Miranda Eduardo Foschini, Diniz Welton Alves, Gomes Marcos Vinicius Nogueira, de Oliveira Marcelo Ferreira Duarte, de Carvalho Paulo de Tarso Camillo, Leal-Junior Ernesto Cesar Pinto
Postgraduate Program in Rehabilitation Sciences, Nove de Julho University, São Paulo, SP, Brazil.
Laboratory of Phototherapy and Innovative Technologies in Health, Nove de Julho University, 01504-001, Rua Vergueiro 235, Sao Paulo, SP, Brasil.
Lasers Med Sci. 2019 Jun;34(4):711-719. doi: 10.1007/s10103-018-2645-z. Epub 2018 Sep 25.
Chronic obstructive pulmonary disease (COPD) is characterized by dyspnea, as well as musculoskeletal and systemic manifestations. Photobiomodulation therapy (PBMT) with use of low-level laser therapy (LLLT) and/or light-emitting diode therapy (LEDT) is an electrophysical intervention that has been found to minimize or delay muscle fatigue. The aim of this study was to evaluate the acute effect of PBMT with combined use of lasers diodes, light-emitting diodes (LEDs), magnetic field on muscle performance, exercise tolerance, and metabolic variables during the 6-minute stepper test (6MST) in patients with COPD. Twenty-one patients with COPD (FEV 46.3% predicted) completed the 6MST protocol over 2 weeks, with one session per week. PBMT/magnetic field or placebo (PL) was performed before each 6MST (17 sites on each lower limb, with a dose of 30 J per site, using a cluster of 12 diodes 4 × 905 nm super-pulsed laser diodes, 4 × 875 nm infrared LEDs, and 4 × 640 nm red LEDs; Multi Radiance Medical™, Solon, OH, USA). Patients were randomized into two groups before the test according to the treatment they would receive. Assessments were performed before the start of each protocol. The primary outcomes were oxygen uptake and number of steps, and the secondary outcome was perceived exertion (dyspnea and fatigue in the lower limbs). PBMT/magnetic field applied before 6MST significantly increased the number of steps during the cardiopulmonary exercise test when compared to the results with placebo (129.8 ± 10.6 vs 116.1 ± 11.5, p = 0.000). PBMT/magnetic field treatment also led to a lower score for the perception of breathlessness (3.0 [1.0-7.0] vs 4.0 [2.0-8.0], p = 0.000) and lower limb fatigue (2.0 [0.0-5.0] vs 4.0 [0.0-7.0], p = 0.001) compared to that with placebo treatment. This study showed that the combined application of PBMT and magnetic field increased the number of steps during the 6MST and decreased the sensation of dyspnea and lower limb fatigue in patients with COPD.
慢性阻塞性肺疾病（COPD）的特征为呼吸困难以及肌肉骨骼和全身表现。使用低强度激光疗法（LLLT）和/或发光二极管疗法（LEDT）的光生物调节疗法（PBMT）是一种电物理干预措施，已被发现可减轻或延缓肌肉疲劳。本研究的目的是评估在慢性阻塞性肺疾病患者的6分钟踏阶试验（6MST）期间，联合使用激光二极管、发光二极管（LED）和磁场的光生物调节疗法对肌肉性能、运动耐力和代谢变量的急性影响。21例慢性阻塞性肺疾病患者（预测FEV为46.3%）在2周内完成了6MST方案，每周进行一次治疗。在每次6MST之前进行光生物调节疗法/磁场或安慰剂（PL）治疗（双下肢各17个部位，每个部位剂量为30 J，使用一组12个二极管，包括4个4×905 nm超脉冲激光二极管、4个4×875 nm红外LED和4个4×640 nm红色LED；美国俄亥俄州索伦市的Multi Radiance Medical™）。患者在试验前根据其将接受的治疗随机分为两组。在每个方案开始前进行评估。主要结局指标为摄氧量和步数，次要结局指标为自觉用力程度（呼吸困难和下肢疲劳）。与安慰剂组相比，在6MST之前应用光生物调节疗法/磁场可显著增加心肺运动试验期间的步数（129.8±10.6对116.1±11.5，p = 0.000）。与安慰剂治疗相比，光生物调节疗法/磁场治疗还导致呼吸困难感知评分更低（3.0[1.0 - 7.0]对4.0[2.0 - 8.0]，p = 0.000）和下肢疲劳评分更低（2.0[0.0 - 5.0]对4.0[0.0 - 7.0]，p = 0.001）。本研究表明，光生物调节疗法和磁场联合应用可增加慢性阻塞性肺疾病患者6MST期间的步数，并减轻呼吸困难和下肢疲劳感。
