Effect of low intensity photobiomodulation associated with norbixin-based poly (hydroxybutyrate) membrane on post-tenotomy tendon repair. In vivo study.

PURPOSE: To evaluate the in vivo response of photobiomodulation therapy associated with norbixin-based poly(hydroxybutyrate) membrane (PHB) in tenotomized calcaneal tendon. METHODS: Thirty rats were randomly allocated to six groups (n=5 each): LED groups (L1, L2 and L3) and membrane + LED groups (ML1, ML2 and ML3). The right calcaneal tendons of all animals were sectioned transversely and were irradiated with LED daily, one hour after surgery every 24 hours, until the day of euthanasia. At the end of the experiments the tendons were removed for histological analysis. RESULTS: The histological analysis showed a significant reduction in inflammatory cells in the ML1, ML2 and ML3 groups (p=0.0056, p=0.0018 and p<0.0001, respectively) compared to those in the LED group. There was greater proliferation of fibroblasts in the ML1 (p<0.0001) and L3 (p<0.0001) groups. A higher concentration of type I collagen was also observed in the ML1 group (p=0.0043) replacing type III collagen. CONCLUSION: Photobiomodulation in association with norbixin-based PHB membrane led to control of the inflammatory process. However, it did not favor fibroblast proliferation and did not optimize type I collagen formation in the expected stage of the repair process.

Effect of Modified Laser Transcutaneous Irradiation on Pain and Quality of Life in Patients with Diabetic Neuropathy.

Background: Diabetic neuropathy (DN) is one of the major complications developed by individuals with diabetes mellitus. DN is responsible for a high morbidity and mortality rate and impacts the public health and medical assistance resources. Intradermic laser irradiation on blood (ILIB) consists of the application of light beams on the radial arterial, providing anti-inflammatory and vasodilator effects, antiarrhythmic action, reduction of glucose, and stabilization of the hormonal and immunological systems. These effects help to maintain the physiological dynamics of the body. Objective: The goal of this research was to evaluate the effects of ILIB to relieve pain and improve the quality of life in DN patients. The sample comprised 30 diabetic volunteers with DN, randomly distributed into 3 groups: Control-conventional treatment; ILIB-100 mW, 660 ± 10 nm, 30 applications in total, divided into 3 stages of 10 applications, 30 min each, daily, with a 20-day interval between each stage; SILIB-same protocol described for ILIB, with the equipment switched off. Before and after the application of the therapeutic protocols, all volunteers were evaluated by the following instruments: Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), visual analog scale, Leeds Assessment of Neuropathic Symptoms and Signs (LANSS), and PAIN DETECT scale. Collected data were statistically analyzed with a 95% confidence interval, p < 0.05. Results: The ILIB group presented significantly lower pain levels and a better quality of life compared with the control and SILIB groups. Conclusions: This study demonstrated that ILIB therapy was effective in reducing pain and improving quality of life in patients with DN.

Long-term analyses of spastic muscle behavior in chronic poststroke patients after near-infrared low-level laser therapy (808 nm): a double-blinded placebo-controlled clinical trial.

Stroke results in impairment of basic motor functions, such as muscle weakness in limbs affected by spasticity, leading to peripheral fatigue and impaired functionality. The clinical use of photobiomodulation therapy (PBMT) has provided major advances in the treatment of muscular disorders and prevention of muscle fatigue. The aim of this study was to analyze the effects of two distinct therapies in biceps spasticity of chronic hemiparetic patients. We analyzed range of elbow motion, torque, electromyography, and mean spectral frequency after 10 sessions of PBMT (Laser 100 mW, 808 nm, 159.24 J/cm2/point, 5 J/point); PBMT active or placebo was associated with exoskeleton-assisted functional treatment. A double-blind placebo-controlled sequential clinical trial was conducted with 12 healthy volunteers and 15 poststroke patients who presented upper-limb spasticity. The healthy volunteers performed only the evaluation protocol, and the poststroke volunteers participated in three consecutive phases (PBMT, PBMT + exoskeleton, placebo + PBMT) with a washout period of 4 weeks between each phase. We could observe significant increases in range of elbow motion after PBMT from 57.7 ± 14 to 84.3 ± 27.6 degrees (p < 0.001). The root mean square (RMS) values also increased after PBMT + exoskeleton from 23.2 ± 15 to 34.9 ± 21 µV (p = 0.0178). Our results suggest that the application of PBMT may contribute to an increased range of elbow motion and muscle fiber recruitment, increases in muscle strength, and, hence, to increase signal conduction on spastic muscle fibers in spastic patients.

