Effects of photobiomodulation and a physical exercise program on the expression of inflammatory and cartilage degradation biomarkers and functional capacity in women with knee osteoarthritis: a randomized blinded study

Abstract

Background The knee osteoarthritis (OA) is a joint disease characterized by degradation of articular cartilage that leads to chronic inflammation. Exercise programs and photobiomodulation (PBM) are capable of modulating the inflammatory process of minimizing functional disability related to knee OA. However, their association on the concentration of biomarkers related to OA development has not been studied yet. The aim of the present study is to investigate the effects of PBM (via cluster) with a physical exercise program in functional capacity, serum inflammatory and cartilage degradation biomarkers in patients with knee OA. Methods Forty-two patients were randomly allocated in 3 groups: ESP: exercise + sham PBM; EAP: exercise + PBM and CG: control group. Six patients were excluded before finished the experimental period. The analyzed outcomes in baseline and 8-week were: the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) and the evaluation of serum biomarkers concentration (IL-1β, IL-6, IL-8, IL-10 e TNF-α, and CTX-II). Results An increase in the functional capacity was observed in the WOMAC total score for both treated groups (p < 0.001) and ESP presents a lower value compared to CG (p < 0.05) the 8-week post-treatment. In addition, there was a significant increase in IL-10 concentration of EAP (p < 0.05) and higher value compared to CG (p < 0.001) the 8-week post-treatment. Moreover, an increase in IL-1β concentration was observed for CG (p < 0.05). No other difference was observed comparing the other groups. Conclusion Our data suggest that the physical exercise therapy could be a strategy for increasing functional capacity and in association with PBM for increasing IL-10 levels in OA knee individuals. Trial registration: ReBEC (RBR-7t6nzr).

How Physical Activity Affects Knee Cartilage and a Standard Intervention Procedure for an Exercise Program: A Systematic Review

“…Azukizawa et al [ 20 ], Centeno et al [ 24 ], Mikesky et al [ 36 ], and Multanen et al [ 37 ] generally detected no significant changing after physical exercise related to pain and functional outcomes. Dinçer et al [ 25 ], Ikuta et al [ 31 ], Kangeswari et al [ 32 ], Knoop et al [ 35 ], and Vassao et al [ 41 ] detected better results after a physical exercise treatment both for the pain scale and functional outcomes.…”

“…Specific muscle strengthening interventions [ 25 , 28 , 31 , 35 , 36 , 41 ] and isometric exercises are proposed [ 32 ]. One of the intervention proposals is individually progressed and consisted of 5 min warm-up and hopping (3–5 sets, 15 s of rest between sets) exercises of approximately 3–4 min [ 28 ].…”

“…Similarly, an intervention proposes muscle strengthening exercises for the gluteal area, hamstrings, quadriceps, and triceps surae muscles [ 31 ]. Another intervention consists of 5 min on treadmill, six strength exercises (3 sets; 8 repetitions; 60% of 1-RM; rest interval of 2–3 min: hip abductors and adductors chair, seated leg raise, glute bridge, knee flexors and extensors chair), and stretching of major muscle groups [ 41 ]. The interventions could be supported also by knee joint stabilization exercises [ 35 ].…”

Physical therapy as a promising treatment for osteoarthritis: A narrative review

“…In recent decades, multiple clinical trials and meta-analysis from different groups have also investigated the effects of various diagrams of physical therapy on the symptoms of OA patients (Chen et al, 2021b;Vassão et al, 2021;Kalo et al, 2022). Trial sequential analysis and network meta-analysis from Olalekan et al (Uthman et al, 2013) analyzed 60 trials covering 12 exercise interventions and 8218 patients, which showed that as of 2002 sufficient evidence supported the significant benefits of exercise over no exercise in OA patients.…”

Functionalized Hydrogels for Cartilage Repair: The Value of Secretome-Instructive Signaling

“…For instance, several studies have shown the beneficial effect of using photobiomodulation, with low- or high-level laser therapies in in vivo models or in patients with OA [ 10 , 11 , 12 ]. The effects of these therapies included reduction of pain, improvement in cartilage function and thickness [ 13 , 14 , 15 ], stimulation of angiogenesis [ 16 ], improvement in the anti-inflammatory [ 17 , 18 , 19 ], and antioxidant [ 14 ] responses. However, in many cases, these treatments alone are not enough to restore cartilage, and surgical interventions become necessary.…”