Radiofrequency and skin rejuvenation: a systematic review.

Increasingly, there is an attempt to minimize expression lines through esthetic procedures, and radiofrequency (RF) is one of the therapeutic modalities. This article aims to systematically review the literature on the different types of RF treatment in clinical trials and in variables related to the aging process. This systematic review included 21 articles that treated 354 people with different physical characteristics. The most used RF was the fractional followed by the non-ablative RF. There was a large discrepancy in relation to the types and parameters. A parameter that did not show so much divergence was the temperature, which was between 38°C and 44°C. The main temporary adverse reactions reported by the authors were as follows: discomfort, pain, erythema, hyperpigmentation, crusting, swelling, edema, and purple and acneic appearance of the skin. Finally, our study concluded that non-ablative and ablative RF was reported to rejuvenate and improve the features of skin in all skin types.

Intense Pulsed Light on skin rejuvenation: a systematic review.

Aged skin is characterized by appearance of wrinkles, vascular lesions, hyperpigmentation, lentignes, texture, rhytides, and pores. These changes occur under the influence of intrinsic and extrinsic factors, as hormone alterations and exposure to ultraviolet light (UV) irradiation, respectively. Skin changes associated with aging have been assuming an important role in nowadays and bring to affect the quality of life. Intense Pulsed Light (ILP) is a noncollimated, polychromatic, and noncoherent non-surgical cosmetic therapy to skin rejuvenation. This is the first systematic review evaluating ILP treatment on skin rejuvenation evaluated by digital photographs and self-reported treatment efficacy. A PRISMA compliant review includes a search of the databases Scopus and PubMed. Sixteen studies treating 637 participants (with Fitzpatrick skin types I to IV and age varying from 21 to 80 years) were included. Patients were treated a mean of 4.29 sessions (range 3-7). The most studies results showed the efficacy of IPL treatment in telangiectasia, wrinkles, pore, erythema, rhytids, texture, lentigines, hiperpigmentation, and photoaging score. Six studies showed IPL-positive effects in association with other treatment and seven studies showed superior effect of other treatment or association to IPL with other treatment related to IPL alone. Nine studies showed low methodological quality. In conclusion, ILP treatment is effective on skin rejuvenation. However, there is no consensus about the parameters and future studies are needed to sample size limitations, made RCTs with low risk of bias, and improve the methodological quality its. Trial registration: Prospero Systematic Review Registration ID: CRD42021237817.

Effects of photobiomodulation and a physical exercise program on the expression of inflammatory and cartilage degradation biomarkers and functional capacity in women with knee osteoarthritis: a randomized blinded study.

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-1ß, 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-1ß 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).

Effects of photobiomodulation and a physical exercise program on the expression of inflammatory and cartilage degradation biomarkers and functional capacity in women with knee osteoarthritis: a randomized blinded study

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).

Acute Photobiomodulation Effects Through a Cluster Device on Skeletal Muscle Fatigue of Biceps Brachii in Young and Healthy Males: A Randomized Double-Blind Session.

Objective: The aim of this study was to investigate and compare the acute effects of red and infrared photobiomodulation (PBM) using a cluster device on biceps brachii muscle fatigue in young and healthy males. Background: Vigorous physical activity could lead to muscle fatigue, which compromises motor control and muscle strength and consequently impairs performance. The positive effects of PBM in reducing fatigue onset have been highlighted. However, the better wavelength with cluster devices is not yet established. Methods: A randomized double-blind session was used. Thirty-two young and healthy males were randomized into the control group (CG), red PBM group (RPG), and infrared PBM group (IPG). A PBM cluster device [7 visible diodes (630 nm), 7 infrared diodes (850 nm), 100 mW/diode, 2 W/cm2 power density, 91 J/cm2 energy density, 4 J per point, 28 J total energy, and 40 sec] was applied after muscle fatigue. Muscle fatigue was analyzed by surface electromyography (EMG) recorded from the long head of biceps brachii, blood lactate concentration, and evaluation of the rate of perceived exertion (RPE) using the Borg Scale. The fatigue protocol consisted of a maximum voluntary isotonic contraction of elbow flexion-extension with 75% of one-repetition maximum until exhaustion. The Borg Scale was applied before and at the end of the experiment to measure the RPE. The electromyography fatigue index (EMGFI) was calculated by windows of median frequency from EMG data. Results: EMGFI, blood lactate concentration, and RPE showed no intergroup statistical difference, except the EMGFI delta value that showed a difference between IPG and CG, with a greater value in the CG. However, intragroup comparisons showed that EMGFI decreased in the CG and RPE and lactate concentration increased significantly in all groups. Conclusions: There was no difference between red and infrared PBM in reduction of biceps brachii fatigue. However, the EMGFI delta value was greater in the IPG compared with the CG, suggesting that infrared can be more effective in reducing biceps brachii fatigue.

Level of pain, muscle strength and posture: effects of PBM on an exercise program in women with knee osteoarthritis - a randomized controlled trial.