Effects of Therapy with Light Emitting Diode (LED) in the Calcaneal Tendon Lesions of Rats: A Literature Review.

The objective of this review was to analyze original articles about the effects of therapy with LED in experimental models of calcaneal tendon lesions of rats. The search was performed in the period from February to May 2018, in the following electronic databases: MEDLINE, SciELO, and LILACS, besides the Google Scholar, using the descriptors "Achilles tendon", "Rats", "LED", "Tendinopathy", and "Low-level Light Therapy", as well as their matching parts in the Portuguese and Spanish languages, related to and in association with the relevant terms to the content sought. From the descriptors used 215 works were found. After application of eligibility criteria 8 works were selected, in which positive results were found after the application of the LED. Regarding the main results found with phototherapy, we observed a significant reduction in inflammation. Only one article mentioned little reduction of inflammation. In relation to the number of sessions, there was wide variation, with an average of approximately 5 sessions every 24 hours. Studies in this review pointed out, therefore, positive results in the repair of the calcaneal tendon after therapy with irradiation LED; however, carrying out more experimental studies that help the standardization of parameters to be used in this therapy for further clinical studies becomes necessary.

Association of facial massage, dry needling, and laser therapy in Temporomandibular Disorder: case report.

This case report aims to evaluate the treatment of Temporomandibular Disorder (TMD) of muscular origin by associating facial massage (FM), dry needling (DN), and low-level laser therapy (LLLT). The pre- and post-treatment evaluations consisted of clinical examinations based on the Research Diagnostic Criteria (RDC) for TMD, pain intensity quantification by means of the Visual Analog Scale (VAS), mandibular movement measurement, and electromyographic (EMG) analysis of the masseter and temporal muscles. Post-therapy assessment indicated a decrease in pain sites of 58%, in pain intensity mean (1.3), and an increase in the maximum aperture of 10 mm, in addition to normalization of EMG signals. We conclude that, after application of the treatment protocol, there was a decrease in painful sites, gain in amplitude of mandibular movements, and normalization of EMG activity.

Effects of Matricaria Recutita (L.) in the Treatment of Oral Mucositis.

OBJECTIVE: The objective of this study was to review the effects of the Matricaria recutita (L.) in the treatment of oral mucositis. METHODOLOGY: The online search was performed in the period from June 2016 to April 2018 by means of databases LILACS (Latin American and Caribbean Center on Health Sciences Information), SciELO (Scientific Electronic Library Online), and MEDLINE (Medical Literature Analysis and Retrieval System Online). The consultation was restricted to the years 1991 to 2018 with the aim of elucidating the effects of Matricaria recutita in the treatment of oral mucositis. RESULTS: The final sample consisted of 21 studies, of which 10 were developed in animals and 11 in humans, published from 1991 to 2017, with a total sample of 644 patients. The total number of patients treated with Matricaria included in 11 studies was 364, while in the control groups the total number was 280. In experimental studies, animal models used were rats and the sample size ranged between 36 and 105 animals submitted to the induction of oral mucositis, where 4 studies used an intraperitoneal injection of 5-fluorouracil, while 7 induced lesion in the mucosa. From the data collected, it should be noted that both studies with humans and with animals showed significant effects. In this way, there is strong evidence for the discussion on the therapy; however, it should be noted that more studies are developed in order to clarify the most appropriate protocol for the prevention and treatment of injuries. CONCLUSION: According to the results found in this study, Matricaria recutita appeared to be a promising alternative for the treatment of oral mucositis. However, due to the great variability in the various types of intervention, more controlled double-blind randomized clinical studies are necessary to ensure the best protocol for treating oral mucositis.

Effects of Low-Power Light Therapy on the Tissue Repair Process of Chronic Wounds in Diabetic Feet.

