Articular mobilization promotes improvement in functional and inflammatory parameters in a gouty arthritis model.

OBJECTIVE: Gouty arthritis is characterized by painful inflammation due to the deposition of monosodium urate crystals in joint tissues. Despite available treatments, many patients experience ineffective management and adverse effects. This study evaluated a manual therapy protocol involving passive joint mobilization at the peak of inflammation in a gouty arthritis model using functional and inflammatory parameters. METHODS: Twenty male Wistar rats, 12 weeks old, were divided into two groups (n=10 each): Gouty Arthritis and Control Groups, which were further subdivided into treated and untreated groups (n=5 each). The Gouty Arthritis Group received intraarticular knee injection of 50µL of monosodium urate crystals, while the Control Group received 50µL of phosphate buffered saline. The treatment involved a 9-minutes session of grade III joint mobilization (according to Maitland). Nociception, grip strength, and edema were evaluated before induction (EV0), 7 hours after assessment (EV1), immediately after treatment (EV2), and 1 hour after treatment (EV3). The animals were euthanized, and synovial fluid was collected to analyze leukocyte migration. RESULTS: The model mimicked the signs of the Gouty Arthritis Group, with a decrease in the threshold of nociception and strength and an increase in edema and leukocyte count. The mobilization protocol significantly increased the nociceptive threshold and grip strength and reduced edema; however, it did not reverse the increase in leukocyte count. CONCLUSION: Our results suggest that mobilization promotes analgesia and may modulate the inflammatory process owing to reduced edema and subtle attenuation of cell migration, which contributes to strength gain.

Resistance exercise and low-level laser therapy improves grip strength and morphological aspects in the ankle joint of Wistar rats with experimental arthritis.

Rheumatoid arthritis (RA) is an inflammatory disease mainly affecting synovial joints. Photobiomodulation through low-level laser therapy (LLLT) and resistance exercise may improve the inflammatory process. Therefore, we analyzed the effects of resistance exercise, LLLT, and the combination of both treatments on hind paw grip strength and ankle joint histomorphometric aspects of Wistar rats subjected to experimental RA. A total of 64 male Wistar rats were divided into eight groups: control, control LLLT, control exercise, control LLLT and exercise, arthritis, arthritis LLLT, arthritis exercise, and arthritis LLLT and exercise groups. The experimental RA was induced by a complete Freund's adjuvant injection into the knee joint cavity. Climbing exercises and LLLT (660 nm; 5 J/cm2 per point) were performed as the treatment. In addition, muscle strength was evaluated using the grip strength test, and morphometric evaluations were performed on the ankle joint. Generalized mixed models and multivariate analysis of variance tests were used for statistical analysis. Statistical significance was set at a p-value of .05. Arthritis LLLT, exercise, and LLLT and exercise had positive effects on grip strength between the groups (F[7.56] = 5.8, p < .004) and within the groups (F[4.3] = 9.9, p < .002) throughout the evaluations. Morphometry revealed degenerative lesions in the ankle joint as subintima with angiogenesis, inflammatory cells, flocculated articular cartilage, chondrocyte disorganization, and pannus in the arthritis group (p < .001). The treated groups exhibited morphological characteristics similar to those of the control group. LLLT and resistance exercise restored muscle strength and morphological aspects of the ankle joint in rats with experimentally induced RA.

Articular mobilization promotes improvement in functional and inflammatory parameters in a gouty arthritis model

ABSTRACT Objective Gouty arthritis is characterized by painful inflammation due to the deposition of monosodium urate crystals in joint tissues. Despite available treatments, many patients experience ineffective management and adverse effects. This study evaluated a manual therapy protocol involving passive joint mobilization at the peak of inflammation in a gouty arthritis model using functional and inflammatory parameters. Methods Twenty male Wistar rats, 12 weeks old, were divided into two groups (n=10 each): Gouty Arthritis and Control Groups, which were further subdivided into treated and untreated groups (n=5 each). The Gouty Arthritis Group received intraarticular knee injection of 50µL of monosodium urate crystals, while the Control Group received 50µL of phosphate buffered saline. The treatment involved a 9-minutes session of grade III joint mobilization (according to Maitland). Nociception, grip strength, and edema were evaluated before induction (EV0), 7 hours after assessment (EV1), immediately after treatment (EV2), and 1 hour after treatment (EV3). The animals were euthanized, and synovial fluid was collected to analyze leukocyte migration. Results The model mimicked the signs of the Gouty Arthritis Group, with a decrease in the threshold of nociception and strength and an increase in edema and leukocyte count. The mobilization protocol significantly increased the nociceptive threshold and grip strength and reduced edema; however, it did not reverse the increase in leukocyte count. Conclusion Our results suggest that mobilization promotes analgesia and may modulate the inflammatory process owing to reduced edema and subtle attenuation of cell migration, which contributes to strength gain.

