Photobiomodulation in Burn Wounds: A Systematic Review and Meta-Analysis of Clinical and Preclinical Studies.

Objective: This systematic review and meta-analysis main goal was to evaluate the efficacy of photobiomodulation as burn wounds treatment. Methods: Systematic review of literature available in databases such as PubMed, Web of Science, Embase, Latin American and Caribbean Health Sciences Literature (LILACS), and The Cumulative Index to Nursing and Allied Health Literature (CINAHL) and gray literature in Google Scholar, Livivi, and Open Gray. SYRCLE's RoB tool was applied to determine methodological quality and risk of bias, and meta-analysis was performed using the software Review Manager. Results: Fifty-one studies, gathering more than three thousand animals were included in this systematic review, and four studies were selected to the meta-analysis due to their suitability. The results indicated that photobiomodulation was not effective to improve, statistical significantly, wound retraction (SMD = -0.22; 95% CI = -4.19, 3.75; p = 0.91; I2 = 92%) or collagen deposition (SMD = -0.02; 95% CI = -2.17, 2.13; p = 0.99; I2 = 78%). Conclusion: This meta-analysis suggests that photobiomodulation, applied in burn wounds, accordingly to the protocols presented by the selected studies, was not effective over analyzed outcomes. However, this conclusion could be further discussed and verified in more homogeneous animal models and human clinical trials.

Articular mobilization promotes improvement in functional and inflammatory parameters in a gouty arthritis model

ABSTRACT Objective Gouty arthritis is characterized by painful inflammation due to the deposition of monosodium urate crystals in joint tissues. Despite available treatments, many patients experience ineffective management and adverse effects. This study evaluated a manual therapy protocol involving passive joint mobilization at the peak of inflammation in a gouty arthritis model using functional and inflammatory parameters. Methods Twenty male Wistar rats, 12 weeks old, were divided into two groups (n=10 each): Gouty Arthritis and Control Groups, which were further subdivided into treated and untreated groups (n=5 each). The Gouty Arthritis Group received intraarticular knee injection of 50µL of monosodium urate crystals, while the Control Group received 50µL of phosphate buffered saline. The treatment involved a 9-minutes session of grade III joint mobilization (according to Maitland). Nociception, grip strength, and edema were evaluated before induction (EV0), 7 hours after assessment (EV1), immediately after treatment (EV2), and 1 hour after treatment (EV3). The animals were euthanized, and synovial fluid was collected to analyze leukocyte migration. Results The model mimicked the signs of the Gouty Arthritis Group, with a decrease in the threshold of nociception and strength and an increase in edema and leukocyte count. The mobilization protocol significantly increased the nociceptive threshold and grip strength and reduced edema; however, it did not reverse the increase in leukocyte count. Conclusion Our results suggest that mobilization promotes analgesia and may modulate the inflammatory process owing to reduced edema and subtle attenuation of cell migration, which contributes to strength gain.