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Peng P, Zheng X, Wang Y, Jiang S, Chen J, Sui X, Zhao L, Xu H, Lu Y, Zhang S. The Effects of Near-Infrared phototherapy Pre-irradiation on Lower Limb Muscle Strength and Injury Following Exercise: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2024:S0003-9993(24)00955-9. [PMID: 38705364 DOI: 10.1016/j.apmr.2024.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 04/23/2024] [Accepted: 04/30/2024] [Indexed: 05/07/2024]
Abstract
OBJECTIVE Assess near-infrared pre-irradiation effects on post-exercise lower limb muscle damage and function, determine optimal dosage. DATA SOURCE PubMed, EMBASE, Cochrane Library, EBSCO, Web of Science, CNKI (China National Knowledge Infrastructure), and Wanfang Data were systematically searched (2009-2023). STUDY SELECTION Incorporate randomized controlled trials of near-infrared pre-irradiation on lower limb muscles post-fatigue exercise into the meta-analysis. Out of 4550 articles screened, 21 met inclusion criteria. DATA EXTRACTION The included studies' characteristics were independently extracted by 2 authors, with discrepancies resolved through discussion or a third author. Quality assessment utilized the Cochrane risk of bias tool and the GRADE System. DATA SYNTHESIS In 21 studies, near-infrared pre-irradiation on lower limb muscles inhibited the decline in peak torque (SMD: 1.33, 95% CI: 1.08 to 1.59, p < 0.001, Increasing 27.97±4.87NM), reduced blood lactate (SMD: -0.2, 95% CI: -0.37 to -0.03, p = 0.272, decreasing 0.54±0.42mmol/L), decreased creatine kinase (SMD: -2.11, 95% CI: -2.57 to -1.65, p < 0.001, decreasing 160.07±27.96U/L), and reduced delayed-onset muscle soreness (SMD: -0.53, 95% CI: -0.81 to 0.24, p < 0.001). Using a 24-hour cutoff revealed two trends: treatment effectiveness depended on power and energy density, with optimal effects at 24.16 J/cm² and 275 J/cm² for energy, and 36.81 mW/cm² and 5495 mW/cm² for power. Noting that out of 21 studies, 19 are from Brazil, 1 from the U.S., and 1 from Australia and the results exhibit high heterogeneity CONCLUSION: : Although we would have preferred a more geographic dispersion of laboratories our findings indicate that near-infrared pre-irradiation mitigates peak torque decline in lower limb muscles. Influenced by energy and power density with a 24-hour threshold, optimal energy and power densities are observed at 24.16 J/cm², 275 J/cm², 36.81 mW/cm², and 5495 mW/cm² respectively. It also reduces blood lactate, CK, and DOMS.
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Affiliation(s)
- PeiQiang Peng
- School of Nursing, Jilin University, 965 Xinjiang Street, Chaoyang District, Changchun 130021, PR China.
| | - XuFei Zheng
- School of Nursing, Jilin University, 965 Xinjiang Street, Chaoyang District, Changchun 130021, PR China.
| | - YueTing Wang
- School of Nursing, Jilin University, 965 Xinjiang Street, Chaoyang District, Changchun 130021, PR China.
| | - ShuNing Jiang
- School of Nursing, Jilin University, 965 Xinjiang Street, Chaoyang District, Changchun 130021, PR China.
| | - JiaJu Chen
- School of Nursing, Jilin University, 965 Xinjiang Street, Chaoyang District, Changchun 130021, PR China.
| | - Xin Sui
- School of Nursing, Jilin University, 965 Xinjiang Street, Chaoyang District, Changchun 130021, PR China.
| | - LiJing Zhao
- School of Nursing, Jilin University, 965 Xinjiang Street, Chaoyang District, Changchun 130021, PR China.
| | - Haiyan Xu
- School of Nursing, Jilin University, 965 Xinjiang Street, Chaoyang District, Changchun 130021, PR China.
| | - Yuming Lu
- Department of orthopedics, Lequn branch, The first hospital of Jilin University, 71, Xinmin Street, Chaoyang District, Changchun, 130021, PR China.
| | - Shuang Zhang
- School of Nursing, Jilin University, 965 Xinjiang Street, Chaoyang District, Changchun 130021, PR China.
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Ketz AK, Anders J, Orina J, Garner B, Hull M, Koreerat N, Sorensen J, Turner C, Johnson J. Photobiomodulation Therapy Plus Usual Care Is Better than Usual Care Alone for Plantar Fasciitis: A Randomized Controlled Trial. Int J Sports Phys Ther 2024; 19:1438-1453. [PMID: 38179590 PMCID: PMC10761604 DOI: 10.26603/001c.90589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 10/30/2023] [Indexed: 01/06/2024] Open
Abstract
Background Plantar fasciitis (PF) results in pain-related disability and excessive healthcare costs. Photobiomodulation therapy (PBMT) has shown promise for decreasing both pain and disability related to PF. Purpose The purpose was to assess the clinical impact of PBMT on pain and function in people with PF. Study Design Prospective, randomized controlled clinical trial. Methods A convenience sample of adults with PF were randomly assigned to one of three groups: (1) usual care, (2) usual care plus nine doses of PBMT with 25W output power over three weeks, or (3) usual care plus nine doses of PBMT with 10W output power over three weeks. Both 10W and 25W PBMT participants received the same total dose (10J/cm2) by utilizing a simple area equation. Pain (with Defense and Veterans Pain Rating Scale) and function (by Foot and Ankle Ability Measure) were measured at baseline, weeks 3, and 6 for all groups, and at 13 and 26 weeks for PBMT groups. Results PBMT groups experienced a reduction in pain over the first three weeks (from an average of 4.5 to 2.8) after which their pain levels remained mostly constant, while the UC group experienced a smaller reduction in pain (from an average of 4 to 3.8). The effects on pain were not different between PBMT groups. PBMT in both treatment groups also improved function more than the UC group, again with the improvement occurring within the first three weeks. Conclusions Pain and function improved during the three weeks of PBMT plus UC and remained stable over the following three weeks. Improvements sustained through six months in the PBMT plus UC groups. Level of Evidence Level II- RCT or Prospective Comparative Study.
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Affiliation(s)
| | - Juanita Anders
- School of Medicine, Department of Anatomy, Physiology, and Genetics Uniformed Services University of the Health Sciences
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He K, Zhou X, Zheng F, Ju X, Fu SN, Wong AYL. Histological, Physiological and Biomechanical Effects of Low-Level Laser Therapy on Tendon Healing in Animals and Humans: A Systematic Review. Ann Biomed Eng 2023; 51:2659-2707. [PMID: 37899380 DOI: 10.1007/s10439-023-03364-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 09/05/2023] [Indexed: 10/31/2023]
Abstract
Low-level Laser Therapy (LLLT) was widely used in clinical practice for tendon disorders. However, the underlying mechanisms and effectiveness of LLLT in treating tendon injury remain unclear. Therefore, the present study was conducted aiming to summarize the evidence regarding the histological, physiological, and biomechanical effects of LLLT on tendon healing in animal and human models. Four databases were searched for relevant literature. Four independent reviewers screened abstracts and full-text articles, extracted relevant data, evaluated the risk of bias, and quantified the quality of evidence. Database searches yielded 1400 non-duplicated citations. Fifty-five studies were included (50 animal and five human studies). Animal studies revealed that LT had stimulating effects on collagen organization, collagen I and collagen II formation, matrix metalloproteinase (MMP)-8, transforming growth factor β1, vascular endothelial growth factor, hydroxyproline, maximum load, maximum elongation before breaking, and tendon stiffness. However, LLLT had inhibitory effects on the number of inflammatory cells, histological scores, relative amount of collagen III, cyclooxygenase-2, prostaglandin E2 (PGE2), interleukin-6, tumor necrosis factor-α, MMP-1, and MMP-3. Although one human study found that LLLT reduced the concentration of PGE2 in peritendinous tissue of the Achilles tendon, other human studies revealed that the effects of LLLT on the physiology and biomechanics of human tendons remained uncertain. LLLT facilitates tendon healing through various histological, physiological, and biomechanical effects in animal models. Only post-LLLT anti-inflammatory effects were found in human studies.
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Affiliation(s)
- Kexu He
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xuelian Zhou
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
| | - Feisheng Zheng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
| | - Xiaojie Ju
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
| | - Siu-Ngor Fu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
| | - Arnold Y L Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China.
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de Oliveira PR, Arrebola LS, Stéfani KC, Pinfildi CE. Photobiomodulation Associated With Conservative Treatment for Achilles Tendon Rupture: A Double-Blind, Superiority, Randomized Controlled Trial. Arch Rehabil Res Clin Transl 2022; 4:100219. [PMID: 36545533 PMCID: PMC9761261 DOI: 10.1016/j.arrct.2022.100219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Objective To investigate the effects of photobiomodulation on Achilles tendon rupture (ATR) treated conservatively. Design Prospective, patient- and assessor-blinded, parallel, randomized controlled trial. Setting Patients with acute ATR treated conservatively. Participants Thirty-four male individuals with acute unilateral ATR treated conservatively (N=34), equally divided in 2 groups: photobiomodulation group (PBMG) and sham group, with mean age of 45.5±9.47 and 48.7±8.38 years, respectively. Intervention All participants underwent through an immobilization period, followed by rehabilitation sessions (2 d/wk for 12 weeks) comprising strengthening, range of motion, and balance/weightbearing exercises. In PBMG, the tendon was irradiated with a photobiomodulation cluster (1 904 nm/50 mW infrared laser, 4 858 nm/50 mW infrared diodes, and 4 658 nm/40 mW red diodes; power density of 105 mW/cm2 per cluster area) during the immobilization period (2 d/wk for 8 weeks) and the sham group received a simulation of the procedure with no irradiation. Outcomes were assessed at the removal of the immobilization 12 and 16 weeks after tendon rupture. Main Outcome Measures Primary outcome was the Achilles Tendon Rupture Score. Secondary outcomes included Numerical Pain Rating Scale at rest and during effort, plantar flexor strength, and ankle range of motion. Results Both groups demonstrated an increase in the Achilles Tendon Rupture Score and improvements in range of motion, plantar flexor strength, and pain. There were no significant differences in outcomes between the 2 groups (P>.05) except in pain during walking, which was significantly lower in the PBMG in week 12 (P<.01, effect size=0.56) and week 16 (P<.01, effect size=0.55). Conclusion Photobiomodulation associated with conservative treatment is not superior to conservative treatment alone for improving function in patients with acute ATR.
