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Background: TENS is a non-pharmacological adjunctive treatment commonly recommended for analgesic purposes, with widespread use and acceptance in clinical practice; however, its effects simultaneously with exercise are controversial, and there are gaps regarding its effectiveness and applicability, especially regarding the parameters and protocols used to treat pain. In view of this, the aim of this study was to systematically review the effects of TENS applied simultaneously with functional activities or exercises in the treatment of individuals with pain., Method: A bibliographic search was performed in electronic databases, including EMBASE, PubMED, Scopus, Web of Science, PEDro, SPORTDiscus, and the grey literature. The search yielded a total of 634 articles, of which only six met the inclusion criteria and were analysed individually. Of the selected studies, four evaluated the simultaneous use of TENS in patients with chronic pain, one in patients with fatigue-induced injury, and one in healthy subjects., Results: The articles selected for synthesis of the review were assessed using the RoB 2.0 risk of bias tool, which found that three of the included studies had a low risk of bias, while two studies were analysed as high risk and only one with some concern. It is concluded that the use of TENS in conjunction with functional activities and exercises may benefit people with pain., Conclusion: The studies showed that the use of TENS with high frequency and intensity at the sensory threshold and applied simultaneously with exercise produced more significant analgesic effects, but new clinical trials with robust methodological designs should be carried out., (© 2024 John Wiley & Sons Ltd.)

The objective of this study was to ascertain the impact of photobiomodulation and radiofrequency on the healing of pressure injuries in mice. A total of 70 animals were randomly assigned to seven experimental groups. A pressure injury was induced in the dorsal region of the mice by the application of two magnets. The photobiomodulation treatment was administered at a dosage of 3.6 J per session. In the radiofrequency group, the treatment time was four minutes and the power was 22 watts. The analyses included the lesion area, infrared thermography, and the collection of material for cytokine, histological, and histochemical analyses following euthanasia. In the macroscopic analyses, the 660 nm photobiomodulation group demonstrated superior outcomes in comparison to the control group. With regard to the microscopic analyses, the greatest difference between the groups was observed when TNF-α was evaluated in the photobiomodulation group. It can be observed that the groups irradiated by electrophysical means (i.e., a combination of radiofrequency with PBM 830 nm-660 nm) exhibited a positive influence on the repair process, with the greatest impact observed in the group irradiated by a combination of radiofrequency and 660 nm photobiomodulation., Competing Interests: Declarations Conflict of interest The authors declare no conflict of interest., (© 2024. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)

The objective was to assess the validity and reliability of the Patient-Specific Functional Scale-Brazil (PSFS-B) in patients with non-specific chronic low back pain. A methodological study was conducted, and 101 volunteers with chronic non-specific low back pain were interviewed and asked to complete the PSFS-B questionnaire and the Oswestry Disability Index-Brazil 2.0 reference questionnaire. The Oswestry Disability Index-Brazil 2.0 is a standardized tool used to assess functional disability of the lumbar spine. A new assessment (follow-up) was conducted one week later using the same instruments. The COSMIN checklist was utilized as a guide. Two questionnaires were employed to assess patients: the Patient-Specific Functional Scale-Brazil (PSFS-Br) and the Oswestry Disability Index-Brazil 2.0 (ODI-Br). Data were analyzed to assess construct validity (hypothesis testing and structural validity), internal consistency, and test-retest reliability. The statistical methods employed included Pearson's correlation coefficient, confirmatory factorial analysis, Cronbach's alpha, and intraclass correlation coefficient. The results of the Patient-Specific Functional Scale-Brazil demonstrated a moderate negative correlation with the ODI-Br in hypothesis testing (r = -0.691 and r = -0.754) and in structural validity (Comparative Fit Index (0.986), Tucker-Lewis Index (0.958), Root Mean Square Error of Approximation (0.194), and Standardized Root Mean Square Residual (0.134). Furthermore, the instrument demonstrated excellent internal consistency (α = 0.951) and test-retest reliability (intraclass correlation coefficient = 0.978), and was additionally validated by the Bland-Altman plot (0.125). In conclusion, the Patient-Specific Functional Scale-Brazil is a valid and reliable tool for the evaluation and follow-up of patients with non-specific chronic low back pain., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Purpose: The objective of the present study was to correlate neck and upper-limb disabilities with neck flexion in university students who are smartphone users. While handling smartphones, a posture with sustained neck flexion known as "Text Neck" is usually adopted, and some authors related to musculoskeletal symptoms on the neck and the upper limb. However, recent studies state that such an association is questionable., Methods: This is an observational study when evaluating 192 university students through questionnaires such as the Neck Disability Index (NDI), Disabilities of Arm, Shoulder, and Hand (DASH), besides the maximal neck flexion, grip and lateral pinch strength of the participants., Results: The sociodemographic questionnaire demonstrated that most participants had used the device for 5 to 10 years, for five or more hours per day. The DASH questionnaire scores presented an average of 7.2 points, while the data regarding grip and lateral pinch strength showed averages of 29.5 kgf and 8.8 kgf, respectively. The NDI questionnaire scores presented an average of 10.5. The average range of motion of the maximum neck flexion was 27°., Conclusion: There was no association between neck flexion with the DASH and NDI or the grip and lateral pinch strength after the correlation and binary logistic regression analyses. The results show that the scores of DASH, NDI, hand grip and lateral pinch strength, have no association with the maximum neck flexion., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: The present study investigated the effects of pulsed and continuous ultrasound (USP and USC) in edema and hyperalgesia after chronic inflammatory process induced by Complete Freund's Adjuvant-CFA and analyzing the relationship of the application frequency of ultrasound, in pro- and anti-inflammatory cytokine production., Methods: Forty-five animals were divided into 9 groups; all animals from groups 2 to 9 were subjected to a persistent inflammation model induced by CFA in mice. We report the effects and the underlying action mechanisms of USP and USC in the animals which were irradiated two, three or five times a week on the left hind paw. The analyses performed in this study were: evaluation of hind paw edema through the plethysmometer, evaluation of thermal hyperalgesia through withdrawal test using a water container at 44.5°C (± 0.5°C), and the plantar region of the left paw which was removed for analysis of cytokines., Results: Our results showed that USP and USC consistently reduced paw edema, and pulsed ultrasound showed a higher significant effect than the continuous mode. Moreover, groups with irradiation frequency of five times a week presented an inhibition of the edema, and groups with frequency of three or two times a week reduced mainly hyperalgesia, in comparison with the control group. The beneficial effects of the US then seem to be associated with upregulation of anti- and pro-inflammatory mediators, such as IL-10 and IL-6, respectively., Conclusion: This study provided evidence that ultrasound constitutes an important non-pharmacological intervention for the management of inflammatory and pain states., Competing Interests: Conflicts of interest The authors declare no conflicts of interest., (Copyright © 2022. Published by Elsevier España S.L.U.)

