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Item Effects of photobiomodulation on pain, lactate and muscle performance (ROM, torque, and EMG parameters) of paretic upper limb in patients with post-stroke spastic hemiparesis: a randomized controlled clinical trial(Springer-Verlag London Ltd.) Neves, Marcele Florêncio das; Pinto, Ana Paula; Maegima, Letícia Tiemi; Lima, Fernanda Pupio Silva; Lopes‑Martins, Rodrigo Álvaro Brandão; Arisawa, Emília Angela Loschiavo; Lima, Mário OliveiraThe objective of the study was to investigate the impact of photobiomodulation (PBM) on the paretic upper limb in post-stroke patients with spastic hemiparesis and to understand the potential of PBM as a long-term non-invasive therapy for reducing the side effects caused by spasticity in the hemiparetic upper limb after a stroke. This is a double-blind randomized clinical trial constituted of 27 participants, being Control group (CG = 12 healthy individuals) and PBM group (PBMG = 15 post-stroke individuals). In the CG, the baseline blood lactate (BL) was evaluated, followed by the evaluation of the IC torque of the biceps and triceps muscles, with the isokinetic dynamometer associated with surface electromyography (EMG) and, subsequently, a new measurement of BL. The PBMG received 10 sessions of treatment with PBM (780 nm, Power: 100 mV, Power Density: 3.18 W/cm2, Energy: 4 J, Fluency: 127.4 J/cm2, Time: 40 s per point and 1.280 s total, Spot: 0.0314 cm2, 32 Points: 16 points (brachial biceps) and 16 points (brachial triceps) applied with contact at 90°, Total Energy: 64 J), which in the pre-treatment evaluation measured BL, the visual analogue scale (VAS) of pain; torque and EMG of the same muscles in the IC, subsequently, a new measurement of VAS and BL, and measurement of range of motion (ROM) during the reaching movement. At the conclusion of the ten sessions, all participants underwent a reassessment, wherein all tests originally administered during the initial evaluation were repeated. Subsequently, the data were analyzed using the Shapiro–Wilk normality test. For related data, the paired t-test was used for normal distributions and the Wilcoxon test for non-normal data. For unrelated data, the t test was used for normal distributions and the Mann–Whitney test for non-normal data. Muscle torque was higher for the CG, with a significant difference (CGxPBMG = p < 0.0001). There was no significant difference between the EMG values of the CG in relation to the Pre-PBM phase and with the Post-PBM phase of the PBMG (p > 0.05). On the other hand, there was a 38% reduction in pain reported by hemiparetic patients (p = 0.0127) and a decrease in BL in the PBMG. Post-PBM ROM increased by 46.1% in the elbow extension of the paretic limb. In conclusion, Photobiomodulation (PBM) demonstrated significant improvements in muscle performance, reducing fatigue and pain levels, and enhancing range of motion in post-stroke patients with spastic hemiparesis. These findings support the potential integration of PBM into rehabilitation protocols, but further research and clinical trials are needed to validate and expand upon these promising outcomes.Item Evaluation of the effects of photobiomodulation (808 nm) on pain and quality of life of diabetic neuropathy patients(CDRR Editors) Leal, Milena Valdinéia da Silva; Lima, Mário Oliveira; Costa, Davidson Ribeiro; Nicolau, Renata Amadei; Ribeiro, Luana Aparecida Pilato; Costa, David Ribeiro; Carvallho, Teresa Marly Teles de; Silva, Kelson Nonato Gomes da; Pessoa, Diego Rodrigues; Arisawa, Emília Ângela Lo SchiavoDiabetic neuropathy (DN) is one of the main complications of diabetes mellitus (DM), responsible for a high morbimortality rate and burdening public health resources. Photobiomodulation has proven to be effective in relieving pain, reducing the inflammation, and improving vascularization. We report an evaluation of the effectiveness of photobiomodulation for the relief of pain and to improve the quality of life in patients with diabetic neuropathy. A total of 30 diabetic volunteers with DN were randomly divided into three groups: control, photobiomodulation (PBM), and placebo (P-PBM). Those in Group control were instructed to take diabetic neuropathy medication for 30 days. The PBM group received laser photobiomodulation treatment with the following protocol: three sessions per week for 30 days, totaling 12 applications (wavelength, 808 nm; energy density, 12 J/cm²). in the of following nerves: tibial medial plantar, own plantar digital, common plantar digital, superficial fibular, deep fibular, sciatic, saphenous, and common fibular. Patients in the P-PBM Group were submitted to the PBM protocol, but with the device switched off. Before and after applying the therapeutic protocols, all volunteers were subjected to pain evaluations. The results showed a statistically significant difference between the groups (p < 0.05). The PBM group confirmed an analgesic effect directly related to the use of the photobiomodulation, whilst the patients in group control and P-PBM, did not present significant results. The study demonstrated that laser photobiomodulation is effective in significantly reducing pain and improving the quality of life of patients with diabetic neuropathy.Item A Comprehensive Review on the Effects of Laser Photobiomodulation on Skeletal Muscle Fatigue in Spastic Patients(Hindawi Publishing Corporation) Stamborowski, Sadi Fernando; Lima, Fernanda Púpio Silva; Leonardo, Patrícia Sardinha; Lima, Mário OliveiraPeripheral muscle fatigue is a common experience in daily life. Every individual at some point in their life has realized the inability to maintain muscle contraction, a phenomenon known as fatigue. Interestingly, neurological patients with peripheral sequelae such as spastic muscle contraction are able to remain in a pattern of muscle contraction for prolonged periods. The effects of laser therapy are already recognized in muscle contraction to delay skeletal muscle fatigue, prolong physical activity, and reduce delayed onset muscle soreness. However, the effects of photobiomodulation on neurological patients with muscular spasticity are still not well established. The present literature review seeks to recognize articles about the application of laser irradiation, also known as photobiomodulation, to patients with muscle fatigue and/or spastic palsy. To perform a literature review, we used the systematic review methodology for the literature search. The following keywords were searched: (skeletal muscle fatigue) AND (spastic patients) AND (low-level laser therapy OR low intensity laser therapy OR low energy laser therapy OR LLLT OR LILT OR LELT OR infrared laser OR IR laser OR diode laser), and these were used for search on the following databases: PubMed, Embase, Web of Science, BIREME, Scopus, and SciELO. Besides that, a literature review concerning on muscle physiology, fatigue, and LLLT was made. No language filter was applied, and altogether, 689 papers were identified. A group of 3 physiotherapists and 01 pharmaceutical scientist performed the literature review, and every exclusion was confirmed by at least two reviewers. After inclusion and exclusion criteria, 128 studies were included in this review. Conclusion, the LLLT can contribute to the recovery of spastic patients and muscles in fatigue. However, the real effect of laser photobiomodulation on muscle spasticity remains to be established. Only a much reduced number of clinical trials have been performed with a small number of participants. There is a lack of clinical trials from different research groups that could help to understand and elucidate the effects of laser in prolonged muscle contraction in spastic palsy.