Low-level laser therapy and static stretching exercises for patients with knee osteoarthritis: A randomised controlled trial.

OBJECTIVES: To investigate the laser effect associated with stretching exercise on pain and functionality in patients with knee osteoarthritis. DESIGN: A randomised controlled trial. SETTING: Special Rehabilitation Services. SUBJECTS: We enrolled 215 knee osteoarthritis patients (430 knees were treated). INTERVENTION: Group Laser + Stretch (n = 43), Placebo + Stretch (n = 43), Stretch (n = 43), Laser (n = 43) and Control (n = 43) were treated with active laser and stretching exercises; placebo laser and stretching exercises; stretching exercises; active laser, and control, respectively. Interventions were conducted 3 times a week for 8 or 11 weeks. MAIN OUTCOME MEASURES: The primary outcome was the change in knee pain and disability. Secondary outcomes included severity of osteoarthritis, mobility, knee range of motion, flexibility, activity, severity of osteoarthritis and medication intake for pain relief. RESULTS: The patients' average age was 63.52 (6.8) years. Pain scores at baseline and post treatment (p < 0.001) were 7.43 (2.10) and 2.79 (1.92) for group Laser + Stretch, 7.39 (1.98) and 4.47 (2.82) for group Placebo + Stretch, 6.83 (1.42) and 4.24 (2.43) for group Stretch, 6.61 (1.68) and 2.94 (2.65) for group Laser, 6.74 (1.75) and 6.47 (2.29) for group Control, respectively. Disability score at baseline and post treatment (p = 0.000237) were 12.36 (5.02) and 8.08 (4.64) for group Laser + Stretch, 12.71 (5.12) and 9.90 (4.95) for group Placebo + Stretch, 11.83 (2.77) and 7.20 (5.28) for group Stretch, 11.58 (5.59) and 8.21 (6.18) for group Laser, 11.23 (4.68) and 11.45 (4.83) for group Control, respectively. CONCLUSION: Laser therapy combined with stretching exercises improves pain during rest, activities of daily living, stiffness, muscle shortening and range of motion in patients with knee osteoarthritis.

The Influence of the Evolutionary Past on the Mind: An Analysis of the Preference for Landscapes in the Human Species.

According to some evolutionary psychologists, landscapes preferences in the human species are influenced by their evolutionary past. Because the Pleistocene savanna is the least inhospitable landscape, it was the most suitable environment for survival and influenced the evolution of hominids in such a way that even today the human being has a universal preference for these environments. However, there is controversy regarding this statement, because in some studies it was evidenced that people prefer images of landscapes that are similar to those of the environment where they live. In this sense, we want to test whether there is indeed a preference for images of the savanna landscape and how the current environmental context may influence this preference. We performed a study in three environmental contexts with different landscapes in order to be able to observe the influence of the familiar landscape on landscape preference, of which two rural communities - one presenting a landscape similar to the deciduous seasonal forest and another presenting a savanna-like landscape - that totaled 132 participants and one urban community with 189 participants. The stimulus consisted of 12 images representing the six major terrestrial biomes and two images of urban landscapes. The variables analyzed were the emotional responses and the preference of the participants in relation to the images of landscapes. We analyzed the data using the Kruskal-Wallis test. The obtained result did not corroborate the idea of universal preference for images of savanna landscape. The image of Rainforest landscape was the preferred one among all the three environmental contexts studied. In this way, the preference for landscape may have been shaped at different periods of human evolutionary history, and not just during the period when hominids lived on the savannah. As much as selective pressures of the Pleistocene savanna have shaped the human mind during the evolutionary history, other factors and different types of environments may have influenced human preferences for landscapes. Thus, evolutionary psychologists who analyze human preferences for images of landscapes, guided by the idea of the past influencing the present, must be cautious before generalizing their results, especially if other variables such as the cultural ones are not controlled.