Efeitos agudos da terapia de fotobiomodulação combinada com o campo magnético estático sobre a mobilidade funcional de pacientes pós-AVC: um ensaio clínico randomizado, placebo controlado, cruzado e triplo-cego

Detalhes bibliográficos
Autor(a) principal: Dumont, Arislander Jonathan Lopes
Data de Publicação: 2020
Tipo de documento: Tese
Idioma: por
Título da fonte: Biblioteca Digital de Teses e Dissertações da Uninove
Texto Completo: http://bibliotecatede.uninove.br/handle/tede/2291
Resumo: Stroke is caused by an interruption in the blood supply to the brain and occurs when an artery that supplies blood supply to the central nervous system is blocked or ruptures. After the stroke, patients may show various levels of motor impairment and disability. The effects of PBMT are photochemical and photophysical, meaning that light is absorbed and causes a chemical change in tissues. The use of static magnetic field (sMF) demonstrated remarkable synergy, leading to enhanced electron transfer and consequent activation of mitochondrial respiratory chain and ATP production. However, in order for PBMT/sMF to be used more often and actually become an adjunctive tool in the rehabilitation of stroke survivors, some important aspects need to be clarified, particularly with regard to the dose and other parameters to be used in this population. Therefore, we aimed to identify the ideal dose of PBMT with different light sources (laser and LED) combined with sMF and determine its on functional mobility, static balance, and on space parameters -temporal and kinematic gait of post-stroke patients. Was conducted a randomized, placebo-controlled, crossover, triple-blind, clinical trial (RCT). Twelve patients were recruited, however ten concluded the study, they were randomly treated with four PBMT/sMF doses (placebo, 10 J, 30 J, and 50 J per site irradiated), with 1week interval washout between treatments. PBMT/sMF was administered after the pre-intervention (baseline) evaluation and the total energy delivered per site at each treatment was determined based on the results of the randomization procedure. PBMT/sMF were administered in direct contact with the skin and applied with slight pressure to nine sites on the knee extensors, six sites on the knee flexors, and two sites on the plantar flexors’ muscles in both lower limbs (bilaterally). PBMT/sMF was administered using a cluster of 12 diodes: four laser diodes of 905 nm (mean power of 0.3125 mW and peak power of 12.5 W for each diode), four LED diodes of 875 nm (mean power of 17.5 mW for each diode), four LED diodes of 640 nm(mean power of 15mWfor each diode), and a magnetic field of 35 mT. The following evaluations were carried out: 6-minute walk test (6MWT), timed and up go test (TUG), three-dimensional gait analysis and center of pressure (CoP) oscillation. Statistical analyzes showed significant improvement in the 6MWT and TUG (p <0.05) at dose 30J compared to placebo, at the 6MWT at dose 30 J (p <0.01) compared to baseline, at TUG dose 30 J (p<0.05) in relation to baseline. The statistical analysis did not show significant differences (p>0.05) in the CoP variables. In the spatiotemporal parameters of the gait, no statistically significant differences were found. However, statistically significant differences (p<0.05) were observed in the kinematic variables of the hip, specifically in the maximum and minimum flexion/extension angulation during the support phase. The use of TFBM with different light sources and wavelengths combined with CME had positive effects on functional mobility and on the kinematic gait variables of post-stroke patients. However, no statistically significant results were found in static balance and spatio-temporal parameters of gait in this population.