Introduction: A sprain describes an excessive amount of force or strain on a ligament, which may or may not lead to its rupture. Orthoses are among the most common modalities prescribed as a conservative treatment for ankle instability and sprain., Objective: We aimed to analyse the effect of neoprene orthosis on the balance and functionality of healthy individuals and volunteers with lateral ankle sprains METHODS: We evaluated 12 healthy volunteers (control group) and 12 volunteers diagnosed with a sprain and/or instability (patient group). A total of 14 men and 10 women participated in the study, with an average age of 26.15 (± 4.40) years. The volunteers' tasks consisted of performing vertical bipodal and unipodal jumps on a force platform, which were recorded in a video from the lateral view of the lower limb for posterior evaluation of the knee and ankle angles. Mann-Whitney and Wilcoxon tests were used for comparisons, considering p < 0.05 level of significance., Results: The control group presented a decrease in ground reaction force when using Orthosis during the bipodal jump (p < 0.05). A decrease in anteroposterior force displacement was also observed in the left unipodal jump (p < 0.01). The patient group presented an increase in force and moment of medial-lateral displacement for both bipodal (p < 0.02) and left unipodal jumps with Orthosis (p < 0.02). A kinematic analysis showed that the control group presented the smallest knee flexion angle (p < 0.01), while the patient group presented the smallest dorsiflexion ankle angle in the bipodal jump when using orthosis (p < 0.01)., Conclusion: We concluded that orthosis had influence on individuals' balance and joint angles. In healthy individuals presented better balance with and without orthosis and greater flexion with orthosis in the bipodal jump, regarding to the patient group presented smaller oscillations in the unipodal jump with orthosis and showed smaller knee flexion and ankle dorsiflexion., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Tissue injuries that affect the skin and/or adjacent tissues and are usually over a bony prominence are called pressure injuries. The prevalence of these dysfunctions remains high, and despite technological advances, there is no consensus on the most appropriate treatment. The objective of this review was to evaluate the efficacy of photobiomodulation (PBM), ultrasound, and high-frequency electrophysical agents in the healing of pressure injuries in adults and the elderly. The search was conducted in the PubMed, Embase, Cochrane Library, Web of Science, and PEDro databases; in clinical trial records, a list of references of the selected articles, as well as through manual search (Google), of the last 5 years in humans in English and Portuguese. Nine thousand and sixty-seven studies were identified, 13 pre-selected, and 6 were included in this systematic review. PBM showed similar efficacy to other technologies indicated in other studies in healing pressure injuries. PBM with red wavelength (660 nm) in stages 2 and 3 pressure injuries effectively promoted healing compared to standard care. It was observed that the use of PBM accelerates tissue repair in pressure injuries; therapeutic ultrasound showed similar efficacy to other electrophysical agents but was effective in reducing the area of pressure injuries when comparing pre- and post-intervention. No clinical studies using the high-frequency electrophysical agent have been described in the last 5 years., (© 2022. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)

