Efficacy of diadynamic currents as an adjunct to exercise to manage symptoms of knee osteoarthritis in adults: A randomized controlled clinical trial.

OBJECTIVE: To investigate the effect of diadynamic currents administered prior to exercises on pain and disability in patients with osteoarthritis of the knee. DESIGN: A randomized-controlled trial. SETTING: Special Rehabilitation Services in Taboão da Serra. PARTICIPANTS: Patients with bilateral knee osteoarthritis. INTERVENTION: Participants were randomly allocated to Group I (diadynamic currents and exercises; n = 30, 60 knees) or Group II (exercises alone; n = 30, 60 knees) and were treated three times a week for 8 weeks. MAIN OUTCOME MEASURES: The primary outcome measures were change in knee pain evaluated by visual analog scale and disability Index Score (Lequesne). Secondary outcomes included change in mobility (Timed Up and Go test), range of motion (goniometer), muscle strength (dynamometer), a composite score for pain and disability (Western Ontario and McMaster Universities Osteoarthritis questionnaire), and a drug diary to measure consumption of rescue pain medication (paracetamol). All measurements were collected at baseline, 8 weeks, and 6 months from baseline (follow-up). RESULTS: There were 60 participants with a mean (SD) age of 63.40 (8.20) years. Between-group differences in the follow-up (8 weeks and 6 months) were observed for pain at rest, pain during activities of daily living and disability. There was improvement in Group I that was maintained for the three variables 6 months after treatment. Mean difference for pain at rest was -3.08 points (95% confidence interval -4.13; -2.02), p < 0.01 with an effect size of 1.4; mean difference for pain during activities of daily living was -2.40 points (95% confidence interval -3.34; -1.45), p < 0.01 with an effect size of 1.24; and mean difference for disability was -4.08 points (95% confidence interval -5.89; -2.26), p < 0.01 with an effect size of 1.04. CONCLUSION: Patients with symptomatic knee osteoarthritis receiving 8 weeks of treatment with diadynamic currents as an adjunct to a program of exercises had significantly greater improvements in pain and disability than those receiving exercises alone. Beneficial effects were sustained for 6 months.

Efficacy of prolonged application of low-level laser therapy combined with exercise in knee osteoarthritis: A randomized controlled double-blind study.

OBJECTIVES: To investigate the effect of prolonged low-level laser therapy application combined with exercise on pain and disability in patients with osteoarthritis of the knee. DESIGN: A randomized controlled trial. SETTING: Special rehabilitation services. SUBJECTS: Forty-three participants with knee osteoarthritis. INTERVENTION: Following initial assessment, participants were randomly allocated to the Laser group (n = 22, 44 knees) and received low-level laser therapy while the Placebo group (n = 21, 42 knees) received placebo therapy three times a week for 3 weeks. Both groups then received low-level laser therapy combined with exercise three times a week for the following 8 weeks. MAIN OUTCOME MEASURES: The primary outcome was change in knee pain and disability (Lequesne). Secondary outcomes included change in mobility (Timed Up and Go test), range of motion (goniometer), muscular strength (dynamometer), activity (Western Ontario and McMaster Universities Osteoarthritis questionnaire), and medication intake and relief. RESULTS: Mean (SD) age of participants was 63.02 (9.9) years. Pain scores at baseline, 3 weeks, 11 weeks, and 6 months follow-up were 9.1 (1.3), 2.6 (2.3), 0.2 (0.9), and 0.2 (0.8) for the Laser group and 9.5 (8.0), 7.7 (5.3), 5.6 (2.4), and 7.4 (5.0) for the Placebo group, respectively. Disability scores at baseline, 3 weeks, 11 weeks, and 6 months follow-up were 14.9 (4.7), 7.6 (4.8), 3.9 (4.2), and 3.5 (4.1) for the Laser group and 17.8 (14.7), 15.2 (11.5), 11.6 (6.4), and 15.8 (11.9) for the Placebo Group, respectively. CONCLUSION: In participants with osteoarthritis of the knee, the isolated application of low-level laser therapy in the initial 3 weeks and combined with exercises in the final 8 weeks reduced pain, disability, and intake of medication over a 6-month period.

