Changes involving temporomandibular joint, masticatory musculature, and associated structures characterize temporomandibular dysfunction (TMD). The analgesic and anti-inflammatory effect produced by photobiomodulation has contributed to pain relief and functional improvement. However, the parameters to be used have not yet been well established. The aim of this study is to compare the efficacy of three different photobiomodulation dosimetries in the treatment of patients with TMD. A randomized, double-blind, placebo-controlled clinical trial with 44 subjects divided into the groups 8 J/cm (n = 11), 60 J/cm (n = 11), 105 J/cm (n = 11), and control (n = 11). Pain, symptom severity, and joint mobility were evaluated before and after a ten-session protocol of photobiomodulation with AlGaAs laser (830 nm), at a power density of 30 mW/cm. The mouth opening increased in the 8-J/cm group from 10.49 ± 4.68 to 15.40 ± 6.43 degrees, and in the right protrusion from 9.80 ± 4.2 to 12.56 ± 5.40 degrees after the intervention protocol (p < 0.05). All groups significantly decreased pain (p < 0.05). 830-nm laser photobiomodulation was effective in reducing TMD pain and symptoms at all doses tested. Only the doses of 8 J/cm were effective regarding maximal opening and protrusion of the mandible.
Introduction
Tendinitis affects a substantial number of people in several occupations involving repetitive work or direct trauma. Iontophoresis is a therapeutic alternative used in the treatment of injury during the inflammatory phase. In recent years, gold nanoparticles (GNP) have been studied due to their therapeutic anti-inflammatory capacity and as an alternative to the transport of several proteins.
Purpose
This study evaluates the therapeutic effects of iontophoresis using GNPs and diclofenac diethylammonium on inflammatory parameters in rats challenged with traumatic tendinitis.
Methods
Wistar rats were divided in three treatment groups (n = 15): (1) iontophoresis + diclofenac diethylammonium; (2) iontophoresis + GNP; and (3) iontophoresis + diclofenac diethylammonium + GNP. External control was formed by challenged tendons without treatment (n = 15). Iontophoresis was administered using 0.3 mA direct current on 1.5 cm
2
electrodes.
Results
The levels of both inflammatory cytokines were significantly higher in untreated challenged rats, when compared with the control (5.398 ± 234 for interleukin 1 beta and 6.411 ± 432 for tumor necrosis factor alpha), which confirms the occurrence of an inflammatory stage in injury (
P
< 0.05). A significant decrease was observed in expression of cytokines interleukin 1 beta in the three treatment groups, in comparison with untreated challenged tendons, although, in the group treated with diclofenac and GNP, results were similar to the control (1.732 ± 239) (
P
< 0.05). Concerning tumor necrosis factor alpha, only the group treated with the association diclofenac and GNPs presented decreased levels, compared with the control (3.221 ± 369) (
P
< 0.05).
Conclusion
The results show the efficacy of drug administration using direct current to treat tendinitis in an animal model, and the potential anti-inflammatory, carrier, and enhancing effects of GNPs in iontophoresis.
Tendinitis is a painful condition that occurs in tendons in response to repetitive use or direct trauma. The therapeutic approaches commonly employed to modulate inflammation have not achieved complete success in chronic cases of tendinitis. In this scenario, considering the anti-inflammatory properties of pulsed therapeutic ultrasound and gold nanoparticles (GNPs), this study assesses the possible therapeutic effects of phonophoresis in association with diclophenac diethylammonium and GNPs by measuring the inflammatory parameters interleukin 1β and tumor necrosis factor alpha in acute tendinous injury. Wistar rats were randomly divided into three groups and were treated with phonophoresis and diclophenac diethylammonium, GNP gel, and a combination thereof. A significant decrease in interleukin 1β and tumor necrosis factor alpha occurred in tendons treated with phonophoresis+diclophenac+GNPs. The content of both cytokines were similar after combined treatment with phonophoresis+diclophenac+GNPs. Apart from the anti-inflammatory effect, GNPs transported and enhanced drug action when used with phonophoresis.
Introduction. Disc Protrusion (DP) is a degenerative spinal disorder. Lumbar intervertebral disc protrusion is one of the most common orthopedic injuries, leading to low back pain that radiates to the lower limbs. Physical exercise is the main element in the conservative treatment of low back pain. Objective. Comparing the effects of the McKenzie method and core stabilization exercises on the rehabilitation of patients with lumbar DP. Methods. We allocated sixty-nine patients with low back pain due to disc protrusion to the Core Group (CG), the McKenzie Group (MG), or the Core + McKenzie Group (CMG). All groups underwent three interventions per week for four weeks, totaling 12 sessions. We assessed pain intensity, hamstring flexibility, functional capacity, muscle strength, and lumbopelvic stability. Results. All intervention groups significantly reduced pain intensity and functional disability, besides improving posterior muscle chain flexibility, quality of life, trunk muscle strength, and lumbopelvic stability (p < 0.05). For functional capacity, assessed through the SF-26 Questionnaire, as well as for posture holding time in the lumbopelvic stability tests, the CG and CMG significantly improved the results compared to the MG (p < 0.05). Conclusions. The results suggest that both exercise methods were efficient in reducing pain and improving function in patients with low back pain due to disc protrusion. However, the groups that used stabilization exercises showed better results in activating lumbopelvic stabilizing muscles.
Introduction: Stretching is a therapeutic technique and may be used as a form of warm-up to increase flexibility or decrease pain throughout the movement, with objective to improve performance and reduce the risk of injury. Objective: To verify the acute and chronic effects of a program of static stretching compared with the dynamic one in performance of young soccer athletes. Methods: Randomized clinical study of equivalence carried out between August and November, 2010 with the under-17 category of the Grêmio Torrense club. After fulfilling the inclusion criteria, the athletes were randomly allocated into two groups: static stretching or dynamic stretching. All of them underwent an initial evaluation and were submitted to the first intervention. They were evaluated once again and at the end of 12 training sessions as well. Flexibility, impulse, speed, strength and muscle recruitment valences were evaluated. Results: The long jump has significantly improved in the two study groups; however, this improvement persisted in the chronic phase only in the static stretching group (p = 0.02). Flexibility increased significantly in both groups in the acute phase, but it only occurred in the static group following this improvement in the chronic phase (p = 0.03). The two examples of stretching led to decrease in performance in the velocity test. No improvement was observed in the hamstrings muscle strength throughout the study period in the two groups. Electric activity of hamstrings significantly decreased in the acute phase for the static stretching group (p = 0.035), while it significantly increased in the chronic phase in the dynamic stretching group (p = 0.038). Conclusion: It could be concluded that static stretching improves flexibility and long jump, while dynamic stretching improves muscular activation.
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