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spelling Leal Junior, Ernesto Cesar PintoLeal Junior, Ernesto Cesar PintoCarvalho, Paulo de Tarso Camillo deCasarotto, Raquel Aparecidahttp://lattes.cnpq.br/5709654850460829Dumont, Arislander Jonathan Lopes2020-10-28T16:26:59Z2020-02-20Dumont, Arislander Jonathan Lopes. Efeitos agudos da terapia de fotobiomodulação combinada com o campo magnético estático sobre a mobilidade funcional de pacientes pós-AVC: um ensaio clínico randomizado, placebo controlado, cruzado e triplo-cego. 2020. 76 f. Tese( Programa de Pós-Graduação em Ciências da Reabilitação) - Universidade Nove de Julho, São Paulo.http://bibliotecatede.uninove.br/handle/tede/2291Stroke is caused by an interruption in the blood supply to the brain and occurs when an artery that supplies blood supply to the central nervous system is blocked or ruptures. After the stroke, patients may show various levels of motor impairment and disability. The effects of PBMT are photochemical and photophysical, meaning that light is absorbed and causes a chemical change in tissues. The use of static magnetic field (sMF) demonstrated remarkable synergy, leading to enhanced electron transfer and consequent activation of mitochondrial respiratory chain and ATP production. However, in order for PBMT/sMF to be used more often and actually become an adjunctive tool in the rehabilitation of stroke survivors, some important aspects need to be clarified, particularly with regard to the dose and other parameters to be used in this population. Therefore, we aimed to identify the ideal dose of PBMT with different light sources (laser and LED) combined with sMF and determine its on functional mobility, static balance, and on space parameters -temporal and kinematic gait of post-stroke patients. Was conducted a randomized, placebo-controlled, crossover, triple-blind, clinical trial (RCT). Twelve patients were recruited, however ten concluded the study, they were randomly treated with four PBMT/sMF doses (placebo, 10 J, 30 J, and 50 J per site irradiated), with 1week interval washout between treatments. PBMT/sMF was administered after the pre-intervention (baseline) evaluation and the total energy delivered per site at each treatment was determined based on the results of the randomization procedure. PBMT/sMF were administered in direct contact with the skin and applied with slight pressure to nine sites on the knee extensors, six sites on the knee flexors, and two sites on the plantar flexors’ muscles in both lower limbs (bilaterally). PBMT/sMF was administered using a cluster of 12 diodes: four laser diodes of 905 nm (mean power of 0.3125 mW and peak power of 12.5 W for each diode), four LED diodes of 875 nm (mean power of 17.5 mW for each diode), four LED diodes of 640 nm(mean power of 15mWfor each diode), and a magnetic field of 35 mT. The following evaluations were carried out: 6-minute walk test (6MWT), timed and up go test (TUG), three-dimensional gait analysis and center of pressure (CoP) oscillation. Statistical analyzes showed significant improvement in the 6MWT and TUG (p <0.05) at dose 30J compared to placebo, at the 6MWT at dose 30 J (p <0.01) compared to baseline, at TUG dose 30 J (p<0.05) in relation to baseline. The statistical analysis did not show significant differences (p>0.05) in the CoP variables. In the spatiotemporal parameters of the gait, no statistically significant differences were found. However, statistically significant differences (p<0.05) were observed in the kinematic variables of the hip, specifically in the maximum and minimum flexion/extension angulation during the support phase. The use of TFBM with different light sources and wavelengths combined with CME had positive effects on functional mobility and on the kinematic gait variables of post-stroke patients. However, no statistically significant results were found in static balance and spatio-temporal parameters of gait in this population.O Acidente Vascular Cerebral (AVC) é provocado por uma interrupção no suprimento de sangue no cérebro, e pode ocorre por um rompimento ou bloqueio de uma artéria responsável pelo aporte sanguíneo ao sistema nervoso central. A terapia de fotobiomodulação (TFBM), com laser de baixa potência e/ou diodos emissores de luz (LEDs), consiste na promoção de efeitos fotoquímicos e fotofísicos. O uso do campo magnético estático (CME) demonstrou uma sinergia notável, levando a transferência de aprimoramento de elétrons e consequente ativação da cadeia respiratória mitocondrial e produção de ATP. Para que o TFBM/CME se torne uma ferramenta auxiliar na reabilitação de pacientes pós-AVC, alguns aspectos importantes precisam ser esclarecidos, particularmente relacionados a dose a ser administrada para esta população. Portanto, o objetivo do presente estudo foi verificar os efeitos agudos da aplicação da TFBM com combinação de diferentes fontes de luz (LASERs e LEDs) e diferentes comprimentos de onda, combinada com CME sobre a mobilidade funcional, o equilíbrio estático, e nos parâmetros espaços-temporais e cinemáticos da marcha de pacientes pós-AVC. Para tanto um