Association of photobiomodulation therapy (PBMT) and exercises programs in pain and functional capacity of patients with knee osteoarthritis (KOA): a systematic review of randomized trials

Vassão, Patrícia Gabrielli; Parisi, Júlia Risso; Penha, Thaise Fernanda Campos; Balão, Ana Beatriz; Rennó, Ana Cláudia Muniz; Ávila, Mariana Arias

doi:10.1007/s10103-020-03223-8

Cited by 14 publications

(12 citation statements)

References 36 publications

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“…Assim, o uso da PBMT por laser na biomodulação da cartilagem articular em processo degenerativo do tecido cartilaginoso, por meio de suas propriedades fotoquímicas e fotobiológicas, tem sido estudado por pesquisadores em todo o mundo e seus efeitos positivos na recuperação tecidual vêm sendo evidenciados (Xiang et al, 2020;Vassão et al, 2021).…”

Section: Referencial Teórico Osteoartrite De Joelhounclassified

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Terapia por fotobiomodulação: mecanismo de ação e importância clínica no tratamento da osteoartrite de joelho

Silva

Rezzo

Tim

et al. 2021

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A osteoartrite do joelho (OAJ) é uma das doenças articulares degenerativa progressiva mais comuns em todo o mundo e também uma das principais causas de incapacidade e danos à qualidade de vida. A terapia de fotobiomodulação (PBMT, do inglês Photobiomodulation Therapy) através de laser de baixa intensidade (LLLT, do inglês Low Level Laser Therapy) tem mostrado ser um tratamento promissora e com bons resultados para diversas doenças crônicas, incluindo as alterações que acometem o sistema articular. Dentro deste contexto, o objetivo deste estudo é proporcionar, por meio de uma revisão narrativa, uma compreensão das evidências atuais disponíveis sobre o mecanismo de ação e importância clínica da PBMT a laser no tratamento da OAJ. As buscas foram realizadas nas bases de dados bibliográficas do PubMed/MEDLINE, Biblioteca virtual da saúde (BVS), Web of Science e SciELO. Com base nos estudos revisados por pares, os dados laboratoriais em modelos animais experimentais e estudos clínicos mostram que a PBM é capaz de reduzir a morte de condrócitos, estimular a síntese de componentes da matriz extracelular (MEC), atenuar a liberação de mediadores inflamatórios e proteolíticos presente em doenças articulares crônicas, prevenindo assim a degradação do tecido articular e periarticulares. Consequentemente, clinicamente, pode ser observado melhora da dor, funcionalidade e qualidade de vida do indivíduo acometido com OAJ e tratados com a PBMT a laser. Assim, podemos concluir que a PBMT a laser pode constituir um excelente coadjuvante no tratamento da OAJ, uma vez que é um método não invasivo e também apresenta custos relativamente baixos.

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Section: Referencial Teórico Osteoartrite De Joelhounclassified

“…Pesquisas com modelos experimentais de OAJ evidenciaram que a PBMT promove uma série de modificações metabólicas e estruturais do tecido articular (Xiang et al, 2020;Vassão et al, 2021).…”

Section: Pbmt Promove Alterações Metabólicas E Estruturais Da Cartilagem Na Oajunclassified

Terapia por fotobiomodulação: mecanismo de ação e importância clínica no tratamento da osteoartrite de joelho

Silva

Rezzo

Tim

et al. 2021

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“…Strength training (ST) has shown to be a promising method to influence cartilage morphology and chemical composition, promoting analgesic and functional effects of people with KOA (6,7) . However, initial pain intensity level can be is so high that prevents the individuals from exercising (8) , and since KOA is a chronic disease, exercise-based rehabilitation may not be enough to reduce pain (5) . Although reduced leg strength is a common disabling feature in KOA, the effectiveness of photobiomodulation (PBMT) associated with ST, in the form of strength training has been investigated in randomized controlled trials (RCTs), however the results are not well clarified (9)(10)(11)(12) .…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, PBMT has shown to upregulate the proliferation of fibroblasts and proteoglycans in the synthesis of collagen, which slows down the deterioration of articular cartilage. Although meta-analyses indicate that these processes translate into pain and disability reduction in KOA, it is unclear to which extent due to statistical heterogeneity of the analyses (8,15) . Therefore, the effect of adding ST to a PBMT regimen in KOA is far from established (16) .…”

