Efeito da fotobiomodulação associada a exercícios na dor e na funcionalidade de pacientes com osteoartrite de joelho: estudo-piloto

Autores

DOI:

https://doi.org/10.1590/1809-2950/18020027022020

Palavras-chave:

Osteoartrite do Joelho, Terapia por Exercício, Terapia com Luz de Baixa Intensidade, Joelho

Resumo

O objetivo do estudo foi avaliar o efeito da fotobiomodulação associada a exercícios na dor e na funcionalidade de pacientes com osteoartrite de joelho. Para isso foram recrutados 20 pacientes com osteoartrite do joelho uni ou bilateral, que foram distribuídos em dois grupos: grupo-controle (GC), que realizou aplicação de fotobiomodulação (FBM) placebo e um protocolo de exercício; e grupo fotobiomodulação (GF), que realizou aplicação ativa da FBM e o protocolo de exercício, sendo esse realizado duas vezes por semana durante oito semanas e consistindo de alongamentos passivos dos músculos de membros inferiores, straight leg raise, treinamento proprioceptivo e exercícios para o controle da marcha. A FBM foi aplicada com o aparelho cluster contendo quatro diodos de 670 nm e cinco diodos de 850 nm, com uma potência de saída de 540 mW, sendo a dose utilizada de 4 J/cm2. Os grupos foram avaliados pré e pós-tratamento com os questionários SF-36, Lequesne, Tinetti, e por meio da Escala Visual Analógica de dor (EVA). Os dados foram analisados com o método Anova, seguido do Bonferroni. Os dados indicaram melhoras significativas para o GF ao fim do tratamento para as avaliações da EVA (2±1,25 vs. 0,7±0,82; p=0,009). Embora ambos os grupos tenham obtido melhoras significativas ao longo do tratamento, não foi possível observar diferenças significativas entre eles para o restante das avaliações ao final do tratamento. Portanto, conclui-se que o uso da FBM associada a exercícios apresentou melhora da dor nos pacie

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Referências

Kraus VB, Blanco FJ, Englund M, Karsdal MA, Lohmander

LS. Call for standardized definitions of osteoarthritis and risk

stratification for clinical trials and clinical use. Osteoarthritis

Cartilage. 2015;23(8):1233-41. doi: 10.1016/j.joca.2015.03.036

Schaible HG. Mechanisms of chronic pain in osteoarthritis.

Curr Rheumatol Rep. 2012;14(6):549-56. doi: 10.1007/

s11926-012-0279-x

World Health Organization. Chronic diseases and health

promotion: chronic rheumatic conditions. [Internet]; c2010.

[citado em 12 jun 2020]. Disponível em: http://www.who.int/

chp/topics/rheumatic/en/

Lin DH, Lin CHJ, Lin YF, Jan MH. Efficacy of 2 non-weightbearing interventions, proprioception training versus strength

training, for patients with knee osteoarthritis: A randomized

clinical trial. J Orthop Sports Phys Ther. 2009;39(6):450-7. doi:

2519/jospt.2009.2923

Duman I, Taskaynatan MA, Mohur H, Tan AK. Assessment

of the impact of proprioceptive exercises on balance

and proprioception in patients with advanced knee

osteoarthritis. Rheumatol Int. 2011;32(12):3793-8. doi: 10.1007/

s00296-011-2272-5

Burrows NJ, Booth J, Sturnieks DL, Barry BK. Acute resistance

exercise and pressure pain sensitivity in knee osteoarthritis:

A randomised crossover trial. Osteoarthritis Cartilage.

;22(3):407-14. doi: 10.1016/j.joca.2013.12.023

McAlindon TE, Bannuru RR, Sullivan MC, Arden NK, Berenbaum

F, Bierma-Zeinstra SM, et al. OARSI guidelines for the nonsurgical management of knee osteoarthritis. Osteoarthritis

Cartilage. 2014;22(3):363-88. doi: 10.1016/j.joca.2014.01.003

Alghadir A, Omar MT, Al-Askar AB, Al-Muteri NK. Effect of lowlevel laser therapy in patients with chronic knee osteoarthritis:

A single-blinded randomized clinical study. Lasers Med Sci.

