Laser auriculotherapy associated with cupping therapy in chronic spinal pain: Randomized controlled clinical trial.

BACKGROUND: Musculoskeletal spine disorders are common causes of chronic pain and impair functionality. Laser auriculotherapy and cupping has played a significant role in the treatment of chronic pain. OBJECTIVE: to evaluate the effect of laser auriculotherapy associated with cupping at systemic acupuncture points on chronic spinal pain. METHODS: Randomized controlled clinical trial. Volunteers underwent three evaluations: an initial evaluation, a final evaluation immediately after the last intervention session, and a 15-day follow-up. The pain was identified using the numeric pain scale. The pain threshold was also evaluated against mechanical stimulation using a Digital Dynamometer at specific points in the cervical, thoracic and lumbar regions. Fifty individuals with chronic spinal pain, randomized into groups: experimental (n = 25), submitted to 10 sessions of auriculotherapy with laser and cupping therapy and control (n = 25). RESULTS: The experimental group achieved pain intensity reduction between pre and post and follow-up moments (p < 0.0001), of greatest pain in the last seven days among all moments (p < 0.0001), of least pain in the pre with post moment (p = 0.006) and follow-up (p = 0.002), and an increased pain threshold between pre and post (p = 0.023). The control group achieved a reduction in the nociceptive threshold between pre and post (p = 0.001) and follow-up (p < 0.0001). The experimental group showed reduced pain intensity (p = 0.027) and greater pain (p = 0.005) after intervention and in pain intensity (p = 0.018), greater (p < 0.0001) and less pain (p = 0.025) at follow-up, compared to the control group. CONCLUSION: Auriculotherapy with laser associated with cupping therapy may effectively reduce pain intensity and increase the nociceptive threshold.

Effects of low-power laser auriculotherapy on chronic spinal pain: Randomized clinical trial.

AIMS AND OBJECTIVES: To evaluate the effect of laser auriculotherapy on chronic spinal pain. It is a randomized controlled clinical trial. METHODS: Volunteers with chronic spinal pain underwent three evaluations: an initial evaluation, a final evaluation immediately after the last intervention session, and a 15-day follow-up. Pain intensity, nociceptive threshold in relation to mechanical stimulus, and degree of pain (the greatest and least pain) in the last seven days were the assessed variables. The experimental group (EG, n = 24) underwent 10 sessions of laser auriculotherapy twice a week, while the control group (CG, n = 23) did not receive any intervention. RESULTS: The EG showed great clinical improvement in relation to the variable pain intensity between pre- and post-interventions (65.2%) and pre-intervention and follow-up (58.62%) compared to the CG. There was a significant increase in the nociceptive threshold for the EG. In contrast, the CG showed a significant reduction in the nociceptive threshold. The intergroup analysis indicated an improvement in pain intensity for the EG (0.006). This result remained at the follow-up (0.012). The nociceptive threshold increased over time for the EG (0.016). In contrast, the CG showed a reduction in this variable with a significant difference over time (<0.001). CONCLUSION: The results of this clinical trial suggest that the proposed intervention may be effective in reducing pain intensity and increasing the nociceptive threshold. The effect of the intervention remained 15 days after the end of the treatment, when the volunteers were re-evaluated.

Analysis of the Muscular Activity, Peak Torque in the Lower Limbs, and Static Balance after Virtual Rehabilitation in Women with Fibromyalgia: A Randomized Controlled Study.

Objective: To analyze the effect of the exergaming on muscular activity at rest and on maximum voluntary isometric contraction by electromyography (EMG) at peak torque, widespread pressure hyperalgesia identified using a tender point count, and static balance in fibromyalgia. Materials and Methods: Thirty-five women were divided into two groups: Wii™ (virtual rehabilitation, n = 16) and control (stretching exercises, n = 19), through simple randomization. The volunteers were evaluated by means of EMG, dynamometry by load cell, baropodometry, and algometry before interventions and reevaluated after the 10th and 20th sessions. The subjects participated fully in three 1-hour treatment sessions per week of 20 sessions. Results: The Wii group showed significant benefits for the peak torque of dorsiflexion movement after 20 sessions and for movement plantarflexion after 10 sessions. The control group showed bilateral improvement in muscular activity in the tibialis anterior muscle after 20 sessions. Both groups showed a significant decrease in tender point count, suggesting improved hyperalgesia after 10 sessions and 20 sessions. No significant improvement was found in static baropodometry in the two evaluated groups. Conclusion: Exergaming have the potential to increase the peak torque for dorsiflexion and plantarflexion movement in women with fibromyalgia. It also produces a decrease in tender point count equal to that with flexibility exercises and does not produce changes in the static balance.