Short- and Long-Term Effectiveness of Low-Level Laser Therapy Combined with Strength Training in Knee Osteoarthritis: A Randomized Placebo-Controlled Trial.

BACKGROUND: Both physical activity and low-level laser therapy (LLLT) can reduce knee osteoarthritis (KOA) inflammation. We conducted a randomized clinical trial to investigate the short- and long-term effectiveness of LLLT combined with strength training in persons with KOA. METHODS: Fifty participants were randomly divided in two groups, one with LLLT plus strength training (n = 26) and one with placebo LLLT plus strength training (n = 24). LLLT and strength training were performed triweekly for 3 and 8 weeks, respectively. In the laser group, 3 joules 904 nm wavelength laser was applied to fifteen points (45 joules) per knee per session. Patient-reported outcomes, physical tests, and ultrasonography assessments were performed at baseline and 3, 8, 26, and 52 weeks after initial LLLT or placebo therapy. The primary outcomes were pain on movement, at rest, at night (Visual Analogue Scale), and globally (Knee injury and Osteoarthritis Outcome Score (KOOS) subscale). Parametric data were assessed with analysis of variance using Sidák's correction. RESULTS: There were no significant between-group differences in the primary outcomes. However, in the laser group there was a significantly reduced number of participants using analgesic and non-steroidal anti-inflammatory drugs and increased performance in the sit-to-stand test versus placebo-control at week 52. The joint line pain pressure threshold (PPT) improved more in the placebo group than in the laser group, but only significantly at week 8. No other significant treatment effects were present. However, pain on movement and joint line PPT were worse in the placebo group at baseline, and therefore, it had more room for improvement. The short-term percentage of improvement in the placebo group was much higher than in similar trials. CONCLUSIONS: Pain was reduced substantially in both groups. LLLT seemed to provide a positive add-on effect in the follow-up period in terms of reduced pain medication usage and increased performance in the sit-to-stand test.

Efficacy of low-level laser therapy combined with exercise for subacromial impingement syndrome: A randomised controlled trial.

OBJECTIVE: To investigate the effect of low-level laser therapy (LLLT) combined with exercise on shoulder pain and disability in patients with subacromial impingement syndrome (SIS). DESIGN: Randomised controlled trial. SETTING: Pontifical Catholic University. SUBJECTS: We enrolled 120 subacromial impingement syndrome patients. INTERVENTION: Groups I (n = 42), II (n = 42) and III (n = 36) were treated with Low-level laser therapy and exercise, exercise only and Low-level laser therapy only, respectively. Interventions were conducted three times a week for 8 weeks. MAIN OUTCOME MEASURES: The primary outcome was the change in shoulder pain and disability index (SPADI). Secondary outcomes included changes in the numeric pain rating scale and medication intake. RESULTS: Average ages of patients in groups I, II and III were 51.9 ± 8.7 years, 56.0 ± 10.4 years and 54.2 ± 7.1 years, respectively. Pain scores at baseline (P = 0.829), 2 months (P = 0.057) and 3 months follow-ups (p = 0.004) were 6.8 (4.7-7.7), 0.2 (0.0-0.5) and 0.3 (0.0-1.0) for group I; 6.6 (5.7-8.0), 0.5 (0.2-2.0) and 0.2 (0.0-3.3) for group II; and 6.5 (5.1-7.4), 2.4 (0.1-6.7) and 4.0 (2.0-5.0) for group III, respectively. SPADI scores at baseline (P = 0.029), 2 months (P < 0.001) and 3 months follow-ups (P = 0.001) were 60.8 (37.7-70.8), 3.8 (0.0-10.8) and 2.3 (0.8-10.8) for group I; 61.5 (41.5-71.5), 9.2 (3.8-29.2) and 14.2 (1.5-38.0) for the group II; and 73.3 (59.2-80.8), 34.2 (16.9-54.6) and 33.1 (22.3-49.2) for the group III, respectively. CONCLUSION: Low-level laser therapy combined with exercises reduce pain intensity, improve shoulder function and reduces pain intensity and medication intake over 3 months. CLINICAL TRIAL REGISTRATION NUMBER: NCT02725749.