;29(2):749-55. doi: 10.1007/s10103-013-1393-3

Pietrosimone BG, Saliba SA, Hart JM, Hertel J, Kerrigan

C, Ingersoll CD. Effects of transcutaneous electrical nerve

stimulation and therapeutic exercise on quadriceps activation

in people with tibiofemoral osteoarthritis. J Orthop Sports Phys

Ther. 2011;41(1):4-12. doi: 10.2519/jospt.2011.3447

Cakir S, Hepguler S, Ozturk C, Korkmaz M, Isleten B, Atamaz

FC. Efficacy of therapeutic ultrasound for the management of

knee osteoarthritis: A randomized, controlled, and double-blind

study. Am J Phys Med Rehabil. 2014;93(5):405-12. doi: 10.1097/

PHM.0000000000000033

Mascarin NC, Vancini RL, Andrade MS, Magalhães EP, de Lira

CA, Coimbra IB. Effects of kinesiotherapy, ultrasound and

electrotherapy in management of bilateral knee osteoarthritis:

Prospective clinical trial. BMC Musculoskelet Disord.

;22(13):182. doi: 10.1186/1471-2474-13-182

Leal Junior ECP, Lopes-Martins RA, Baroni BM, De Marchi T,

Rossi RP, Grosselli D, et al. Comparison between single-diode

low-level laser therapy (LLLT) and LED multi-diode (cluster)

therapy (LEDT) applications before high-intensity exercises.

Photomed Laser Surg. 2009;27(4):617-23. doi: 10.1089/

pho.2008.2350

Hunter DJ, Altman RD, Cicuttini F, Crema MD, Duryea J, Eckstein

F, et al. OARSI clinical trials recommendations: Knee imaging

in clinical trials in osteoarthritis. Osteoarthritis Cartilage.

;23(5):698-715. doi: 10.1016/j.joca.2015.03.012

Kellgren JH, Lawrence JS. Radiological assessment of osteoarthrosis. Ann Rheum Dis. 1957;16(4):494-502. doi: 10.1136/

ard.16.4.494

Jan MH, Lin JJ, Liau JJ, Lin YF, Lin DH. Investigation of clinical

effects of high- and low-resistance training for patients with

knee osteoarthritis: A randomized controlled trial. Phys Ther.

;88(4):427-36. doi: 10.2522/ptj.20060300

McKnight PE, Kasle S, Going S, Villanueva I, Cornett M, Farr J,

et al. A comparison of strength training, self-management, and

the combination for early osteoarthritis of the knee. Arthritis

Care Res. 2010;62(1):45-53. doi: 10.1002/acr.20013

Farr JN, Going SB, McKnight PE, Kasle S, Cussler EC, Cornett

M. Progressive resistance training improves overall physical

activity levels in patients with early osteoarthritis of the knee:

A randomized controlled trial. Phys Ther. 2010;90(3):356-66.

doi: 10.2522/ptj.20090041

Foroughi N, Smith RM, Lange AK, Singh MA, Vanwanseele

B. Progressive resistance training and dynamic alignment in

osteoarthritis: A single-blind randomized controlled trial. Clin

Biomech. 2011;26(1):71-7. doi: 10.1016/j.clinbiomech.2010.08.013

Villadsen A, Overgaard S, Holsgaard-Larsen A, Christensen

R, Roos EM. Immediate efficacy of neuromuscular exercise

in patients with severe osteoarthritis of the hip or knee: A

secondary analysis from a randomized controlled trial.