Purpose: To investigate and compare the effects of therapeutic exercise, therapeutic ultrasound and photobiomodulation on pain, functionality and recruitment pattern of motor units, after a rehabilitation protocol for seamstresses with neck pain., Materials and Methods: All 36 female, randomly divided into three groups; i)exercise control group, ii)exercise and photobiomodulation group, iii)exercise and ultrasound group. The groups were composed of sewing machine operators with complaints neck pain. Clinical evaluations: Visual analog pain scale, questionnaires Nordic Musculoskeletal Questionnaire and the International Physical Activity Questionnaire, and electromyographic evaluations of the sternocleidomastoid and upper trapezius muscles. All variables were compared before and after the protocol. For statistical analysis, the values of mean, standard deviation and standard error of the mean were used. The values obtained were compared using the One-Way ANOVA with post-hoc Tukey, and Cohen's-d, with a significance coefficient of p < 0.05., Results: In the Ultrasound and laser groups there was a greater tendency to improve pain (p < 0.0001) and size of the effect on pain reduction (ultrasound = d:1.99; photobiomodulation = d:1.81). Between groups, there was a significant difference in post-treatment for the onset of right trapezius (p = 0.024) in the exercise and photobiomodulation groups (p = 0.0347). The photobiomodulation group showed pre and post-intervention differences in the left trapezius maximum onset (p = 0.010)., Conclusion: Interventions with photobiomodulation, ultrasound, and exercise assist to pain, function, and muscular activation in seamstresses with neck pain., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Introduction: Patellofemoral pain (PFP) is a chronic condition that affects up to 25% of the general population and has a negative impact on functionality and quality of life due to the high levels of pain experienced by these patients. In order to improve pain and function, rehabilitation programmes that combine adjunctive treatments with exercise therapy are often used in research and clinical settings. However, despite the variety of adjunctive treatments available, their effectiveness when compared with exercise therapy has yet to be elucidated. Thus, the aim of this study is to evaluate the effectiveness of adjunctive treatments plus exercise therapy versus exercise therapy, and determine the relative efficacy of different types of adjunctive treatments plus exercise therapy for individuals with PFP., Methods and Analysis: A systematic review and network meta-analysis will be conducted based on the Cochrane Collaboration recommendations and reported in line with Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. We will search Embase, PubMed (MEDLINE), CENTRAL, CINAHL, PEDro, SPORTDiscus, Web of Science and OpenGrey. It will be included randomised controlled trials that compared adjunctive treatment plus exercise therapy to placebo adjunctive treatment plus exercise therapy or exercise therapy. The outcomes of interest will be pain and function, with no restrictions on language, setting or year of publication. Study selection will be performed by two independent reviewers, based on the eligibility criteria. Risk of bias will be assessed using the Physiotherapy Evidence Database scale and the evidence summarised via the Grading of Recommendation, Assessment, Development and Evaluation approach. A Bayesian network meta-analysis will be performed to compare the efficacy of different adjunctive treatments plus exercise therapy. Consistency between direct and indirect comparisons will be assessed., Ethics and Dissemination: No ethical statement will be required for this systematic review and meta-analysis. The findings will be published in a relevant international peer-reviewed journal and presented at conferences., Prospero Registration Number: CRD42020197081., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Report the effects of photobiomodulation (PBM) and therapeutic ultrasound (TUS) on the viability of TRAM in mice., Materials and Methods: Fifty-five mice Swiss were subjected to treatment for 5 days. Group 1, treatment was performed with the agents switched off. Groups 2 to 5 were treated with different wavelengths 660 and 830 nanometers (nm) and groups 6 to 11 with TUS of 1 and 3 MHz frequency. Macrometric analyses were performed using a specific camera and analyzed by the ImageJ® software. Thermographic analyses were performed with the Flir C2 and analyzed using the FLIR Tools software., Results: Group 9 obtained 95% of viable area on the 3rd day and 85% on the 5th day, showing the effectiveness of the TUS in the flap viability. Regarding skin temperature, there was a difference only in the immediate postoperative period in group 1, which had a lower temperature than the other groups., Conclusions: TUS demonstrated greater efficiency in maintaining the viability of TRAM. PBM 830 nm also demonstrated good results in the viability of TRAM., (© 2021. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)

This study aimed to investigate the effects of photobiomodulation at a wavelength of 660 and 830 nm at different numbers of application points in the healing of open wounds in mice. In total, 120 mice were divided into 10 groups. The animals were submitted to cutaneous lesion of the open wound type (1.5 × 1.5 cm). Photobiomodulation at a wavelength of 660 and 830 nm and total energy of 3.6 J were used, applied at 1, 4, 5, and 9 points, for 14 days. The animals were subjected to analysis of the lesion area, skin temperature, and histological analysis. Macroscopic analysis results showed a difference (p < 0.05) between the irradiated groups and the sham group at 14 days PO. There was no statistical difference in skin temperature. Histological analysis findings showed better results for the epidermis thickness. Regarding the number of blood vessels, a difference was found between the 1- and 5-point 830-nm photobiomodulation groups and between the 4-point 660-nm group and the naive group. A significant difference in the number of fibroblasts was observed between the 830- and 660-nm photobiomodulation groups and the naive and sham groups. When comparing photobiomodulation wavelength, the 830-nm groups were more effective, and we emphasize the groups irradiated at 5 points, which showed an improvement in macroscopic analysis and epidermis thickness, an increase in the number of vessels, and a lower number of fibroblasts on the 14th day after skin injury., (© 2020. The Author(s), under exclusive licence to Springer-Verlag London Ltd. part of Springer Nature.)

