Dumont Arislander Jonathan Lopes, Casalechi Heliodora Leão, Tomazoni Shaiane Silva, Grecco Luanda Collange, Galli Manuela, Oliveira Claudia Santos, Leal-Junior Ernesto Cesar Pinto
Laboratory of Phototherapy and Innovative Technologies in Health (LaPIT), Post-Graduated Program in Rehabilitation Sciences, U Nove de Julho University (UNINOVE), São Paulo 01525-000, Brazil.
Physiotherapy Research Group, Department of Global Public Health and Public Care, University of Bergen (UiB), 5020 Bergen, Norway.
Life (Basel). 2022 Jan 27;12(2):186. doi: 10.3390/life12020186.
Gait deficit is a major complaint in patients after stroke, restricting certain activities of daily living. Photobiomodulation therapy combined with a static magnetic field (PBMT-SMF) has been studied for several diseases, and the two therapies are beneficia. However, their combination has not yet been evaluated in stroke. Therefore, for PBMT-SMF to be used more often and become an adjunctive tool in the rehabilitation of stroke survivors at physical therapy rehabilitation centers and clinics, some important aspects need to be clarified.
This study aimed to test different doses of PBMT-SMF, to identify the ideal dose to cause immediate effects on the spatiotemporal and kinematic variables of gait in post-stroke patients.
A randomized, triple-blinded, placebo-controlled crossover pilot study was performed. A total of 10 individuals with hemiparesis within 6 months to 5 years since the occurrence of stroke, aged 45-60 years, were included in the study. Participants were randomly assigned and treated with a single PBMT-SMF dose (sham, 10 J, 30 J, or 50 J) on a single application, with one dose per stage at 7-day intervals between stages. PBMT-SMF was applied with a cluster of 12 diodes (4 of 905 nm laser, 4 of 875 nm LEDs, and 4 of 640 nm LEDs, SMF of 35 mT) at 17 sites on both lower limbs after baseline evaluation: plantar flexors (2), knee extensors (9), and flexors (6). The primary outcome was self-selected walking speed, and the secondary outcomes were kinematic parameters. Gait analysis was performed using SMART-D 140 and SMART-D INTEGRATED WORKSTATION. The outcomes were measured at the end of each stage after the single application of each PBMT-SMF dose tested.
No significant differences ( > 0.05) in spatiotemporal variables were observed between the different doses, compared with the baseline evaluation. However, differences ( < 0.05) were observed in the kinematic variable of the hip in the paretic and non-paretic limbs, specifically in the minimum flexion/extension angulation during the support phase (HMST-MIN) in doses 10 J, 30 J, and 50 J.
A single application of PBMT-SMF at doses of 10 J, 30 J, and 50 J per site of the lower limbs did not demonstrate positive effects on the spatiotemporal variables, but it promoted immediate effects in the kinematic variables of the hip (maximum and minimum flexion/extension angulation during the support phase) in the paretic and non-paretic limbs in post-stroke people.
步态缺陷是中风患者的主要诉求,限制了某些日常生活活动。光生物调节疗法联合静磁场(PBMT-SMF)已针对多种疾病进行了研究,且这两种疗法均有益处。然而,它们的联合应用在中风患者中尚未得到评估。因此,为了使PBMT-SMF更频繁地被使用,并成为物理治疗康复中心和诊所中风幸存者康复的辅助工具,一些重要方面需要阐明。
本研究旨在测试不同剂量的PBMT-SMF,以确定对中风后患者步态的时空和运动学变量产生即时影响的理想剂量。
进行了一项随机、三盲、安慰剂对照的交叉试点研究。共有10名在中风后6个月至5年内出现偏瘫、年龄在45 - 60岁的个体纳入研究。参与者被随机分配,并在单次应用中接受单一PBMT-SMF剂量(假治疗、10 J、30 J或50 J)治疗,每个阶段一剂,阶段之间间隔7天。在基线评估后,使用一组12个二极管(4个905 nm激光二极管、4个875 nm发光二极管和4个640 nm发光二极管,静磁场为35 mT)在双下肢的17个部位应用PBMT-SMF:跖屈肌(2个部位)、膝关节伸肌(9个部位)和屈肌(6个部位)。主要结局是自我选择的步行速度,次要结局是运动学参数。使用SMART-D 140和SMART-D集成工作站进行步态分析。在测试的每种PBMT-SMF剂量单次应用后的每个阶段结束时测量结局。
与基线评估相比,不同剂量之间在时空变量上未观察到显著差异(> 0.05)。然而,在患侧和非患侧肢体的髋关节运动学变量中观察到差异(< 0.05),特别是在10 J、30 J和50 J剂量下支撑期的最小屈伸角度(HMST-MIN)。
在下肢每个部位单次应用10 J、30 J和50 J剂量的PBMT-SMF对时空变量未显示出积极影响,但在中风患者的患侧和非患侧肢体中,对髋关节的运动学变量(支撑期的最大和最小屈伸角度)产生了即时影响。