Exercise-based physiotherapeutic interventions in frailty syndrome: A systematic review and meta-analysis.

OBJECTIVE: To identify the effect of exercise interventions on physical frailty in community-dwelling older adults. METHODS: Relevant articles were searched in MEDLINE, LILACS, Scielo, Embase, and PEDro in November 2022, based on a protocol registered in PROSPERO and according to items prescribed in Report for Systematic Reviews and Meta-Analyses, using Health Sciences Descriptors (DeCS) and free terms for search strategy, with no language restrictions. The studies were considered if they had been published between January 2010 and November 2022, and were randomized clinical trials in which pre-frail and frail older community-dwelling adults had undergone exercise-based physical therapy. RESULTS: The systematic review found 5360 citations; after screening, abstract, and full-text screening for eligibility, seven studies were included, involving 1304 participants overall. The exercise modalities differed substantially between studies. The meta-analysis identified a statistically significant difference in frailty between older adults who exercised compared with those who exercised with no or minimal intervention. No heterogeneity between articles was observed, and the risk of bias was considered low according to funnel plot visual inspection. CONCLUSIONS: The results of this review suggest that physical therapy programs are effective in decreasing levels of physical frailty in community-dwelling older adults.

Effects of photobiomodulation therapy on the functional performance of healthy individuals: a systematic review with meta-analysis.

The aim of this study is to assess the effect of photobiomodulation therapy (PBMT) on functional performance concerning strength, fatigue, and functional capacity in healthy individuals. This systematic review with meta-analysis involved searches on data platforms and active searches of randomized clinical trials, focusing on PBMT as the sole intervention. Primary outcomes assessed included strength, fatigue, and functional capacity. Three reviewers screened studies by title and abstract using Rayyan, and data were extracted using a specific form. Bias risk was assessed using RoB2, and confidence in the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). The RevMan was used for meta-analysis. Sixteen studies were included, totaling 340 individuals (183 males and 157 women). Most articles presented a low risk of bias. Variability was observed in device types and application domains, including wavelengths (655-905 nm), power (10-200 nW), energy (0.6-30 J per point), and time (30-100 s per point). PBMT improved fatigue recovery (mean difference: 5.87; 95% CI 3.83, 7.91). There was no enhancement in strength (peak torque: mean difference 12.40; 95% CI -5.55, 30.55; one-repetition maximum test: mean difference 39.97, 95% CI -2.44, 82.38; isometric and isokinetic strength: mean difference 2.77, 95% CI -14.90, 20.44) nor improvement in short-term (mean difference 0.67, 95% CI -0.58, 1.91) and long-term (mean difference 18.44, 95% CI -55.65, 92.54) functional capacity. PBMT may aid in favoring fatigue recovery in healthy individuals; however, there's no evidence to support PBMT enhancing strength or improving functional capacity.

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.

The immediate effect of whole-body vibration on rectus abdominis muscle activity and cutaneous temperature: A randomized controlled trial.

OBJECTIVES: To compare acute effects of isometric abdominal exercises performed with or without vibration on the electromyographic activity and cutaneous temperature in the abdominal region of physically active individuals. METHODS: A randomized controlled crossover clinical trial was undertaken in thirty volunteers who completed one unique session of two different protocols of interventions apart from a week from each other, in a two-week study protocol. The subjects were randomly divided in to two groups of 15 volunteers; both were assigned to perform board exercise (30 s on the front, right and left lateral boards, with a rest interval of 2 min). The first group performed it on a vibrating platform at a frequency of 30 Hz for the first week, while the remaining participants executed the same exercise without stimulates vibration. In the second week the protocol was inverted. The outcome were surface electromyography (EMG) data for the rectus abdominis muscle (RAM) and cutaneous temperature (CT) of the abdominal region. Normality was accepted, and Student's t-tests were used to compare the measurements for dependents variables (P < 0.05). RESULTS: There were no differences in RAM activation and CT between protocols with or without vibration (P > 0.05). CT increased (P = 0.001) after both the exercises with and without vibration. CONCLUSION: The results suggest that there were no effects in cutaneous temperature or muscle activation through the use of vibration associated with isometric abdominal exercises.

Skin temperature changes during muscular static stretching exercise.

This study aimed to investigate the acute effects of stretching exercise on skin temperature, flexibility, passive muscle stiffness, and pain during hamstring stretching in healthy young subjects. Thirty-one participants (n=31) were randomly divided into 2 groups: an experimental group (EG, n=15), which was submitted to hamstring stretching exercise for 180 sec, and the control group (n=16), which was not exercised. Skin temperature (TsK) was collected in subjects' posterior thigh using a thermographic camera at 7 time points with intervals of 30 sec each: T0 (rest), T30, T60, T90, T120, T150, and T180. In addition, the knee range of motion, passive stiffness and muscle soreness (visual analogue scale) were recorded during the stretching procedure at the same times. The EG presented a small but progressive increase in TsK (30.8°C±0.6°C to 31.1°C±0.6°C, P<0.01), with an increased range of motion (P<0.01) and muscle soreness levels (P<0.01) during the gradual hamstring stretching protocol. Additionally, there was an increment of passive stiffness (P<0.01) that was partially reversed toward the end of the stretching period. This research presents evidence that constant, passive and progressive stretching of the hamstrings progressively increased the local TsK by about 0.3°C after 180 sec of stretching. These findings may help to understand the effects of repeated stress on the muscle-tendon unit and the role of muscle stretching in warm-up protocols and rehabilitation.