ensaio clínico randomizado, placebo-controlado, cruzado e triplo-cego, foi realizado. Doze pacientes foram recrutados inicialmente, mas apenas 10 foram submetidos ao protocolo de randomização e completaram o estudo. Quatro doses (placebo, 10J, 30J e 50J por local) de TFBM/CME, foram administradas aleatoriamente de acordo com a randomização com um intervalo de uma semana entre as sessões de tratamento. A TFBM/CME foi aplicada em contato direto com a pele leve pressão em 9 locais nos músculos extensores do joelho, 6 locais nos músculos flexores do joelho e dois locais nos músculos flexores plantares nos dois membros inferiores, usando um cluster de 12 diodos: quatro diodos a laser de 905 nm, quatro diodos LED de 875 nm, quatro diodos de LED de 640nm e um sMT de 35mT. Foram realizadas as seguintes avaliações: teste da caminha de 6 minutos (TC6), teste timed and up go (TUG), analise tridimensional da marcha e a oscilação do centro de pressão (CoP), antes e após o a TFBM/CME. As analises estatísticas mostraram melhora significativa no TC6 e TUG (p<0,05) com a dose 30J em relação ao placebo, no TC6 na dose 30 J (p<0,01) em relação ao baseline, no TUG dose 30 J (p<0,05) em relação baseline. A análise estatística não mostrou diferenças significativas (p>0,05) nas variáveis de CoP. Nos parâmetros espaço-temporais da marcha, não foram encontradas diferenças estaticamente significativas, porém foram observadas, nas variáveis cinemáticas do quadril, especificamente na máxima e mínima angulação de flexão/extensão durante a fase de apoio (p<0.05). A utilização da TFBM com diferentes fontes de luz e comprimentos de onda combinados com CME apresentou efeitos positivos na mobilidade funcional e nas variáveis cinemáticas da marcha de pacientes pós-AVC. Porém não foram encontrados resultados estatisticamente significativos no equilíbrio estático e nos parâmetros espaço-temporais da marcha nesta população.Submitted by Nadir Basilio (nadirsb@uninove.br) on 2020-10-28T16:26:58Z No. of bitstreams: 1 ARISLANDER JONATHAN LOPES DUMONT.pdf: 1514980 bytes, checksum: 1470ebb6bd98edc1c2795dfac6cd4678 (MD5)Made available in DSpace on 2020-10-28T16:26:59Z (GMT). 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dc.title.por.fl_str_mv Efeitos agudos da terapia de fotobiomodulação combinada com o campo magnético estático sobre a mobilidade funcional de pacientes pós-AVC: um ensaio clínico randomizado, placebo controlado, cruzado e triplo-cego
dc.title.alternative.eng.fl_str_mv Acute effects of photobiomodulation therapy and magnetic field on functional mobility in stroke survivors
title Efeitos agudos da terapia de fotobiomodulação combinada com o campo magnético estático sobre a mobilidade funcional de pacientes pós-AVC: um ensaio clínico randomizado, placebo controlado, cruzado e triplo-cego
spellingShingle Efeitos agudos da terapia de fotobiomodulação combinada com o campo magnético estático sobre a mobilidade funcional de pacientes pós-AVC: um ensaio clínico randomizado, placebo controlado, cruzado e triplo-cego
Dumont, Arislander Jonathan Lopes
AVC
equilíbrio
fotobiomodulação
marcha
mobilidade funcional
balance
functional mobility
gait
photobiomodulation
stroke
CIENCIAS DA SAUDE
title_short Efeitos agudos da terapia de fotobiomodulação combinada com o campo magnético estático sobre a mobilidade funcional de pacientes pós-AVC: um ensaio clínico randomizado, placebo controlado, cruzado e triplo-cego
title_full Efeitos agudos da terapia de fotobiomodulação combinada com o campo magnético estático sobre a mobilidade funcional de pacientes pós-AVC: um ensaio clínico randomizado, placebo controlado, cruzado e triplo-cego
title_fullStr Efeitos agudos da terapia de fotobiomodulação combinada com o campo magnético estático sobre a mobilidade funcional de pacientes pós-AVC: um ensaio clínico randomizado, placebo controlado, cruzado e triplo-cego
title_full_unstemmed Efeitos agudos da terapia de fotobiomodulação combinada com o campo magnético estático sobre a mobilidade funcional de pacientes pós-AVC: um ensaio clínico randomizado, placebo controlado, cruzado e triplo-cego
title_sort Efeitos agudos da terapia de fotobiomodulação combinada com o campo magnético estático sobre a mobilidade funcional de pacientes pós-AVC: um ensaio clínico randomizado, placebo controlado, cruzado e triplo-cego
author Dumont, Arislander Jonathan Lopes
author_facet Dumont, Arislander Jonathan Lopes
author_role author
dc.contributor.advisor1.fl_str_mv Leal Junior, Ernesto Cesar Pinto
dc.contributor.referee1.fl_str_mv Leal Junior, Ernesto Cesar Pinto
dc.contributor.referee2.fl_str_mv Carvalho, Paulo de Tarso Camillo de
dc.contributor.referee3.fl_str_mv Casarotto, Raquel Aparecida
dc.contributor.authorLattes.fl_str_mv http://lattes.cnpq.br/5709654850460829
dc.contributor.author.fl_str_mv Dumont, Arislander Jonathan Lopes
contributor_str_mv Leal Junior, Ernesto Cesar Pinto
Leal Junior, Ernesto Cesar Pinto
Carvalho, Paulo de Tarso Camillo de
Casarotto, Raquel Aparecida
dc.subject.por.fl_str_mv AVC
equilíbrio
fotobiomodulação
marcha
mobilidade funcional
topic AVC
equilíbrio
fotobiomodulação
marcha
mobilidade funcional
