O objetivo do estudo foi realizar uma revisão de literatura a respeito da terapia com laser de baixa potência e sua relação com as fases iniciais de reparo. Foram analisados 22 artigos, observou-se a utilização de diferentes doses e comprimentos de ondas (632,8 a 904 nm). Nos estudos in vitro foram utilizadas doses entre 2,2 e 16 J/cm². A dose de 5 J/cm² tem sido apontada como responsável por mudanças significativas in vitro, porém a dose de 16 J/cm² promove efeito inibitório sobre o crescimento celular em culturas. Em estudos in vivo, envolvendo animais foram utilizadas doses entre 0,04 a 21 J/cm². Para estudos em humanos foram utilizadas doses entre 1,8 a 16 J/cm². Conclui-se que a terapia com laser de baixa potência exerce efeitos antiinflamatórios importantes nos processos iniciais da cicatrização: redução de mediadores químicos, de citocinas, do edema, diminuição da migração de células inflamatórias e incremento de fatores de crescimento contribuindo diretamente para o processo de reabilitação tecidual. Porém, a falta de padronização dificulta a escolha de parâmetros ideais. Keywords: Fibroblast growth factors; Inflammation; Inflammation mediators; Laser therapy, Low-level; Lasers Resumo: O objetivo do estudo foi revisar a literatura a respeito da terapia com laser de baixa potência e sua relação com as fases iniciais de reparo. Foram analisados 22 artigos, observando-se a utilização de diferentes doses e comprimentos de ondas (632,8 a 904 nm). Nos estudos in vitro, foram utilizadas doses entre 2,2 e 16 J/cm². A dose de 5 J/cm² tem sido apontada como responsável por mudanças significativas in vitro; porém, a dose de 16 J/cm² promove efeito inibitório sobre o crescimento celular em culturas. Em estudos in vivo, envolvendo animais, foram utilizadas doses entre 0,04 a 21 J/cm². Para estudos em humanos, foram utilizadas doses entre 1,8 a 16 J/cm². Conclui-se que a terapia com laser de baixa potência exerce efeitos anti-inflamatórios importantes nos processos iniciais da cicatrização: redução de mediadores químicos, de citocinas, do edema, diminuição da migração de células inflamatórias e incremento de fatores de crescimento, contribuindo diretamente para o processo de reabilitação tecidual. Porém, a falta de padronização dificulta a escolha de parâmetros ideais. Palavras-chave: Fatores de crescimento de fibroblastos; Inflamação; Lasers; Mediadores da inflamação; Terapia a laser de baixa intensidade
The SCIG (above T6) showed greater cardiovascular autonomic impairment compared to SCIG (below T6) and CG. The SCIG (below T6) also presented some degree of autonomic dysfunction. All parameters, linear or nonlinear, are suitable to demonstrate the differences between the SCIG and CG.
The aim of this study was to investigate the cardiovascular autonomic acute response, during recovery after handcycle training, in quadriplegics with spinal cord injury (SCI). [Subjects and Methods] Seven quadriplegics (SCIG −level C6–C7, male, age 28.00 ± 6.97 years) and eight healthy subjects (CG −male, age 25.00 ± 7.38 years) were studied. Their heart rate variability (HRV) was assessed before and after one handcycle training. [Results] After the training, the SCIG showed significantly reduced: intervals between R waves of the electrocardiogram (RR), standard deviation of the NN intervals (SDNN), square root of the mean squares differences of sucessive NN intervals (rMSSD), low frequency power (LF), high frequency power (HF), and Poincaré plot (standard deviation of short-term HRV −SD1 and standard deviation of long-term HRV −SD2). The SDNN, LF, and SD2 remained decreased during the recovery time. The CG showed significantly reduced: RR, rMSSD, number of pairs of adjacent NN intervals differing by more than 50 ms (pNN50), LF, HF, SD1, and sample entropy (SampEn). Among these parameters, only RR remained decreased during recovery time. Comparisons of the means of HRV parameters evaluated between the CG and SCIG showed that the SCIG had significantly lower pNN50, LF, HF, and SampEn before training, while immediately after training, the SCIG had significantly lower SDNN, LF, HF, and SD2. The rMSSD30s of the SCIG significantly reduced in the windows 180 and 330 seconds and between the windows 300 seconds in the CG. [Conclusion] There was a reduction of sympathetic and parasympathetic activity in the recovery period after the training in both groups; however, the CG showed a higher HRV. The parasympathetic activity also gradually increased after training, and in the SCIG, this activity remained reduced even at three minutes after the end of training, which suggests a deficiency in parasympathetic reactivation in quadriplegics after SCI.
