ABSTRACT
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).
ABSTRACT
Abstract Introduction: Aging is associated with structural changes in muscle tissue, which leads to the loss of functional independence. The preservation of the muscle strength through strength training, and recently, low-level laser therapy (LLLT), has high clinical significance. Objective: to investigate the effects of photobiomodulation (PBM - 808 nm, 100 mW, 35.7 W/cm2 and 7 J) associated with a strength training program on quadriceps muscle strength, balance and functional capacity in elderly women. Methods: Thirty-five healthy women between 60 to 70 years old were divided into two groups: Placebo Group (n = 13) and Active Group (n = 14). The exercise protocol consisted of knee flexion-extension exercise followed by application of PBM placebo or active, twice a week for 8 consecutive weeks. Results: showed a significant increase in 6MWT (p = 0.001), SPPB (p = 0.006) and 1-MR (p = 0.001) in both groups. The strength training program associated with PBM active improved a significant increase, relative to baseline, to the right medial/lateral stability index (p = 0.007) and decrease in the Fall Risk Test (p = 0.005). Conclusion: the strength training produced a significant increase of muscle strength and functionality and when combined with the PMB it was significant in the improvement of postural stability and decrease of fall risk.
Resumo Introdução: O envelhecimento está associado a mudanças estruturais no tecido muscular, que levam à perda da independência funcional. A preservação da força muscular através do treinamento de força e, recentemente, da terapia laser de baixa intensidade (TLBI), têm alta significância clínica. Objetivo: investigar os efeitos da fotobiomodulação (808 nm, 100 mW, 35,7 W/cm2 e 7 J) associada a um programa de força muscular direcionado à força do músculo do quadríceps, equilíbrio e capacidade funcional de mulheres idosas. Métodos: 35 mulheres saudáveis entre 60 e 70 anos de idade foram divididas em dois grupos: Grupo Placebo (n = 13) e Grupo Ativo (n = 14). O protocolo de exercício consistiu no exercício de flexão e extensão de joelhos seguido da aplicação da fotobiomodulação placebo ou ativa, 2 vezes por semana por 8 semanas consecutivas. Resultados: mostraram um aumento significativo no TC6 (p = 0,001), SPPB (p = 0,006) e 1-RM (p = 0,001) em ambos os grupos. O programa de treinamento de força associado a fotobiomodulação ativa promoveu um significativo aumento relativo à avaliação inicial, no índice de estabilidade medial/lateral direito (p = 0,007) e diminuição no Teste de Risco de Queda (p = 0,005). Conclusão: o treinamento de força produziu um significativo aumento da força muscular e da funcionalidade e, quando combinado com a fotobiomodulação, foi significativo em promover estabilidade postural e diminuição do risco de queda.
Resumen Introducción: Envejecimiento está asociado a cambios estructurales en el tejido muscular, que llevan a la perdida de la independencia funcional. La preservación de la fuerza muscular a través del entrenamiento de fuerza, y recientemente, la terapia láser de baja intensidad (TLBI), tiene alta significancia clínica. Objetivo: investigar los efectos de la fotobiomodulación (808nm, 100mW, 35,7 W/cm2 y 7J) asociado a un programa de fuerza muscular del músculo cuádriceps, equilibrio y capacidad funcional de mujeres mayores. Métodos: 35 mujeres sanas entre 60 y 70 años de edad fueran repartidas en dos grupos: Grupo Ejercicio y Láser Placebo (n = 13) y Grupo Ejercicio y Láser Activo (n = 14). El protocolo de ejercicio consistió en flexión extensión de rodillas seguido de la aplicación de la fotobiomodulación placebo o activa, 2 veces en la semana durante 8 semanas consecutivas. Resultados: mostraron un aumento significativo en el TC6 (p = 0,001), SPPB (p = 0,006) y 1-RM (p = 0,001) en los dos grupos. El programa de entrenamiento de fuerza asociado a la fotobiomodulación activa promovió un aumento significativo, relativo a la evaluación inicial, en el índice de estabilidad medial / lateral derecho (p = 0,007) y disminución en la prueba de riesgo de caída (p = 0,005). Conclusión: El entrenamiento de fuerza produjo un aumento significativo de la fuerza muscular y funcionalidad, incluso cuando se combinó con la fotobiomodulación fue significativo en promover estabilidad postural y disminución del riesgo de caída.