Section: Introductionmentioning

confidence: 99%

Photobiomodulation Therapy Using Infrared (808 nm) Low Level Laser Therapy Associated with Strength Training in Knee Osteoarthritis: A Randomized placebo-controlled clinical trial

et al. 2022

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Mechanisms for significant clinical and statistical benefits of photobiomodulation (PBMT) in the treatment of knee osteoarthritis (KOA) include anti-inflammatory effects, optimization of tissue repair, improved muscle function and analgesia. The effectiveness of (PBMT) associated with strength training (ST), in the form of strength training, has been investigated in randomized clinical trials, but the results are not well clarified. The aim of this study was to evaluate the effects of ST associated with PBMT on joint pain intensity, range of motion, physical function and muscle strength of the quadriceps femoris and hamstrings in patients diagnosed with KOA. Twenty-eight adult patients of both genders with KOA were randomly distributed in 2 treatment groups, performed 3 times a week, for 6 weeks: ST Group (ST), submitted to stretching, self- mobilization, muscle strengthening and sensorimotor training and ST and STP Group (STP), submitted to the same program as the ST followed by infrared laser irradiation (Therapy XT, DMC, São Carlos, Brasil, l= 808 nm, P= 100mW, 5 points in the medial joint region and 4 points lateral, 3 J/point, 30 s/point). Blinded evaluators assessed pain at movent and no movement and range of motion using Analogic Visual Scale and goniometry, respectively. To assess physical function, the WOMAC questionnaire (Western Ontario and MacMaster University Osteoarthritis Index) and functional tests were used: Sit and stand test; 2 min-walk test. The muscular strength of the quadriceps and hamstrings were measured using an isometric dynamometer. The evaluations were performed in 4 moments: before (EV0), during (EV1: 3 weeks of treatment), at the end (EV2: after 6 weeks of treatment) and 30 days after the end of treatment (follow-up). The STP group showed a significant reduction in pain intensity at rest and at movement in EV1, as well as, significant improvement in relation to stiffness, total WOMAC and knee flexion amplitude, an improvement in physical function and an increase in muscle strength of quadriceps femoris when compared to ST group (p <0.05). In the assessment of the strength of the hamstring muscles, there was no significant difference between the groups at any time evaluated (p> 0.05). ST associated with PBMT had greater effects in reducing joint pain intensity, active knee flexion, physical function and muscle strength, especially in the quadriceps femoris, than strength training alone in patients with KOA.

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“…Pain, stiffness, and crepitus in joint movement are some of the symptoms that disable individuals. The treatment of this disease includes control of body mass (weight reduction), use of anti-inflammatory drugs, and exercise 1 .…”

Section: Introductionmentioning

confidence: 99%

Comparison between pain intensity, functionality, central sensitization, and self-efficacy in individuals with unilateral or bilateral knee osteoarthritis: a cross-sectional study

Oliveira

Pontes‐Silva

Damasceno

et al. 2022

Rev. Assoc. Med. Bras.

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Osteoarthritis is a chronic degenerative disease that affects the joints, in particular, the knee is the most commonly affected. Pain, stiffness, and crepitus in joint movement are some of the symptoms that disable individuals. The treatment of this disease includes control of body mass (weight reduction), use of anti-inflammatory drugs, and exercise 1 .Recent studies have focused on understanding the risks of comorbidities associated with knee osteoarthritis 2 , the biochemical and gait parameters after arthroplasty 2,3 , and prognosis after therapies in bilateral knee osteoarthritis (B-KO) and unilateral knee osteoarthritis (U-KO) 4 .Asymmetry between the lower limbs seems to be more prevalent in individuals with B-KO 5 , while the reduction in muscle strength and volume of the affected limb is more observed in individuals with U-KO 6 , and both (B-KO and U-KO) have already been associated with primary and secondary hyperalgesia 7 . However, these clinical differences have been less investigated.Marmon et al. 8 and Messier et al. 9 described that, regardless of the number of affected knees, individuals with knee osteoarthritis have similar functional capacity and biomechanical parameters. Riddle and Stratford 10 pointed out that people with U-KO have higher levels of pain; however, according to the authors themselves, the differences between the clinical variables of bilateral and unilateral involvement in knee osteoarthritis remain controversial and little known. In this perspective, this study aimed to compare pain intensity, stiffness, functionality, central sensitization, and self-efficacy between individuals

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Association of photobiomodulation therapy (PBMT) and exercises programs in pain and functional capacity of patients with knee osteoarthritis (KOA): a systematic review of randomized trials

Cited by 14 publications

References 36 publications

Terapia por fotobiomodulação: mecanismo de ação e importância clínica no tratamento da osteoartrite de joelho

Terapia por fotobiomodulação: mecanismo de ação e importância clínica no tratamento da osteoartrite de joelho

Photobiomodulation Therapy Using Infrared (808 nm) Low Level Laser Therapy Associated with Strength Training in Knee Osteoarthritis: A Randomized placebo-controlled clinical trial

Comparison between pain intensity, functionality, central sensitization, and self-efficacy in individuals with unilateral or bilateral knee osteoarthritis: a cross-sectional study

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