Tomazoni Shaiane Silva, Frigo Lúcio, Dos Reis Ferreira Tereza Cristina, Casalechi Heliodora Leão, Teixeira Simone, de Almeida Patrícia, Muscara Marcelo Nicolas, Marcos Rodrigo Labat, Serra Andrey Jorge, de Carvalho Paulo de Tarso Camillo, Leal-Junior Ernesto Cesar Pinto
Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo (UNICID), Rua Cesário Galeno, 448/475, São Paulo, SP, 05508-900, Brazil.
Biological Sciences and Health Center, Cruzeiro do Sul University (UNICSUL), São Paulo, SP, Brazil.
Lasers Med Sci. 2017 Dec;32(9):2111-2120. doi: 10.1007/s10103-017-2346-z. Epub 2017 Oct 5.
Musculoskeletal injuries are very frequent and are responsible for causing pain and impairment of muscle function, as well as significant functional limitations. In the acute phase, the most prescribed treatment is with non-steroidal anti-inflammatory drugs (NSAIDs), despite their questionable effectiveness. However, the use of photobiomodulation therapy (PBMT) in musculoskeletal disorders has been increasing in the last few years, and this therapy appears to be an interesting alternative to the traditional drugs. The objective of the present study was to evaluate and compare the effects of PBMT, with different application doses, and topical NSAIDs, under morphological and functional parameters, during an acute inflammatory process triggered by a controlled model of musculoskeletal injury induced via contusion in rats. Muscle injury was induced by means of a single trauma to the animals' anterior tibialis muscle. After 1 h, the rats were treated with PBMT (830 nm; continuous mode, with a power output of 100 mW; 3.57 W/cm; 1 J-35.7 J/cm, 3 J-107.1 J/cm, and 9 J-321.4 J/cm; 10, 30, and 90 s) or diclofenac sodium for topical use (1 g). Morphological analysis (histology) and functional analysis (muscle work) were performed, 6, 12, and 24 h after induction of the injury. PBMT, with all doses tested, improved morphological changes caused by trauma; however, the 9 J (321.4 J/cm) dose was the most effective in organizing muscle fibers and cell nuclei. On the other hand, the use of diclofenac sodium produced only a slight improvement in morphological changes. Moreover, we observed a statistically significant increase of muscle work in the PBMT 3 J (107.1 J/cm) group in relation to the injury group and the diclofenac group (p < 0.05). The results of the present study indicate that PBMT, with a dose of 3 J (107.1 J/cm), is more effective than the other doses of PBMT tested and NSAIDs for topical use as a means to improve morphological and functional alterations due to muscle injury from contusion.
肌肉骨骼损伤非常常见，会导致疼痛、肌肉功能受损以及严重的功能受限。在急性期，尽管非甾体抗炎药（NSAIDs）的有效性存疑，但仍是最常用的治疗药物。然而，在过去几年中，光生物调节疗法（PBMT）在肌肉骨骼疾病中的应用不断增加，这种疗法似乎是传统药物的一个有趣替代方案。本研究的目的是在通过大鼠挫伤诱导的肌肉骨骼损伤控制模型引发的急性炎症过程中，根据形态学和功能参数评估并比较不同应用剂量的PBMT与外用NSAIDs的效果。通过对动物的胫骨前肌进行单次创伤诱导肌肉损伤。1小时后，用PBMT（830nm；连续模式，功率输出100mW；3.57W/cm；1J - 35.7J/cm、3J - 107.1J/cm和9J - 321.4J/cm；10、30和90秒）或外用双氯芬酸钠（1g）对大鼠进行治疗。在损伤诱导后6、12和24小时进行形态学分析（组织学）和功能分析（肌肉功能）。所有测试剂量的PBMT均改善了创伤引起的形态学变化；然而，9J（321.4J/cm）剂量在组织肌纤维和细胞核方面最有效。另一方面，双氯芬酸钠的使用仅使形态学变化略有改善。此外，我们观察到PBMT 3J（107.1J/cm）组的肌肉功能相对于损伤组和双氯芬酸组有统计学上的显著增加（p < 0.05）。本研究结果表明，剂量为3J（107.1J/cm）的PBMT比其他测试剂量的PBMT和外用NSAIDs更有效地改善因挫伤引起的肌肉损伤导致的形态学和功能改变。