To determine whether the effects of photobiomodulation (PBM) were associated with the use of Simvastatin in the functional recovery from sciatic nerve in mice submitted to crush injury. Fifty Swiss mice (approximately 3 months old; average weight 40 g) were randomly divided into six groups: naive, sham, control, PBM (660 nm, 10 J/cm 2 ; 30 mW; 0.6 J per day for 28 days; 0.06 cm 2 ; 16.8 J total and 20 s), Simvastatin (20 mg/kg), and PBM/Simv (association of the two protocols). The sciatic functional index (SFI), thermal heat hyperalgesia, mechanical hyperalgesia, and thermographic evaluation were used as analyses. The evaluations were performed preoperatively and 7, 14, 21, and 28 days after the initial injury analyzed by two-way analysis of variance (ANOVA) for mixed models followed by the Bonferroni post-test. All groups except sham and naive presented an SFI compatible with severe peripheral nerve injury on the 7th day of evaluation. The PBM group presented better results in the SFI analysis (p < 0.001) on the 21st postoperative day compared to the control group. This benefit was maintained when compared to the Simvastatin (p < 0.001) and PBM/Simv groups (p < 0.01). The results of the thermal and mechanical hyperalgesia and thermography analyses were not significant (p > 0.05). The obtained results showed that PBM alone was more effective compared to Simvastatin alone or PBM combined with Simvastatin for sciatic nerve injury in mice., (© 2020. Springer-Verlag London Ltd., part of Springer Nature.)

Background: Complex regional pain syndrome type I (CRPS-I) consists of disorders caused by spontaneous pain or induced by some stimulus. The objective was to verify the effects of photobiomodulation (PBM) using 830 nm wavelength light at the affected paw and involved spinal cord segments during the warm or acute phase., Methods: Fifty-six mice were randomized into seven groups. Group (G) 1 was the placebo group; G2 and G3 were treated with PBM on the paw in the warm and acute phase, respectively; G4 and G5 treated with PBM on involved spinal cord segments in the warm and acute phase, respectively; G6 and G7 treated with PBM on paw and involved spinal cord segments in the warm and acute phase, respectively. Edema degree, thermal and mechanical hyperalgesia, skin temperature, and functional quality of gait (Sciatic Static Index [SSI] and Sciatic Functional Index [SFI]) were evaluated., Results: Edema was lower in G3 and G7, and these were the only groups to return to baseline values at the end of treatment. For thermal hyperalgesia only G3 and G5 returned to baseline values. Regarding mechanical hyperalgesia, the groups did not show significant differences. Thermography showed increased temperature in all groups on the seventh day. In SSI and SFI assessment, G3 and G7 showed lower values when compared to G1, respectively., Conclusions: PBM irradiation in the acute phase and in the affected paw showed better results in reducing edema, thermal and mechanical hyperalgesia, and in improving gait quality, demonstrating efficacy in treatment of CRPS-I symptoms.

Objective: The purpose of this study was to assess whether dry needling (DN) added to photobiomodulation (PBM) has effects on the treatment of active myofascial trigger points in the upper trapezius., Methods: This study was a randomized clinical trial, with 43 participants divided into 3 groups: DN and PBM (DNP), DN, and DN outside of the trigger point (DNout). Each group received 1 session of DN followed by PBM therapy with the machine turned on or off. Pain, disability, pain pressure threshold, and muscle activity were assessed before the intervention and afterward at intervals of 10 minutes, 30 minutes, 1 week, and 1 month., Results: Pain decreased after intervention in the DNP and DNout groups, with mean differences, respectively, of 1.33 cm (95% confidence interval [CI], 0.019-2.647) and 2.78 cm (95% CI, 1.170-2.973). Scores for the disability questionnaire decreased in all groups after intervention (F = 36.53, P < .0001) after the intervention, with mean differences of 3.8 points in the DNP group (95% CI, 1.082-5.518), 3.57 in the DN group (95% CI, 0.994-6.149), and 5.43 in the DNout group (95% CI, 3.101-7.756). There were no significant differences between or within groups in pain pressure threshold (F = 2.14, P = .139), with mean differences after 30 minutes of 0.139 kgf for the DNP group (95% CI, -0.343 to 0.622), 0.273 for the DN group (95% CI, -0.661 to 1.209), and -0.07 for the DNout group (95% CI, -0.465 to 0.324). Muscle activation for the DN group increased 8.49% after the intervention, where for the DNP group it decreased 11.5%, with a significant difference between groups., Conclusion: DN added to PBM presented similar results compared to DNout and DN. In this sample, the effects of the application of DN outside of the trigger point had better effects on pain and disability scores than DN applied directly on the trigger point., (Copyright © 2020. Published by Elsevier Inc.)

Objective : To evaluate the influence of two different photobiomodulation therapy (PBMT) protocols (red 660 nm vs. infrared 830 nm) combined with a blood flow restriction (BFR) training protocol in wrist extensor muscles on handgrip, wrist extension force, and electromyographic behavior [root mean square (RMS)]. Background : PBMT has been widely used to increase muscle performance and recovery in recent clinical trials. However, there is no evidence whether PBMT (red and/or infrared) can promote better results when combined with BFR, a known method to induce better strength gains. Methods : This study was a randomized controlled trial including 58 volunteers allocated into four groups: (1) control (conventional strengthening), (2) BFR (strengthening with BFR), (3) 660 nm (BFR strengthening with 660 nm PBMT-35 mW; 0.05 cm 2 ; 2.10 J, total energy 18.9 J), and (4) 830 nm (BFR strengthening with 830 nm PBMT-32 mW; 0.101 cm 2 ; 1.92 J, total energy 17.2 J). Data were analyzed by using a mixed-effects model, with a 5% significance index. Results : A statistically significant increase was obtained for handgrip strength for the 660 nm group [27.36 ± 2.61 kilogram force (kgF)] compared with the 830 nm group (23.04 ± 3.06 kgF) ( p  = 0.010) and for wrist extensor strength in the 660 nm (7.77 ± 0.58 kgF) and BFR (7.54 ± 0.92 kgF) groups compared with the control group (5.33 ± 0.61 kgF) ( p  = 0.001 and p  = 0.004, respectively). The RMS value for the 660 nm group was significantly higher than control ( p  < 0.0001), BFR ( p  < 0.0001), and the 830 nm group ( p  = 0.0009). Conclusions : The association of PBMT (660 nm) and BFR was effective for increasing handgrip strength of the wrist extensors, associated with an increase in RMS.

