Effects of photobiomodulation on re-epithelialization of burn wound: protocol for a randomized controlled trial.

BACKGROUND: Burns are a global public health problem and cause approximately 180,000 deaths annually, mainly in low- and middle-income countries. Topical antibiotics and occlusive dressing are standard treatments for burns not requiring a skin graft. However, physiotherapy has low-cost phototherapeutic and electrophysical resources (e.g., light-emitting diode [LED]) that may accelerate burn healing. This study aims to compare the re-epithelialization rate of second-degree burns, pain, pruritus, skin temperature, quality of wound healing, and scar quality and mobility among individuals undergoing treatment with red LED, infrared LED, and simulated photobiomodulation. METHODS: This is a double-blinded, three-arm parallel-group, randomized controlled superiority trial. Individuals of both sexes, aged over 18 years, and with second-degree burns will be included. The sample will be divided into three groups of 13 individuals: two will receive LED therapy (red or infrared) and one placebo. Pain, pruritus, skin temperature, and wound size will be assessed daily. Interventions will take place until complete healing, when scar mobility and quality will be evaluated. Data will be presented as mean and 95% confidence interval and analyzed using mixed linear models. DISCUSSION: This randomized controlled trial has minimal risk of bias and intends to identify the ideal type, procedures, and doses of photobiomodulation to heal burns, which are not standardized in clinical practice. Positive results will allow the implementation of the technique in burn and wound guidelines. TRIAL REGISTRATION: Brazilian Clinical Trials Registry (ReBEC) RBR-8bfznx6 . Registered on October 13, 2021.

Activation of upper limb muscles in subjects with scapular dyskinesis during bench-press and dumbbell fly on stable and unstable surfaces.

BACKGROUND: Scapular dyskinesis has been associated with shoulder dysfunctions, and changes in electromyographic (EMG) activity have been reported during the execution of some exercises. OBJECTIVE: To compare upper limb muscles EMG of asymptomatic subjects with and without scapular dyskinesis during bench-press and dumbbell fly exercise performed on different surface stability conditions. METHODS: Twenty-eight physically active men were allocated into two groups: Control group (n= 14) and Dyskinesis group (n= 14). The participants performed six repetitions lasting three seconds of the bench press and dumbbell fly exercises with 50% of one-repetition maximum (1RM) on a bench and a Swiss ball. The EMG activity of the pectoralis major, serratus anterior, upper and lower trapezius, anterior deltoid, biceps and triceps muscles were recorded. RESULTS: No differences were found between groups, regardless of exercise or surface type. Inserting the unstable surface in the supine exercise promoted a slight increase in upper trapezius EMG activity for the control [4.32 (95% CI: 1.04 to 7.60)] and dyskinesis [3.30 (95% CI: 0.34 to 6.27)] groups. CONCLUSIONS: There is no difference in upper limb muscle EMG activity between subjects with and without scapular dyskinesis. In addition, inserting unstable surfaces did not modify EMG activity.

Additional Functional Performance Gains After 24-Week Unstable Strength Training With Cognitive Training in Community-Dwelling Healthy Older Adults: A Randomized Trial.

The authors investigated the effects of unstable strength training (UST) without or with cognitive training (C+UST) on functional performance in community-dwelling older adults. A total of 50 participants were randomly assigned (1:1) to either 24 weeks of thrice-weekly UST (n = 25) or C+UST (n = 25). All participants performed moderate-intensity strength exercises using unstable surfaces, and C+UST participants simultaneously received cognitive training in addition to UST. Primary outcomes included measures of functional performance: single- and dual-task timed up and go tests. Secondary outcomes included dynamic balance, mobility, handgrip strength, flexibility, quality of life, and concern about falling. The authors observed similar improvements on functional performance through the interventions. The C+UST group experienced additional gains at completion (single-task timed up and go: -0.90 s, 95% confidence interval [-2.38, -0.03]; dual-task timed up and go: -4.80 s, 95% confidence interval [-8.65, -0.95]) compared with the UST group. Moreover, significant differences were observed in mobility (sitting-rising test: -1.34, 95% confidence interval [-2.00, -0.20]) at 24 weeks. Both exercise modes improved single-task functional performance, while adding cognitive-training-optimized dual-task functional performance gains.

Effects of a 12-Week Chronic Stretch Training Program at Different Intensities on Joint and Muscle Mechanical Responses: A Randomized Clinical Trial.

CONTEXT: Stretching intensity is an important variable that can be manipulated with flexibility training. However, there is a lack of evidence regarding this variable and its prescription in stretching programs. OBJECTIVE: To investigate the effects of 12 weeks of knee flexor static stretching at different intensities on joint and muscle mechanical properties. DESIGN: A randomized clinical trial. SETTING: Laboratory. PARTICIPANTS: A total of 14 untrained men were allocated into the low- or high-intensity group. MAIN OUTCOME MEASURES: Assessments were performed before, at 6 week, and after intervention (12 wk) for biceps femoris long head architecture (resting fascicle length and angle), knee maximal range of motion (ROM) at the beginning and maximal discomfort angle, knee maximal tolerated passive torque, joint passive stiffness, viscoelastic stress relaxation, knee passive torque at a given angle, and affective responses to training. RESULTS: No significant differences were observed between groups for any variable. ROM at the beginning and maximal discomfort angle increased at 6 and 12 weeks, respectively. ROM significantly increased with the initial angle of discomfort (P < .001, effect size = 1.38) over the pretest measures by 13.4% and 14.6% at the 6- and 12-week assessments, respectively, and significantly improved with the maximal discomfort angle (P < .001, effect size = 1.25) by 15.6% and 18.8% from the pretest to the 6- and 12-week assessments, respectively. No significant effects were seen for muscle architecture and affective responses. Initial viscoelastic relaxation for the low-intensity group was lower than ending viscoelastic relaxation. CONCLUSION: These results suggest that stretching with either low or high discomfort intensities are effective in increasing joint maximal ROM, and that does not impact on ROM, stiffness, fascicle angle and length, or affective response differences.

Effect of 24-week strength training on unstable surfaces on mobility, balance, and concern about falling in older adults.

OBJECTIVE: To evaluate the effects of 24 weeks of strength training on stable (ST) and unstable surfaces (UST) on the functional mobility, balance, and concern about falling in healthy older adults, younger than 70. DESIGN: A single-center randomized clinical trial. PARTICIPANTS: Sixty-four older adults (58 females and 6 males; 68 years) were randomized into control, ST, or UST groups. INTERVENTIONS: Both ST and UST intervention groups received a core muscle, upper, and lower limb moderate-intensity strength exercises using stable and unstable surfaces. The classes were performed three times per week over a 24-week period. The control group did not receive any type of active intervention. MEASUREMENTS: The primary outcome measures were the dynamic balance (Berg Balance Scale (BBS)) and functional mobility (timed up and go (TUG) test). The secondary outcomes included the sitting and rising test (SRT) and Falls Efficacy Scale-International (FESI) scores. RESULTS: There was a significant improvement in balance performance (BBS = +4 points) after 24 weeks of both ST (+1.22; 95% CI, -0.19 to 2.63) and UST (+2.26; 95% CI, 0.83-3.70) compared with the control group. Additionally, compared with the control, only UST experienced functional mobility gains (TUG = -2.44; 95% CI, -4.41 to -0.48; SRT = +1.12; 95% CI, 0.08-2.17) and decreased concern about falling (FESI = -4.41; 95% CI, -9.30 to -0.27). CONCLUSION: Long-term ST with and without unstable devices was effective to improve dynamic balance in older adults. Furthermore, the effects of UST were extended to functional mobility gains and reduced concern about falling.