J Rheumatol. 2014;41(7):1385-94. doi: 10.3899/jrheum.130642

Smith TO, King JJ, Hing CB. The effectiveness of proprioceptivebased exercise for osteoarthritis of the knee: A systematic

review and meta-analysis. Rheumatol Int. 2012;32(11):3339-51.

doi: 10.1007/s00296-012-2480-7

Henriksen M, Klokker L, Graven-Nielsen T, Bartholdy C,

Jørgensen TS, Bandak E, et al. Association of exercise

therapy and reduction of pain sensitivity in patients with knee

osteoarthritis: A randomized controlled trial. Arthritis Care Res

(Hoboken). 2014;66(12):1836-43. doi: 10.1002/acr.22375

Bennell KL, Kyriakides M, Metcalf B, Egerton T, Wrigley TV, Hodges

PW, et al. Neuromuscular versus quadriceps strengthening

exercise in patients with medial knee osteoarthritis and

varus malalignment: A randomized controlled trial. Arthritis

Rheumatol. 2014;66(4):950-9. doi: 10.1002/art.38317

Hegedűs B, Viharos L, Gervain M, Gálfi M. The effect of low-level

laser in knee osteoarthritis: A double-blind, randomized, placebocontrolled trial. Photomed Laser Surg. 2009;27(4):577-84. doi:

1089/pho.2008.2297

Nakamura T, Ebihara S, Ohkuni I, Izukura H, Harada T, Ushigome

N, et al. Low-level laser therapy for chronic knee joint patients.

Laser Ther. 2014;23(4):273-7. doi: 10.5978/islsm.14-OR-21

Soleimanpour H, Gahramani K, Taheri R, Golzari SE, Safari S,

Esfanjani RM, et al. The effect of low-level laser therapy on

knee osteoarthritis: Prospective, descriptive study. Lasers Med

Sci. 2014;29(5):1695-700. doi: 10.1007/s10103-014-1576-6

Al Rashoud AS, Abboud RJ, Wang W, Wigderowitz C. Efficacy

of low-level laser therapy applied at acupuncture points in knee

osteoarthritis: A randomised double-blind comparative trial.

Physiotherapy. 2014;100(3):242-8. doi: 10.1016/j.physio.2013.09.007

da Silva MM, Albertini R, de Tarso Camillo de Carvalho P, Leal-Junior

ECP, Bussadori SK, Vieira SS, et al. Randomized, blinded, controlled

trial on effectiveness of photobiomodulation therapy and

exercise training in the fibromyalgia treatment. Lasers Med

Sci. 2018;33(2):343-51. doi: 10.1007/s10103-017-2388-2

Rossato M, Dellagrana RA, Lanferdini FJ, Sakugawa RL,

Lazzari CD, Baroni BM, Diefenthaeler F. Effect of preexercise phototherapy applied with different cluster probe

sizes on elbow flexor muscle fatigue. Lasers Med Sci.

;31(6):1237-44. doi: 10.1007/s10103-016-1973-0

Alfredo PP, Bjordal JM, Dreyer SH, Meneses SR, Zaguetti

G, Ovanessian V, et al. Efficacy of low-level laser therapy

associated with exercises in knee osteoarthritis: A randomized

double-blind study. Clin Rehabil. 2012;26(6):523-33. doi:

1177/0269215511425962

Youssef EF, Muaidi QI, Shanb AA. Effect of laser therapy on

chronic osteoarthritis of the knee in older subjects. J Lasers

Med Sci. 2016;7(2):112-9. doi: 10.15171/jlms.2016.19

World Association for photobiomodulation therapy: Recommended

treatment doses for low-level laser therapy [Internet]. WALT; 2010.

[citado em 6 maio 2020]. Disponível em: https://waltza.co.za/

wp-content/uploads/2012/08/Dose_table_780-860nm_for_

Low_Level_Laser_Therapy_WALT-2010.pdf

Publicado

2020-03-03

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Como Citar

Efeito da fotobiomodulação associada a exercícios na dor e na funcionalidade de pacientes com osteoartrite de joelho: estudo-piloto. (2020). Fisioterapia E Pesquisa, 27(2), 119-125. https://doi.org/10.1590/1809-2950/18020027022020