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Vendrusculo-Fangel LM, Fangel R, Vieira de Sousa Neto I, Nobrega OT, Dos Reis FJJ, Durigan JLQ, de Cassia Marqueti R. Structural equation modelling provides insights to understand the construct of chronic pain in women with rheumatoid arthritis. Mod Rheumatol 2021; 32:554-564. [PMID: 34897496 DOI: 10.1093/mr/roab027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 05/06/2021] [Accepted: 06/15/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVES We aimed to adopt a multidimensional approach and investigate the interconnections between biomarkers (cytokines, matrix metalloproteinases, and cortisol) and psychosocial aspects considering pain acceptance, the individual construct of pain perception in terms of blood inflammation biomarkers, anxiety, self-efficacy, and functional performance and to define the quality of life (QoL) in women with rheumatoid arthritis (RA). METHODS An observational cross-sectional study with a total of 42-RA participants, with chronic pain and 42-women without rheumatic diseases or chronic pain were included. A structural equation model was used to investigate the association between independent variables. RESULTS Women with RA presented high blood biomarker levels, representing an intense inflammatory process. The participants with RA reported moderate pain most of the time, a worsening QoL, functionality, engagement in activities, and a willingness to live with pain and self-efficacy. It was found that the higher the chronic pain, the greater the intensity of pain perceived by these women with RA, as well as, the worse the functionality, the higher the perceived pain. CONCLUSIONS The exacerbation of pain perception leads to worsening of the experience of chronic pain. The new construct of pain experience should include functionality as a crucial factor in understanding the mechanisms underlying pain.
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Affiliation(s)
- Leticia Meda Vendrusculo-Fangel
- Graduate Program of Sciences and Technology of Health and Rehabilitation Sciences, Faculty of Ceilândia, University of Brasilia, Distrito Federal, Brazil.,Occupational therapy professor, University of Brasilia, Distrito Federal, Brazil
| | - Renan Fangel
- Graduate Program of Sciences and Technology of Health and Rehabilitation Sciences, Faculty of Ceilândia, University of Brasilia, Distrito Federal, Brazil.,Physical Therapy Department, Instituto Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ivo Vieira de Sousa Neto
- Graduate Program of Sciences and Technology of Health and Rehabilitation Sciences, Faculty of Ceilândia, University of Brasilia, Distrito Federal, Brazil
| | - Otavio Toledo Nobrega
- Division of Geriatric Medicine, Faculty of Medicine, McGill University Health Center (MUHC), Glen site, 1001 Boul. Décarie, Montreal, QC, Canada
| | - Felipe José Jandre Dos Reis
- Physical Therapy Departament, Euro-American University Center Distrito Federa, Brazil.,Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - João Luiz Quaglioti Durigan
- Graduate Program of Sciences and Technology of Health and Rehabilitation Sciences, Faculty of Ceilândia, University of Brasilia, Distrito Federal, Brazil.,Graduate Program of Rehabilitation Sciences, Faculty of Ceilândia, University of Brasilia, Distrito Federal, Brazil
| | - Rita de Cassia Marqueti
- Graduate Program of Sciences and Technology of Health and Rehabilitation Sciences, Faculty of Ceilândia, University of Brasilia, Distrito Federal, Brazil.,Graduate Program of Rehabilitation Sciences, Faculty of Ceilândia, University of Brasilia, Distrito Federal, Brazil
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Vendrusculo-Fangel LM, Fangel R, Leles TDS, Moura LDM, Marqueti RDC. Modificações dos papéis ocupacionais de mulheres com dor crônica e Artrite Reumatoide, comparada a mulheres saudáveis. Cad Bras Ter Ocup 2019. [DOI: 10.4322/2526-8910.ctoao1798] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Fangel R, Vendrusculo-Fangel LM, Albuquerque CPD, Parizotto NA, Paz CCDSC, Matheus JPC. Low level laser therapy for reducing pain in rheumatoid arthritis and osteoarthritis: a systematic review. Fisioter mov 2019. [DOI: 10.1590/1980-5918.032.ao29] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: Treatments for rheumatoid arthritis (RA) and osteoarthritis (OA) can reduce, modulate inflammation, and reduce deformities. Low-Level Laser Therapy is a biomodulator and may aid in the clinical picture of these conditions. Objective: To analyze the parameters most frequently used to determine the responses of patients with RA and OA in controlled and uncontrolled clinical trials. Method: This is a systematic review with search of articles in English, Portuguese and Spanish in PUBMED, SCOPUS, LILACS and Web of SCIENCE, of articles published between 2006 and 2018. MeSH terms were used. Inclusion criteria: evaluation of LLLT in the evaluations, evaluation and evaluation of the period, controlled and uncontrolled clinical trials, full publications. The base date of the energy dosimetry and the analysis of mean, median and mode of energy per point and energy per treatment. Results: Three articles on RA and 16 on OA were included in this study. Regarding dosimetry, it was one of the most recent of the pain, being this one with a greater energy dose. In OA, most of the articles presented are of importance, with variability in the dosage applied. Conclusion: There are several reports for patient studies purposes, mainly with doses of 6 J per point and 48 J. In the joints affected with OA and AR, it would be important to publish more scientific articles with better methodological quality and description of dosimetry.