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Key Words
- ATR, Achilles tendon rupture
- ATRS, Achilles Tendon Rupture Score
- Achilles tendon
- CI, confidence interval
- ES, effect size
- IAMSPE, Institute of Medical Assistance to the State Public Servant
- Low-level light therapy
- NPRS, Numerical Pain Rating Scale
- PBM, photobiomodulation
- PBMG, photobiomodulation group
- ROM, range of motion
- Rehabilitation
- SG, sham group
- WALT, World Association for Photobiomodulation Therapy
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Affiliation(s)
- Pedro Rizzi de Oliveira
- Department of Human Movement Sciences, Federal University of São Paulo (UNIFESP), Baixada Santista Campus, São Paulo,Physical Therapy Department, Institute of Medical Assistance to the State Public Servant (IAMSPE), São Paulo,Corresponding author Pedro Rizzi de Oliveira, PT, MSc, Department of Human Movement Sciences, Federal University of São Paulo (UNIFESP), Rua Silva Jardim, 136 Vila Matias, Santos, São Paulo 11015-020.
| | - Lucas Simões Arrebola
- Department of Human Movement Sciences, Federal University of São Paulo (UNIFESP), Baixada Santista Campus, São Paulo,Physical Therapy Department, Institute of Medical Assistance to the State Public Servant (IAMSPE), São Paulo
| | - Kelly Cristina Stéfani
- Center of Technological Innovation, University of Sao Paulo Hospital of Clinics (HC-FMUSP), São Paulo, Brazil
| | - Carlos Eduardo Pinfildi
- Department of Human Movement Sciences, Federal University of São Paulo (UNIFESP), Baixada Santista Campus, São Paulo
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Alzyoud JA, Omoush SA, Al-Qtaitat A. Photobiomodulation for Tendinopathy: A Review of Preclinical Studies. Photobiomodul Photomed Laser Surg 2022; 40:370-377. [DOI: 10.1089/photob.2021.0192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
Affiliation(s)
- Jihad A.M. Alzyoud
- Department of Basic Medical Sciences, Faculty of Medicine, The Hashemite University, Zarqa, Jordan
| | - Samya A. Omoush
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan
| | - Aiman Al-Qtaitat
- Department of Anatomy and Histology, Faculty of Medicine, Mutah University, Karak, Jordan
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Lopes Silva RSD, Pessoa DR, Mariano RR, Castro ABS, de Oliveira RA, Ferraresi C. Systematic Review of Photobiomodulation Therapy (PBMT) on the Experimental Calcaneal Tendon Injury in Rats. Photochem Photobiol 2020; 96:981-997. [PMID: 32191817 DOI: 10.1111/php.13262] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 02/21/2020] [Indexed: 12/22/2022]
Abstract
This systematic review analyzed the light parameters and the effects of photobiomodulation therapy (PBMT) through low-level laser therapy (LLLT) and/or LED (light-emitting diode) on tendon repair of rats submitted to calcaneal injury. This study was conducted in accordance with the guidelines of the Preferred Reporting Items for Meta-Analysis, and PubMed and MEDLINE databases were accessed to search eligible studies published in English. The search terms were as follows: "Achilles tendon" or "Calcaneal tendon" or "tendon injuries" or "soft tissue injuries" and "tendinopathy" or "tendinitis" and "low-level light therapy" or "low-level laser therapy" or "low intensity power therapy" or "light-emitting diode" or photobiomodulation." The SYRCLE (SYstematic Review Center for Laboratory animal Experimentation) risks of bias was used to assess the risk of bias for selected studies. A total of 225 studies were found based on the descriptors used, and only 33 studies were eligible. Light parameters identified per point of irradiation were approximately 60 mW (continuous mode at infrared spectra), 2 W cm-2 , 2 J and 45 J cm-2 . Light parameters at red spectra, continuous versus pulsed mode, and PBMT combined or compared with other therapies such as ultrasound, and studies using unhealthy rats (ovariectomized and/or diabetic models) were also identified and grouped according to these similarities. The main effects found were decreased inflammatory markers and signs of inflammatory process. PBMT (laser/LED) has positive effects in reducing the inflammatory and time for tissue repair in animal models of tendon injury and/or tendinitis using parameters identified.
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Affiliation(s)
- Rauena Souto Diogo Lopes Silva
- Health Sciences Center, Universidade Estadual do Piaui, Teresina, Brazil.,Post-graduation program in Biomedical Engineering, Universidade Brasil, Sao Paulo, Brazil
| | | | | | | | | | - Cleber Ferraresi
- Post-graduation program in Biomedical Engineering, Universidade Brasil, Sao Paulo, Brazil
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7
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Fernandes de Jesus J, Spadacci-Morena DD, Rabelo NDDA, Pinfildi CE, Fukuda TY, Plapler H. Photobiomodulation of Matrix Metalloproteinases in Rat Calcaneal Tendons. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 37:421-427. [PMID: 31184972 DOI: 10.1089/photob.2019.4633] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective: The main objective was to verify the modulatory effects of MMP-1, MMP-3, and MMP-13 levels on the partially injured calcaneal tendons of rat exposure to photobiomodulation. Background: Photobiomodulation has been shown to have anti-inflammatory and regenerative effects on tendon injuries. However, there is still uncertainty regarding the beneficial effects in matrix metalloproteinase (MMP) levels, especially MMP-1, -3, and -13. Materials and methods: Sixty-five male Wistar rats were used. Sixty were submitted to a direct trauma on the calcaneal tendons and were randomly distributed into the following six groups: LASER 1, 3, and 7 (10 partially injured calcaneal tendons in each group treated with photobiomodulation for 1, 3, and 7 days, respectively) and Sham 1, 3, and 7 (same injury, with simulated photobiomodulation). The remaining five animals were allocated to the normal group (no injury or treatment procedure). The 780 nm low-level laser was applied with 70 mW of mean power and 17.5 J/cm2 of fluency for 10 sec, once a day. The tendons were surgically removed and analyzed for MMP-1, MMP-3, and MMP-13 through immunohistochemistry. Results: MMP-3 levels remained close to normal in all experimental groups (p > 0.05); however, reductions (p < 0.05) in MMP-1 and MMP-13 levels were detected in the groups submitted to one, three, and seven low level laser therapy applications. Conclusions: The photobiomodulation protocol was able to reduce MMP-1 and MMP-13 levels in injured calcaneal tendons.
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Affiliation(s)
| | | | | | - Carlos Eduardo Pinfildi
- 3 Human Movement of Science Department, Physical Therapy Course, Universidade Federal de São Paulo, UNIFESP, São Paulo, Brazil
| | | | - Helio Plapler
- 5 Surgery Department, Universidade Federal de São Paulo-UNIFESP, São Paulo, Brazil
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8
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Fernandes KR, Parisi JR, Magri AMP, Kido HW, Gabbai-Armelin PR, Fortulan CA, Zanotto ED, Peitl O, Granito RN, Renno ACM. Influence of the incorporation of marine spongin into a Biosilicate®: an in vitro study. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2019; 30:64. [PMID: 31127392 DOI: 10.1007/s10856-019-6266-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 05/10/2019] [Indexed: 06/09/2023]
Abstract
The combination of different biomaterials can be a promising intervention for the composites manufacture, mainly by adding functional and structural characteristics of each material and guarantee the advantages of the use of these composites. In this context, the aim of this study was to develop and evaluated the influence of the incorporation of marine spongin (SPG) into Biosilicate® (BS) in different proportions be used during bone repair. For this purpose, it was to develop and investigate different BS/SPG formulations for physico-chemical and morphological characteristics by pH, loss mass, Fourier transform infrared spectrometer (FTIR) and scanning electron microscope (SEM) analysis. Additionally, the influence of these composites on cell viability, proliferation, and alkaline phosphatase (ALP) activity were investigated. The results revealed that the pH values of all BS groups (with or without SPG) increased over time. A significant mass loss was observed in all composites, mainly with higher SPG percentages. Additionaly, SEM micrographies demonstrated fibers of SPG into BS and material degradation over time. Moreover, FTIR spectral analysis revealed characteristic peaks of PMMA, BS, and SPG in BS/SPG composites. BS/SPG groups demonstrated a positive effect for fibroblast proliferation after 3 and 7 days of culture. Additionally, BS and BS/SPG formulations (at 10% and 20% of SPG) presented similar values of osteoblasts viability and proliferation after 7 days of culture. Furthermore, ALP activity demonstrated no significant difference between BS and BS/SPG scaffolds, at any composition. Based on the present in vitro results, it can be concluded that the incorporation of SPG into BS was possible and produced an improvement in the physical-chemical characteristics and in the biological performance of the graft especially the formulation with 80/20 and 90/10. Future research should focus on in vivo evaluations of this novel composite.