Morphometric aspects of the articular cartilage of rats treated with low-level laser therapy and exercise in a rheumatoid arthritis model

INTRODUCTION: Rheumatoid arthritis (RA) is classified as an autoimmune, chronic disease affecting diarthrodial joints and periarticular structures. OBJECTIVE: To evaluate whether low-intensity laser treatment (LLLT) and/or exercise reduce the deleterious effects of tissue in a rheumatoid arthritis model. METHODS: 128 rats were divided into two inflammatory periods: acute (7 days) and chronic (28 days) and subdivided into control, injury and treatment. The protocol with Freund's Complete Adjuvant was used in two inoculations, one intradermal and one intraarticular in the tibiofemoral joint, the control animals received saline solution. For treatment, LLLT 660 nm, 5 J/cm² was used in the sensitized joint and climbing exercise in stairways with an overload of 100 grams. After the experimental period, the animals were euthanized and the joints were prepared for morphometric analysis of the total thickness, superficial, deep, and cellular density of the articular cartilage. Generalized Linear Models with Sidak post-test were chosen. RESULTS: The control group was found to be different from the lesion group with greater joint cartilage thickness, andthe animals treated with exercise alone increased the joint cartilage compared to thecontrol group. CONCLUSION: The animals treated with laser association and exercise showed improvement in the morphometric aspects of the articular cartilage.

Analysis of Wistar Rats Submitted to a Gout Model, Treated with Double Cryotherapy Protocol.

Gout arthritis commonly affects joint regions by deposition of crystals, promoting functional damage mainly during periods of exacerbation. Cryotherapy is a commonly used resource to contain inflammatory processes, however, its use during a gout crisis is not yet well understood. Therefore, the objective was to evaluate the parameters of Wistar rats submitted to an experimental gout model and treated with dual cryotherapy protocol. Twenty-one male Wistar rats were used, separated into three groups: control group (CG), lesion group (LG), and lesion + cryotherapy group (LCG). Gout model induction was through intra-articular injection, with urate crystal solution, in the right knee and cryoimmersion treatment was performed for 20 minutes at a temperature of 5° ± 2°C. Seven evaluations and two treatment moments were performed, and the following parameters were analyzed: joint edema, grip strength, joint disability, motor function, and leukocyte migration through synovial lavage. In the statistical analysis we used SPSS 20.0 with Generalized Linear Models, with least significant difference posttest, always with 5% significance level. The treatment reduced edema, promoted strength recovery, and was effective in reducing total leukocytes in the synovial fluid. No difference was observed between the injured groups for joint disability and motor function. Cryotherapy promoted edema reduction and increased pelvic limb grip strength in Wistar rats during the acute period.

Low-level laser therapy in periarticular morphological aspects of the knee of Wistar rats in rheumatoid arthritis model / Laser de baixa intensidade nos aspectos morfológicos periarticulares do joelho de ratos Wistar em modelo de artrite reumatoide

ABSTRACT BACKGROUND AND OBJECTIVES: The deleterious effects of rheumatoid arthritis on periarticular tissues have not yet been fully elucidated. Therefore, the search for treatments that can modulate the inflammatory profile and tissue remodeling is pertinent. The present study evaluated the effects of low-level laser therapy (LLLT) on the morphology of periarticular tissues and synovial membrane of rats in a rheumatoid arthritis model. METHODS: Sixty-four male rats were divided into acute (7 days) and chronic (28 days) inflammatory periods, with four groups (n=8) each, being: CG (control group), LG (lesion group), CLaG (laser control group) and LLaG (laser lesion group). The animals of the lesion groups received two inoculations of Freund's Complete Adjuvant at a concentration of 50µL, the first at the base of the tail, and the second at the right knee. The animals in the control groups were injected with isotonic sodium chloride solution. The ClaG and LLaG were treated with 660nm LBI, 5J/cm2 in the right knee. After the experimental period, the animals were euthanized, and the knees were processed for light microscopy. RESULTS: The CG and CLaG morphological analysis had normal aspects. The LG showed synovitis, femur, and tibia with changes in the periosteum, with inflammatory cells and bone modifications. In the LLaG, the synovial membrane showed signs of improvement. Bone tissue in the chronic period showed morphological aspects, denoting tissue remodeling. CONCLUSION: The experimental model was efficient in simulating inflammatory tissue events, and the low-level laser therapy showed beneficial effects on the morphology of the periarticular tissues.