To evaluate the effectiveness of an exercise program associated to photobiomodulation (PBM) on pain, postural changes, functionally, and muscular strength in women, one of the risk factors, with knee osteoarthritis (OA). A randomized controlled trial, with a blinded assessor and intention-to-treat analysis and placebo control. Sixty-two participants with knee OA (with confirmed radiological diagnosis) were evaluated for this study. However, 34 were considered eligible and were randomized into two groups: EPPG - exercise and PBM placebo group (n = 17) and EPAG - exercise and PBM active group (n = 16), but one participant was excluded of EPAG. The exercise program and PBM (808 nm, 100 mW/point, 4 J/point, 56 J total, 91 J/cm2) were realized twice a week, during 8 weeks. West Ontario and the McMaster University Osteoarthritis Index (WOMAC) and Lequesne questionnaires, 1-repetition maximum test (1-RM) and posture evaluation software (SAPO) were used to analyze the effects of the therapies. In intragroup analysis, a significant improvement in pain WOMAC (p < 0.001), stiffness (p < 0.001), function (p < 0.001), Lequesne (p < 0.001), and 1-RM (all muscle groups) (p < 0.001) were observed. In this study, the exercise program improved pain, function, and muscle strength of all the participants. However, PBM, in the parameters used, did not optimize the effects of the exercise program in women with knee OA.

Pre-Conditioning and Post-Operative Photobiomodulation Therapy by a Novel Light Patch System for Knee Arthroplasty: A Protocol for a Phase 1 Study.

Objective: To determine the potential efficacy and feasibility of photobiomodulation therapy (PBMT) before and after knee arthroplasty (KA) surgery. Background: Total knee replacements (total knee arthroplasty, TKA) are one of the most common and successful surgical interventions for osteoarthritis. Up to 20,000 knee replacement arthroplasties are performed in Australia annually. Although TKA aims to restore knee alignment and relieve pain in the long term, the initial post-operative period is difficult and rehabilitation is often hindered by persistent pain and swelling. A promising therapeutic approach, PBMT using a novel self-adhesive light patch system, may be feasible for reducing post-operative pain and swelling and aiding recovery. Materials and methods: This is an interventional clinical feasibility study protocol. Patients from a surgical waitlist will be invited to take part. PBMT will be applied for 30 min daily for 7 days pre-operatively using a novel light patch system (CareWear®) with both 450 nm (6.75 mW/cm2) and 640 nm (2.25 mW/cm2) microdiodes. Post-operative treatment will utilize the same device second daily for 1 week after removal of compression bandages. Results: Outcomes will be evaluated at seven time points: baseline at week 1 pre-operatively, 1 day before surgery, day 4 after surgery, weekly for a further 2 weeks, and fortnightly until 6 weeks post-hospital discharge. Outcome measures include the following: Numeric Pain Rating Scale, stair climb test, 30-sec chair stand test, timed up and go test, 40-m fast-paced walk test, modified Iowa Level of Assistance Scale, muscle strength, knee range of motion, Knee Injury and Osteoarthritis Outcome Score, and Lower Limb Functional Index. Conclusions: This study will provide an assessment of feasibility of using PBMT applied using a novel light patch system for management of pain symptoms and swelling, and aiding recovery of patients undergoing TKA. The results of this feasibility study will contribute to planning of the design and methods of a large clinical trial.

Photobiomodulation via a cluster device associated with a physical exercise program in the level of pain and muscle strength in middle-aged and older women with knee osteoarthritis: a randomized placebo-controlled trial.

Osteoarthritis (OA) is a chronic joint disease that leads to pain and functional incapacity. The aim of the study is to investigate the effects of the incorporation of photobiomodulation (PBM) (via cluster) into a physical exercise program on the level of pain, lower limb muscle strength, and physical capacity, in patients with knee OA. Sixty-two female volunteers with a diagnosis of knee OA were distributed in 4 groups: exercise associated with placebo PBM group, exercise associated with active PBM group, active PBM group, and placebo PBM group. Sixteen sessions of lower limb strength exercises and PBM via cluster (808 nm, 100 mW, 7 points each side, 56 J total) were performed. The level of pain, physical capacity, and lower limb muscle strength were evaluated with the use of the numeric pain rating scale (NPRS), 6-min walking test (6-MWT) and timed up and go (TUG), and maximal voluntary isometric torque (MVIT) before and after the interventions. Both groups presented a significant decrease in the level of pain when compared with the placebo-treated women. Furthermore, the 6-MWT showed that the trained groups (with or without PBM) demonstrated higher values in the distance walked comparing pre and post-treatment values. The same behavior was found for the MVIT load before and after intervention. TUG was higher for all the treated with exercise groups comparing the pre and post-treatment values. Physical exercise and PBM showed analgesic effects. However, PBM did not have any extra effect along with the effects of exercise in improving the distance walked, the TUG, and the muscle strength.Trial registration: RBR-7t6nzr.

Interleukin-10 and collagen type II immunoexpression are modulated by photobiomodulation associated to aerobic and aquatic exercises in an experimental model of osteoarthritis.

