Effects of pre- or post-exercise low-level laser therapy (830 nm) on skeletal muscle fatigue and biochemical markers of recovery in humans: double-blind placebo-controlled trial.

OBJECTIVES: The purpose of this study was to investigate the effect of low-level laser therapy (LLLT) before and after exercise on quadriceps muscle performance, and to evaluate the changes in serum lactate and creatine kinase (CK) levels. METHODS: The study was randomized, double blind, and placebo controlled. PATIENTS: A sample of 27 healthy volunteers (male soccer players) were divided into three groups: placebo, pre-fatigue laser, and post-fatigue laser. The experiment was performed in two sessions, with a 1 week interval between them. Subjects performed two sessions of stretching followed by blood collection (measurement of lactate and CK) at baseline and after fatigue of the quadriceps by leg extension. LLLT was applied to the femoral quadriceps muscle using an infrared laser device (830 nm), 0.0028 cm(2) beam area, six 60 mW diodes, energy of 0.6 J per diode (total energy to each limb 25.2 J (50.4 J total), energy density 214.28 J/cm(2), 21.42 W/cm(2) power density, 70 sec per leg. We measured the time to fatigue and number and maximum load (RM) of repetitions tolerated. Number of repetitions and time until fatigue were primary outcomes, secondary outcomes included serum lactate levels (measured before and 5, 10, and 15 min after exercise), and CK levels (measured before and 5 min after exercise). RESULTS: The number of repetitions (p=0.8965), RM (p=0.9915), and duration of fatigue (p=0.8424) were similar among the groups. Post-fatigue laser treatment significantly decreased the serum lactate concentration relative to placebo treatment (p<0.01) and also within the group over time (after 5 min vs. after 10 and 15 min, p<0.05 both). The CK level was lower in the post-fatigue laser group (p<0.01). CONCLUSIONS: Laser application either before or after fatigue reduced the post-fatigue concentrations of serum lactate and CK. The results were more pronounced in the post-fatigue laser group.

Effect of low-level laser therapy (660 nm) on acute inflammation induced by tenotomy of Achilles tendon in rats.

In this study, we aimed to analyze the effects of low-level laser therapy (LLLT; 660 nm) on levels of protein expression of inflammatory mediators after cutting Achilles tendon of rats. Thirty Wistar male rats underwent partial incisions of the left Achilles tendon, and were divided into three groups of 10 animals according to the time of euthanasia after injury: 6, 24 and 72 h. Each group was then divided into control group and LLLT group (treated with 100 mW, 3.57 W cm(-2), 0.028 cm(2), 214 J cm(-2), 6 J, 60 s, single point). In LLLT group, animals were treated once time per day until the time of euthanasia established for each group. The group treated with LLLT showed a significant reduction of IL-1ß compared with control groups at three time points (6 h: P=0.0401; 24 h: P=0.0015; 72 h: P=0.0463). The analysis of IL-6 showed significant reduction only in the LLLT group at 72 h compared with control group (P=0.0179), whereas IL-10 showed a significant increase in the treated group compared with control group at three experimental times (6 h: P=0.0007; 24 h: P=0.0256; 72 h: P<0.0001). We conclude that LLLT is an important modulator of inflammatory cytokines release after injury in Achilles tendon.

Low-level laser therapy attenuates creatine kinase levels and apoptosis during forced swimming in rats.

Studies suggest that high-intensity physical exercise can cause damage to skeletal muscles, resulting in muscle soreness, fatigue, inflammatory processes and cell apoptosis. The aim of this study was to investigate the effects of low-level laser therapy (LLLT) on a decrease in creatine kinase (CK) levels and cell apoptosis. Twenty male Wistar rats were randomly divided into two equal groups: group 1 (control), resistance swimming; group 2 (LLLT), resistance swimming with LLLT. They were subjected to a single application of indium gallium aluminum phosphide (InGaAlP) laser immediately following the exercise for 40 s at an output power of 100 mW, wavelength 660 nm and 133.3 J/cm(2). The groups were subdivided according to sample collection time: 24 h and 48 h. CK was measured before and both 24 h and 48 h after the test. Samples of the gastrocnemius muscle were processed to determine the presence of apoptosis using terminal deoxynucleotidyl transferase (TdT)-mediated deoxyuridine triphosphate (dUTP) nick end labeling. (There was a significant difference in CK levels between groups (P < 0.0001) as well as between the 24 h and 48 h levels in the control group, whereas there was no significant intra-group difference in the LLLT group at the same evaluation times. In the LLLT group there were 66.3 +/- 13.2 apoptotic cells after 24 h and 39.0 +/- 6.8 apoptotic cells after 48 h. The results suggest that LLLT influences the metabolic profile of animals subjected to fatigue by lowering serum levels of CK. This demonstrates that LLLT can act as a preventive tool against cell apoptosis experienced during high-intensity physical exercise.

Influence of laser (660 nm) on functional recovery of the sciatic nerve in rats following crushing lesion.

With the aim of accelerating the regenerative processes, the objective was to study the influence of gallium-aluminum-arsenide (GaAlAs) laser (660 nm) on functional and histomorphological recovery of the sciatic nerve in rats. The sciatic nerves of 12 Wistar rats were crushed divided into two groups: control and laser therapy. For the latter, GaAlAs laser was utilized (660 nm, 4 J/cm(2), 26.3 mW and 0.63 cm(2) beam), at three equidistant points on the lesion, for 20 days. Comparison of the sciatic functional index (SFI) showed that there was a significant difference only between the pre-lesion value of the laser therapy group and that after the 21st day in the control group. It was concluded that the parameters and methods utilized demonstrated positive results regarding the SFI over the time period evaluated.