Background and Objectives: Complex regional pain syndrome (CRPS) is defined as an extreme and chronic pain condition, and photobiomodulation has relevance as a complementary treatment for CRPS. The objective of this study was to verify the effects of photobiomodulation (PBMT) therapy protocols at two wavelengths 660 and 830 nm, associated or not to nicotine in complex regional pain syndrome type I (CRPS-I)., Study Design/materials and Methods: Sixty-four Swiss mice were divided into the following groups: (i) Naive, (ii) Sham, (iii) Control, (iv) 660 nm, (v) 830 nm, (vii) Nicotine, (vii) Nicotine/660 nm, and (viii) Nicotine/830 nm. CRPS-I was induced in an experimental ischemia/reperfusion model by affixing an elastic ring, proximal to the ankle joint of the right hind mouse paw, for 3 hours. Nicotine, in the respective groups was administered for 28 days prior to the induction of CRPS-I. PBMT was applied immediately after the procedure and for 20 consecutive days. The animals were evaluated for mechanical hyperalgesia, thermal hyperalgesia, paw edema at baseline and for 7, 14, and 21 days. Statistical analyses comprised a mixed-effects model, using the Tukey post hoc test (P < 0.05)., Results: The PBMT wavelengths in 660 and 830 nm groups had beneficial effects (P < 0.05) in reducing mechanical and thermal hyperalgesia, but the effects at 660 nm were significantly better than 830 nm. At reducing edema, both wavelengths had significant effects statistically, absolutely no difference between them., Conclusions: The use of PBMT (660 and 830 nm) was effective in reducing mechanical hyperalgesia and thermal hyperalgesia; however, PBMT at 660 nm generated significant results. In reducing edema, both wavelengths had similar effects, which were significant statistically. The deleterious effects of nicotine were evident statistically and were softened when treated with PBMT (P < 0.05). Lasers Surg. Med. © 2020 Wiley Periodicals, Inc., (© 2020 Wiley Periodicals, Inc.)

Objective: To analyse the construct validity, test-retest reliability and responsiveness of the Brazilian version of Quick-DASH (QD-Br) in patients with upper limb disorders., Method: Participants completed the full Brazilian DASH, the QD-Br and the SF-12 Brazil questionnaires at the beginning of treatment, after 48-72h and the after 2-12 months. Construct validity was analysed by Pearson's correlation coefficient (r). To evaluate the test-retest reliability we used the Intraclass Correlation Coefficient (ICC) and the Cronbach's alpha coefficient to test the internal consistency. Responsiveness was analysed by Standardized Response Mean (SRM) and Effect Size (ES). The Minimal detectable change (MDC) score was based upon calculations of the standard error of measurement (SEM), confidence interval of 95%., Results: The construct validity presented strong direct correlation with the total QD-Br score and the Brazilian DASH (r = 0.91), a moderate inverse correlation between the total QD-Br score and the physical component of the SF- 12 Brazil (r = -0.55) and weak inverse correlation between the QD-Br and the mental component of SF-12 Brazil (r = -0.49). The ICC test-retest showed good reliability of 0.81 (0.72-0.87). QD-BR presented high responsiveness, with ES of 1.06 and SRM of 0.94. The MDC was 17.27 points., Conclusion: These results provide evidence that the QD-Br was a valid, reliable and responsive instrument when utilized in patients with upper limb traumatic and no-traumatic disorders in the Brazilian population., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Objective : The aim of the study was to perform a literature review to analyze the effect of photobiomodulation in experimental studies on peripheral nerve regeneration after sciatic nerve crush injury in rodents. Methods: A bibliographic search was performed in the electronic databases, including MEDLINE (PubMed), SCOPUS, and SciELO, from 2008 to 2018. Results: A total of 1912 articles were identified in the search, and only 19 fulfilled all the inclusion criteria. Along with the parameters most found in the manuscripts, the most used wavelengths were 660 nm and 830 nm, power of 30 and 40 mW, and energy density of 4 and 10 J/cm 2 . For total energy throughout the intervention period, the lowest energy found with positive effects was 0.70 J, and the highest 1.141 J. Seventeen studies reported positive effects on nerve regeneration. The variables selected to analyze the effect were: Sciatic Functional Index (SFI), Static Sciatic Index (SSI), morphometric, morphological, histological, zymographic, electrophysiological, resistance mechanics and range of motion (ROM). The variety of parameters used in the studies demonstrated that there is yet no pre-determined protocol for treating peripheral nerve regeneration. Only two studies by different authors used the same power, energy density, beam area, and power density. Conclusion: It was concluded that the therapeutic window of the photobiomodulation presents a high variability of parameters with the wavelength (632.8 to 940 nm), power (5 to 170 mW) and energy density (3 to 280 J /cm 2 ), promoting nerve regeneration through the expression of cytokines and growth factors that aid in modulating the inflammatory process, improving morphological aspects, restoring the functionality to the animals in a brief period., (Copyright © 2020 J Lasers Med Sci.)