Objetivo. Realizar uma revisão sobre os efeitos da terapia a laser de baixa intensidade (TLBI) na regeneração do tecido nervoso após lesão medular (LM). Método. Buscou-se artigos nos bancos de dados Medline, Scielo e Lilacs, entre 2002 e 2014. Utilizou-se as palavras-chaves: terapia a laser de baixa intensidade, medula espinal, ferimentos e lesões. Resultados. Foram identificados sete estudos relacionados ao tema, a maioria usou modelo animal (86%) e apenas um (14%) humano. Em relação aos parâmetros de irradiação, o comprimento de onda variou de 780-904nm, a dose de 1,59-20 J/cm², o tempo de aplicação de 2-30 minutos, o período de irradiação de 5-21 dias consecutivos e no estudo com humanos, foram de 40-57 sessões (não consecutivas). As formas de irradiação foram direta ou transcutânea. Dois estudos utilizaram transplante de células associado à TLBI. As causas da LM foram secção completa, hemissecção e contusão. Todos os estudos mostraram resultados positivos da TLBI. Conclusão. A TLBI parece exercer efeitos positivos sobre a LM a partir da diminuição do processo inflamatório, diminuição de citocinas e quimiocinas, melhora da distribuição de fibrocartilagem/elastina, maior número e brotamento axonal, e consequentemente menor cavitação no local da lesão, melhor potencial evocado somatossensorial e melhor recuperação funcional.
RESUMOObjetivo. Realizar uma revisão sobre os efeitos da terapia a laser de baixa intensidade (TLBI) na regeneração do tecido nervoso após lesão medular (LM). Método. Buscou-se artigos nos bancos de dados Medline, Scielo e Lilacs, entre 2002 e 2014. Utilizou-se as palavras-chaves: terapia a laser de baixa intensidade, medula espinal, ferimentos e lesões. Resultados. Foram identificados sete estudos relacionados ao tema, a maioria usou modelo animal (86%) e apenas um (14%) humano. Em relação aos parâmetros de irradiação, o comprimento de onda variou de 780-904nm, a dose de 1,59-20 J/cm², o tempo de aplicação de 2-30 minutos, o período de irradiação de 5-21 dias consecutivos e no estudo com humanos, foram de 40-57 sessões (não consecutivas). As formas de irradiação foram direta ou transcutânea. Dois estudos utilizaram transplante de células associado à TLBI. As causas da LM foram secção completa, hemissecção e contusão. Todos os estudos mostraram resultados positivos da TLBI. Conclusão. A TLBI parece exercer efeitos positivos sobre a LM a partir da diminuição do processo inflamatório, diminuição de citocinas e quimiocinas, melhora da distribuição de fibrocartilagem/elastina, maior número e brotamento axonal, e consequentemente menor cavitação no local da lesão, melhor potencial evocado somatossensorial e melhor recuperação funcional. Unitermos. Terapia a Laser de Baixa Intensidade, Medula Espinal, Ferimentos e LesõesCitação. Abreu EMC, Nicolau RA. Terapia a laser de baixa intensidade na regeneração do tecido nervoso após lesão medular. ABSTRACTObjective. Conduct a literature review about the low intensity laser therapy (LILT) action on regeneration of central nervous tissue after spinal cord injury (SCI). Method. We searched for articles on Medline, Scielo, and Lilacs, from 2002 to 2014, with the descriptors: low intensity laser therapy, spinal cord, wounds and injuries. Results. Seven studies related to the theme were identified. The animal model was used in most of them (86%), and one (14%) used human. The wavelength varied from 780-904 nm, dose of 1.59-20 J/cm, exposure time of 2-30 minutes, irradiation period of 5-21 consecutive days, and the study with humans conducted 40-57 sessions (not consecutive). The cited forms of irradiation were transcutaneous and punctual. Two studies used cell transplantation associated with LILT. The cause of SCI ranged from complete section, hemisection, and contusion. All studies showed positive results of LILT. Conclusion. LILT exerts effects on SCI, decreasing the inflammatory process, decreasing cytokines and chemokines, improving the distribution of fibrocartilage/elastin, increasing axonal budding, which consequently lessened cavitation at the lesion site, improved evoked somatosensory potential, and improved functional recovery. Keywords. Low Intensity Laser Therapy, Spinal Cord, Wounds and InjuriesCitation. Abreu EMC, Nicolau RA. Low intensity laser therapy on regeneration of nervous tissue after spinal cord injury. Terapia a laser de baixa intensidade na regeneração do ...