Efficacy of continuous and pulsed therapeutic ultrasound combined with exercises for knee osteoarthritis: a randomized controlled trial.

OBJECTIVES: To compare the effects of continuous and pulsed therapeutic ultrasound combined with strengthening exercises. DESIGN: This is a double-blind randomized controlled trial. SETTING: Pontifical Catholic University. SUBJECTS: One hundred participants with Grade 2-4 knee osteoarthritis and both genders were involved. INTERVENTION: Participants were randomized into five groups: Group I (n = 20; in the first month, continuous ultrasound was applied), Group II (n = 20; in the first month, pulsed ultrasound was applied), Group III (n = 20; in the first and second months, continuous ultrasound was applied), Group IV (n = 20; in the first and second months, pulsed ultrasound was applied) and Group V (n = 20; patients received only exercise sessions for eight weeks). All patients in the groups that received ultrasound application performed exercises in the second month of treatment. The sessions occurred three times a week. MAIN MEASURES: Pain was assessed using the visual analogical scale, functionality was assessed using the Lequesne questionnaire, range of motion was assessed using a universal goniometer, muscular strength was assessed using a dynamometer, mobility was assessed using the Timed Up and Go test and 8-meter walk test and the activity level was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire. RESULTS: Statistically significant differences (P < 0.05) were presented by Group III in the variables pain during activities of daily living (ADLs) 5.89 (2.18), mobility assessed by 8-meter test 2.68 (2.56), in pain 10.65 (4.40), function 25.50 (10.87) and total 38.65 (15.29) of WOMAC and functionality 9.10 (5.15). CONCLUSION: Prolonged applications of continuous ultrasound combined with exercises are effective in providing pain, mobility, functionality and activity in subjects with knee osteoarthritis.

Long-term results of a randomized, controlled, double-blind study of low-level laser therapy before exercises in knee osteoarthritis: laser and exercises in knee osteoarthritis.

OBJECTIVES: To assess the long-term effects of low-level laser therapy (LLLT), in combination with strengthening exercises in patients with osteoarthritis of the knee. DESIGN: Follow-up results at three and six months in a previously published randomized, double-blind, placebo-controlled trial. SETTING: Specialist Rehabilitation Services. SUBJECTS: Forty participants of both genders, aged 50-75 years with knee osteoarthritis grade 2-4 on Kellgren-Lawrence scale. INTERVENTION: The LLLT group received 10 LLLT treatments with invisible infrared laser (904 nm, 3 Joules/point) over three weeks followed by an eight-week supervised strengthening exercise program. The placebo LLLT group received identical treatment, but the infrared laser output was disabled. MAIN MEASURES: Pain on a visual analogue scale, paracetamol consumption, and osteoarthritis severity measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Lequesne Index. RESULTS: The new data obtained during the follow-up period showed that all outcomes remained stable and there were no significant differences between the groups at three and six months. However, daily consumption of rescue analgesics (paracetamol) was significantly lower in the LLLT group throughout the follow-up period, ending at a group difference of 0.45 vs. 3.40 units ( P < 0.001) at six months follow-up. We conclude that within the limitations of this small study, the previously reported improvement after LLLT plus exercise was maintained for a period of six months. CONCLUSION: We find that the immediate post-intervention improvements from LLLT plus strengthening exercises were maintained for six months.

Avaliação da qualidade de vida e estresse em acadêmicos do curso de Fisioterapia / Evaluation of quality of life and stress in academic course of Physiotherapy