Background: Electromyography may be useful for assessing and understanding trunk muscle activation, and Pilates is commonly used as a treatment for low back pain. The objective of this study was to verify electromyography of trunk muscles after a Pilates protocol in individuals with non-specific low back pain and in healthy individuals., Methods: Volunteers were divided into two groups: non-specific low back pain (n = 19) and clinically healthy (n = 16) groups. Clinical assessments, classification of patients into subgroups, electromyography evaluations of the right lumbar extensor and right transverse abdominal/internal oblique muscle of the abdomen were performed before and after an 8-week Pilates protocol., Findings: Comparisons were made before and after the protocol and with the control group. There was significant improvement in pain, flexibility, resistance and strength of trunk muscles. In addition, after the Pilates, there was a decrease in the time elapsed between the onset and peak of lumbar muscle activation during the evaluation of trunk extension in the low back pain group, coming closer to the time of the abdominal muscle, as it also occurred in the control group., Interpretation: Pilates caused clinical improvement and balanced trunk muscle activation in the low back group, becoming similar to that of the control group. Furthermore, the effects of the proposed protocol were the same between the groups. Thus, Pilates may be indicated for management of non-specific low back pain., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: Many tools have been described for outcome assessment after nerve repair. The Patient-Rated Wrist and Hand Evaluation (PRWHE) have been shown to be valid for several hand conditions., Objectives: To explore the construct validity of the PRWHE in comparison to cold intolerance, pain and dysfunction questionnaires; the Rosén score and its subcomponents; and threshold sensibility, dynamometry and dexterity tests for nerve repair of the hand., Study Design: Clinical measurement., Methods: Construct validity was analysed through Pearson's correlation coefficient in a convenience sample of 32 adult patients after long-term median and ulnar nerve repair., Results: The PRWHE total score was highly to moderately associated with the Disability of Arm, Shoulder and Hand (r = 0.83), Cold Intolerance Symptom Severity (r = -0.60) and McGill's Pain (r = 0.58) questionnaires. In addition, it was correlated to motor (r = -0.55) and sensor subdomains (r = -0.56) of the Rosén score. Substantial to high associations were found for the motor, sensory impairment and dexterity test., Conclusions: The PRWHE was shown to be valid, based on construct validity, for patients with nerve repair of the hand., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: Outcome after nerve repair of the hand needs standardized psychometrically robust measures. We aimed to systematically review the psychometric properties of available functional, motor, and sensory assessment instruments after nerve repair., Methods: This systematic review of health measurement instruments searched databases from 1966 to 2017. Pairs of raters conducted data extraction and quality assessment using a structured tool for clinical measurement studies. Kappa correlation was used to define the agreement prior to consensus for individual items, and intraclass correlation coefficient (ICC) was used to assess reliability between raters. A narrative synthesis described quality and content of the evidence., Results: Sixteen studies were included for final critical appraisal scores. Kappa ranged from 0.31 to 0.82 and ICC was 0.81. Motor domain had manual muscle testing with Kappa from 0.72 to 0.93 and a dynamometer ICC reliability between 0.92 and 0.98. Sensory domain had touch threshold Semmes-Weinstein monofilaments (SWM) as the most responsive measure while two-point discrimination (2PD) was the least responsive (effect size 1.2 and 0.1). A stereognosis test, Shape and Texture Identification (STI), had Kappa test-retest reliability of 0.79 and inter-rater reliability of 0.61, with excellent sensibility and specificity. Manual tactile test had moderate to mild correlation with 2PD and SWM. Function domain presented Rosén-Lundborg score with Spearman correlations of 0.83 for total score. Patient-reported outcomes measurements had ICC of 0.85 and internal consistency from 0.88 to 0.96 with Patient-Rated Wrist and Hand Evaluation with higher score for reliability and Spearman correlation between 0.38 and 0.89 for validity., Conclusions: Few studies included nerve repair in their sample for the psychometric analysis of outcome measures, so moderate evidence could be confirmed. Manual muscle test and Rotterdam Intrinsic Hand Myometer dynamometer had excellent reliability but insufficient data on validity or responsiveness. Touch threshold testing was more responsive than 2PD test. The locognosia test and STI had limited but positive supporting data related to validity. Rosén-Lundborg score had emerging evidence of reliability and validity as a comprehensive outcome following nerve repair. Few questionnaires were considered reliable and valid to assess cold intolerance. There is no patient-reported outcome measurement following nerve repair that provides comprehensive assessment of symptoms and function by patient perspective.

To analyze the effect of photobiomodulation and dexamethasone on nerve regeneration after a sciatic nerve crushing model. Twenty-six Swiss mice were divided into the following groups: naive; sham; injured, low-level laser therapy (LLLT) (660 nm, 10 J/cm 2 , 0.6 J, 16.8 J total energy emitted during the 28 days of radiation, 20 s, for 28 days); dexamethasone (Dex) (local injection of 2 mg/kg for 10 consecutive days); and LLLT group associated with Dex (LLLT/Dex), with the same parameters of the other groups. For nerve injury, a portable adjustable pinch was used. The animals were evaluated using the Sciatic Functional Index (SFI) and Sciatic Static Index (SSI). The results obtained were evaluated with Image J™ and Kinovea™. Data and images were obtained at baseline and after 7, 14, 21, and 28 days after surgery. The evaluation of hyperalgesia, using Hargreaves, and behavior through the open field was also performed. In functional and static analysis, all groups presented significant differences when compared to the injured group. In the analysis of the SSI results, the group treated with both LLLT and dexamethasone was more effective in improving the values of this parameter, and in the SFI, the laser-treated group obtained better results. In the evaluation through the open field and the Hargreaves, there was no difference. The application of LLLT and dexamethasone was effective in nerve regeneration according to the results and was more effective when LLLT was associated with dexamethasone than in LLLT alone for the SSI.