RESUMO JUSTIFICATIVA E OBJETIVOS: Os efeitos deletérios da artrite reumatoide nos tecidos periarticulares ainda não estão totalmente elucidados, sendo pertinente a busca por tratamentos que possam modular o perfil inflamatório e a remodelação tecidual. O presente estudo avaliou os efeitos do laser de baixa intensidade (LBI) na morfologia dos tecidos periarticulares e membrana sinovial de ratos submetidos à um modelo de artrite reumatoide. MÉTODOS: Para tanto, 64 ratos machos foram divididos em períodos inflamatórios agudo (7 dias) e crônico (28 dias), com 4 grupos (n=8) cada, sendo: GC (grupo controle), GL (grupo lesão), GCLa (grupo controle laser) e GLLa (grupo lesão laser). Os animais dos grupos lesão foram submetidos a duas inoculações de Adjuvante Completo de Freund na concentração de 50µL, sendo a primeira na base da cauda e a segunda no joelho direito. Os animais do grupo controle foram submetidos a injeções com solução isotônica de cloreto de sódio. Os grupos GCla e GLLa foram tratados com LBI 660nm, pontual no joelho direito, 5J/ cm2. Após o período experimental, os animais foram eutanasiados e os joelhos processados para análises em microscopia de luz. RESULTADOS: Na análise morfológica, GC e GCLa apresentaram aspectos normais. O GL apresentou sinovite, fêmur e tíbia com alterações no periósteo, com células inflamatórias e modificações ósseas. A membrana sinovial mostrou sinais de melhora no GLLa. No período crônico, o tecido ósseo apresentou aspectos morfológicos, denotando remodelação tecidual. CONCLUSÃO: O modelo experimental foi eficiente em simular os eventos inflamatórios teciduais, e o laser de baixa intensidade apresentou efeitos benéficos sobre a morfologia dos tecidos periarticulares.

Physical exercise and low-level laser therapy on the nociception and leukocyte migration of Wistar rats submitted to a model of rheumatoid arthritis.

Rheumatoid arthritis denotes hyperplasia and intense inflammatory process. Treatment involves exercise protocols and use of resources such as low-level laser therapy (LLLT) to modulate the inflammatory process and maintain physical capacity. The objective was to investigate whether treatment with LLLT and exercise modulates the inflammatory process and peripheral functionality. Sample is composed of 128 male rats, separated into three groups, control, treated and untreated, in the acute and chronic period of the disease with 64 animals in each group, divided into 8 subgroups with n = 8. The animals were immunized with injection at the base of the tail and 7 days after intra-articular injection with complete Freund adjuvant (CFA) for lesion groups, and saline solution for the controls. Joint disability was evaluated by PET (paw elevation time) and joint edema and treated with LLLT and/or resisted stair climbing exercise. Normality Shapiro-Wilk test, ANOVA mixed for the functional analyses, and ANOVA one-way for the variables of cellular differentiation, with Bonferroni post hoc, p = 5% were used. For the evaluations of joint disability and nociception, there was a significant difference between the evaluations, the groups, and the interaction groups-evaluations. The treated groups showed recovery of functionality; it is still verified that laser therapy increased the nociceptive threshold of the chronic inflammatory period, and the exercise reflected in significant functional improvement and modulation of the inflammatory process both in the acute and chronic periods. LLLT, resistance exercise, or a combination of treatments had a positive effect on the modulation of the inflammatory process, reducing the migration of leukocytes, in addition to helping the return of peripheral functionality by reducing joint disability in a model of rheumatoid arthritis induced by CFA in rats.