Introdução ­ Estresse é um estado de tensão que causa uma ruptura no equilíbrio interno do organismo e pode afetar diretamente a qualidade de vida de um indivíduo. Objetivo ­ Avaliar e correlacionar a qualidade de vida e o nível de estresse em acadêmicos da área da saúde de uma faculdade da cidade de São Paulo. Métodos ­ Trata-se de um estudo transversal que foi realizado com acadêmicos de um curso de Fisioterapia da cidade de São Paulo. Estes foram avaliados através dos questionários SF-36, WHOQOL-BREF e Teste de Lipp-ISSL. Para a análise dos dados coletados foi utilizado o programa estatístico R versão 3.2.2. Resultados ­ Foram incluídos no estudo 363 questionários. Referente ao questionário SF-36 os acadêmicos de fisioterapia apresentaram menor escore no domínio vitalidade e maior na capacidade funcional. No questionário WHOQOL-BREF apresentaram menor escore no domínio ambiente e maior no social. Houve correlação positiva significante entre todos os domínios comparados entre os questionários de qualidade de vida. Na comparação entre os questionários ISSL e WHOQOL-BREF foi observada a correlação negativa significativa em todos os domínios, exceto, pela correlação entre a Fase de Alerta (P1) do ISSL com os domínios do WHOQOL. Também na comparação entre os questionários ISSL e SF- 36 foi observada a correlação negativa significativa em todos os domínios, exceto, pela correlação entre a Fase de Alerta (P1) do ISSL com os domínios do SF-36. Conclusão ­ Graduandos de fisioterapia de uma universidade da cidade de São Paulo apresentam sintomas de estresse, o que influenciam na sua qualidade de vida.

Introduction ­ Stress is a state of tension that causes a break in the internal balance of the body and can directly affect the quality of life of an individual. Objective ­ This study aimed to evaluate and correlate the quality of life and the level of stress in the academic health of a college of São Paulo. Methods ­ This is a cross-sectional study was conducted with students from the physiotherapy course in São Paulo. The instruments used for data collection were the Quality of Life Questionnaire SF-36, WHOQOL-BREF questionnaire and Test Lipp Stress Symptoms Inventory-ISS. For the analysis of the data collected was used the statistical program R version 3.2.2. Results ­ Concerning the SF-36 physical therapy students had lower scores in the field vitality and increased functional capacity. You WHOQOL-BREF questionnaire had lower scores in the environment domain and increased social. It was found a statistically significant positive correlation between all areas compared between the questionnaires of quality of life. Comparing the ISSL and WHOQOL-BREF questionnaire was observed a significant negative correlation in all areas except for the correlation between the Alert Phase (P1) of the ISSL with the domains of WHOQOL. Also when comparing the ISSL and SF-36 questionnaires a significant negative correlation was observed in all areas except for the correlation between the Alert Phase (P1) of the ISSL with the SF-36. Conclusions ­ Physiotherapy graduate from a university in São Paulo present symptoms of stress, which influence their quality of life.

Efeito do ultrassom pulsado e do ultrassom contínuo associado a exercícios em pacientes com osteoartrite de joelho: estudo piloto / Effect of pulsed ultrasound and continuous ultrasound linked to exercise in patients with knee osteoarthritis: pilot study

A osteoartrite (OA) é uma doença crônica associada à morbidade significante. O objetivo deste estudo foi comparar o exercício isolado ao ultrassom pulsado (USP) e contínuo (USC) associados a exercício na redução da dor, melhora da amplitude de movimento (ADM), força muscular (FM), qualidade de vida (QV) e funcionalidade de pacientes com OA de joelhos. Trinta indivíduos, 50 a 75 anos, OA grau 2–4, foram randomizados: Grupo USC (USC + exercícios), Grupo USP (USP + exercícios) e Grupo EXE (exercícios). Os grupos foram avaliados antes e após o tratamento. A intervenção foi realizada três vezes por semana durante oito semanas: nas quatro primeiras foi aplicado USC ou USP e, nas demais foram realizados os exercícios. O Grupo EXE realizou exercícios durante oito semanas. Para análises intragrupos, utilizou-se o teste de Wilcoxon e, intergrupos, o teste de Kruskall-Walis. Na comparação intragrupos, o Grupo USC apresentou melhora significativa (p<0,05) nas variáveis da Western Ontario and McMaster Universities Osteoarthritis (WOMAC) dor, função e escore total; o Grupo USP na dor repouso, ADM, FM e nas variáveis da WOMAC dor, função e escore total; já, o Grupo EXE na mobilidade e ADM. Na comparação intergrupos, o Grupo USC apresentou melhora significativa (p<0,05) quando comparado aos demais grupos na dor repouso, ADM, escores função e total da WOMAC e o Grupo EXE na dor da WOMAC. A associação do USC a exercícios foi mais efetiva na melhora da dor, ADM, função e QV em pacientes com OA de joelho.