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Affiliation(s)
- K R Fernandes
- Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil.
| | - J R Parisi
- Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - A M P Magri
- Department of Biosciences, Federal University of São Paulo (UNIFESP), Santos, SP, Brazil
| | - H W Kido
- Department of Biosciences, Federal University of São Paulo (UNIFESP), Santos, SP, Brazil
| | - P R Gabbai-Armelin
- Department of Biosciences, Federal University of São Paulo (UNIFESP), Santos, SP, Brazil
| | - C A Fortulan
- Department of Mechanical Engineering, São Carlos School of Engineering, São Carlos, SP, Brazil
| | - E D Zanotto
- Department of Materials Engineering, Vitreous Materials Laboratory (LaMaV), Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - O Peitl
- Department of Materials Engineering, Vitreous Materials Laboratory (LaMaV), Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - R N Granito
- Department of Biosciences, Federal University of São Paulo (UNIFESP), Santos, SP, Brazil
| | - A C M Renno
- Department of Biosciences, Federal University of São Paulo (UNIFESP), Santos, SP, Brazil
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Moon KS, Park YB, Bae JM, Oh S. Near-infrared laser-mediated drug release and antibacterial activity of gold nanorod-sputtered titania nanotubes. J Tissue Eng 2018; 9:2041731418790315. [PMID: 30083309 PMCID: PMC6071157 DOI: 10.1177/2041731418790315] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 07/02/2018] [Indexed: 01/05/2023] Open
Abstract
The infection control of implants is one of the hot issues in the field of
medicine and dentistry. In this study, we prepared gold nanorod–sputtered
titania nanotubes on titanium surface, which is the main component of implant
material, and aimed to estimate the remote-controlled tetracycline release and
resulting antibacterial effects of gold nanorod–sputtered titania nanotubes
using near-infrared laser irradiation. Gold nanorods prepared by ion plasma
sputtering (aspect ratio = 1:3) showed optical properties like those of
chemically synthesized gold nanorods, exhibiting photothermal effects in the
near-infrared region, as demonstrated using field-emission scanning electron
microscopy, transmission electron microscopy, and diffuse
ultraviolet–visible–near-infrared spectrophotometry. In addition, a 2 wt%
tetracycline/polycaprolactone mixture was found to be the most suitable
experimental group to demonstrate the biological compatibilities and
antibacterial activities. The results of antibacterial agar diffusion tests and
near-infrared-mediated tetracycline release tests in vivo confirmed that
remote-controlled tetracycline elution using near-infrared laser irradiation was
highly effective. Therefore, gold nanorod–sputtered titania nanotubes would be
expected to enable the continued use of the photothermal therapy of gold
nanorods and extend the limited use of titania showing photocatalytic activity
only within the ultraviolet-to-near-infrared region.
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Affiliation(s)
- Kyoung-Suk Moon
- Department of Dental Biomaterials and Institute of Biomaterial and Implant, College of Dentistry, Wonkwang University, Iksan, Republic of Korea
| | - Young-Bum Park
- Department of Prosthodontology, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Ji-Myung Bae
- Department of Dental Biomaterials and Institute of Biomaterial and Implant, College of Dentistry, Wonkwang University, Iksan, Republic of Korea
| | - Seunghan Oh
- Department of Dental Biomaterials and Institute of Biomaterial and Implant, College of Dentistry, Wonkwang University, Iksan, Republic of Korea
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Hochman L. Photobiomodulation Therapy in Veterinary Medicine: A Review. Top Companion Anim Med 2018; 33:83-88. [PMID: 30243364 DOI: 10.1053/j.tcam.2018.06.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 06/25/2018] [Accepted: 06/26/2018] [Indexed: 12/20/2022]
Abstract
Laser therapy, or photobiomodulation, has rapidly grown in popularity in human and veterinary medicine. With a number of proposed indications and broad, sometimes anecdotal, use in practice, research interest has expanded aimed at providing scientific support. Recent studies have shown that laser therapy alters the inflammatory and immune response as well as promotes healing for a variety of tissue types. This review will cover the history of the modality, basic principles, proposed mechanisms of action, evidence-based clinical indications, and will guide the practitioner through its application in practice.
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Affiliation(s)
- Lindsay Hochman
- University of Florida, College of Veterinary Medicine, Integrative Medicine Service, Gainesville, FL, USA.
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Improvement of Performance and Reduction of Fatigue With Low-Level Laser Therapy in Competitive Cyclists. Int J Sports Physiol Perform 2017; 13:14-22. [PMID: 28422520 DOI: 10.1123/ijspp.2016-0187] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Evidence indicates that low-level laser therapy (LLLT) minimizes fatigue effects on muscle performance. However, the ideal LLLT dosage to improve athletes'performance during sports activities such as cycling is still unclear. Therefore, the goal of this study was to investigate the effects of different LLLT dosages on cyclists'performance in time-to-exhaustion tests. In addition, the effects of LLLT on the frequency content of the EMG signals to assess fatigue mechanisms were examined. Twenty male competitive cyclists participated in a crossover, randomized, double-blind, placebo-controlled trial. They performed an incremental cycling test to exhaustion (on day 1) followed by 4 time-to-exhaustion tests (on days 2-5) at their individual maximal power output. Before each time-to-exhaustion test, different dosages of LLLT (135, 270, and 405 J/thigh, respectively) or placebo were applied at the quadriceps muscle bilaterally. Power output and muscle activation from both lower limbs were recorded throughout the tests. Increased performance in time-to-exhaustion tests was observed with the LLLT-135 J (∼22 s; P < .01), LLLT-270 J (∼13 s; P = .03), and LLLT-405 J (∼13 s; P = .02) compared to placebo (149 ± 23 s). Although LLLT-270 J and LLLT-405 J did not show significant differences in muscle activation compared with placebo, LLLT-135 J led to an increased high-frequency content compared with placebo in both limbs at the end of the exhaustion test (P ≤ .03). In conclusion, LLLT increased time to exhaustion in competitive cyclists, suggesting this intervention as a possible nonpharmacological ergogenic agent in cycling. Among the different dosages, LLLT-135 J seems to promote the best effects.
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Naterstad IF, Rossi RP, Marcos RL, Parizzoto NA, Frigo L, Joensen J, Lopes Martins PSL, Bjordal JM, Lopes-Martins RAB. Comparison of Photobiomodulation and Anti-Inflammatory Drugs on Tissue Repair on Collagenase-Induced Achilles Tendon Inflammation in Rats. Photomed Laser Surg 2017; 36:137-145. [PMID: 29265910 DOI: 10.1089/pho.2017.4364] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Tendinopathy is characterized by pain, edema, and structural changes in tendon tissue. OBJECTIVE In this animal study we decided to compare the short- and medium-term effects of low-level laser therapy (LLLT), dexamethasone, and diclofenac on inflammation and tendon tissue repair in collagenase-induced tendinitis. MATERIALS AND METHODS Two hundred five female Wistar rats were randomly divided into five groups. Animals in the control group were given a saline injection and the experimental groups received a collagenase injection (100 μg/tendon) in the peritendinous Achilles and received no treatment, LLLT (3 J, 810 nm, 100 mW), diclofenac (1.1 mg/kg), or dexamethasone (0.02 mg/kg). Histological analyses were performed at 10 time points up to 60 days (n = 5/group each time point), and included an assessment of the severity of inflammation, collagen fiber content, and organization. RESULTS Collagenase injection induced a severe inflammatory reaction with significant reduction in collagen content for 48 h, and disorientation of collagen fibers lasting between 14 and 21 days. Diclofenac and dexamethasone reduced inflammatory signs during the first 2 days, although there was prolongation of the inflammatory phase and slower normalization of tendon quality, particularly in the dexamethasone group. LLLT prevented hemorrhage, reduced inflammation severity, and preserved tendon morphology compared with the other groups. CONCLUSIONS LLLT showed a significant superiority over commonly used anti-inflammatory pharmaceutical agents in acute collagenase-induced tendinitis.
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Affiliation(s)
- Ingvill Fjell Naterstad
- 1 Physiotherapy Research Group, Department of Global Public Health and Primary Care, University of Bergen , Bergen, Norway
| | - Rafael Paolo Rossi
- 2 Post-Graduate Program in Pharmacology, Institute of Biomedical Sciences, University of São Paulo , São Paulo, Brazil
| | - Rodrigo Labat Marcos
- 3 Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho , São Paulo, Brazil
| | | | - Lucio Frigo
- 5 Department of Health Sciences, University of Cruzeiro do Sul , São Paulo, Brazil
| | - Jón Joensen
- 1 Physiotherapy Research Group, Department of Global Public Health and Primary Care, University of Bergen , Bergen, Norway
| | | | - Jan Magnus Bjordal
- 1 Physiotherapy Research Group, Department of Global Public Health and Primary Care, University of Bergen , Bergen, Norway
| | - Rodrigo Alvaro Brandão Lopes-Martins
- 6 Postgraduate Program in Biomedical Engineering, Technological Research Center , Universidade de Mogi das Cruzes, São Paulo, Brazil .,7 Department of Bioengineering, Universidade Brasil , São Paulo, Brazil
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13
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Sub-failure Stretch Injury Response in Rat Achilles Tendon. REGENERATIVE ENGINEERING AND TRANSLATIONAL MEDICINE 2017. [DOI: 10.1007/s40883-017-0043-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Nicodemo MDC, Neves LRD, Aguiar JC, Brito FDS, Ferreira I, Sant'Anna LB, Raniero LJ, Martins RÁL, Barja PR, Arisawa EALS. Amniotic membrane as an option for treatment of acute Achilles tendon injury in rats. Acta Cir Bras 2017; 32:125-139. [PMID: 28300874 DOI: 10.1590/s0102-865020170205] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 01/26/2017] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To evaluate the effect of human amniotic membrane (hAM) fragment on inflammatory response, proliferation of fibroblast and organization of collagen fibers in injured tendon. METHODS Sixty rats were divided into 3 groups: C - surgical procedures without tendon lesion and with simulation of hAM application; I - surgical procedures, tendon injury and simulation of hAM application; T - surgical procedures, tendon injury and hAM application. These groups were subdivided into four experimental times (3, 7, 14 and 28 days). The samples underwent histological analysis and ATR-FTIR spectroscopy. RESULTS Histological analysis at 14 days, the T group showed collagen fibers with better alignment. At 28 days, the I group presented the characteristics described for the T group at 14 days, while this group presented aspects of a mature connective tissue. FT-IR analysis showed a clear distinction among the three groups at all experimental times and groups T and I presented more similarities to each other than to group C. CONCLUSION Acute injury of tendon treated with human amniotic membrane fragment showed a faster healing process, reduction in inflammatory response, intense proliferation of fibroblasts and organization of collagen fibers.