Effects of Exergames in Women with Fibromyalgia: A Randomized Controlled Study.

Objective: Evaluation of the effects of exergames in women with fibromyalgia on the impact of the disease-pain threshold and physical variables-compared to performing stretching exercises. Materials and Methods: Thirty-five women were enrolled in the study and divided by simple randomization into two treatment groups: the control group (n = 19) and the Wii™ (exergames) group (n = 16). Participants were evaluated using the fibromyalgia impact questionnaire (FIQ), algometry, step tests, cardiopulmonary parameters, and fatigue in the lower limbs. The participants underwent treatments for a period of 7 weeks with three 1-hour sessions weekly and were reevaluated after the 10th and the 20th sessions. Results: The exergames group showed significant reduction of their fibromyalgia symptoms, as demonstrated by lower FIQ scores in the key domains on questions regarding missed work, pain, fatigue, problems resting, stiffness, anxiety, and depression. Significant improvements were observed in mean algometric values in the cervical region, the second chondrocostal junction, the lateral epicondyle, left medial knee border, left occipital region, trapezius, supraspinatus, gluteal muscles, and the greater trochanter. Improved cardiovascular adaptation was reflected by decreased systolic blood pressure, reduction in fatigue of the lower limbs assessed by the CR10 Borg scale, and improved exercise capacity assessed by a step test. Conclusion: Exergames have the potential to increase exercise capacity, decrease the impact of fibromyalgia, promote cardiovascular adaptation, reduce fatigue of lower limbs, and improve the pain threshold in women with fibromyalgia.

Effect of Exergaming on Muscle Strength, Pain, and Functionality of Shoulders in Cancer Patients.

Objective: To compare the strength of the middle deltoid muscle by means of dynamometry and the Shoulder Pain and Disability Index (SPADI) in participants in treatment for cancer after the practice of an exergaming protocol. Materials and Methods: We conducted a randomized controlled clinical trial. Thirty-eight voluntary participants were divided into two groups: cancer group (n = 19; age = 61.46 ± 8.79 years; body mass index [BMI] = 28.36 ± 4.94 kg/m3) and control group (n = 19; age = 57.62 ± 7.57 years; BMI = 28.06 ± 3.74 kg/m3), and they participated in the study. All participants performed an exergame protocol by using Xbox 360 Kinect® (Microsoft, Redmond) with the game Your Shape Fitness Evolved 2012 two to three times per week for 20 sessions. They were evaluated through the isometric dynamometer in the middle deltoid muscle and the SPADI at three moments: preintervention (EV1), after 10 sessions (EV2), and after 20 sessions (EV3). Results: The cancer group scored higher on both the disability index, in all three evaluations, and the pain index, in EV2 and EV3, when compared with the control group. There was a significant reduction in the disability score in EV2 and EV3 when compared with EV1 in the cancer group, whereas pain was lower in EV2 and EV3 when compared with EV1 in the control group. There were no significant interevaluation or intergroup differences in the maximal isometric voluntary contraction of the deltoid muscle of both upper limbs. Conclusion: At the end of the exergaming, protocol reduced the disability of the shoulder joint of the cancer group and decreased the differences between the groups for disability and pain scores, without changing isometric force.

Validação de um protocolo de auriculoterapia com laser para dor crônica na coluna vertebral / Validación de un protocolo de auriculoterapia láser para el dolor crónico en la columna vertebral / Validation of a laser auriculotherapy protocol for chronic spinal pain

RESUMO Objetivo: validar um protocolo de auriculoterapia com laser para dor crônica na coluna vertebral. Método: estudo metodológico realizado a partir de uma revisão sistemática, baseada no PRISMA Statement; validação de conteúdo por 21 experts e validação clínica do protocolo desenvolvido em pessoas com dor. Resultados: a partir da análise de 13 artigos foi observado o efeito positivo da acupuntura no alívio da dor e foi possível construir o seguinte protocolo: auriculoterapia com laser, em cinco sessões, com a proporção de uma sessão por semana, aplicação bilateral com alternância do pavilhão auricular nos pontos Shenmen, rim, simpático, bexiga, fígado, subcórtex e vértebras cervical, torácica e/ ou lombar, dependendo do local da dor. A avaliação desse conteúdo assumindo nível de concordância de 80% interavaliadores resultou em aprovação de todos os itens do protocolo. Na avaliação clínica, ao ser administrado em pessoas com dor na coluna vertebral, o protocolo desenvolvido demonstrou reduzir a média de dor, aumentar o limiar de tolerância e diminuir o impacto da dor nas atividades de vida diária. Conclusão: a acupuntura auricular, realizada com laser de baixa potência infravermelho no protocolo estudado, provou ser capaz de tratar com efetividade a dor crônica na coluna vertebral.