Osteoarthritis (OA) is a chronic disease associated with significant morbidity. The aim of this study was to compare the isolated exercises with association of pulsed (PUS) and continuous (CUS) ultrasound with exercise in reducing pain, improving range of motion (ROM), muscle strength (MS), quality of life (QL) and functionality of patients with knee OA. Thirty individuals, 50 to 75 years old, 2–4 OA grade, were randomized: Group CUS (CUS + exercise), Group PUS (PUS + exercise) and EXE group (exercises). The groups were evaluated before and after treatment. The intervention was performed three times a week for eight weeks: in the first four weeks, it was applied CUS or PUS, and in other weeks, exercises were carried out. The EXE group performed exercises for eight weeks. For intra-group analysis, the Wilcoxon test was used and inter-group analysis, the Kruskall-Walis test was used. Within the groups, the USC group showed significant improvement (p<0.05) in variables of Western Ontario and McMaster Universities Osteoarthritis (WOMAC) pain, function and total score; the Group USP in pain-rest, ROM, MS, variables of WOMAC pain, function and total score; and EXE Group in mobility and ROM. In intergroup comparison, the USC group showed significant improvement (p<0.05) when compared to other groups in pain-rest, ROM, variables of WOMAC function and total score and EXE group in WOMAC-pain. The association of USC and exercise was more effective in reducing pain, ROM, function and QL in patients with knee OA.

Efficacy of low level laser therapy associated with exercises in knee osteoarthritis: a randomized double-blind study.

OBJECTIVES: To estimate the effects of low level laser therapy in combination with a programme of exercises on pain, functionality, range of motion, muscular strength and quality of life in patients with osteoarthritis of the knee. DESIGN: A randomized double-blind placebo-controlled trial with sequential allocation of patients to different treatment groups. SETTING: Special Rehabilitation Services. SUBJECTS: Forty participants with knee osteoarthritis, 2-4 osteoarthritis degree, aged between 50 and 75 years and both genders. INTERVENTION: Participants were randomized into one of two groups: the laser group (low level laser therapy dose of 3 J and exercises) or placebo group (placebo laser and exercises). MAIN MEASURES: Pain was assessed using a visual analogue scale (VAS), functionality using the Lequesne questionnaire, range of motion with a universal goniometer, muscular strength using a dynamometer, and activity using the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) questionnaire at three time points: (T1) baseline, (T2) after the end of laser therapy (three weeks) and (T3) the end of the exercises (11 weeks). RESULTS: When comparing groups, significant differences in the activity were also found (P = 0.03). No other significant differences (P > 0.05) were observed in other variables. In intragroup analysis, participants in the laser group had significant improvement, relative to baseline, on pain (P = 0.001), range of motion (P = 0.01), functionality (P = 0.001) and activity (P < 0.001). No significant improvement was seen in the placebo group. CONCLUSION: Our findings suggest that low level laser therapy when associated with exercises is effective in yielding pain relief, function and activity on patients with osteoarthritis of the knees.

Eficácia a curto prazo do laser de baixa intensidade em pacientes com osteoartrite do joelho: ensaio clínico aleatório, placebo-controlado e duplo-cego / Short-term efficacy of low-level laser therapy in patients with knee osteoarthritis: a randomized placebo-controlled, double-blind clinical trial

OBJETIVO: Este estudo foi designado para avaliar a eficácia a curto prazo da laserterapia de baixa intensidade (LBI) na melhora da dor e função em pacientes portadores de osteoartrite (OA) do joelho. MÉTODOS: Participaram deste ensaio clínico aleatório, duplo-cego e controlado 47 pacientes (79 joelhos) de ambos os sexos portadores de OA do joelho, que foram distribuídos aleatoriamente em dois grupos; grupo laser com 25 pacientes (41 joelhos) e grupo placebo com 22 pacientes (38 joelhos). A LBI foi realizada três vezes por semana totalizando nove sessões, com uso do laser AsGa de 904nm, 60mW de potência média e 0,5cm² de área do feixe, sendo irradiados nove pontos no joelho com energia de 3,0J por ponto. O grupo placebo foi tratado com o mesmo aparelho de laser, porém com uma caneta selada. As avaliações Lequesne, escala visual numérica (EVN), Timed Up and Go (TUG), goniometria e dinamometria foram realizadas antes do início do tratamento e após as nove sessões da LBI. RESULTADOS: Foi encontrada melhora significante da dor e função para todas as avaliações aplicadas no grupo laser. Quando comparado o grupo laser ao grupo placebo encontrou-se diferença significante para as avaliações EVN-Repouso e Lequesne. CONCLUSÃO: O tratamento com a LBI melhora a dor e função a curto prazo de pacientes portadores de OA do joelho.