OBJECTIVE: To analyze the efficacy of the therapeutic use of Low-Level Laser Therapy (LLLT) on the tissue repair process of chronic wounds in patients with diabetic feet through the analysis of Pressure Ulcer Scale for Healing (PUSH) scales, pain and the measurement done using the ImageJ© software. METHODS: This clinical trial was carried out with 18 patients 30-59 years of age, who had chronic wounds on their foot due to complications of diabetes mellitus. The patients were randomly allocated in two different groups of equal numbers: Control and Laser Groups. The LLLT equipment used in the research has a wavelength of 660 nm, 30 mW power, continuous mode emission, 6 J/cm2 dosimetry, 48/48 h in a 4-week period. Measurement and the aspect of wounds were noted in the PUSH scale and the pain was evaluated weekly. The Mann-Whitney U nonparametric test was used to compare groups. RESULTS: The Laser Group presented a significant increase of the tissue repair index when compared with the Control Group, with a significant statistical difference (p < 0.013). There was no significant difference between the groups in all the weeks using the PUSH scale. CONCLUSIONS: The use of LLLT on chronic wounds in a diabetic foot demonstrated efficacy on the progression of the tissue repair process in a short period.

Transformada wavelet na análise do efeito da terapia LED sobre a atividade do músculo masseter em mulheres com disfunção temporomandibular / Wavelet transformed in the analysis of LED therapy effect on the activity of masseter muscles in women with temporomandibular disorder

OBJETIVOS: Apresentar a transformada wavelet como uma ferramenta alternativa para o processamento dos sinais oriundos da eletromiografia quando utilizada na avaliação da atividade elétrica do músculo masseter de mulheres com disfunção temporomandibular. MÉTODOS: Cinco voluntárias com disfunção temporomandibular passaram por quatro sessões de terapia com diodo emissor de luz (LED, light emitting diode). A eletromiografia do músculo masseter foi realizada bilateralmente antes e após o tratamento, empregando um eletromiógrafo de dois canais. Na análise dos sinais eletromiográficos foi empregada a transformada wavelet na função Morlet. RESULTADOS: Nos escalogramas, observou-se a diminuição da ativação das fibras de alta frequência no protocolo de repouso e seu aumento no protocolo de movimento isométrico. Na análise baseada no sistema de cores RGB, foi possível observar que no protocolo de repouso do músculo masseter direito houve redução dos momentos de máxima intensidades de energia em 82% para frequências de 256-512Hz e em 42% para frequências acima de 512Hz. No músculo masseter esquerdo a redução foi de 42% na banda de frequências de 256-512Hz. CONCLUSÕES: A análise pela transformada wavelet permitiu identificar fatores fisiológicos relacionados não somente à ativação do músculo masseter, mas também à intensidade e à relação tempo/frequência, assim como os principais tipos de fibras ativadas durante os protocolos antes e após a terapia LED em pacientes com disfunção temporomandibular

AIMS: To present the wavelet transform as an alternative tool in the evaluation of the masseter muscle electrical activity in women with temporomandibular disorder after therapy with Light Emitting Diode (LED). METHODS: Five volunteers with temporomandibular disorder underwent four sessions of LED therapy. Electromyography of the masseter muscle was performed bilaterally before and after treatment. For analysing the electromyographic signals, the wavelet transform was applied in the Morlet function. RESULTS: In the scalogram, a decrease in the activation of the high-frequency fibers in the rest protocol and its increase in the isometric movement protocol were observed. In the analysis based on the RGB color system, we observed that in the right masseter muscle resting protocol, the moments of maximum energy intensities were reduced by 82% for frequencies of 256-512Hz and by 42% for frequencies above 512Hz. In the left masseter muscle the reduction was 42% in the frequency band of 256-512Hz. CONCLUSIONS: Analysis by the wavelet transform allowed identification of physiological factors related not only to the activation of the masseter muscle, but also to the intensity and time / frequency relationship, as well as the main types of fibers activated during the protocols before and after LED therapy in patients with dysfunction temporomandibular.

Evaluation of the therapeutic effects of led (λ627 ± 10 nm) on the initial phase of ankle sprain treatment: a randomised placebo-controlled clinical trial.