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Affiliation(s)
- Mariana de Castro Nicodemo
- Postgraduate Program in Biomedical Engineering, Universidade do Vale do Paraíba, São José dos Campos, SP, Brazil
| | - Lia Renó das Neves
- Postgraduate Program in Biomedical Engineering, UNIVAP, São José dos Campos, SP, Brazil
| | | | | | | | | | | | - Rodrigo Álvaro Lopes Martins
- Postgraduate Program in Biomedical Engineering, Technology Research Center, Universidade Mogi das Cruzes, Brazil
| | - Paulo Roxo Barja
- Photoacoustic Applied to Biological Systems Laboratory, UNIVAP, São José dos Campos, SP, Brazil
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15
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Low level laser therapy accelerates the extracellular matrix reorganization of inflamed tendon. Tissue Cell 2017; 49:483-488. [DOI: 10.1016/j.tice.2017.05.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 05/22/2017] [Accepted: 05/23/2017] [Indexed: 11/18/2022]
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16
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Pereira FC, Parisi JR, Maglioni CB, Machado GB, Barragán-Iglesias P, Silva JRT, Silva ML. Antinociceptive effects of low-level laser therapy at 3 and 8 j/cm2in a rat model of postoperative pain: possible role of endogenous Opioids. Lasers Surg Med 2017; 49:844-851. [DOI: 10.1002/lsm.22696] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2017] [Indexed: 01/19/2023]
Affiliation(s)
- Fabio C. Pereira
- Department of Physiotherapy; College of Nursing of the Federal University of Alfenas-UNIFAL; Alfenas Brazil
| | - Julia R. Parisi
- Department of Physical Therapy; Federal University of São Carlos-UFSCar; São Carlos Brazil
| | - Caio B. Maglioni
- Department of Physiotherapy; College of Nursing of the Federal University of Alfenas-UNIFAL; Alfenas Brazil
| | - Gabriel B. Machado
- Department of Physiotherapy; College of Nursing of the Federal University of Alfenas-UNIFAL; Alfenas Brazil
| | | | - Josie R. T. Silva
- Department of Physiotherapy; College of Nursing of the Federal University of Alfenas-UNIFAL; Alfenas Brazil
| | - Marcelo L. Silva
- Department of Physiotherapy; College of Nursing of the Federal University of Alfenas-UNIFAL; Alfenas Brazil
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Ferreira R, Silva R, Folha RAC, Polacow MLO, Teodori RM, Pinfildi CE. Achilles Tendon Vascularization of Proximal, Medial, and Distal Portion Before and After Partial Lesion in Rats Treated with Phototherapy. Photomed Laser Surg 2017; 33:579-84. [PMID: 26666977 DOI: 10.1089/pho.2015.3974] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The Achilles tendon is one of the tendons most commonly injured by microtraumas and overuse during sports practice. This tendon is especially fragile because of the low blood supply in its central part. Nevertheless, the literature does not offer enough scientific support to explain the composition and vascular dynamic of animal tendons, despite the relevance of being able to observe if the animal tendon undergoes the same processes of vascularization in different regions, as occurs in humans. METHODS We used 28 rats weighing 280 ± 20 g, which were divided into four groups with seven animals each (control, sham, 830 nm, 660 nm). The laser parameters were: power output 60 mW for both lasers, 40 J/cm(2) of energy density, total energy 1.1 J, power density 2.14 W/cm(2), and application time 18.6 sec. This study evaluated the vascular constitution of healthy and injured calcaneous tendons. The tendons of each animal were processed to be embedded in Paraplast and, after that, they were divided into three parts: proximal, medial, and distal. Afterwards, they were cut in slices of 6 μm were made, then they were stained with hematoxylin and eosin. Using an ocular lens reticulated with magnification × 400, we analyzed the number and the area density of the blood vessels using morphometric methods. Data were analyzed with the Shapiro-Wilk test, followed by Tukey, considering p as <0.05. RESULTS The area density and the number of blood vessels in the proximal part were 36% and 42%, respectively, of the values found in the medial part. The distal part had 64% more vessels and 52.8% more area density (p < 0.05) than the medial part. CONCLUSIONS Low-level laser therapy (LLLT) had no effect on the studied parameters. The vascularization of rat tendon is similar to that of humans, which contributes to the studies of therapies that have been applied in humans.
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Affiliation(s)
- Rafaela Ferreira
- 1 Department of Physiotherapy, University Metodista of Piracicaba-Piracicaba , SP, Brazil
| | - Rosangela Silva
- 1 Department of Physiotherapy, University Metodista of Piracicaba-Piracicaba , SP, Brazil
| | - Roberta A C Folha
- 2 Department of Human Movement Science (DHMS)-University Federal of São Paulo-Campus Baixada Santista-Santos, SP, Brazil. Post-Graduation Interdisciplinary Health Science-Unifesp-Baixada Santista, Santos SP, Brazil
| | - Maria Luiza O Polacow
- 1 Department of Physiotherapy, University Metodista of Piracicaba-Piracicaba , SP, Brazil
| | - Rosana Macher Teodori
- 1 Department of Physiotherapy, University Metodista of Piracicaba-Piracicaba , SP, Brazil
| | - Carlos Eduardo Pinfildi
- 2 Department of Human Movement Science (DHMS)-University Federal of São Paulo-Campus Baixada Santista-Santos, SP, Brazil. Post-Graduation Interdisciplinary Health Science-Unifesp-Baixada Santista, Santos SP, Brazil
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Iacopetti I, Perazzi A, Maniero V, Martinello T, Patruno M, Glazar M, Busetto R. Effect of MLS(®) laser therapy with different dose regimes for the treatment of experimentally induced tendinopathy in sheep: pilot study. Photomed Laser Surg 2017; 33:154-63. [PMID: 25751667 DOI: 10.1089/pho.2014.3775] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE The aim of this preliminary study was to investigate the effect of Multiwave Locked System (MLS(®)), a particular model of low-level laser, in the acute phase of collagenase-induced tendon lesions in six adult sheep randomly assigned to two groups. BACKGROUND DATA Tendon injuries are common among human athletes and in sport horses, require a long recovery time, and have a high risk of relapse. Many traditional treatments are not able to repair the injured tendon tissue correctly. In recent years, the use of low-level laser therapy (LLLT) produced interesting results in inflammatory modulation in different musculoskeletal disorders. METHODS Group 1 received 10 treatments of MLS laser therapy at a fluence of 5 J/cm(2) on the left hindlimb. Group 2 received 10 treatments of MLS laser therapy at a fluence of 2.5 J/cm(2) on the left hindlimb. In every subject in both groups, the right hindlimb was considered as the control leg. RESULTS Clinical follow-up and ultrasonography examinations were performed during the postoperative period, and histological examinations were performed at day 30 after the first application of laser therapy. In particular, results from histological examinations indicate that both treatments induced a statistically significant cell number decrease, although only in the second group did the values return to normal. Moreover, the MLS laser therapy dose of 2.5 J/cm(2) (group 2) caused a significant decrease of vessel area. CONCLUSIONS In this study, clinical and histological evaluation demonstrated that a therapeutic dose <5 J/cm(2) furnished an anti-inflammatory effect, and induced a decrease of fibroblasts and vessel area. Overall, our results suggest that MLS laser therapy was effective in improving collagen fiber organization in the deep digital flexor tendon.
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Affiliation(s)
- Ilaria Iacopetti
- 1 Department of Animal Medicine, Production and Health, University of Padua , Padua, Italy
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Haslerud S, Lopes-Martins RAB, Frigo L, Bjordal JM, Marcos RL, Naterstad IF, Magnussen LH, Joensen J. Low-Level Laser Therapy and Cryotherapy as Mono- and Adjunctive Therapies for Achilles Tendinopathy in Rats. Photomed Laser Surg 2017; 35:32-42. [DOI: 10.1089/pho.2016.4150] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Affiliation(s)
- Sturla Haslerud
- NorPhyPain Research Group, Faculty of Health and Social Sciences, Centre for Evidence Based Practice, Bergen University College, Bergen, Norway
- Physiotherapy Research Group, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | | | - Lúcio Frigo
- Centro de Ciências da Saúde, Universidade Cruzeiro do Sul, São Paulo, Brazil
| | - Jan Magnus Bjordal
- NorPhyPain Research Group, Faculty of Health and Social Sciences, Centre for Evidence Based Practice, Bergen University College, Bergen, Norway
- Physiotherapy Research Group, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Rodrigo Labat Marcos
- Programa de Pós-Graduação em Biofotônica Aplicada as Ciências da Saúde, Universidade Nove de Julho, São Paulo, Brazil
| | - Ingvill Fjell Naterstad
- Physiotherapy Research Group, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Liv Heide Magnussen
- Physiotherapy Research Group, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Occupational Therapy, Physiotherapy and Radiography, Faculty of Health and Social Sciences, Bergen University College, Bergen, Norway
| | - Jon Joensen
- Physiotherapy Research Group, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Occupational Therapy, Physiotherapy and Radiography, Faculty of Health and Social Sciences, Bergen University College, Bergen, Norway
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Analysis of experimental tendinitis in rats treated with laser and platelet-rich plasma therapies by Raman spectroscopy and histometry. Lasers Med Sci 2016; 31:19-26. [PMID: 26498452 DOI: 10.1007/s10103-015-1819-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Accepted: 10/13/2015] [Indexed: 01/25/2023]
Abstract
The objective of this controlled experimental study was to analyze the changes in the Achilles tendons of rats with experimentally induced tendinitis after treatment with platelet-rich plasma (PRP) and/or laser therapies by histometry to quantify fibroblasts and by Raman spectroscopy to determine the biochemical concentration of collagen types I and III. Fifty-four male Wistar rats were divided into six treatment groups: control (G1); PRP only (G2); irradiation with 660 nm laser (G3); irradiation with 830 nm laser (G4); PRP plus 660 nm laser irradiation (G5); and PRP plus 830 nm laser irradiation (G6). Injuries (partial tenotomy) were inflicted in the middle third of the Achilles tendon, with PRP added prior to suture in the appropriate experimental groups. A diode laser (model Laser Flash® III, DMC Equipamentos Ltda, São Carlos, SP, Brazil) that can be operated in two wavelengths 660 and 830 nm was used for irradiation treatments. The irradiation protocol was energy density of 70 J/cm², 20 s irradiation time, and 0.028 cm² spot area, per point in three points in the injured. The histometry was made in micrographical images of the H&E stained sections and evaluated by ImageJ (version 1.46r)®. Raman spectra were collected using a dispersive spectrometer at 830 nm excitation, 200 mW power, and 10 s integration time (P-1 Raman system, Lambda Solutions, Inc. MA, USA). The relative amount of type I collagen was significantly greater in the PRP plus 830 nm laser irradiation group (468 ± 188) than in the control (147 ± 137), 630 nm laser only (191 ± 117), and 830 nm laser only (196 ± 106) groups (p < 0.01), while the quantity of type III collagen was significantly greater in the PRP-only group compared to both irradiated groups without PRP (p < 0.05). Treatment with PRP combined with irradiation at 830 nm resulted in a larger number of fibroblasts and increased concentration of type I collagen, thus accelerating the healing of the injured tendon.