The aim of this study was to compare the effects of photobiomodulation (PBM) associated with an aerobic and an aquatic exercise training on the degenerative process related to osteoarthritis (OA) in the articular cartilage in rats. Fifty male Wistar rats were randomly divided into 5 groups: OA control group (CG), OA plus aerobic training group (AET), OA plus aquatic training group (AQT), OA plus aerobic training associated with PBM group (AETL), OA plus aquatic training associated with PBM group (AQTL). The aerobic training (treadmill; 16 m/min; 50 min/day) and the aquatic training (water jumping; 50-80% of their body mass) started 4 weeks after the surgery and they were performed 3 days/week for 8 weeks. Moreover, PBM was performed after the physical exercise trainings on the left joint. Morphological characteristics and immunoexpression of IL-10, TGF-ß, and collagen type I (Col I) and II (Col II) of the articular cartilage were evaluated. The results showed that all the treated groups (exercise and PBM) presented less intense signs of degradation (measured by histopathological analysis and OARSI grade system). Additionally, aerobic and aquatic exercise training rats (associated or not with PBM) showed increased IL-10 (AET p = 0.0452; AETL p = 0.03; AQTL p = 0.0193) and Col II (AET p = 0.012; AQT p = 0.0437; AETL p = 0.0001; AQTL p = 0.0001) protein expression compared to CG. Furthermore, a statistically higher TGF-ß expression was observed in AET (p = 0.0084) and AETL (p = 0.0076) compared to CG. These results suggest that PBM associated with aerobic and aquatic exercise training were effective in mediating chondroprotective effects and maintaining the integrity of the articular tissue in the knees of OA rats.

Photobiomodulation and physical exercise on strength, balance and functionality of elderly women / Fotobiomodulação e exercício fisíco na força, equilíbrio e funcionalidade de mulheres idosas / Fotobiomodulación y ejercicio físico en la fuerza, equilibrio y funcionalidad de mujeres mayores

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.

Non-ablative radiofrequency associated or not with low-level laser therapy on the treatment of facial wrinkles in adult women: A randomized single-blind clinical trial.

OBJECTIVES: The objective of this study was to evaluate the effects of Non-ablative Radiofrequency (RF) associated or not with low-level laser therapy (LLLT) on aspect of facial wrinkles among adult women. METHODS: Forty-six participants were randomized into three groups: Control Group (CG, n = 15), RF Group (RG, n = 16), and RF and LLLT Group (RLG, n = 15). Every participant was evaluated on baseline (T0), after eight weeks (T8) and eight weeks after the completion of treatment (follow-up). They were photographed in order to classify nasolabial folds and periorbital wrinkles (Modified Fitzpatrick Wrinkle Scale and Fitzpatrick Wrinkle Classification System, respectively) and improvement on appearance (Global Aesthetic Improvement Scale). Photograph analyses were performed by 3 blinded evaluators. RESULTS: Classification of nasolabial and periorbital wrinkles did not show any significant difference between groups. Aesthetic appearance indicated a significant improvement for nasolabial folds on the right side of face immediately after treatment (p = 0.018) and follow-up (p = 0.029) comparison. RG presented better results than CG on T8 (p = 0.041, ES = -0.49) and on follow-up (p = 0.041, ES = -0.49) and better than RLG on T8 (p = 0.041, ES = -0.49). RLG presented better results than CG on follow-up (p = 0.007, ES = -0.37). CONCLUSION: Nasolabial folds and periorbital wrinkles did not change throughout the study; however, some aesthetic improvement was observed. LLLT did not potentiate RF treatment.

Low level laser therapy associated with a strength training program on muscle performance in elderly women: a randomized double blind control study.

The aging process leads to a gradual loss of muscle mass and muscle performance, leading to a higher functional dependence. Within this context, many studies have demonstrated the benefits of a combination of physical exercise and low level laser therapy (LLLT) as an intervention that enhances muscle performance in young people and athletes. The aim of this study was to evaluate the effects of combination of LLLT and strength training on muscle performance in elderly women. For this, a hundred elderly women were screened, and 48 met all inclusion criteria to participate in this double-blind placebo-controlled trial. Volunteers were divided in three groups: control (CG = 15), strength training associated with placebo LLLT (TG = 17), and strength training associated with active LLLT (808 nm, 100 mW, 7 J) (TLG = 16). The strength training consisted of knee flexion-extension performed with 80 % of 1-repetition maximum (1-RM) during 8 weeks. Several outcomes related to muscle performance were analyzed through the 6-min walk test (6-MWT), isokinetic dynamometry, surface electromyography (SEMG), lactate concentration, and 1-RM. The results revealed that a higher work (p = 0.0162), peak torque (p = 0.0309), and power (p = 0.0223) were observed in TLG compared to CG. Furthermore, both trained groups increased the 1-RM load (TG vs CG: p = 0.0067 and TLG vs CG: p < 0.0001) and decreased the lactate concentration in the third minute after isokinetic protocol (CG vs TLG: p = 0.0289 and CG vs TG: p = 0.0085). No difference in 6-MWT and in fatigue levels were observed among the groups. The present findings suggested that LLLT in combination with strength training was able to improve muscle performance in elderly people.