Various therapies for the treatment of sprains have emerged as advances occur in biomedical engineering and photobiology. Therapy with coherent and non-coherent light is a treatment modality for various musculoskeletal injuries. The main certified phototherapy benefits are the reduction of nociceptive processes and the modulation of the inflammatory process, among others. The objective of this study was to analyse the changes caused by the use of light-emitting diodes (LED) (λ627 ± 10 nm) with an energy density of 10 J/cm2 in 40 subjects divided into two groups (20 placebo and 20 LED). All of the volunteers had acute ankle sprains by inversion of grade II treated with the PRICE (protection, rest, ice, compression and elevation) technique and were treated for 6 days with LED therapy and LED therapy turned off (placebo). Pain assessment was performed on the 1st, 3rd and 6th days using the visual analogue scale (VAS) of pain, the McGill Pain Questionnaire and volumetry. The group treated with LED showed statistically decreased pain compared to the placebo group in both the VAS (85.79 vs 55.73%) and McGill questionnaire (83.33 vs 52.52%). The reduction of oedema in the LED group on the 3rd and 6th days after therapy was statistically superior to that in the placebo (p < 0.0001). Based on the results of this study, treatment with LED, using the tested dose, is effective for pain and oedema in the initial phase of ankle sprains.

Effects of photobiostimulation in the treatment of post-herpetic neuralgia: a case report / Efeitos da fotobioestimulação no tratamento da neuralgia pós-herpética: relato de caso

Abstract Objectives: to describe the effect of photobiomodulation therapy in the treatment of post-herpetic neuralgia in the elderly. Case report: a female patient, 61 years old, 56 kg, 1.67cm tall, sought treatment at the Laser Therapy Center of the Universidade do Vale do Paraíba, in the city of São José dos Campos, São Paulo, Brazil, on October 27, 2015. She had been diagnosed with herpes zoster on September 4, 2015 with complaints of intermittent neuralgia in the long thoracic nerve path and spikes of intense pain (level 10, according to the analogue pain scale). Photobiomodulation was performed with low intensity laser spot irradiations at 20 points around the herpesvirus nerve, with a distance of 2cm between each point. Irradiation was performed at each point after 20 seconds, with 3J/cm2 per point and total energy of 60 J. At the end of the treatment the pain level was 0 and the patient exhibited a normal sleep pattern (8 hours of sleep). Conclusions: Photobiomodulation treated painful discomfort, improved the quality of life of the patient and proved to be an effective, safe and promising treatment, with significant potential to become the therapy of choice in such cases. AU

Resumo Objetivo: Descrever o efeito da fotobiomodulação no tratamento de neuralgia pós-herpética em idosa. Relato de caso: Paciente do gênero feminino, 61 anos, 56kg, 1,67cm de altura, procurou o Centro de Laserterapia da Universidade do Vale do Paraíba, na cidade de São José dos Campos, SP, Brasil, no dia 27 de outubro de 2015. Diagnosticada com herpes zoster em 4 de setembro de 2015 com queixas de neuralgia intermitente no trajeto do nervo torácico longo e picos de dor intensa (nível 10, segundo escala analógica de dor). A fotobiomodulação foi realizada com irradiações pontuais do laser de baixa intensidade em 20 pontos ao redor do nervo acometido pelo herpesvírus, com uma distância de 2 cm de cada ponto. A irradiação foi realizada com o tempo de 20 segundos em cada ponto, ou seja, 3J/cm2 por ponto e energia total de 60 J. Sendo ao final do tratamento o nível de dor 0 e o padrão de sono normal (oito horas de sono). Conclusão: A fotobiomodulação tratou o desconforto álgico, melhorou a qualidade de vida da paciente e mostrou-se, por meio de suas vantagens, ser um tratamento efetivo, seguro e promissor, com grande potencial de se tornar a terapia de escolha em tais casos. AU

Effectiveness of Low-Intensity Laser Therapy on Tissue Repair Following Saphenectomy in Patients Who Underwent Coronary Artery Bypass Graft: A Randomized, Double-Blind Study.

OBJECTIVE: To verify the effectiveness of low-intensity laser therapy (LLLT) on tissue repair following saphenectomy during postoperative period in patients having undergone coronary artery bypass graft (CABG). MATERIALS AND METHODS: A randomized clinical trial, controlled and double-blind study was conducted with 40 volunteers, divided into 2 groups: a placebo group (PG, n = 20) and a laser group (LG, n = 20). The patients in the LG group were irradiated with laser during saphenectomy (InGaAlP, λ 660 nm, energy density 6 J/cm2) daily from the first to the fourth postoperative day. The surgical incision was clinically evaluated and imaged at the beginning and at the end of the treatment. The areas of hematoma and hyperemia were evaluated using the software ImageJ 1.4©, and border closure was evaluated by three researchers, who were blinded concerning the allocation of the participants. RESULTS: The LG group presented a reduction of the areas of hematoma and hyperemia (p = 0.0003) and better border closure (p = 0.009), when compared with the PG group. CONCLUSIONS: The proposed LLLT protocol improved the tissue repair following saphenectomy in CABG patients.