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Rampazo ÉP, Liebano RE, Pinfildi CE, Folha RAC, Ferreira LM. High voltage pulsed current in collagen realignment, synthesis, and angiogenesis after Achilles tendon partial rupture. Braz J Phys Ther 2016; 20:312-9. [PMID: 27556387 PMCID: PMC5015677 DOI: 10.1590/bjpt-rbf.2014.0167] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 02/10/2016] [Indexed: 11/21/2022] Open
Abstract
Objective To verify the efficacy of high voltage pulsed current in collagen realignment and synthesis and in angiogenesis after the partial rupturing of the Achilles tendon in rats. Method Forty male Wistar rats were randomized into four groups of 10 animals each: sham, cathodic stimulation, anodic stimulation, and alternating stimulation. Their Achilles tendons were submitted to direct trauma by a free-falling metal bar. Then, the treatment was administered for six consecutive days after the injury. In the simulation group, the electrodes were positioned on the animal, but the device remained off for 30 minutes. The other groups used a frequency of 120 pps, sensory threshold, and the corresponding polarity. On the seventh day, the tendons were removed and sent for histological slide preparation for birefringence and Picrosirius Red analysis and for blood vessel quantification. Results No significant difference was observed among the groups regarding collagen realignment (types I or III collagen) or quantity of blood vessels. Conclusion High voltage pulsed current for six consecutive days was not effective in collagen realignment, synthesis, or angiogenesis after the partial rupturing of the Achilles tendon in rats.
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Affiliation(s)
- Érika P Rampazo
- Departamento de Cirurgia Plástica, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Richard E Liebano
- Departamento de Fisioterapia, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil
| | | | - Roberta A C Folha
- Departamento de Cirurgia Plástica, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Lydia M Ferreira
- Departamento de Cirurgia Plástica, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
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de Jesus JF, Spadacci-Morena DD, Dos Anjos Rabelo ND, Pinfildi CE, Fukuda TY, Plapler H. Low-Level Laser Therapy (780 nm) on VEGF Modulation at Partially Injured Achilles Tendon. Photomed Laser Surg 2016; 34:331-5. [PMID: 27228125 DOI: 10.1089/pho.2016.4092] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE The aim of this study was to analyze the modulatory effects of near infrared (780 nm) low-level laser therapy (LLLT) on the presence of the vascular endothelial growth factor (VEGF) in the partially injured Achilles tendons of rats. BACKGROUND LLLT stimulates the healing process for Achilles tendon injuries, although the extent of the modulatory effect of LLLT on the VEGF levels found in the injured tendons remains unclear. METHODS Sixty-five male Wistar rats were distributed in the following seven groups: LASER 1, 3, and 7 (10 partially injured Achilles tendons in each group, which were treated with LLLT for 1, 3, and 7 days, respectively); Sham 1, 3, and 7 (same injury, with simulated LLLT); Control group containing the five remaining animals and in which no procedures were performed. LLLT was applied once a day for 10 sec, with a mean power of 70 mW and fluency of 17.5 J/cm(2). After euthanasia, all of the Achilles tendons were surgically removed and the VEGF levels were analyzed using immunohistochemistry. RESULTS The VEGF levels remained close to normal (p > 0.05) when comparing the experimental groups (LASER and Sham: 1, 3, and 7) with the Control group. CONCLUSION LLLT did not stimulate the expression of VEGF in the treated Achilles tendons.
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Affiliation(s)
| | | | | | | | | | - Helio Plapler
- 5 Surgery Department, Universidade Federal de São Paulo-UNIFESP , São Paulo, Brazil
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Da Ré Guerra F, Vieira CP, Oliveira LP, Marques PP, dos Santos Almeida M, Pimentel ER. Low-level laser therapy modulates pro-inflammatory cytokines after partial tenotomy. Lasers Med Sci 2016; 31:759-66. [PMID: 26984348 DOI: 10.1007/s10103-016-1918-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 03/01/2016] [Indexed: 10/25/2022]
Abstract
Tendon injuries give rise to substantial morbidity, and current understanding of the mechanisms involved in tendon injury and repair is limited. This lesion remains a clinical issue because the injury site becomes a region with a high incidence of recurrent rupture and has drawn the attention of researchers. We already demonstrated that low-level laser therapy (LLLT) stimulates the synthesis and organization of collagen I, MMP-9, and MMP-2 and improved the gait recovery of the treated animals. The aim of this study was to evaluate the effects of LLLT in the nitric oxide and cytokines profile during the inflammatory and remodeling phases. Adult male rats were divided into the following groups: G1--intact, G2-- injured, G3--injured + LLLT (4 J/cm(2) continuous), G4--injured + LLLT (4 J/cm(2)-20 Hz--pulsed laser). According to the analysis, the animals were euthanized on different dates (1, 4, 8, or 15 days after injury). ELISA assay of TNF-α, IL-1β, IL-10, and TGF-β was performed. Western blotting of isoform of nitric oxide synthase (i-NOS) and nitric oxide dosage experiments was conducted. Our results showed that the pulsed LLLT seems to exert an anti-inflammatory effect over injured tendons, with reduction of the release of proinflammatory cytokines, such as TNF-α and the decrease in the i-NOS activity. Thanks to the pain reduction and the facilitation of movement, there was a stimulation in the TGF-β and IL-1β release. In conclusion, we believe that pulsed LLLT worked effectively as a therapy to reestablish the tendon integrity after rupture.
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Affiliation(s)
- Flávia Da Ré Guerra
- Department of Anatomy, Institute of Biomedical Science, Federal University of Alfenas - UNIFAL-MG, 37130-000, Alfenas, MG, Brazil.
| | - Cristiano Pedrozo Vieira
- Department of Structural and Functional Biology, Institute of Biology, CP 6109, University of Campinas - UNICAMP, 13083-970, Campinas, SP, Brazil
| | - Letícia Prado Oliveira
- Department of Structural and Functional Biology, Institute of Biology, CP 6109, University of Campinas - UNICAMP, 13083-970, Campinas, SP, Brazil
| | - Petrus Pires Marques
- Department of Biochemistry, Institute of Biomedical Science, Federal University of Alfenas - UNIFAL-MG, 37130-000, Alfenas, MG, Brazil
| | - Marcos dos Santos Almeida
- Department of Anatomy, Institute of Biomedical Science, Federal University of Alfenas - UNIFAL-MG, 37130-000, Alfenas, MG, Brazil
| | - Edson Rosa Pimentel
- Department of Structural and Functional Biology, Institute of Biology, CP 6109, University of Campinas - UNICAMP, 13083-970, Campinas, SP, Brazil
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Souza MVD, Silva MOD. LASERTERAPIA EM AFECÇÕES LOCOMOTORAS: REVISÃO SISTEMÁTICA DE ESTUDOS EXPERIMENTAIS. REV BRAS MED ESPORTE 2016. [DOI: 10.1590/1517-869220162201144326] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Introdução: Ao longo dos anos a fisioterapia tem contribuído para o tratamento das lesões musculotendíneas e osteoarticulares pela utilização de diversos recursos eletrotermofototerapêuticos como, por exemplo, o laser de baixa potência. Objetivo: A finalidade desse estudo foi identificar mediante revisão sistemática, o efeito da laserterapia de baixa potência em afecções do sistema locomotor de ratos, com destaque para a dose de energia e o comprimento de onda utilizado, assim como para a resposta ao tratamento. Métodos: Foram consultadas as bases de dados Medline, Lilacs, PEDro e SciELO, entre janeiro de 2005 a maio de 2013, utilizando os termos "tendinopathy", "laser therapy", "rats", "tendon", "muscle", "bone", "low-level laser therapy", assim como "tendinopatia", "laserterapia", "ratos", "tendão", "músculo", "osso" e "laser de baixa potência". Apenas foram incluídos estudos experimentais publicados nos idiomas português e inglês, que induziram lesão em tendões, músculos, ossos e/ou articulação, tratada com laserterapia, associada ou não a outros tratamentos. Resultados: Foi encontrado um total de 30 estudos experimentais nas bases de dados consultadas, dos quais 15 (50%) foram realizados em tendão, 10 (33,33%) em músculo e cinco (16,66%) em osso e/ou articulação. As doses de energia mais comumente utilizadas foram de 3 J (26,66%) e 1 J (16,66%). Já os comprimentos de onda foram de 904 nm (21,21%) e 830 nm (21,21%). Conclusão: A informação mais expressiva obtida com a terapia foi a diminuição da resposta inflamatória (36,66%) em lesões ortopédicas agudas.
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Photobiomodulation and eccentric exercise for Achilles tendinopathy: a randomized controlled trial. Lasers Med Sci 2015; 31:127-35. [DOI: 10.1007/s10103-015-1840-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 11/18/2015] [Indexed: 10/22/2022]
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Helrigle C, de Carvalho PDC, Casalechi HL, Leal-Junior ECP, Fernandes GHC, Helrigel PA, Rabelo RL, de Oliveira Aleixo-Junior I, Aimbire F, Albertini R. Effects of low-intensity non-coherent light therapy on the inflammatory process in the calcaneal tendon of ovariectomized rats. Lasers Med Sci 2015; 31:33-40. [PMID: 26507001 DOI: 10.1007/s10103-015-1821-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 10/13/2015] [Indexed: 12/21/2022]
Abstract
The aim of this experimental study was to investigate the effects of low-intensity light-emitting diode (LED) phototherapy on the inflammatory process in the calcaneal tendon of ovariectomized rats (OVX) through the involvement of the inflammatory mediators interleukin (IL)-6, IL-10, and tumor necrosis factor-alpha (TNF-α). Thirty-five female Wistar rats were divided into 4 groups: 3 groups of OVX rats totaling 30 rats (untreated OVX rats [OVX injury group], treated OVX rats [OVX LED group], and control OVX rats; subgroups existed based on the sampling times, which were 3, 7, and 14 days) and 1 group of non-OVX rats (not OVX; n = 5). Tendon injury was induced by trauma using a 208-g mass placed at 20 cm from the right tendon of each animal with energy of 0.70 J. The animals were treated 12 h after tendonitis with LED therapy and every 48 h thereafter until euthanasia (at 3, 7, or 14 days). The tendons were dissected and stored in liquid nitrogen at -196 °C, thawed only at the time of immunoenzymatic testing (ELISA). Groups treated with LED showed a decrease in the number of pro-inflammatory cells, IL-6, and TNF-α (p <0.05), and an increase in IL-10 (p < 0.05) when compared to the not OVX group (p < 0.05). It was concluded that low-intensity LED treatment using the parameters and wavelength of 945 nm in the time periods studied reduced the release of IL-6 and TNF-α and increased the release of IL-10, thereby improving the inflammatory response in OVX rats.
