The Influence of Phototherapy on Recovery From Exercise-Induced Muscle Damage.

Background: Intense physical activity can result in exercise-induced muscle damage, delayed-onset muscle soreness, and decrements in performance. Phototherapy (PhT), sometimes referred to as photobiomodulation or low-level laser therapy, may enhance recovery from vigorous exercise. Purpose: The purpose of this study was to assess the influence of phototherapy on functional movements (vertical jump, agility), and perceptions of muscle soreness following exercise-induced muscle damage caused by high volume sprinting and decelerations. Methods: In a between-group design, 33 participants performed 40x15m sprints, a protocol intended to cause muscle damage. Immediately following sprinting and in the four days following, vertical jump and agility were assessed, as well as calf, hamstring, quadriceps, and overall perceptions of soreness. Sixteen subjects (age 20.6±1.6 yrs; BMI 25.8±4.6 kg.m-2) received PhT prior to testing each day, while 17 (age 20.8±1.3 yrs; BMI 26.2±4.5 kg.m-2) received sham PhT and served as a control (CON). Measurements were recorded during five days of recovery from the repeated sprint protocol, then compared to those recorded during three baseline days of familiarization. Area under the curve was calculated by summing all five scores, and comparing those values by condition via a two-tailed unpaired t-test for normally distributed data, and a two-tailed Mann-Whitney U test for nonparametric data (alpha level = 0.05). Results: Calf soreness was lower in PhT compared to CON (p = 0.02), but no other significant differences were observed between groups for vertical jump, agility, quadriceps, hamstring, and overall soreness (p > 0.05). Discussion: Phototherapy may attenuate soreness in some muscle groups following exercise-induced muscle damage, but may not enhance recovery after explosive, short-duration activities. Conclusion: Phototherapy may not be a useful recovery tool for those participating in explosive, short-duration activities. Level of evidence: 2c.

Recanalization of CTOs with SoundBite™ Active Wire.

BACKGROUND: The aim of this study was to examine the safety and efficacy of the SoundBite™ Crossing System for the recanalization of infrainguinal chronic total occlusion (CTO) lesions. CTOs are frequent among patients with severe claudication or critical limb ischemia. Failure to recanalize CTOs remains common and is associated with poor prognosis. The SoundBite™ Crossing System (SoundBite Medical Solutions Inc., Montreal, QC, Canada) is a newly developed device that uses a 0.018-inch wire (SoundBite™ Active Wire) to deliver acoustic shock waves to the distal tip of a steerable guidewire to facilitate directed penetration of the proximal cap and crossing of the occlusion. METHODS: Symptomatic patients with de novo infrainguinal CTOs from 3 centers were enrolled in a prospective, single-arm feasibility study. The primary endpoint was 30-day device success defined as composite of technical success, defined as penetration and progression within the CTO with the SoundBite™ Active Wire followed by complete recanalization, and freedom from device-related major adverse events including death, urgent amputation, clinically-driven target vessel revascularization, perforation, type ≥C dissection, or distal embolization requiring intervention. RESULTS: Thirty-seven patients including 41 CTO lesions were enrolled in this study. CTO length ranged from 10 mm to 270 mm (mean 97.9±77.4 mm), and moderate-to-severe calcification was present in 24 (58.5%) of the treated lesions. CTOs were successfully crossed in 34 (91.9%) patients. No device-related adverse events occurred, resulting in a 30-day device success rate of 91.9%. Compared with baseline, 30-day ankle brachial index (0.66±0.24 versus 0.89±0.20; P<0.001) and Rutherford class (3 [2, 4] versus 0 [0, 1], P<0.001) significantly improved. CONCLUSIONS: The SoundBite™ Active Wire Crossing System feasibility study demonstrates a favorable safety and efficacy profile for the SoundBite™ Active Wire in infrainguinal CTOs.

Novel Crossing System for Chronic Total Occlusion Recanalization: First-in-Man Experience With the SoundBite Crossing System.

Chronic total occlusion (CTO) lesions are frequent in patients with peripheral and coronary artery disease, and are associated with a higher risk of adverse events, including mortality, decreased quality of life, and increased health-care costs. Percutaneous intervention of CTO lesions has been associated with a lower procedural success rate, and current dedicated CTO devices may be of limited use for non-CTO experts, and associated with increased intraprocedural complication rates. The SoundBite Crossing System (SoundBite Medical Solutions, Inc) is a newly-developed device using shockwaves (short-duration, high-amplitude pressure pulses) delivered to the tip of guidewire to facilitate penetration of the proximal cap and crossing of the occlusion. The current report describes the first-in-man use of the SoundBite Crossing System in the recanalization of two occluded lower-limb arteries.