Analysis of the effects of low-level laser therapy on muscle fatigue of the biceps brachii muscle of healthy individuals and spastic individuals: Study protocol for a single-center, randomized, double-blind, and controlled clinical trial.

BACKGROUND: Muscular fatigue is caused by biochemical alterations that modify the mechanics of muscle contraction, resulting in negative changes in the performance of the contraction. Several resources are studied to mitigate this situation among which we can cite low-level laser therapy (LLLT). The effects of LLLT are being studied in healthy subjects with fibromyalgia and who are athletes, and currently the studies are being performed in spastic muscles with poststroke individuals. The aim will be to evaluate the effects of LLLT on the fatigue of the biceps brachii muscle of healthy individuals and individuals with spastic hemiparesis. METHODS: A cross-sectional, comparative, randomized, placebo, double-blind clinical trial will be divided into 2 phases: phase I shall consist of 30 healthy subjects and phase II of 30 poststroke individuals. The study will consist of 3 groups (control group, placebo group, and LLLT group), and all individuals will pass through all groups, following the randomization criteria. The protocol consists of the application of LLLT in the biceps brachii muscle on the dominant side in healthy individuals and in the hemiparetic side of poststroke individuals, and, subsequently, 3 maximal isometric voluntary contractions (MIVCs) will be performed for 50 seconds in the dynamometer, with an interval of 50 seconds between them. Pain intensity will be evaluated by means of the visual analog scale, and the myoelectric activity by means of surface electromyography associated with the evaluation of muscular strength by means of the dynamometer. The local temperature will be evaluated by infrared thermography and blood lactate concentration through the lactimeter, which will be measured at 4 different times, before the application of the laser (basal), and 3, 15, and 25 minutes after the MIVC.

Sensory-motor and cardiorespiratory sensory rehabilitation associated with transcranial photobiomodulation in patients with central nervous system injury: Trial protocol for a single-center, randomized, double-blind, and controlled clinical trial.

BACKGROUND: Central nervous system diseases such as stroke, spinal cord injury, traumatic brain injury, and multiple sclerosis can be fatal or cause sequelae, affecting sensorimotor and cardiorespiratory systems and quality of life. These subjects present a low response to aerobic and resistance exercise, due to decreased recruitment of muscle fibers and reduction of metabolic capacity. Aerobic exercises bring benefits in terms of fatigue retardation, gait improvement, regulation of the autonomic nervous system, neuroprotection of the brain, stimulation of the production of endogenous neutrotransmitters related to general well-being, and a favoring of neuroplasticity. Photobiomodulation (PBM Therapy) (previously known as low-level laser therapy), and especially transcranial PBM Therapy, has shown benefits in animals and humans such as cognitive improvement, memory, and behavioral improvement, including attenuation of depression and anxiety, and increased cortical oxygenation. The aims of this trial will be to evaluate the parameters related to the function of the musculoskeletal and cardiorespiratory system and the impact of PBM therapy on these parameters, as part of a rehabilitation and training program for people with reduced mobility. METHODS: This is a randomized, double-blind, placebo-controlled trial with 3 groups: Control, only cardiorespiratory rehabilitation (CCR), CCR with PBM Therapy (CR-PBM), CCR and placebo PBM Therapy (CR-PlaceboPBM). n = 90, 30 per group. PBM Therapy parameters: 810 nm laser, 0.028 cm, 100 mW, 3.5 W/cm, 30 seconds per point, 3 J per point, 107.1 J /cm to 3 electroencephalogram points F7 and F8 and AFz. The trial will be conducted at the University Clinics and the sessions will be 1 hour twice a week for 9 weeks. Baseline, intermediate (4th week), final (9th week), and 2-month follow-up will be performed. Muscular activation, heart rate variability, lung volumes and capacities, fatigability, exercise tolerance, cognition, and quality of life at baseline will be evaluated. Subsequent to baseline evaluations, the PBM Therapy groups will be offered laser therapy (active or inactive); all groups will then receive CCR. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov ID - NCT03751306 (approval date: November 22, 2018).

Impact of mastectomy and breast-conserving surgery on quality of life of women after breast cancer / Impacto da mastectomia e da cirurgia conservadora na qualidade de vida de mulheres pós-câncer de mama

Breast cancer is public health problem, in Brazil, it is estimated 57,960 new cases for the biennium of 2016/2017. Conservative surgery is considered the procedure of choice in the initial stage, including tumor removal involving a border of normal tissue, with preservation of breast tissue. While mastectomy, or non-conservative surgery, includes the removal of the entire breast tissue, with the removal of the pectoralis major and minor. Surgical interventions performed in women with breast cancer can cause physical, emotional/psychological, social and sexual repercussions that generate negative impact in their life. Considering that, this study was conducted over the hypothesis: what is the impact of breast cancer removal surgery in quality of life of women from São José dos Campos and Jacareí cities, aiming to recognize the variables that affect their qualityof daily life, and to improve the assistance offered during physical therapy. Therefore, this study aimed to analyze the quality of life among women underwent mastectomy and breast-conserving surgery for breast cancer and how it could impact their socio-demographic aspects. This was a transversal descriptive study with exploratory character. The sample consisted of 105 women post breast cancer with mean age of 55.4 ± 11.1 years old, divided into two groups according to the kind of surgery performed. It was used the quality of life questionnaire SF-36 "Short-Form Health Survey" and a socio-demographic questionnaire...

O câncer de mama é um problema de saúde pública, no Brasil, as estimativas para o biênio de 2016/2017, apontam para57.960 novos casos. A cirurgia conservadora é considerada o procedimento de escolha no estágio inicial, incluindo aremoção do tumor envolvendo uma borda de tecido normal, com preservação do tecido mamária, enquanto a mastectomia(ou cirurgia não-conservadora) inclui a remoção de todo o tecido mamário, com a remoção do peitoral maior e menor.As intervenções cirúrgicas realizadas em mulheres com câncer de mama podem causar repercussões físicas, emocionais,psicológicas, sociais e sexuais que geram impacto negativo em sua qualidade de vida. Levando isso em consideração, a hipótese deste estudo foi baseada na questão: qual é o impacto das cirurgias de remoção do câncer de mama na qualidade de vida de mulheres das cidades de São José dos Campos e Jacareí. Portanto, este estudo teve como objetivo analisar a qualidade de vida entre mulheres submetidas à mastectomia e cirurgia conservadora da mama após o diagnóstico de câncer de mama e como isso poderia ser impactado pelos aspectos sócio demográficos...