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Affiliation(s)
- Renan Fangel
- Centro Universitário EuroAmericano, Brazil; Universidade de Brasília, Brazil
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Cury V, Moretti AIS, Assis L, Bossini P, Crusca JDS, Neto CB, Fangel R, de Souza HP, Hamblin MR, Parizotto NA. Low level laser therapy increases angiogenesis in a model of ischemic skin flap in rats mediated by VEGF, HIF-1α and MMP-2. J Photochem Photobiol B 2013; 125:164-70. [PMID: 23831843 DOI: 10.1016/j.jphotobiol.2013.06.004] [Citation(s) in RCA: 352] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Revised: 05/10/2013] [Accepted: 06/10/2013] [Indexed: 11/24/2022]
Abstract
It is known that low level laser therapy is able to improve skin flap viability by increasing angiogenesis. However, the mechanism for new blood vessel formation is not completely understood. Here, we investigated the effects of 660 nm and 780 nm lasers at fluences of 30 and 40 J/cm(2) on three important mediators activated during angiogenesis. Sixty male Wistar rats were used and randomly divided into five groups with twelve animals each. Groups were distributed as follows: skin flap surgery non-irradiated group as a control; skin flap surgery irradiated with 660 nm laser at a fluence of 30 or 40 J/cm(2) and skin flap surgery irradiated with 780 nm laser at a fluence of 30 or 40 J/cm(2). The random skin flap was performed measuring 10×4 cm, with a plastic sheet interposed between the flap and the donor site. Laser irradiation was performed on 24 points covering the flap and surrounding skin immediately after the surgery and for 7 consecutive days thereafter. Tissues were collected, and the number of vessels, angiogenesis markers (vascular endothelial growth factor, VEGF and hypoxia inducible factor, HIF-1α) and a tissue remodeling marker (matrix metalloproteinase, MMP-2) were analyzed. LLLT increased an angiogenesis, HIF-1α and VEGF expression and decrease MMP-2 activity. These phenomena were dependent on the fluences, and wavelengths used. In this study we showed that LLLT may improve the healing of skin flaps by enhancing the amount of new vessels formed in the tissue. Both 660 nm and 780 nm lasers were able to modulate VEGF secretion, MMP-2 activity and HIF-1α expression in a dose dependent manner.
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Affiliation(s)
- Vivian Cury
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
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Bossini PS, Rennó ACM, Ribeiro DA, Fangel R, Ribeiro AC, Lahoz MDA, Parizotto NA. Low level laser therapy (830nm) improves bone repair in osteoporotic rats: Similar outcomes at two different dosages. Exp Gerontol 2012; 47:136-42. [DOI: 10.1016/j.exger.2011.11.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2010] [Revised: 10/06/2011] [Accepted: 11/10/2011] [Indexed: 10/15/2022]
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Fangel R, Bossini PS, Renno AC, Ribeiro DA, Wang CC, Toma RL, Nonaka KO, Driusso P, Parizotto NA, Oishi J. Low-level laser therapy, at 60 J/cm2 associated with a Biosilicate(®) increase in bone deposition and indentation biomechanical properties of callus in osteopenic rats. J Biomed Opt 2011; 16:078001. [PMID: 21806293 DOI: 10.1117/1.3598847] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
We investigate the effects of a novel bioactive material (Biosilicate(®)) and low-level laser therapy (LLLT), at 60 J/cm(2), on bone-fracture consolidation in osteoporotic rats. Forty female Wistar rats are submitted to the ovariectomy, to induce osteopenia. Eight weeks after the ovariectomy, the animals are randomly divided into four groups, with 10 animals each: bone defect control group; bone defect filled with Biosilicate group; bone defect irradiated with laser at 60 J/cm(2) group; bone defect filled with Biosilicate and irradiated with LLLT, at 60 J/cm(2) group. Laser irradiation is initiated immediately after surgery and performed every 48 h for 14 days. Histopathological analysis points out that bone defects are predominantly filled with the biomaterial in specimens treated with Biosilicate. In the 60-J/cm(2) laser plus Biosilicate group, the biomaterial fills all bone defects, which also contained woven bone and granulation tissue. Also, the biomechanical properties are increased in the animals treated with Biosilicate associated to lasertherapy. Our results indicate that laser therapy improves bone repair process in contact with Biosilicate as a result of increasing bone formation as well as indentation biomechanical properties.
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Affiliation(s)
- Renan Fangel
- Federal University of São Carlos, Department of Physiotherapy, Rod. Washington Luiz, km 235, São Carlos, Sao Paulo 13600-970 Brazil.
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Bossini PS, Muniz Rennó AC, Ribeiro DA, Fangel R, Peitl O, Zanotto ED, Parizotto NA. Biosilicate® and low-level laser therapy improve bone repair in osteoporotic rats. J Tissue Eng Regen Med 2010; 5:229-37. [DOI: 10.1002/term.309] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2010] [Accepted: 04/14/2010] [Indexed: 11/07/2022]
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Cury V, Bossini PS, Fangel R, de Sousa Crusca J, Renno AC, Parizotto NA. The Effects of 660 nm and 780 nm Laser Irradiation on Viability of Random Skin Flap in Rats. Photomed Laser Surg 2009; 27:721-4. [DOI: 10.1089/pho.2008.2383] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Vivian Cury
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Paulo Sérgio Bossini
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Renan Fangel
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, SP, Brazil
| | | | - Ana Claudia Renno
- Department of Bioscience, Federal University of São Paulo, Santos, SP, Brazil
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