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Objective: To evaluate the effect of Global Postural Reeducation (GPR) on cardiovascular system by heart rate variability (HRV), blood pressure (BP) and heart rate (HR). Materials and methods: Seventeen healthy men (22.47 ± 3.02 years) were submitted to the postures frog on the floor, frog on the air, sitting, standing against the wall and inclined standing, two postures per session. The systolic and diastolic blood pressure (SBP and DBP) and HR were recorded. The intervals between heartbeats were collected during the whole session (Polar S810i). The frequency domain was analyzed (Wavelet Transform), the low frequency (LF) and high frequency (HF) were obtained. The data were analyzed by ANOVA and Tukey (p < 0.05). Results: Increased LF/HF ratio was observed in the frog on the floor (1 ± 0.1 vs. 2 ± 0.3 p < 0.05) and on the air postures (1 ± 0.1 vs. 2 ± 0.2 p < 0.01). There was an increase in SBP in the postures frog on the floor (123 ± 2 vs. 136 ± 4 p < 0.05), frog on the air (122 ± 2 vs. 133 ± 3 p < 0.05), standing against the wall (123 ± 2 vs. 136 ± 4 p < 0.05), inclined standing (124 ± 3 vs. 146 ± 5 p < 0.05). There was increase of DBP in the postures frog on the floor (69 ± 2 vs. 81 ± 2 p < 0.01), frog on the air (72 ± 2 vs. 83 ± 3 p < 0.05), sitting (85 ± 2 vs. 102 ± 3 p < 0.01). There was increase in HR in the postures frog on the air (67 ± 2 vs. 77 ± 3 p < 0.05) and inclined standing (88 ± 3.5 vs. 101 ± 3 p < 0.05). Conclusion: The increase in LF/HF ratio and also the BP and HR indicates high sympathetic activity, possibly related to the work isometric developed during GPR method. [P] Keywords: Posture. Autonomic nervous system. Cardiovascular system.
Introduction: Threshold doses of electromagnetic radiation can initiate necrosis and apoptosis in cells. The purpose of this study was to evaluate cellular apoptosis and necrosis immediately (t 0 ) and 24 hours (t 24 ) after irradiation with different doses of coherent light (laser) or non-coherent light (LED). Methods: CHO-K1 lineage cells were irradiated with laser (810nm) or LED (945±20nm), with 24mW, contact area of 1cm 2 and doses of 10, 20, 30, 40 and 50J/cm 2 for 300, 660, 960, 1230 and 1620s, respectively, at both wavelengths. Cells were evaluated by fluorescence microscopy, differentiating viable, apoptotic and necrotic cells immediately and 24 hours after irradiation. Results: The number of necrotic cells at t 0 was higher in the LED 40 and 50J/cm 2 groups (86±14 and 84±16% respectively, p <0.05), than in the 10 and 20J/cm 2 laser (5±2 and 5±3%, p<0.05) and LED (5±3 and 4±1%, p<0.05) conditions. At t 24, the LED 40J/cm 2 (80±20%, p<0.05) group also showed more necrosis than the control and lower dose groups (laser 10, 20, and 30J/cm 2 percentage of 6±4, 10±3 and 7±3%, p<0.05; LED 10 and 20J/cm 2 percentage of 3±1 and 17±10%, p<0.05). A decrease in apoptotic cells was observed in the laser group with doses of 10, 40, and 50J/cm 2 (6±4, 3±1 and 1±1% respectively, not significant), as well as in the LED 40J/cm 2 (2±2%, not significant) group versus control. The cells had a higher percentage of apoptosis cells in the control group and with laser doses of 10 and 30J/cm 2 (percentage of 20±1 and 20±4%, not significant), while only the LED 40J/cm 2 (10±10%, not significant) had a lower percentage compared the control group. Conclusion: Laser or LED stimulation promoted an increase in cell necrosis in a high energy density condition as characterized in a dose-dependent inhibition therapy. Laser or LED infrared irradiation in low doses (up to 20J/cm 2 ) reduced the percentage of apoptosis in CHO-K1 cells, while high doses (30J/cm 2 ) elevated apoptosis.
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