Low-level laser therapy associated to a resistance training protocol on bone tissue in diabetic rats

ABSTRACT Objective The present study aimed to evaluate the in vivo response of a resistance training and low-level laser therapy (LLLT) on tibias and femurs of rats with diabetes mellitus (DM). Materials and methods Forty male Wistar rats were randomly distributed into four experimental groups: control group (CG), diabetic group (DG), diabetic trained group (TG) and diabetic trained and laser irradiated group (TLG). DM was induced by streptozotocin (STZ) and after two weeks laser and resistance training started, performed for 24 sessions, during eight weeks. At the end of the experiment, animals were euthanized and tibias and femurs were removed for analysis. Histological, histomorphometrical, immunohistochemistry and mechanical analyses were performed. Results Trained groups, with or without laser irradiation, showed increased cortical area, bone density and biomechanical properties. The immunohistochemical analysis revealed that TG and TLG demonstrated an increased RUNX2 expression. RANK-L immunoexpression was similar for all experimental groups. Conclusion In conclusion, it can be suggested that the resistance exercise program stimulated bone metabolism, culminating in increased cortical tibial area, bone mineral content, bone mineral density and biomechanical properties. Furthermore, the association of physical exercises and LLLT produced higher values for bone mineral content and stiffness. Consequently, these data highlight the potential of physical exercise in the management of bone loss due to DM and the possible extra osteogenic stimulus offered by lasertherapy. Further long-term studies should be carried out to provide additional information.

Avaliação funcional da disfunção temporomandibular após bioestimulação associado à cinesioterapia / Functional evaluation of temporomandibular joint disorders after bioestimulation combined with kinesiotherapy

A disfunção temporomandibular (DTM) é altamente debilitantee causa alteração na realização de algumas funções importantescomo mastigar alimentos ou falar adequadamente. Esta disfunçãogeralmente segue uma trajetória de eventos progressivos, podendodesencadear uma condição articular degenerativa. Diante disso, otratamento fisioterapêutico se destaca, por ser um tratamento nãomedicamentoso e não invasivo. Há uma escassez de artigos na literaturasobre a utilização de técnicas cinesioterapêuticas associadascom aplicação de laser de baixa intensidade. Diante deste contexto,o presente estudo teve como objetivo verificar o quadro clínico depacientes portadores de DTM, após intervenção fisioterapêutica.Cinco pacientes receberam tratamento fisioterapêutico, associandotécnicas cinesioterapêuticas e aplicação de laser de baixa intensidade.Foram realizadas três sessões semanalmente, durante dois meses. Paraverificar o quadro clínico, foi realizada avaliação da amplitude demovimento e aplicação dos questionários: questionário de Fonseca,índice de disfunção clínica craniomandibular, índice temporomandibulare o SF36. Através dos resultados deste estudo, a associação dasduas técnicas de tratamento demonstrou um aumento da amplitudede movimento articular e melhora nos escores de funcionalidade,correlacionados com a melhora importante dos aspectos sociais eemocionais. Assim, este é um importante indicador para o surgimentode novos estudos que enfatizem esta associação de técnicas.

The temporomandibular disorder (TMD) is a debilitating diseasethat causes changes in some important functions such as to chewfood or speak properly. This disorder usually develops a progressivetrajectory of events, which can lead to a degenerative joint disease.Therefore, physical therapy stands out for being a non-medicationand noninvasive treatment. There is little articles in the literatureconcerning the use of kinesiotherapy techniques associated withlow level laser. This study aimed to verify the clinical picture of patientswith TMD, after physical therapy intervention. Five patientsunderwent physical therapy combining kinesiotherapy and lowlevel laser application. Three sessions were held weekly during twomonths. In order to verify clinical current status, we carried out anevaluation of range of motion and used the following questionnaires:Fonseca questionnaire, Clinical Craniomandibular dysfunctionIndex, Temporomandibular Index and SF36. From the results ofthis study we observed that the combination of the two treatmenttechniques showed an increase in range of motion and improvementin functional scores, correlated with significant improvement ofsocial and emotional aspects. Thus, new studies emphasizing thecombination of the two techniques should be conducted.