (p < 0.05). This study showed reduced pain and increased physical functionality after 3 months of US + LLLT with and without TE.
Patients with pain avoid movements, leading to a gradual impairment of their physical condition and functionality. In this context, the use of ultrasound (US) and low-level laser therapy (LLLT) show promising results for nonpharmacological and noninvasive treatment. The aim of this study was evaluated the synergistic effects of the US and the LLLT (new prototype) with or without therapeutic exercises (TE) on pain and grip strength in women with hand osteoarthritis. Forty-five women with hand osteoarthritis, aged 60 to 80 years, were randomly assigned to one of three groups, but 43 women successfully completed the full study. The three groups were as follows: (i) the placebo group which did not perform TE, but the prototype without emitting electromagnetic or mechanical waves was applied (n = 11); (ii) the US + LLLT group which carried out only the prototype (n = 13); and (iii) the TE + US + LLLT group which performed TE before the prototype is applied (n = 13). The parameters of US were frequency 1 MHz; 1.0 W/cm(2) intensity, pulsed mode 1:1 (duty cycle 50%). Regarding laser, the output power of the each laser was fixed at 100 mW leading to an energy value of 18 J per laser. Five points were irradiated per hand, during 3 min per point and 15 min per session. The prototype was applied after therapeutic exercises. The treatments are done once a week for 3 months. Grip strength and pressure pain thresholds (PPT) were measured. Grip strength did not differ significantly for any of the groups (p ≥ 0.05). The average PPT between baseline and 3 months shows significant decrease of the pain sensitivity for both the US + LLLT group (∆ = 30 ± 19 N, p˂0.001) and the TE + US + LLLT group (∆ = 32 ± 13 N, p < 0.001). However, there were no significant differences in average PPT for placebo group (∆ = -0.3 ± 9 N). There was no placebo effect. The new prototype that combines US and LLLT reduced pain in women with hand osteoarthritis.
O objetivo desta pesquisa foi investigar as variáveis cardio-respiratórias (Pa, FC, VO2, VCO2 e Ve) durante a Estimulação Elétrica Neuromuscular (EENM) do quadríceps em portadores de lesão medular. Participaram da pesquisa dez pacientes (cinco paraplégicos e cinco tetraplégicos). O protocolo do teste consistiu em 10 minutos de repouso, 20 minutos de EENM dos quadriceps e 10 minutos de recuperação. Durante a EENM foram constatados baixos valores de VO2 e VCO2. Os paraplégicos apresentaram rápida cinética dos gases e os tetraplégicos lenta cinética dos gases. Houve o aumento da Pa sistólica e da FC. Ainda, os valores das variáveis cardio-respiratórias foram inversamente relatadas para o nível de lesão, ou seja, quanto maior o nível de lesão, menor os valores. Portanto, a maioria dos pacientes apresentaram algumas limitações nas respostas cardio-respiratórias, indicando realização de exercício exaustivo, mas apresentaram capacidade de realização de exercício induzido artificialmente, possivelmente devido aos benefícios da EENM.
Objective To evaluate the effects of infrared-light-emitting diode (LED) during treadmill training on functional performance.Methods Thirty postmenopausal women aged 50 -60 years were randomly assigned to one of three groups and successfully completed the full study. The three groups were: (1) the LED group, which performed treadmill training associated with phototherapy ( n ϭ 10); (2) the exercise group, which carried out treadmill training only ( n ϭ 10); and (3) the sedentary group, which neither performed physical training nor underwent phototherapy ( n ϭ 10). Training was performed over a period of 6 months, twice a week for 45 min per session at 85 -90% of maximal heart rate, which was obtained during progressive exercise testing. The irradiation parameters were 100 mW, 39 mW/cm 2 and 108 J/cm 2 for 45 min. Quadriceps performance was measured during isokinetic exercise testing at 60 ° /s and 300 ° /s.Results Peak torque did not differ amongst the groups. However, the results showed signifi cantly higher values of power and total work for the LED group ( Δ ϭ 21 ϩ Ϫ 6 W and Δ ϭ 634 ϩ Ϫ 156 J, p Ͻ 0.05) when compared to both the exercise group ( Δ ϭ 13 ϩ Ϫ 10 W and Δ ϭ 410 ϩ Ϫ 270 J) and the sedentary group ( Δ ϭ 10 ϩ Ϫ 9 W and Δ ϭ 357 ϩ Ϫ 327 J). Fatigue was also signifi cantly lower in the LED group ( Δ ϭ Ϫ 7 ϩ Ϫ 4%, p Ͻ 0.05) compared to both the exercise group ( Δ ϭ 3 ϩ Ϫ 8%) and the sedentary group (Δ ϭ Ϫ 2 ϩ Ϫ 6%).Conclusions Infrared-LED during treadmill training may improve quadriceps power and reduce peripheral fatigue in postmenopausal women.
Aos meus pais Marta e Nicola pelo apoio, incentivo e afeto. Aos meus filhos Lucas, Marina e Júlia pelo carinho, compreensão e paciência. Ao Giovani pelo suporte, estímulo e companheirismo. À minha irmã Fernanda pelo afeto, colaboração e importantes contribuições. A toda minha família, aos que estão ao meu lado e torcem por mim e aos que partiram, antes da conclusão desse trabalho... Meu eterno agradecimento à querida Tia Rosa. Ao PPGIB-USP, IFSC-USP e EESC-USP por propiciarem a realização desse trabalho. Ao PPGIB-USP por disponibilizar a infraestrutura para a realização desse trabalho. Ao Prof. Dr. José Marcos Alves do PPGIB-USP pela orientação, paciência e amizade durante o desenvolvimento desse trabalho. Ao Prof. Dr. Vanderlei Salvador Bagnato do IFSC-USP pela co-orientação, apoio financeiro para a realização desse trabalho e amizade. À Prof.ª Drª Janice Rodrigues Perussi, do IQSC-USP, e Dr. Orivaldo Lopes da Silva, do PPGIB-USP, pelos ensinamentos e conversas edificantes.
Post‐stroke sequelae includes loss functions, such as cognitive and sensory‐motor which lead to emotional and social problems, reducing quality of life and well‐being. The main aim of our study was to investigate the effects of transcranial laser photobiomodulation together with neuromuscular electrical stimulation (NMES) in post‐stroke patients. We performed a clinical trial and an ex vivo study. For the clinical trial, hemiplegic patients were separated into two groups: Treated Group (TG): Hemiplegics treated with transcranial laser (on) associated with NMES (on) and; Placebo Group (PG): Hemiplegics treated with placebo transcranial laser (off) associated with NMES (on). The cluster prototype includes 12 diode laser beams (4 × 660 nm, 4 × 808 nm and 4 × 980 nm) with average power of 720 mW per cluster applied during one minute, leading to 43.2 J energy per cluster. Fifteen regions for all head were irradiated by cluster, leading to 648 J energy per session. The parameters of NMES of the paretic limbs to generate extension wrist and ankle dorsiflexion were symmetrical biphasic rectangular waveforms, 50 Hz frequency, 250 μs pulse duration, and adjustable intensity to maintain the maximum range of motion (amplitude between 0 and 150 mA). Our clinical trial showed improvement of cognitive function, pain relief, greater manual dexterity, enhancement of physical and social–emotional health which lead to better quality of life and well‐being. There was also increased temperature in the treated regions with laser and NMES. For the ex vivo study, the distribution of infrared and red radiation after penetration through the cranium and hemihead of cadavers were showed. Therefore, transcranial laser photobiomodulation associated with NMES can be an important therapeutic resource for rehabilitation after stroke.
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