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Affiliation(s)
- Carla Helrigle
- Post-graduation Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, São Paulo, SP, Brazil
| | - Paulo deTarso Camilo de Carvalho
- Post-graduation Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, São Paulo, SP, Brazil. .,Post-graduation Program in Rehabilitation Sciences, Universidade Nove de Julho, UNINOVE, Rua Vergueiro, 235, 01504-001, São Paulo, SP, Brazil.
| | - Heliodora Leão Casalechi
- Post-graduation Program in Rehabilitation Sciences, Universidade Nove de Julho, UNINOVE, Rua Vergueiro, 235, 01504-001, São Paulo, SP, Brazil
| | - Ernesto Cesar Pinto Leal-Junior
- Post-graduation Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, São Paulo, SP, Brazil.,Post-graduation Program in Rehabilitation Sciences, Universidade Nove de Julho, UNINOVE, Rua Vergueiro, 235, 01504-001, São Paulo, SP, Brazil
| | | | | | - Rogério Leão Rabelo
- Medical Veterinary Department, Federal University of Goiás-UFG, Jataí, GO, Brazil
| | - Ivo de Oliveira Aleixo-Junior
- Post-graduation Program in Rehabilitation Sciences, Universidade Nove de Julho, UNINOVE, Rua Vergueiro, 235, 01504-001, São Paulo, SP, Brazil
| | - Flavio Aimbire
- Institute of Science and Technology - ICT, Federal University of São Paulo-Unifesp, São José dos Campos, SP, Brazil
| | - Regiane Albertini
- Post-graduation Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, São Paulo, SP, Brazil.,Post-graduation Program in Rehabilitation Sciences, Universidade Nove de Julho, UNINOVE, Rua Vergueiro, 235, 01504-001, São Paulo, SP, Brazil
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Henderson AL, Latimer C, Millis DL. Rehabilitation and Physical Therapy for Selected Orthopedic Conditions in Veterinary Patients. Vet Clin North Am Small Anim Pract 2015; 45:91-121. [DOI: 10.1016/j.cvsm.2014.09.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Second messengers mediating the proliferation and collagen synthesis of tenocytes induced by low-level laser irradiation. Lasers Med Sci 2014; 30:263-72. [PMID: 25231827 DOI: 10.1007/s10103-014-1658-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 09/09/2014] [Indexed: 10/24/2022]
Abstract
For decades, low-level laser therapy (LLLT) has widespread applications in tendon-related injuries. Although the therapeutic effect of LLLT could be explained by photostimulation of target tissue and cells, how tenocytes sense photonic energy and convert them into cascades of cellular and molecular events is still not well understood. This study was designed to elucidate the effects of LLLT on cell proliferation and collagen synthesis by examining the associated second messengers including ATP, Ca(2+), and nitric oxide using rat Achilles tenocytes. Moreover, proliferating cell nuclear antigen (PCNA) and transforming growth factor-β1 (TGF-β1) related to cell proliferation and matrix metabolism were also studied. The results showed that 904 nm GaAs laser of 1 J/cm(2) could significantly increase the MTT activity and collagen synthesis of tenocytes. Second messengers including ATP and intracellular Ca2+ were increased after laser treatment. Quantitative PCR analysis of tenocytes treated with laser revealed up-regulated expression of PCNA, type I collagen, and TGF-β1. Besides, laser-induced TGF-β1 expression was significantly inhibited by extracellular signal-regulated kinase (ERK) specific inhibitor (PD98059). The findings suggested that LLLT stimulated ATP production and increased intracellular calcium concentration. Directly or indirectly via production of TGF-β1, these second messengers mediated the proliferation of tenocytes and synthesis of collagen.
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de Jesus JF, Spadacci-Morena DD, dos Anjos Rabelo ND, Pinfildi CE, Fukuda TY, Plapler H. Low-level laser therapy in IL-1β, COX-2, and PGE2 modulation in partially injured Achilles tendon. Lasers Med Sci 2014; 30:153-8. [PMID: 25070591 DOI: 10.1007/s10103-014-1636-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 07/16/2014] [Indexed: 12/15/2022]
Abstract
This study evaluated IL-1β, COX-2, and PGE2 modulation in partially injured Achilles tendons treated with low-level laser therapy (LLLT). Sixty-five male Wistar rats were used. Sixty were submitted to a direct injury on Achilles tendon and then distributed into six groups: LASER 1 (a single LLLT application), LASER 3 (three LLLT applications), and LASER 7 (seven LLLT applications) and Sham 1, 3, and 7 (the same injury but LLLT applications were simulated). The five remaining animals were allocated at control group (no procedure performed). LLLT (780 nm) was applied with 70 mW of mean power and 17.5 J/cm(2) of fluency for 10 s, once a day. The tendons were surgically removed and assessed immunohistochemically for IL-1β, COX-2, and PGE2. In comparisons with control (IL-1β: 100.5 ± 92.5 / COX-2: 180.1 ± 97.1 / PGE2: 187.8 ± 128.8) IL-1β exhibited (mean ± SD) near-normal level (p > 0.05) at LASER 3 (142.0 ± 162.4). COX-2 and PGE2 exhibited near-normal levels (p > 0.05) at LASER 3 (COX-2: 176.9 ± 75.4 / PGE2: 297.2 ± 259.6) and LASER 7 (COX-2: 259.2 ± 190.4 / PGE2: 587.1 ± 409.7). LLLT decreased Achilles tendon's inflammatory process.
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Affiliation(s)
- Julio Fernandes de Jesus
- Interdisciplinary Surgical Science Program, Universidade Federal de São Paulo-UNIFESP, São Paulo, SP, 04021-001, Brazil,
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de Jesus JF, Spadacci-Morena DD, Rabelo NDDA, Pinfildi CE, Fukuda TY, Plapler H. Low-Level Laser Therapy on Tissue Repair of Partially Injured Achilles Tendon in Rats. Photomed Laser Surg 2014; 32:345-50. [DOI: 10.1089/pho.2013.3694] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
- Julio Fernandes de Jesus
- Interdisciplinary Surgical Science Program, Universidade Federal de São Paulo-UNIFESP, São Paulo, Brazil
| | | | | | | | - Thiago Yukio Fukuda
- Physical Therapy Sector, Irmandade da Santa Casa de Misericórdia de São Paulo-ISCMSP, São Paulo, Brazil
| | - Helio Plapler
- Department of Surgery, Universidade Federal de São Paulo-UNIFESP, São Paulo, Brazil
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Tsai WC, Cheng JW, Chen JL, Chen CY, Chang HN, Liao YH, Lin MS, Pang JHS. Low-level laser irradiation stimulates tenocyte proliferation in association with increased NO synthesis and upregulation of PCNA and cyclins. Lasers Med Sci 2014; 29:1377-84. [PMID: 24510281 DOI: 10.1007/s10103-014-1528-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 01/13/2014] [Indexed: 01/15/2023]
Abstract
Low-level laser therapy is commonly used to treat tendinopathy or tendon injury. Tendon healing requires tenocyte migration to the repair site, followed by proliferation and synthesis of the extracellular matrix. There are few evidence to elucidate that low-level laser promote tenocyte proliferation. This study was designed to determine the effect of laser on tenocyte proliferation. Furthermore, the association of this effect with secretion of nitric oxide (NO) and the expressions of proliferating cell nuclear antigen (PCNA) and cyclins D1, E, A, and B1 was investigated. Tenocytes intrinsic to rat Achilles tendon were treated with low-level laser (660 nm). Tenocyte proliferation was evaluated by MTT assay and immunocytochemistry with Ki-67 stain. NO in the conditioned medium was measured by ELISA. Western blot analysis was used to evaluate the protein expressions of PCNA and cyclins D1, E, A, and B1. The results revealed that tenocytes proliferation was enhanced dose dependently by laser. NO secretion was increased after laser treatment. PCNA and cyclins E, A, and B1 were upregulated by laser. In conclusion, low-level laser irradiation stimulates tenocyte proliferation in a process that is mediated by upregulation of NO, PCNA, and cyclins E, A, and B1.
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Affiliation(s)
- Wen-Chung Tsai
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Gueishan Township, Taoyuan County, Taiwan
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Vieira CP, Guerra FDR, Oliveira LPD, Almeida MDSD, Pimentel ER. Alterations in the Achilles tendon after inflammation in surrounding tissue. ACTA ORTOPEDICA BRASILEIRA 2014; 20:266-9. [PMID: 24453615 PMCID: PMC3718442 DOI: 10.1590/s1413-78522012000500004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2009] [Accepted: 06/01/2010] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To analyze the characteristics of the Achilles tendon of rats after induction of localized inflammation in the rat paw. METHODS IN OUR STUDY THREE GROUPS WERE USED: inflamed group with carrageenan in rat paw (G1); saline group (G2) and control group (G3). After 4 hours the animals were euthanized and the Achilles tendon removed. RESULTS No significant differences were observed in the analysis of non-collagenous proteins, glycosaminoglycans and hydroxyproline in the groups but a tendency of reduction was verified in G1. As regards the organization of collagen molecules, no differences were observed between groups. With respect to MMPs activity, a stronger presence of the active isoform of MMP-2 in G1 was observed, suggesting that the remodeling was occurring. CONCLUSION Thus, we conclude that the inflammatory process in rat paw may affect the remodeling of tendons located near the inflamed site. Level of Evidence I, Prognostic Studies - Investigating the Effect of a Patient Characteristic on the Outcome of Disease.