balance
functional mobility
gait
photobiomodulation
stroke
CIENCIAS DA SAUDE
dc.subject.eng.fl_str_mv balance
functional mobility
gait
photobiomodulation
stroke
dc.subject.cnpq.fl_str_mv CIENCIAS DA SAUDE
description Stroke is caused by an interruption in the blood supply to the brain and occurs when an artery that supplies blood supply to the central nervous system is blocked or ruptures. After the stroke, patients may show various levels of motor impairment and disability. The effects of PBMT are photochemical and photophysical, meaning that light is absorbed and causes a chemical change in tissues. The use of static magnetic field (sMF) demonstrated remarkable synergy, leading to enhanced electron transfer and consequent activation of mitochondrial respiratory chain and ATP production. However, in order for PBMT/sMF to be used more often and actually become an adjunctive tool in the rehabilitation of stroke survivors, some important aspects need to be clarified, particularly with regard to the dose and other parameters to be used in this population. Therefore, we aimed to identify the ideal dose of PBMT with different light sources (laser and LED) combined with sMF and determine its on functional mobility, static balance, and on space parameters -temporal and kinematic gait of post-stroke patients. Was conducted a randomized, placebo-controlled, crossover, triple-blind, clinical trial (RCT). Twelve patients were recruited, however ten concluded the study, they were randomly treated with four PBMT/sMF doses (placebo, 10 J, 30 J, and 50 J per site irradiated), with 1week interval washout between treatments. PBMT/sMF was administered after the pre-intervention (baseline) evaluation and the total energy delivered per site at each treatment was determined based on the results of the randomization procedure. PBMT/sMF were administered in direct contact with the skin and applied with slight pressure to nine sites on the knee extensors, six sites on the knee flexors, and two sites on the plantar flexors’ muscles in both lower limbs (bilaterally). PBMT/sMF was administered using a cluster of 12 diodes: four laser diodes of 905 nm (mean power of 0.3125 mW and peak power of 12.5 W for each diode), four LED diodes of 875 nm (mean power of 17.5 mW for each diode), four LED diodes of 640 nm(mean power of 15mWfor each diode), and a magnetic field of 35 mT. The following evaluations were carried out: 6-minute walk test (6MWT), timed and up go test (TUG), three-dimensional gait analysis and center of pressure (CoP) oscillation. Statistical analyzes showed significant improvement in the 6MWT and TUG (p <0.05) at dose 30J compared to placebo, at the 6MWT at dose 30 J (p <0.01) compared to baseline, at TUG dose 30 J (p<0.05) in relation to baseline. The statistical analysis did not show significant differences (p>0.05) in the CoP variables. In the spatiotemporal parameters of the gait, no statistically significant differences were found. However, statistically significant differences (p<0.05) were observed in the kinematic variables of the hip, specifically in the maximum and minimum flexion/extension angulation during the support phase. The use of TFBM with different light sources and wavelengths combined with CME had positive effects on functional mobility and on the kinematic gait variables of post-stroke patients. However, no statistically significant results were found in static balance and spatio-temporal parameters of gait in this population.
publishDate 2020
dc.date.accessioned.fl_str_mv 2020-10-28T16:26:59Z
dc.date.issued.fl_str_mv 2020-02-20
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/doctoralThesis
format doctoralThesis
status_str publishedVersion
dc.identifier.citation.fl_str_mv Dumont, Arislander Jonathan Lopes. Efeitos agudos da terapia de fotobiomodulação combinada com o campo magnético estático sobre a mobilidade funcional de pacientes pós-AVC: um ensaio clínico randomizado, placebo controlado, cruzado e triplo-cego. 2020. 76 f. Tese( Programa de Pós-Graduação em Ciências da Reabilitação) - Universidade Nove de Julho, São Paulo.
dc.identifier.uri.fl_str_mv http://bibliotecatede.uninove.br/handle/tede/2291
identifier_str_mv Dumont, Arislander Jonathan Lopes. Efeitos agudos da terapia de fotobiomodulação combinada com o campo magnético estático sobre a mobilidade funcional de pacientes pós-AVC: um ensaio clínico randomizado, placebo controlado, cruzado e triplo-cego. 2020. 76 f. Tese( Programa de Pós-Graduação em Ciências da Reabilitação) - Universidade Nove de Julho, São Paulo.
url http://bibliotecatede.uninove.br/handle/tede/2291
dc.language.iso.fl_str_mv por
language por
dc.relation.cnpq.fl_str_mv 8765449414823306929
dc.relation.confidence.fl_str_mv 600
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Universidade Nove de Julho
dc.publisher.program.fl_str_mv Programa de Pós-Graduação em Ciências da Reabilitação
dc.publisher.initials.fl_str_mv UNINOVE
dc.publisher.country.fl_str_mv Brasil
dc.publisher.department.fl_str_mv Saúde
publisher.none.fl_str_mv Universidade Nove de Julho
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