Although photobiomodulation therapy (PBM) has been applied clinically for the treatment of pain and inflammation, wound healing, sports and soft tissue injuries, as well as to repair injured spinal cords and peripheral nerves, it remains unclear which molecular substrates (receptor) are implicated in the cellular mechanisms of PBM. Here, we reported that PBM (660 nm, 30 mW, 0.06 cm 2 , 50 J/cm 2 , plantar irradiation) significantly inhibited carrageenan-induced paw oedema, but not noxious thermal response, through positive modulation to both CB1 and CB2 cannabinoid receptors. The use of CB1 antagonist AM281 or CB2 antagonist AM630 significantly reversed the anti-inflammatory effect of PBM. Analysis of signalling pathway downstream of cannabinoid receptors activation reveals that anti-inflammatory effects of PBM depend, in great extent, on its ability to activate ATP-dependent K + channels and p38 mitogen-activated protein kinase. Moreover, PBM therapy significantly reduced the levels of pro-inflammatory cytokine IL-6 in both paw and spinal cord, and restored the reduction of the level of anti-inflammatory cytokine IL-10 in spinal cord after carrageenan injection. Unlike the potent cannabinoid receptor agonist (WIN 55212-2), PBM did not exert any CNS-mediated effects in the tetrad assay. Finally, PBM does not reduce inflammation and noxious thermal response induced by LPS and zymosan, a TLR4 and TLR2/dectin-1 ligand, respectively. Thus, cannabinoid receptors and, possibly, the endocannabinoid system, represent an important site of action of PBM that opens the possibility of complementary and nonpsychotropic therapeutic interventions in clinical practice. Graphical Abstract ᅟ.

The aim of this study was to investigate the effect of laser photobiomodulation (PBM) on the viability of the transverse rectus abdominis musculocutaneous (TRAM) flap in rats subjected to the action of nicotine. We evaluated 60 albino Wistar rats, divided into six groups of ten animals. Group 1 (saline) underwent the surgical technique to obtain a TRAM flap; group 2 (laser 830 nm) underwent the surgical technique and was irradiated with a laser 830 nm; group 3 (laser 660 nm) underwent the surgical technique and was irradiated with a laser 660 nm; group 4 was treated with nicotine subcutaneously (2 mg/kg/2×/day/4 weeks) and underwent surgery; group 5 (nicotine + laser 830 nm) was exposed to nicotine, underwent the surgical technique, and was irradiated with a laser 830 nm; group 6 (nicotine + laser 660 nm) was exposed to nicotine, underwent the surgical technique, and was irradiated with a laser 660 nm. The application of PBM occurred immediately after surgery and on the two following days. The percentage of necrosis was assessed using the AxioVision® software. The number of mast cells (toluidine blue staining) was evaluated, and immunohistochemistry was performed to detect vascular endothelial growth factor expression (anti-VEGF-A), fibroblasts (anti-basic FGF), and neoformed vessels (anti-CD34). PBM with a wavelength of 830 nm increased the viability of the TRAM flap, with a smaller area of necrosis, increased number of mast cells, and higher expression of VEGF and CD34. PBM increases the viability of musculocutaneous flaps treated with to nicotine.

Purpose: The objective of this study was to evaluate the effectiveness of mobilization with movement and kinesiotherapy in the treatment of patients with lateral epicondylosis., Methods: This cases series included eight volunteers who had chronic lateral epicondylosis. The patients were treated with stretching, massage deep transverse at the lateral epicondyle and mobilization with movement associated with eccentric exercise. The mobilization with movement that consisted of a force of lateral glide of the proximal forearm. We performed twelve sessions, twice a week for 45 min/session. All patients underwent an evaluation with a visual analog scale and functional assessment through questionnaires patient-rated tennis elbow evaluation (PRTEE) and disabilities of the arm, shoulder and hand (DASH), before and after the treatment. Data were analyzed by student's t test (p < 0.05)., Results: The results showed statistical differences in pain symptoms before and after treatment, in the analysis and functional assessment through both questionnaires comparing the pre and post treatment., Conclusion: The data obtained in this study demonstrates improvement of the function and pain status of the sample investigated.

Background: The musculocutaneous flap of the transverse rectus abdominis muscle is a technique used for breast reconstruction, and one of the complications of this procedure is tissue necrosis. The objective of the study is to determine the effect of high-voltage electrical stimulation (HVES) in the transverse rectus abdominis muscle flap in rats., Methods: Fourteen rats underwent surgery for obtaining the flap. The rats were distributed into 2 homogeneous groups: group 1 underwent both surgery and the use of HVES, whereas group 2 underwent just the surgery (control). Electrical stimulation was applied immediately after surgery and for 2 consecutive days. The percentage of necrotic area was analyzed using the Image J software, and blood flow was assessed by infrared thermography in different regions of the flap, divided into 4 zones according to the proximity of the pedicle of the inferior epigastric artery., Results: The results were analyzed using a Student t test, where group 1 experienced a necrotic area of 26.2%, and group 2 had an area of 54.5%. Regarding the temperature, the 2 groups showed increase in the minimum and maximum temperature on the fourth postoperative day., Conclusion: The HVES appeared to have a positive influence on the viability of the flap.

