Effect of Photobiomodulation Combined with Physiotherapy on Functional Performance in Children with Myelomeningo-Cele-Randomized, Blind, Clinical Trial.

BACKGROUND: This study aimed to evaluate the electrical activity of the rectus femoris, tibialis anterior, and lateral gastrocnemius muscles during the sit-to-stand task and functional mobility after a neurofunctional physiotherapy protocol associated with PBM. METHODS: Twenty-five children were randomly allocated to either Active PBM + physiotherapy (n = 13) or PBM sham + physiotherapy (n = 12). PBM was carried out with a LED device (850 nm, 25 J, 50 s per point and 200 mW) at four points over the area with absence of a spiny process. Both groups completed a twelve-week supervised program with two weekly 45-60 min sessions. Pre-training and post-training assessments involved the Pediatric Evaluation of Disability Inventory (PEDI). Muscle activity was assessed using portable electromyography (BTS Engineering) and the electrodes were positioned on the lateral gastrocnemius, anterior tibialis, and rectus femoris muscles. The RMS data were recorded and analyzed. RESULTS: After 24 sessions of the treatment protocol, improvements were found in the PEDI score. The participants presented greater independence in performing the tasks, requiring less assistance from their caregivers. More significant electrical activity was found in the three muscles evaluated between the rest period and execution of the sit-to-stand tasks, both in the more compromised or less compromised lower limbs. CONCLUSION: Neurofunctional physiotherapy with or without PBM improved functional mobility and electrical muscle activity in children with myelomeningocele.

Effects of systemic vascular photobiomodulation using LED or laser on sensory-motor recovery following a peripheral nerve injury in Wistar rats.

Peripheral nerve injury (PNI) is associated with considerable functional impairment. Photobiomodulation (PBM) has demonstrated positive effects regarding neuromuscular repair after PNI when applied locally to the nerve or injured muscle. However, the effects of systemic PBM with transcutaneous application over an important artery, which is also denominated vascular PBM (VPBM), remain unclear. The aim of the study was to compare the effects of VPBM with low-level laser (LLL) and light-emitting diode (LED) on gait, sensitivity and muscle morphology following a PNI. PNI was induced on Wistar rats using the sciatic nerve crushing technique. VPBM was performed over the rat's artery tail region with LED (850 nm, 40 mW, 3.2 J) and LLL (780 nm, 40 mW, 3.2 J). Gait functionality, mechanical (nociceptive) sensitivity, and morphology of the tibialis anterior muscle were evaluated at 7, 14, and 21 days after injury. An improvement in functional gait was shown in the VPBM-LLL group in all periods. Motor sensitivity was found after 14 days in the VPBM-LLL group. The left/right (L/R) muscle mass ratio revealed a reduction in muscle atrophy in the VPBM-LLL group at 7 days. Muscle fiber diameter increased in the VPBM-LED group at 14 days and increases in the cross-section area were found in the VPBM-LED and VPBM-LLL groups at 7 days. VPBM with both light sources (LED and LLL) positively modulated functioning and neuromuscular recovery following sciatic nerve injury in rats, with more pronounced results when using LLL.

Effect of photobiomodulation combined with physical therapy on functional performance in children with myelomeningocele: A protocol randomized clinical blind study.

INTRODUCTION: Myelomeningocele is a severe type of spina bifida, resulting from improper closure of the neural tube. This condition drastically affects the structures of the spinal cord resulting in deficiencies. The combination of these deficiencies results in an overall decrease in mobility and functional participation amongst this population. Physiotherapy plays an essential role in rehabilitating people with MMC. The current literature shows that resources such as photobiomodulation (PBM) may support the rehabilitation of neurological conditions. The aim of the proposed study is to evaluate the effects of photobiomodulation (PBM) combined with physical therapy on functional performance in children with low lumbosacral myelomeningocele. MATERIALS AND METHODS: This is a protocol randomized clinical blind study, that will include 30 individuals of both sexes, aged between 5 to 8 years, diagnosed with low and sacral lumbar myelomeningocele and capable of performing the sit-to-stand task. The participants will be randomly assigned into two treatment groups: PBM + physiotherapeutic exercises and sham PBM + physiotherapeutic exercises. Irradiation will be carried out with light emitting diode (LED) at a wavelength of 850 nm, energy of 25 J per point, 50 seconds per point and a power of 200 mW. The same device will be used in the placebo group but will not emit light. Muscle activity will be assessed using a portable electromyograph (BTS Engineering) and the sit-to-stand task will be performed as a measure of functioning. Electrodes will be positioned on the lateral gastrocnemius, tibialis anterior and rectus femoris muscles. The Pediatric Evaluation of Disability Inventory will be used to assess functional independence. Quality of life will be assessed using the Child Health Questionnaire-Parent Form 50. Changes in participation will be assessed using the Participation and Environment Measure for Children and Youth. The data will be analyzed with the aid of GraphPad PRISM. DISCUSSION: The results of this study can contribute to a better understanding of the effectiveness of PBM on functioning and quality of life in children with myelomeningocele. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04425330.