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Guerra FDR, Vieira CP, dos Santos de Almeida M, Oliveira LP, Claro ACF, Simões GF, de Oliveira ALR, Pimentel ER. Pulsed LLLT improves tendon healing in rats: a biochemical, organizational, and functional evaluation. Lasers Med Sci 2013; 29:805-11. [DOI: 10.1007/s10103-013-1406-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Accepted: 07/18/2013] [Indexed: 01/21/2023]
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Low-level laser therapy combined with platelet-rich plasma on the healing calcaneal tendon: a histological study in a rat model. Lasers Med Sci 2013; 28:1489-94. [PMID: 23307438 DOI: 10.1007/s10103-012-1241-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Accepted: 11/18/2012] [Indexed: 10/27/2022]
Abstract
The objective of this study was to investigate the effects of low-level laser therapy (LLLT) treatment alone (λ = 660 nm and λ = 830 nm) or associated with platelet-rich plasma (PRP). We used 54 male rats divided into six groups, with nine animals each: group 1, partial tenotomy; group 2 (GII), PRP; group 3 (GIII): λ660 nm; group 4 (GIV), λ830 nm; group 5 (GV), PRP + λ660 nm; and group 6 (GVI), PRP + λ830 nm. The protocol used was power density 0.35 W/cm(2), energy 0.2 J, energy density 7.0 J/cm(2), time 20 s per irradiated point, and number of points 3. Animals in groups GII, GV, and GVI received treatment with PRP, consisting of a single dose of 0.2 mL directly into the surgical site, on top of the tenotomy. Animals were killed on the 13th day post-tenotomy and their tendons were surgically removed for a quantitative analysis using polarization microscopy. The percentages of collagen fibers of types I and III were expressed as mean ± SD. Higher values of collagen fibers type I were obtained for groups GV and GVI when compared with all other groups (p < 0.05), whereas groups GIII and GIV showed no significant difference between them (p > 0.05). For collagen type III, a significant difference was observed between GII and all other groups (p < 0.5), but no significant difference was found between GIII and GIV and between GV and GVI. Results showed that the deposition of collagen type I was higher when treatment with PRP and LLLT was combined, suggesting a faster regeneration of the tendon.
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Tumilty S, McDonough S, Hurley DA, Baxter GD. Clinical effectiveness of low-level laser therapy as an adjunct to eccentric exercise for the treatment of Achilles' tendinopathy: a randomized controlled trial. Arch Phys Med Rehabil 2012; 93:733-9. [PMID: 22541305 DOI: 10.1016/j.apmr.2011.08.049] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2011] [Revised: 08/23/2011] [Accepted: 08/23/2011] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To investigate the effectiveness of low-level laser therapy (LLLT) as an adjunct to a program of eccentric exercises for the treatment of Achilles' tendinopathy. DESIGN Randomized controlled trial with evaluations at baseline and 4, 12, and 52 weeks. SETTING Primary care clinic. PARTICIPANTS Participants with midportion Achilles' tendinopathy were randomly assigned to 2 groups (LLLT n=20: mean age ± SD, 45.6±9.1y; placebo n=20: mean age ± SD, 46.5±6.4y). The 12-week evaluation was completed by 36 participants (90%), and 33 participants (82.5%) completed the 52-week evaluation. INTERVENTION Both groups of participants performed eccentric exercises over a 3-month period. In addition, they received either an active or placebo application of LLLT 3 times per week for the first 4 weeks; the dose was 3J per point. MAIN OUTCOME MEASURES The primary outcome was the Victorian Institute of Sport Assessment-Achilles' questionnaire (VISA-A) score at 12 weeks; secondary outcome was a visual analog scale for pain. Outcomes were measured at baseline and 4, 12, and 52 weeks. RESULTS Baseline characteristics exhibited no differences between groups. At the primary outcome point, there was no statistically significant difference in VISA-A scores between groups (P>.05). The difference in VISA-A scores at the 4-week point significantly favored the placebo group (F(1)=6.411, sum of squares 783.839; P=.016); all other outcome scores showed no significant difference between the groups at any time point. Observers were blinded to groupings. CONCLUSIONS The clinical effectiveness of adding LLLT to eccentric exercises for the treatment of Achilles' tendinopathy has not been demonstrated using the parameters in this study.
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Affiliation(s)
- Steve Tumilty
- Centre for Physiotherapy Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand.
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Tsai WC, Hsu CC, Pang JHS, Lin MS, Chen YH, Liang FC. Low-level laser irradiation stimulates tenocyte migration with up-regulation of dynamin II expression. PLoS One 2012; 7:e38235. [PMID: 22666495 PMCID: PMC3364209 DOI: 10.1371/journal.pone.0038235] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Accepted: 05/01/2012] [Indexed: 12/12/2022] Open
Abstract
Low-level laser therapy (LLLT) is commonly used to treat sports-related tendinopathy or tendon injury. Tendon healing requires tenocyte migration to the repair site, followed by proliferation and synthesis of the extracellular matrix. This study was designed to determine the effect of laser on tenocyte migration. Furthermore, the correlation between this effect and expression of dynamin 2, a positive regulator of cell motility, was also investigated. Tenocytes intrinsic to rat Achilles tendon were treated with low-level laser (660 nm with energy density at 1.0, 1.5, and 2.0 J/cm2). Tenocyte migration was evaluated by an in vitro wound healing model and by transwell filter migration assay. The messenger RNA (mRNA) and protein expressions of dynamin 2 were determined by reverse transcription/real-time polymerase chain reaction (real-time PCR) and Western blot analysis respectively. Immunofluorescence staining was used to evaluate the dynamin 2 expression in tenocytes. Tenocytes with or without laser irradiation was treated with dynasore, a dynamin competitor and then underwent transwell filter migration assay. In vitro wound model revealed that more tenocytes with laser irradiation migrated across the wound border to the cell-free zone. Transwell filter migration assay confirmed that tenocyte migration was enhanced dose-dependently by laser. Real-time PCR and Western-blot analysis demonstrated that mRNA and protein expressions of dynamin 2 were up-regulated by laser irradiation dose-dependently. Confocal microscopy showed that laser enhanced the expression of dynamin 2 in cytoplasm of tenocytes. The stimulation effect of laser on tenocytes migration was suppressed by dynasore. In conclusion, low-level laser irradiation stimulates tenocyte migration in a process that is mediated by up-regulation of dynamin 2, which can be suppressed by dynasore.
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Affiliation(s)
- Wen-Chung Tsai
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan County, Taiwan
- College of Medicine, Chang Gung University, Taoyuan County, Taiwan
| | - Chih-Chin Hsu
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan County, Taiwan
- College of Medicine, Chang Gung University, Taoyuan County, Taiwan
| | - Jong-Hwei S. Pang
- Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan County, Taiwan
- * E-mail:
| | - Miao-Sui Lin
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan County, Taiwan
- College of Medicine, Chang Gung University, Taoyuan County, Taiwan
| | - Ying-Hsun Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan County, Taiwan
| | - Fang-Chen Liang
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan County, Taiwan
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Fukuda TY, Tanji MM, de Jesus JF, da Silva SR, Sato MN, Plapler H. Infrared low-level diode laser on serum chemokine MCP-1 modulation in mice. Lasers Med Sci 2012; 28:451-6. [PMID: 22415574 DOI: 10.1007/s10103-012-1072-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Accepted: 02/15/2012] [Indexed: 10/28/2022]
Abstract
The effect of the low-level laser therapy (LLLT) in the modulation of cells related to inflammatory processes has been widely studied, with different parameters. The objective was to investigate the immediate and cumulative effect of infrared LLLT on chemokine monocyte chemotactic protein-1 (MCP-1) modulation in mice. Fifty-two isogenic mice were distributed in seven groups: control (n = 10, no surgical procedure), laser I (n = 7, surgical procedure and a single LLLT exposure 12 h after the surgery), laser II (n = 7, surgery followed by two LLLT exposures, 12 and 36 h after surgery), and laser III (n = 7, surgery followed by three LLLT exposures, 12, 36, and 60 h after surgery). For each group, a sham group (n = 21) underwent surgery without laser application. The animals in the laser groups received an infrared diode continuous laser exposure (AsGaAl, 780 nm wavelength, power of 20 mW, energy density of 10 J/cm(2), spot size of 0,04 cm(2)) on three points (20 s per point), and a final energy of 0.4 J. The animals were sacrificed 36 h (laser I and sham I groups), 60 h (laser II and sham II), and 84 h (laser III and sham III groups) after surgery. The MCP-1 concentrations were measured by cytometric bead array. There was no significant difference between the three periods in the sham group (p = 0.3). There was a lower concentration of MCP-1 in the laser III group compared to the laser I group (p = 0.05). The infrared LLLT showed a cumulative effect in the modulation of chemokine MCP-1 concentration. Three LLLT exposures were necessary to achieve the MCP-1 modulation.
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Affiliation(s)
- Thiago Y Fukuda
- Experimental Surgery, Federal University of São Paulo (UNIFESP), Rua Botucatu, 740-Vila Clementino, São Paulo, São Paulo, Brazil.
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Ng GYF, Chung PYM. Effects of a therapeutic laser and passive stretching program for treating tendon overuse. Photomed Laser Surg 2012; 30:155-9. [PMID: 22235970 DOI: 10.1089/pho.2011.3095] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE This study investigated the effects of a therapeutic laser, passive stretching, and their combined treatment on the strength of Achilles tendons with overuse pathologies. BACKGROUND DATA Tendinopathy involving overuse is usually treated with exercise and stretching, but there has been no report on the treatment effect of a therapeutic laser combined with passive stretching on managing this condition. Despite the beneficial effect of a therapeutic laser on healing tendons that have had traumatic injury, its effect on degenerative tendons is not known. METHODS Twenty-five mature Sprague-Dawley (SD) rats were used, with 20 subjected to daily bipedal downhill running for 8 weeks, to induce Achilles overuse, and 5 as normal controls. The exercised rats were divided into four groups: 1, laser treatment; 2, passive stretching; 3, combined laser and stretching; and 4, no treatment, running controls. GaAlAs laser with 660 nm wavelength was applied to both Achilles tendons for 50 sec for Groups 1 and 3. Passive stretching of 20 times/10 sec of maximum ankle plantar flexion was applied to Groups 2 and 3. Treatments were applied after each running session for a a total of 56 treatment sessions. On week 9, the tendons were tested for load-relaxation, stiffness, and ultimate strength. RESULTS Stiffness was different (p=0.01), difference in ultimate strength was marginally insignificant (p=0.07), and load-relaxation difference was not significant among groups. Post-hoc analyses revealed that the mean stiffness of all the four exercise groups was lower than the normal control, whereas the ultimate strength from the laser and combined laser and stretching was not different from that of the normal control group, but was higher than that of the passive stretching and no treatment groups. CONCLUSIONS We conclude that a therapeutic laser and combined laser with passive stretching might slow down the decrease in Achilles tendon strength but would not be able to stop the pathological changes of overuse from developing.