Low-intensity LED therapy (λ 640 ± 20 nm) on saphenectomy healing in patients who underwent coronary artery bypass graft: a randomized, double-blind study.

Myocardial revascularization surgery (CABG) is the most appropriate treatment for coronary artery disease. Currently, the great challenge is to reduce postoperative complications, such as wound infections, dehiscence, pain, and patients' quality of life. The saphenectomy is the target of complications in 10% of cases, which can cause greater morbidity, time, and cost of hospitalization. Studies show that low-intensity laser or light-emitted diode (LED) therapy promotes positive biomodulation of the tissue repair process, culminating in a lower incidence of dehiscence, pain reduction, and improvement in quality of life. The objective of the present study was to evaluate clinically the saphenous tissue repair after LED therapy. Forty subjects of both genders who underwent CABG with extracorporeal circulation were randomly divided into two groups: the placebo (PG) and experimental (EG). The experimental group underwent low-intensity LED therapy (λ 640 ± 20 nm, 6 J/cm2) on saphenectomy. The tissue repair was analyzed by digital photogrammetry on the first and fifth postoperative day. The border closure was blindly evaluated by three researchers. The hematoma and hyperemia area was quantitatively analyzed using ImageJ© software. The results showed that in the experimental group, there were less bleeding points and no dehiscence in saphenectomy, as compared to the placebo group. There was also a smaller area of hematoma and hyperemia in the experimental group (p < 0.0009). These data lead to the conclusion that the type of phototherapy protocol employed can assist in tissue repair.

Association of facial massage, dry needling, and laser therapy in Temporomandibular Disorder: case report / Associação entre massagem facial, agulhamento a seco e laserterapia no tratamento da Disfunção Temporomandibular: relato de caso

ABSTRACT This case report aims to evaluate the treatment of Temporomandibular Disorder (TMD) of muscular origin by associating facial massage (FM), dry needling (DN), and low-level laser therapy (LLLT). The pre- and post-treatment evaluations consisted of clinical examinations based on the Research Diagnostic Criteria (RDC) for TMD, pain intensity quantification by means of the Visual Analog Scale (VAS), mandibular movement measurement, and electromyographic (EMG) analysis of the masseter and temporal muscles. Post-therapy assessment indicated a decrease in pain sites of 58%, in pain intensity mean (1.3), and an increase in the maximum aperture of 10 mm, in addition to normalization of EMG signals. We conclude that, after application of the treatment protocol, there was a decrease in painful sites, gain in amplitude of mandibular movements, and normalization of EMG activity.

RESUMO O objetivo do presente relato de caso é avaliar a associação entre a Massagem Facial (MF), Agulhamento a Seco (AS) e Terapia a Laser de Baixa Intensidade (TLBI) no tratamento da Disfunção Temporomandibular (DTM) de origem muscular. Paciente com DTM crônica foi submetida a 4 sessões de associação entre a MF, AS e TLBI. A avaliação inicial e final foi composta por exame clínico baseado nos Critérios diagnósticos de pesquisa para DTM (RDC - Research Diagnostic Criteria), quantificação da intensidade da dor por meio da Escala visual analógica de dor, mensuração dos movimentos mandibulares e análise eletromiográfica (EMG) dos músculos masseter e temporal. Na pós-terapia, foi observada a redução de 58% dos sítios dolorosos, da média (1,3) da intensidade de dor e aumento de 10 mm na abertura máxima, além da normalização dos sinais EMG. Conclui-se que, após a aplicação de protocolo de tratamento, houve a redução dos sítios dolorosos, ganho de amplitude dos movimentos mandibulares e normalização da atividade EMG.

Effect of non-coherent infrared light (LED, λ945 ± 20 nm) on bone repair in diabetic rats-morphometric and spectral analyses.