OBJECTIVE: This study was designed to evaluate the short-term efficacy of low-level laser therapy (LLLT) for improving pain and function in patients with knee osteoarthritis. METHODS: Forty-seven patients with knee osteoarthritis (79 knees), of both genders, participated in this randomized controlled double-blind clinical trial. They were randomly allocated to two groups: laser group with 25 patients (41 knees) and placebo group with 22 patients (38 knees). LLLT was performed three times a week, totaling nine sessions, using a AsGa 904 nm laser with mean power of 60 mW and beam area of 0.5 cm². Nine points were irradiated on the knee, with energy of 3.0 J/point. The placebo group was treated with the same laser device, but with a sealed probe. Evaluations using Lequesne, visual numerical scale (VNS), Timed Up and Go (TUG), goniometry and dynamometry were conducted before the treatment started and after the nine sessions of LLLT. RESULTS: A significant improvement in pain and function was found in all the assessments applied to the laser group. On comparing the laser group with the placebo group, significant differences were found in the VNS-resting and Lequesne evaluations. CONCLUSION: Treatment with LLLT improves pain and function over the short term in patients with knee osteoarthritis.

Efeitos da craniopuntura de Yamamoto na osteoartrite de joelho: estudo de caso / The Yamamoto scalp acupuncture effects in knee osteoarthritis: a case study

O objetivo deste estudo foi verificar os efeitos da craniopuntura de Yamamoto na dor, na amplitude de movimento, qualidade de vida e funcionalidade de paciente com osteoartrite (OA) de joelho. Foi realizado um estudo de caso de uma paciente de 59 anos apresentando quadro de dor no joelho, redução funcional nos últimos três meses e radiografia constando o grau 3 de OA de joelhos. A avaliação foi feita antes e após o tratamento através da Escala Visual Analógica (EVA) para avaliação da dor, da qualidade de vida pelo questionário Western Ontario and McMaster Universities Osteoarthritis (WOMAC), da funcionalidade pelo Knee injury and Osteoarthritis Outcome Score (KOOS) e da amplitude de movimento do joelho pela goniometria. A craniopuntura foi realizada duas vezes por semana, com duração de 40 minutos cada, totalizando 10 sessões. A análise dos dados foi feita de forma descritiva. A variável utilizada foi o ganho relativo (GR) medido no pré e no pós-tratamento. A dor no joelho diminuiu (GR=100%), enquanto a amplitude de movimento aumentou em ambos os joelhos (GR=20%). Observou-se melhora na dor (GR=83%), na rigidez (GR=50%), na função (GR=80%) e no escore total da WOMAC (GR= 79%). Verificou-se, através da KOOS, melhora nos sintomas (GR=8%), na dor (GR=26%), nas atividades de vida diária (GR=21%) e na qualidade de vida (GR= 17%). Conclui-se que a craniopuntura foi efetiva no alívio da dor, na amplitude de movimento, qualidade de vida e funcionalidade de paciente com OA de joelho.