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Affiliation(s)
- Gabriel Y F Ng
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong (SAR), China.
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Neves MAI, Pinfildi CE, Wood VT, Gobbato RC, da Silva FM, Parizotto NA, Hochman B, Ferreira LM. Different power settings of LLLT on the repair of the calcaneal tendon. Photomed Laser Surg 2011; 29:663-8. [PMID: 21668375 DOI: 10.1089/pho.2010.2919] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The purpose of this study was to evaluate the effect of an 830-nm GaAlAs diode laser operating at output powers of 40, 60, 80, and 100 mW and energy density of 30 J/cm(2) on the repair of partial calcaneal tendon ruptures in rats. METHODS A partial tendon rupture was induced in all animals, which were treated with laser irradiation for 5 consecutive days. Six days after injury, the injured tendons were removed and examined by polarized light microscopy. Collagen fiber organization was evaluated by birefringence measurements, and collagen content was determined by Picrosirius Red staining. RESULTS It was observed that the higher the output power (60-100 mW) the greater the amount of type III collagen (p<0.01). The amount of type I collagen was significantly greater (p=0.05) in the 80 mW group than in the control group (sham stimulation). A non-statistically significant improvement in the realignment of collagen fibers was observed in the irradiated groups. CONCLUSIONS Low-level laser therapy resulted in significantly greater amounts of type III collagen (output powers of 60 mW or more) and type I collagen (output power of 80 mW), however, no significant differences between groups were found in the realignment of collagen fibers.
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Affiliation(s)
- Marco Aurelio Invaldi Neves
- Department of Plastic Surgery, Universidade Federal de São Paulo, Rua Napoleão de Barros 715, São Paulo, Brazil.
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Joensen J, Gjerdet NR, Hummelsund S, Iversen V, Lopes-Martins RAB, Bjordal JM. An experimental study of low-level laser therapy in rat Achilles tendon injury. Lasers Med Sci 2011; 27:103-11. [PMID: 21547473 PMCID: PMC3254871 DOI: 10.1007/s10103-011-0925-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2010] [Accepted: 04/06/2011] [Indexed: 12/27/2022]
Abstract
The aim of this controlled animal study was to investigate the effect of low-level laser therapy (LLLT) administered 30 min after injury to the Achilles tendon. The study animals comprised 16 Sprague Dawley male rats divided in two groups. The right Achilles tendons were injured by blunt trauma using a mini guillotine, and were treated with LLLT or placebo LLLT 30 min later. The injury and LLLT procedures were then repeated 15 hours later on the same tendon. One group received active LLLT (λ = 904 nm, 60 mW mean output power, 0.158 W/cm2 for 50 s, energy 3 J) and the other group received placebo LLLT 23 hours after LLLT. Ultrasonographic images were taken to measure the thickness of the right and left Achilles tendons. Animals were then killed, and all Achilles tendons were tested for ultimate tensile strength (UTS). All analyses were performed by blinded observers. There was a significant increase in tendon thickness in the active LLLT group when compared with the placebo group (p < 0.05) and there were no significant differences between the placebo and uninjured left tendons. There were no significant differences in UTS between laser-treated, placebo-treated and uninjured tendons. Laser irradiation of the Achilles tendon at 0.158 W/cm2 for 50 s (3 J) administered within the first 30 min after blunt trauma, and repeated after 15 h, appears to lead to edema of the tendon measured 23 hours after LLLT. The guillotine blunt trauma model seems suitable for inflicting tendon injury and measuring the effects of treatment on edema by ultrasonography and UTS. More studies are needed to further refine this model.
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Affiliation(s)
- Jon Joensen
- Department of Physiotherapy, Faculty of Health and Social Science, Bergen University College, Bergen, Norway.
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Abstract
Foot and ankle injuries in athletes are common. Physical therapy plays a fundamental role in the management of sports injuries. The purpose of this article is to (1) raise awareness for using physical therapy for treatment of foot and ankle injuries in athletes, (2) discuss considerations specific to athletes during the rehabilitation process, and (3) increase the reader's knowledge about the in-depth role of physical therapy in the management of foot and ankle injuries in athletes.
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Affiliation(s)
- Suzanne T Hawson
- Physical Therapy Department, University Foot and Ankle Institute, 26357 McBean Parkway, Valencia, CA 91355, USA.
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43
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Wood VT, Pinfildi CE, Neves MAI, Parizoto NA, Hochman B, Ferreira LM. Collagen changes and realignment induced by low-level laser therapy and low-intensity ultrasound in the calcaneal tendon. Lasers Surg Med 2010; 42:559-65. [PMID: 20662033 DOI: 10.1002/lsm.20932] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND OBJECTIVE The treatment of calcaneal tendon injuries requires long-term rehabilitation. Ultrasound (US) and low-level laser therapy (LLLT) are the most used and studied physical agents in the treatment of tendon injuries; however, only a few studies examined the effects of the combination of US and LLLT. Therefore, the purpose of this study was to investigate which treatment (the exclusive or combined use of US and LLLT) most effectively contribute to tendon healing. STUDY DESIGN/MATERIALS AND METHODS This was a controlled laboratory study with 50 rats whose Achilles tendon was injured by direct trauma. The rats were randomly divided into five groups and treated for 5 consecutive days, as follows: group 1 (control) received no treatment; group 2 was treated with US alone; group 3 was treated with LLLT alone; group 4 was treated first with US followed by LLLT; and group 5 was treated first with LLLT followed by US. On the sixth post-injury day, the tendons were removed and examined by polarized light microscopy. The organization of collagen fibers was assessed by birefringence measurements. Picrosirius-stained sections were examined for the presence of types I and III collagen. RESULTS There was a significantly higher organization of collagen fibers in group 2 (US) than in the control group (P = 0.03). The amount of type I collagen found in groups 2 (US), 3 (LLLT), and 5 (LLLT + US) was significantly higher than that in the control group (P <or= 0.01), but no significant differences were found between treatment groups. There were no differences in the amount of type III collagen between groups. CONCLUSION Ultrasound, LLLT, and the combined use of LLLT and US resulted in greater synthesis of type I collagen; US was also effective in increasing collagen organization in the early stages of the healing process.
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Affiliation(s)
- Viviane T Wood
- Division of Plastic Surgery, Universidade Federal de São Paulo (UNIFESP), CEP 04023-002 Sao Paulo, SP, Brazil.
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Yilmaz HG, Kusakci-Seker B, Bayindir H, Tözüm TF. Low-level laser therapy in the treatment of mucous membrane pemphigoid: a promising procedure. J Periodontol 2010; 81:1226-30. [PMID: 20450370 DOI: 10.1902/jop.2010.100095] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Mucous membrane pemphigoid is a heterogeneous group of autoimmune, subepithelial, blistering diseases. A combination of topical and systemic steroid treatment is often used when managing patients with mucous membrane pemphigoid. The use of systemic steroids presents an increased risk of adverse side effects. Consequently, effective alternative modalities of therapy should be considered, such as the application of low-level laser therapy (LLLT). METHODS A patient presented with mucous membrane pemphigoid and was successfully treated with the application of local corticosteroids and LLLT using an 810-nm diode laser. The lesions were treated by LLLT over a period of 7 days using a continuous waveform for 40 seconds and an energy density of 5 J/cm(2). RESULTS After treatment, a significant improvement in tissue color and consistency was observed. The patient was followed every month for a period of 12 months, and the lesions healed uneventfully. CONCLUSION The results reported in this case show that the healing of mucous membrane pemphigoid was achieved when LLLT was used as an adjunct to the application of a local corticosteroid.
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Affiliation(s)
- Hasan Guney Yilmaz
- Department of Periodontology, Faculty of Dentistry, Near East University, Mersin, Turkey.
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Low-level laser therapy (LLLT; 780 nm) acts differently on mRNA expression of anti- and pro-inflammatory mediators in an experimental model of collagenase-induced tendinitis in rat. Lasers Med Sci 2010; 26:85-94. [PMID: 20737183 DOI: 10.1007/s10103-010-0811-z] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2009] [Accepted: 06/24/2010] [Indexed: 12/15/2022]
Abstract
Low-level laser therapy (LLLT) has been found to produce anti-inflammatory effects in a variety of disorders. Tendinopathies are directly related to unbalance in expression of pro- and anti-inflammatory cytokines which are responsible by degeneration process of tendinocytes. In the current study, we decided to investigate if LLLT could reduce mRNA expression for TNF-α, IL-1β, IL-6, TGF-β cytokines, and COX-2 enzyme. Forty-two male Wistar rats were divided randomly in seven groups, and tendinitis was induced with a collagenase intratendinea injection. The mRNA expression was evaluated by real-time PCR in 7th and 14th days after tendinitis. LLLT irradiation with wavelength of 780 nm required for 75 s with a dose of 7.7 J/cm(2) was administered in distinct moments: 12 h and 7 days post tendinitis. At the 12 h after tendinitis, the animals were irradiated once in intercalate days until the 7th or 14th day in and them the animals were killed, respectively. In other series, 7 days after tendinitis, the animals were irradiated once in intercalated days until the 14th day and then the animals were killed. LLLT in both acute and chronic phases decreased IL-6, COX-2, and TGF-β expression after tendinitis, respectively, when compared to tendinitis groups: IL-6, COX-2, and TGF-β. The LLLT not altered IL-1β expression in any time, but reduced the TNF-α expression; however, only at chronic phase. We conclude that LLLT administered with this protocol reduces one of features of tendinopathies that is mRNA expression for pro-inflammatory mediators.
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Baroni BM, Leal Junior ECP, De Marchi T, Lopes AL, Salvador M, Vaz MA. Low level laser therapy before eccentric exercise reduces muscle damage markers in humans. Eur J Appl Physiol 2010; 110:789-96. [DOI: 10.1007/s00421-010-1562-z] [Citation(s) in RCA: 117] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2010] [Indexed: 01/09/2023]
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