Phototherapy using coherent light (lasers) and non-coherent light (light-emitting diodes (LEDs)) has been investigated for the purpose of biomodulation in biological tissues. Several effects can be expected, including pain moderation, biostimulation of cellular tropism, anti-inflammatory effects, regular circulatory stimulation, and tissue repair. The aim of this study was to evaluate the effect of LED (λ945 ± 20 nm, 48 mW) therapy on the regeneration process in femoral lesions of rats (Wistar). Seven irradiation sessions were held, with a 48-h interval between sessions. The animals were euthanised 14, 21, and 28 days after surgery. Bone samples were analysed by histomorphometry, micro X-ray fluorescence spectroscopy, scanning electron microscopy, and optical densitometry. The results demonstrated the effective positive influence of low-intensity LED therapy using the near-infrared region on the tissue repair process in diabetic animals, especially in the early stages of repair (14 and 21 days after surgery). It can be concluded that LED therapy positively influences bone formation in the early stages of the bone repair process in non-diabetic and diabetic animals, without causing changes in the optical density and volume of tissue in the final stages. No influence of LED therapy was observed on the percentage of calcium, percentage of phosphorus, Ca/P ratio, or optical mineral density in non-diabetic animals. However, increased mineral concentration was evident in the diabetic animals treated with the LED during the repair process.

Efeito da terapia LED na disfunção temporomandibular: estudo de caso / Effect of LED therapy on temporomandibular disorder: a case study

OBJETIVOS: Avaliar o efeito da terapia light emitting diode (LED) na disfunção temporomandibular. DESCRIÇÃO DO CASO: Uma paciente diagnosticada com disfunção temporomandibular foi submetida a quatros sessões de terapia LED com intervalo de sete dias entre as irradiações. No exame inicial da articulação temporomandibular a paciente apresentava abertura de boca sem dor de 23 mm, abertura máxima de 25 mm e abertura máxima com auxílio de 27 mm. Após o tratamento houve aumento de 7 mm na abertura sem dor entre a primeira e a última avaliação enquanto que a abertura máxima de boca e a abertura máxima com auxílio aumentaram 6 mm entre a primeira e a última avaliação. Após 21 dias de tratamento detectou-se redução de 50% dos sítios dolorosos ao exame de palpação. Após o final do tratamento, a escala visual analógica de dor detectou diminuição da intensidade de dor em ambos os lados, e houve diminuição da média total da intensidade de dor. Pela análise das respostas ao questionário Medical Outcomes Study 36- item Short Form Health Survey (SF-36), dos oito domínios de qualidade de vida avaliados, quatro apresentaram melhora. CONCLUSÕES: No protocolo empregado neste caso, após a terapia LED houve redução da intensidade da dor e aumento da amplitude de movimentos mandibulares. A remissão dos sinais e sintomas da disfunção temporomandibular resultou em melhora na qualidade de vida da paciente.

AIMS: To evaluate the effect of light emitting diode (LED) therapy on temporomandibular disorder. CASE DESCRIPTION: A woman diagnosed with temporomandibular disorder was subjected to four LED therapy sessions at a seven-day interval. In the initial examination of the temporomandibular joint the patient presented a mouth opening without pain of 23 mm, a maximum opening of 25 mm and a maximum opening with the aid of 27 mm. After the treatment, there was an increase of 7 mm in the opening without pain between the first and last evaluation, while the maximum opening of the mouth and the maximum opening with aid increased 6 mm between the first and last evaluation. After 21 days of treatment, a 50% reduction in painful sites was detected on the palpation examination. After the end of the treatment, the visual analog pain scale detected a decrease in pain intensity on both sides, and there was a decrease in the total mean pain intensity. By analyzing the responses to the Medical Outcomes Study 36-item Short Form Health Survey (SF-36), of the eight quality of life domains evaluated, four showed improvement. CONCLUSIONS: In this case study, after LED therapy there was reduction in pain intensity and increase of the mandibular range of motion. The resolution of the signs and symptoms of temporomandibular disorder resulted in patient's better quality of life.

Low-intensity laser (660 NM) has analgesic effects on sternotomy of patients who underwent coronary artery bypass grafts.

BACKGROUND: The aim of this study was to evaluate the efficacy of low-level laser therapy for reducing the acute pain of sternotomy in patients who underwent a coronary artery bypass graft (CABG). METHODS: This study was conducted with ninety volunteers who electively submitted to CABG. The volunteers were randomly allocated into three groups of equal size (n = 30): control, placebo, and laser (λ of 660 nm and spatial average energy fluency of 1.06 J/cm 2 ). Pain when coughing was assessed by a visual analog scale (VAS) and McGill Pain Questionnaire, according to sensory, affective, evaluative, and miscellaneous domains. The patients were followed for 1 month after the surgery. RESULTS: The laser group had a greater decrease in pain with analogous results, as indicated by both the VAS and the McGill questionnaire (P ≤ 0.05) on sensory and affective scores, on days 6 and 8 postsurgery compared to the placebo and control groups. CONCLUSION: Laser seems to be effective promoting pain reduction after coronary-arterial bypass grafting.