The purpose of this study was to investigate the effects of Yamamoto New Scalp Acupuncture in pain, range of motion, life quality and functionality of patients with knee osteoarthritis (OA). We conducted a case study of a patient of 59 years complaining of knee pain, functional reduction in the last three months and radiography consisting of grade 3 knee OA. The evaluation was done before and after treatment using the Visual Analogue Scale index (VAS) for pain assessment, life quality by Western Ontario and McMaster Universities Osteoarthritis index (WOMAC), the functionality for Knee injury and Osteoarthritis Outcome Score index (KOOS) and range of motion of the knee by goniometry. The craniopuncture was performed twice on week, lasting 40 minutes, totaling 10 sessions. Data analysis was performed descriptively. The variable used was the relative gain (GR) measured before and after treatment. The knee pain decreases (GR=100%), while the range of motion increases in both knees (GR=20%). An improvement in pain (GR=83%), stiffness (GR = 50%), function (GR = 80%) and total score of WOMAC (GR=79%). By KOOS, it was found, improvement in symptoms (GR=8%), pain (GR=26%) in activity od daily living (GR=21%) and life quality (GR=17%). We conclude that the craniopuncture was effective in pain relieving, motion range, life quality and functionality of patient with knee osteoarthritis.

SHORT-TERM EFFICACY OF LOW-LEVEL LASER THERAPY IN PATIENTS WITH KNEE OSTEOARTHRITIS: A RANDOMIZED PLACEBO-CONTROLLED, DOUBLE-BLIND CLINICAL TRIAL.

OBJECTIVE: This study was designed to evaluate the short-term efficacy of low-level laser therapy (LLLT) for improving pain and function in patients with knee osteoarthritis. METHODS: Forty-seven patients with knee osteoarthritis (79 knees), of both genders, participated in this randomized controlled double-blind clinical trial. They were randomly allocated to two groups: laser group with 25 patients (41 knees) and placebo group with 22 patients (38 knees). LLLT was performed three times a week, totaling nine sessions, using a AsGa 904 nm laser with mean power of 60 mW and beam area of 0.5 cm(2). Nine points were irradiated on the knee, with energy of 3.0 J/point. The placebo group was treated with the same laser device, but with a sealed probe. Evaluations using Lequesne, visual numerical scale (VNS), Timed Up and Go (TUG), goniometry and dynamometry were conducted before the treatment started and after the nine sessions of LLLT. RESULTS: A significant improvement in pain and function was found in all the assessments applied to the laser group. On comparing the laser group with the placebo group, significant differences were found in the VNS-resting and Lequesne evaluations. CONCLUSION: Treatment with LLLT improves pain and function over the short term in patients with knee osteoarthritis.

Eficácia da laserterapia de baixa intensidade associada a exercícios em pacientes com osteoartrose de joelho: um estudo randomizado e duplo-cego / Efficacy of low-level laser therapy associated to exercises in knee osteoarthritis: a randomized, double-blind study

Introdução: A osteoartrite (OA) é uma doença degenerativa que atinge as articulações sinoviais, sendo uma das causas mais comuns dalimitação funcional. Objetivo: Investigar os efeitos do Laser de Baixa Intensidade (LBI) associado a exercícios na dor, amplitude de movimento, força muscular, funcionalidade, mobilidade e qualidade de vida de pacientes com osteoartrite de joelhos. Métodos: Quarenta e seis indivíduosde ambos os sexos, entre 50 e 75 anos, com OA de joelho (graus 2-4), foram randomizados em dois grupos: Grupo Laser- LBI ativo com dose de 3J mais exercícios e Grupo Placebo- LBI placebo e exercícios. A avaliação foi realizada antes de iniciar o tratamento (AV1), três semanas após o tratamento com o laser (AV2), oito semanas após o tratamento com exercícios (AV3), três e seis meses após o término do tratamento (AV4 e AV5). A dor foi avaliada com a Escala Visual Analógica (EVA), amplitude de movimento com goniômetro universal, força muscular com dinamômetro, funcionalidade com a Escala AlgofuncionalLequesne, a mobilidade pela TimedGetUpandGo(TGUG) e qualidade de vida com a Western Ontario andMcMasterUniversitiesOsteoarthritis (WOMAC). A intervenção foi realizada três vezes por semana durante 11 semanas, sendo que nas três primeiras foi aplicado o laser e nas demais somente os exercícios. Os dados foram analisados com os testes não paramétricos de Friedman e Mann- Whitney, com nível de significância de 5%.Resultados: Na análise intragrupo, o Grupo Laser apresentou melhora significativa na dor (p<0,001), amplitude de movimento (p=0,032), funcionalidade (p=0,003), mobilidade (p<0,001), WOM-dor (p=0,001), WOM-função (p<0,001) e WOM-total (p<0,001), enquanto o Grupo Placebo apresentou diferença significativa na mobilidade (p=0,013), WOM-função (p=0,017) e WOM-total (p=0,02). Na análise intergrupo foi constatada diferença significativa entre os grupos na AV2 para as variáveis WOM-função (p=0,01) e WOM-total (p=0,02) e na AV3 para as variáveis WOM-dor...