RESUMEN Objetivo: validar un protocolo de auriculoterapia láser para el dolor crónico en la columna vertebral. Método: estudio metodológico realizado a partir de una revisión sistemática, en base a la declaración PRISMA; validación de contenido por 21 expertos y validación clínica del protocolo de tratamiento en personas con dolor. Resultados: del análisis de 13 artículos se observó el efecto positivo de la acupuntura en el alivio del dolor y se pudo construir el siguiente protocolo: auriculoterapia láser, en cinco sesiones, con una sesión por semana, aplicación bilateral con alternancia de pabellón auricular en los puntos Shen Men, Riñón, Nervio simpático, Vejiga, Hígado, Subcórtex y vértebras cervicales, torácicas y / o lumbares, dependiendo de la localización del dolor. La evaluación de este contenido, asumiendo un nivel de acuerdo del 80% entre evaluadores, resultó en la aprobación de todos los ítems del protocolo. En la evaluación clínica, cuando se administró a personas con dolor en la columna, el protocolo de tratamiento demostró reducir el promedio de dolor, aumentar el umbral de tolerancia y disminuir el impacto del dolor en las actividades de la vida diaria. Conclusión: la acupuntura auricular, realizada con láser infrarrojo de baja potencia en el protocolo estudiado, demostró ser capaz de tratar eficazmente el dolor crónico de columna vertebral.

ABSTRACT Objective: to validate a laser auriculotherapy protocol for chronic spinal pain. Method: methodological study carried from a systematic review based on the PRISMA Statement; content validation carried out by 21 specialists and pilot test with clinical validation of the protocol developed in people with pain. Results: from the analysis of 13 articles, a positive effect of acupuncture on pain relief was noted and it was possible to develop the following protocol: laser auriculotherapy, in 5 sessions, with the proportion of one session a week, bilateral application with alternation of the auricular pavilion at Shenmen points, Kidney, Sympathetic Nervous System, Urinary Bladder, Liver, Subcortex and Cervical, Thoracic and/or Lumbar Vertebrae, depending on the location of the pain. The evaluation of this content, assuming a level of agreement of 80% interobserver, resulted in the approval of all items in the protocol. In the clinical evaluation, when it was administered in people with spinal pain, the protocol developed showed a reduction in the pain average, an improvement in the tolerance threshold and a reduction in the pain impact on daily activities. Conclusion: the auricular acupuncture, carried out using an infrared low-level laser, in the studied protocol, proved to be capable of effectively treating chronic spinal pain.

Effects of Exergaming in Cancer Related Fatigue in the Quality of Life and Electromyography of the Middle Deltoid of People with Cancer in Treatment: A Controlled Trial

Objective: In the present study, we aimed to evaluate the effects an exergaming protocol for cancer patients who undergo or have already undergone cancer treatment. We sought to evaluate changes in cancer-related fatigue, function, and ability to perform daily activities, in addition to changes in the electromyographic pattern of the middle deltoid muscle. Methods: We conducted a controlled trial. Nineteen volunteers in the cancer group (aged 61 ± 9 years; body mass index28 ± 5) and 19 in the control group (aged 58 ± 8 years); body mass index 28 ± 4) participated in the study. They were evaluated by means of a sociodemographic and clinical questionnaire, the Functional Assessment of Chronic Therapy-Fatigue (FACIT-F) questionnaire, and surface electromyography in the deltoid muscle at three moments: before the beginning of the exergaming protocol, after 10 training sessions, and after 20 sessions. The protocol consisted of practicing exergaming using Xbox 360® (Microsoft, Redmond, USA) with Kinect®. The game "Your Shape Fitness Evolved" (Ubisoft, Rennes, France) was used. Results: Total FACIT-F scores, fatigue subscale scores, and median frequency values observed in the cancer group were lower than those in the control group. These values improved in relation to the initial evaluation in the cancer group after the practice of the exergaming protocol. Conclusion: The exergaming protocol used in this study was effective for reducing reported symptoms of fatigue, increasing perceived quality of life, and improving the pattern of deltoid muscle contraction in cancer patients.