Photobiomodulation (Laser and LED) on Sternotomy Healing in Hyperglycemic and Normoglycemic Patients Who Underwent Coronary Bypass Surgery with Internal Mammary Artery Grafts: A Randomized, Double-Blind Study with Follow-Up.

BACKGROUND AND OBJECTIVE: This study aimed at analyzing the healing effects of low-level laser therapy (LLLT) (λ620 nm, 6 J/cm2) and light-emitting diode (LED) therapy (λ640 nm, 6 J/cm2) on the longitudinal sternotomy incisions of hyperglycemic and normoglycemic patients who underwent coronary artery bypass grafting (CABG). MATERIALS AND METHODS: 120 volunteers were electively submitted to CABG and were randomly allocated into four different groups of equal size (n = 30): control, placebo, laser (λ of 640 nm and spatial average energy fluency [SAEF] of 1.06 J/cm2), and LED (λ of 660 ± 20 nm and SAEF of 0.24 J/cm2). Laser and LED groups were irradiated from the second to eighth day postsurgery, and sternotomy incision was photographically registered. Then, participants were also separated into hyperglycemic and normoglycemic groups, according to their fasting blood glucose test before surgery. Three researchers blindly analyzed the incision photographs to determine hyperemia and wound closure at the first day of hospital discharge (eighth postoperative day). RESULTS: LLLT and LED groups had similarly less hyperemia and less incision bleeding or dehiscence (p ≤ 0.005) and the outcomes were also analogous between hyperglycemic and normoglycemic patients, which indicates no difference observed in an intragroup analysis (p ≥ 0.05). CONCLUSIONS: With the present therapy parameters, it may be assumed that both coherent light (laser) and non-coherent light (LED) are effective in promoting sternotomy and healing acceleration, which are evident on the eighth day postsurgery.

Low-intensity laser (660 nm) on sternotomy healing in patients who underwent coronary artery bypass graft: a randomized, double-blind study.

The aim of this study was to analyze the healing effects of low-level laser therapy (LLLT) on the longitudinal sternotomy incisions of patients who underwent coronary artery bypass graft (CABG). The volunteers were randomized into three groups of equal size (n = 30): control, placebo, and laser (λ = 660 nm and spatial average energy fluency [SAEF] = 1.06 J/cm2). The patients in the laser group underwent irradiation on postoperative days 2, 4, 6, and 8, and their sternotomy incisions were photographed immediately after the surgery and 8 days later for analysis. Three researchers who were blinded to the patient treatment groups analyzed the incision photographs to assess hyperemia and wound closure on the day of hospital discharge (eighth postoperative day). The sternotomy incisions in the LLLT group demonstrated less hyperemia, incisional bleeding, and dehiscence (p ≤ 0.005).

Effects of low-level laser therapy (LLLT 808 nm) on lower limb spastic muscle activity in chronic stroke patients.

A cerebrovascular accident (CVA) may affect basic motor functions, including spasticity that may be present in the upper extremity and/or the lower extremity, post-stroke. Spasticity causes pain, muscle force reduction, and decreases the time to onset of muscle fatigue. Several therapeutic resources have been employed to treat CVA to promote functional recovery. The clinical use of low-level laser therapy (LLLT) for rehabilitation of muscular disorders has provided better muscle responses. Thus, the aim of this study was to evaluate the effect of the application of LLLT in spastic muscles in patients with spasticity post-CVA. A double-blind clinical trial was conducted with 15 volunteer stroke patients who presented with post-stroke spasticity. Both males and females were treated; the average age was 51.5 ± 11.8 years old; the participants entered the study ranging from 11 to 48 months post-stroke onset. The patients participated in three consecutive phases (control, placebo, and real LLLT), in which all tests of isometric endurance of their hemiparetic lower limb were performed. LLLT (diode laser, 100 mW 808 nm, beam spot area 0.0314 cm(2), 127.39 J/cm(2)/point, 40 s) was applied before isometric endurance. After the real LLLT intervention, we observed significant reduction in the visual analogue scale for pain intensity (p = 0.0038), increased time to onset of muscle fatigue (p = 0.0063), and increased torque peak (p = 0.0076), but no significant change in the root mean square (RMS) value (electric signal in the motor unit during contraction, as obtained with surface electromyography). Our results suggest that the application of LLLT may contribute to increased recruitment of muscle fibers and, hence, to increase the onset time of the spastic muscle fatigue, reducing pain intensity in stroke patients with spasticity, as has been observed in healthy subjects and athletes.