Introduction:Osteoarthritis(OA) is adegenerative diseasethat affectssynovial joints, one of the most common causesoffunctional limitation. Objectives:To estimate the effects of Low-Level Laser Therapy (LLLT),in combination with a program of exercises on pain, range of motion, muscular strength, functionality, mobility and quality of life in patients with osteoarthritis of the knee. Methods: Sample consisted of 40 participants of both genders, ages ranging from 50 to 75 years. All had level 2-4 OA. Participants were randomized into two groups: Laser Group(low-level laser, 3 Joules dose and exercises), and Placebo Group (placebo-laser and exercises). Pain was assessed using visual analogical scale (VAS), range of motion with the universal goniometer, muscular strength using a dynamometer, functionality using the LequesneQuestionnaire, mobility using Timed Get Up and Go (TGUG)and quality using the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) of life in five moments: (T1) baseline, (T2) after at the end of laser therapy (3rd week), (T3) after the end of exercises (11th week), (T4) three and six monthsafter thetreatment (T4 and T5). The intervention was performedduring three weeks; patients received laser therapy or placebo three times a week; for the remaining 8 weeks, all patients exercised three times a week.Data was assessed through Friedman and Mann-Whitney non-parametrical tests, with 5% significance. Results:In theintragroup analysis, the Laser Groupshowed significant improvementin pain (p<0.001), range of motion (p=0.032), functionality (p=0.003), mobility (p<0.001), WOM-pain (p=0.001), WOM-function (p<0.001) and WOM-total (p<0.001), while the Placebo Group showeda significant difference inmobility (p=0.013), WOM-function (p=0.017) andWOM-total (p=0.02). In the analysisbetween groupsthere wassignificant differenceinAV2between groupsfor variables WOM-function (p=0.01) andWOM-total (p=0.02) and in AV3for variablesWOM-pain (p<0.01)...

Exercícios terapêuticos nas desordens temporomandibulares: uma revisão de literatura / Therapeutic exercises in temporomandibular disorders: a literature review

A articulação temporomandibular faz parte do sistema estomatognático que junto com os dentes, periodonto, coluna cervical, crânio, cintura escapular, é responsável pela mastigação, fonação, deglutição, respiração e expressão facial. Exercícios terapêuticos têm sido empregados na reabilitação e prevenção das disfunções temporomandibulares (DTM)...

The temporomandibular joint is part of the stomatognatic system, which comprises a complex set of orofacial structures, including teeth, cervical spine, cranium and shoulder. The system is responsible for masticatory, phonation, and deglution function, as well as for breathing and facial expression. Physical therapy exercises have been used for rehabilition and prevention of temporomandibular disorders...

Análise qualitativa dos efeitos da fonoforese com Arnica montana sobre o processo inflamatório agudo do músculo esquelético de ratos / Qualitative analysis of effects of phonophorese with Arnica montana onto acute inflammatory process in rat skeletal muscles

Este estudo visou verificar o efeito da fonoforese com Arnica montana sobre a fase inflamatoria aguda de uma lesão muscular. Para isso, 40 ratos Wistar machos, lesados cirurgicamente, foram divididos em 4 grupos: controle (C), 10 ratos lesados e não tratados grupo ultra-som (US), 10 lesados tratados com fonoforese de gel de arnica; grupo arnica (A), 10 ratos lesados, tratados com massagem de gel de arnica...

This study aimed at verifying the effects of phonophoresis associated to Arnica montana on the acute phase of an inflammatory muscle injury. Forty Wistar male rats of which the Tibialis. Anterior muscle was surgically lesioned, were divided into 4 groups (n+10 each); control group received no treatment the ultrasound group (US), treat with US; the US+A group was treat with arnica phonophoresis...