Effect of laser therapy (660 nm) on recovery of the sciatic nerve in rats after injury through neurotmesis followed by epineural anastomosis.

The aim of this study was to analyze the influence of aluminum gallium arsenide (AlGaAs) laser (660 nm) on the myelin sheath and functional recovery of the sciatic nerve in rats. The sciatic nerves of 12 Wistar rats were subjected to injury through neurotmesis and epineural anastomosis, and the animals were divided into two groups: group 1 was the control and group 2, underwent low-level laser therapy (LLLT). After the injury, AlGaAs laser at 660 nm, 4 J/cm(2), 26.3 mW and beam area of 0.63 cm(2) was administered to three equidistant points on the injury for 20 consecutive days. In the control group the mean area of the myelin impairment was 0.51 (+/- 0.11) on day 21 after the operation, whereas this value was 1.31 (+/- 0.22) in the LLLT group. Student's t-test revealed a P value = 0.0229 for the mean area values of the myelin sheath between the LLLT and control groups. Comparison of the sciatic functional index (SFI) showed that there was no significant difference between the pre-lesion value in the laser therapy group and the control group. The use of AlGaAs laser (660 nm) provided significant changes to the morphometrically assessed area of the myelin sheath, but it did not culminate in positive results for functional recovery in the sciatic nerve of the rats after injury through neurotmesis.

Morphometric and histological analysis of low-power laser influence on bone morphogenetic protein in bone defects repair.

Bone morphogenetic proteins (BMPs) are secreted signaling molecules belonging to the transforming growth factor-beta (TGF-beta) superfamily. The objective of this study was to determine how gallium-aluminum-arsenium (GaAlAs) 650 nm laser influenced the action of BMPs on bone defects created in rat femurs. The sample consisted of 24 male albino Wistar rats. Group 1 was composed of rats with bone defects filled with bone-inducing substance, with the application of low-power laser. Group 2 contained rats with bone defects filled with a bone-inducing substance, without the application of low-power laser. Group 3 rats had bone defects not filled with a bone-inducing substance, with the application of low-power laser. Group 4 rats had bone defects and no treatment (control group). A bone defect was produced with drills. In groups 1 and 2 the defects were filled with a bone-inducing substance. The animals were treated with GaAlAs (50 mW) laser, energy density 4 J/cm(2), for 80 ss on a 1 cm(2) area. Groups 2 and 4 were used as control. Bone samples were removed for histological procedures and morphometric analysis on the 7th, 14th and 21st days after surgery. Results obtained were subjected to statistical analysis. Rejection level for the null hypothesis was 0.05. Statistical differences were found in the comparison between group 1 (G1), G2, G3 and G4 [analysis of variance (ANOVA); P < 0.0134]. There was a statistically significant correlation between groups 1 and 4 (P < 0.01). The results of other correlations by Tukey's post-hoc test were: group 1 vs group 3 (P = 0.341), group 1 vs group 2 (P = 0.862), group 2 vs group 4 (P = 0.061), group 2 vs group 3 (P = 0.744), and group 3 vs group 4 (P = 0.249). We concluded that the association of low-power laser with a bone-inducing substance produced better results than when low-power laser or BMPs were used alone.

Analysis of the influence of low-power HeNe laser on the healing of skin wounds in diabetic and non-diabetic rats.

PURPOSE: To study the influence of HeNe laser irradiation on the collagen percentage in surgically-induced skin wounds in rats with and without alloxan-induced diabetes, by morphometric analysis of collagen fibers. METHODS: 48 male Wistar rats were used, divided into groups: laser-treated diabetic (group 1); untreated diabetic (group 2); treated non-diabetic (group 3); and untreated non-diabetic (group 4). For groups 1 and 2, diabetes was induced by intravenous injection of alloxan (2,4,5,6-tetraoxypyrimidine; 5,6-dioxyuracil; Sigma), into the dorsal vein of the penis, at a rate of 0.1 ml of solution per 100 g of body weight. A wound was made on the back of all the animals. Groups 1 and 3 were treated with HeNe laser (4 J/cm2) for 60 s. One animal from each group was sacrificed on the 3rd, 7th and 14th days after wounding. Samples were taken, embedded in paraffin, stained with hematoxylin-eosin and Masson's trichrome, and morphometrically analyzed using the Imagelab software. The percentages of collagen fibers were determined from the samples from the euthanasia animals. The data were treated statistically using analysis of variance (ANOVA) and the Student t and Kruskal-Wallis tests. The significance level was set at 0.05 or 5%. RESULTS: The results obtained from the samples taken on the third, seventh and fourteenth days after wounding demonstrated that the laser-treated group presented a statistically significant (p<0.05) greater mean quantity of collagen fibers than in the non-treated group, both for diabetic rats (p = 0.0104) and for non-diabetic rats (p = 0.039). CONCLUSION: The low-power laser (632.8 nm) was shown to be capable of influencing the collagen percentage in skin wounds by increasing the mean quantity of collagen fibers, both for the diabetic and for the non-diabetic group.