Tratamento da neuralgia pós-herpética com irradiações a laser de baixa intensidade: revisão da literatura / Treatment of postherpetic neuralgia with low-level laser irradiation: literature review

OBJETIVOS: Realizar uma revisão da literatura sobre o tratamento da neuralgia pós-herpética com irradiações a laser de baixa intensidade. MÉTODOS: A revisão foi realizada nos meses de novembro a dezembro de 2015 nas bases de dados LILACS, SciELO e Medline, utilizando-se os descritores "herpes zoster", "neuralgia" e "terapia a laser de baixa intensidade" e seus correspondentes termos em inglês. Os critérios de inclusão foram artigos disponíveis na íntegra, publicados em português, inglês, alemão ou espanhol, no período compreendido entre 2008 a 2015. Os critérios de exclusão foram textos incompletos, artigos que não abordaram diretamente a temática do estudo e repetição de um mesmo artigo na mesma ou em diferentes bases de dados, nesse caso sendo considerado apenas um deles. RESULTADOS: A partir dos descritores utilizados foram encontrados 32 estudos. Após aplicação dos critérios de elegibilidade foram selecionados 15 artigos para leitura, dos quais foram excluídos dois por repetição e um por não apresentar resultados relevantes a esta pesquisa. Dessa forma, 11 estudos foram incluídos na revisão, dos quais cinco foram realizados nos Estados Unidos, dois no Brasil, dois na Alemanha e dois na Itália, sendo quatro ensaios clínicos, duas revisões sistemáticas e cinco relatos de casos. Os 11 estudos encontraram resultados positivos após aplicação do laser, principalmente diminuição da dor, e apenas um artigo mencionou pouca redução da neuralgia. Nos três estudos que informaram os parâmetros de irradiação estes não foram uniformes, sendo a média do comprimento de onda 740,6 nm, a média da potência 28 mW e a média do tempo de irradiação por ponto 53,4 segundos. Quanto ao número de sessões, houve grande variação, com uma média de aproximadamente 12 sessões em dia alternados. CONCLUSÕES: A terapia com laser de baixa intensidade ofereceu resultados positivos aos pacientes com neuralgia pós-herpética, entretanto não há um consenso quanto aos parâmetros a serem utilizados. Em razão dos diferentes protocolos descritos, é importante realizar mais estudos que auxiliem a padronizar os parâmetros dessa terapia aplicados à neuralgia pós-herpética.

AIMS: To perform a literature review on the treatment of postherpetic neuralgia with low-intensity laser irradiation. METHODS: The review was conducted in November and December 2015 by searching the terms "herpes zoster", "neuralgia", "low-level laser therapy", and "low-intensity laser therapy" in the LILACS, SciELO, and Medline databases. Full articles published in Portuguese, English, German, or Spanish between 2008 and 2015 were included. Incomplete articles, those that did not directly address the topic of interest, and those appearing in the same or in different databases were excluded. In the latter case, only one article was included. RESULTS: Thirty-two studies were selected using the search terms. After the application of the eligibility criteria, 15 studies were read; two of them were excluded for being available in more than one database and one was eliminated for not adding relevant information. Therefore, 11 studies were included in the review: five of them conducted in the United States, two in Brazil, two in Germany, and two in Italy. There were four clinical trials, two systematic reviews and five case reports. The 11 studies found positive results after laser application, especially reduction of pain, with only one article mentioning little reduction of neuralgia. In the three studies that reported the irradiation parameters, these have not been uniform, with a medium wavelength of 740.6 nm, a medium power of 28 mW and a medium time of irradiation per point of 53.4 seconds. There was great variation in the number of sessions, with an average of about 12 sessions on alternate days. CONSLUSIONS: The low-intensity laser therapy provided positive results to patients with postherpetic neuralgia, however there is no consensus about the parameters to be used. In view of the different protocols, it is important to perform new studies in order to standardize the lowintensity laser therapy parameters applied to postherpetic neuralgia.