Objective: Compare the efficacy of orthoses and patient education with and without the addition to Low-Level Laser Therapy (LLLT - 660 nm, 30 mW, a continuous regime and bean area of 0.06 cm2). The laser irradiation was delivered with the fluency of 10J/cm2 in patients with mild and moderate Carpal Tunnel Syndrome (CTS)., Methods: 48 patients were randomized and 30 finished the protocol (a sample loss of 37.5%), 90% female and 10% males. Randomization was applied to allocate the patients in each one of the groups, with association or not to LLLT (group orthoses or LLLT and orthoses). All of them were submitted to ergonomic home orientations. The short-term symptoms and function outcome were assessed through: Boston Carpal Tunnel Questionnaire (BCTQ) - Severity of Symptoms (SS) Functional Score (FS). Pain (VAS), Semmes-Weinstein monofilaments, 2PD and pinch strength was used for characterization of the sample. Most of the participants were women, over 4th decade enrolled on heavy hand duties occupations, right-handed, 66.7% affected on dominant hand, without alterations in sensory median nerve thresholds or pinch strength., Results: Both groups showed a reduction of total BCTQ score and its subdomains after six weeks, with significant difference (p< 0.05), comparing to baseline. No significant difference was found between groups. A Minimal clinical change was observed after the intervention in 92.3% of participants for BCTQ subdomain severity of symptoms at individual comparison for LLLT and orthoses group and 76.5% for the orthoses group, demonstrating clinical relevance. Effect size Cohen's index was moderate for the severity of symptoms., Conclusion: LLLT in association to orthoses and ergonomic orientation seems to be effective in short-term symptoms relieve for patients with mild and moderate CTS.

Purpose: The purpose this study was perform a biomechanical evaluation to compare the influence of commercial models of different non-articular proximal forearm orthoses widths (2.5 cm, 5.5 cm, 7.5 cm and 12.0 cm) in the extensor muscle activation, range of motion and grip strength in healthy subjects., Methods: Was analyzed data from extensor carpi radialis, extensor carpi ulnares and extensor digitorum comunis using surface electromyography, simultaneous with a wrist electrogoniometer MiotecTM and a hydraulic dynamometer JamarTM. The sequence of tests with all the commercial orthoses models was randomized. Statistics analyses were performed by linear model with mixed effects., Results: According to our findings the non-articular proximal forearm orthoses (2.5 cm - narrowest) positioned close to lateral epicondyle provided lesser muscle activation on extensor carpi radialis brevis/longus and extensor digitorum comunis, decreased wrist extension and grip strength during submaximal grip task (p< 0.01)., Conclusions: A narrow non-articular proximal forearm orthosis positioned close to the lateral epicondyle might decrease the extensor muscle activation and therefore could reduce mechanical stress on its insertion, based on this sample. Clinical studies must be conducted to confirm these findings.

Background: Mirror therapy has been used as an alternative stimulus to feed the somatosensory cortex in an attempt to preserve hand cortical representation with better functional results., Objective: To analyze the short-term functional outcome of an early re-education program using mirror therapy compared to a late classic sensory program for hand nerve repair., Method: This is a randomized controlled trial. We assessed 20 patients with median and ulnar nerve and flexor tendon repair using the Rosen Score combined with the DASH questionnaire. The early phase group using mirror therapy began on the first postoperative week and lasted 5 months. The control group received classic sensory re-education when the protective sensation threshold was restored. All participants received a patient education booklet and were submitted to the modified Duran protocol for flexor tendon repair. The assessments were performed by the same investigator blinded to the allocated treatment. Mann-Whitney Test and Effect Size using Cohen's d score were used for inter-group comparisons at 3 and 6 months after intervention., Results: The primary outcome (Rosen score) values for the Mirror Therapy group and classic therapy control group after 3 and 6 months were 1.68 (SD=0.5); 1.96 (SD=0.56) and 1.65 (SD=0.52); 1.51 (SD=0.62), respectively. No between-group differences were observed., Conclusion: Although some clinical improvement was observed, mirror therapy was not shown to be more effective than late sensory re-education in an intermediate phase of nerve repair in the hand. Replication is needed to confirm these findings.

Background and Objectives: The physical injuries caused by +Gz include skeletal-muscle overloads. This study has aimed at demonstrating ergonomic conditions of the pilots from the Brazilian Air Force’s Aerial Demonstration Squadron (BAFADS) during flight., Methods: All the 13 pilots from the BAFADS were evaluated through an interview. Surface electromyography (SEMG) was employed during the flight manoeuvre simulation (under normal and overload conditions)., Results: The report analyses showed perception of discomfort in the right shoulder related to +Gz. The SEMG showed moderate levels of shoulder muscles activation for normal contractions (± 25%). During vigorous contraction, levels of recruitment were high: upper trapezius fibres (± 105%), middle trapezius fibres (± 90%) and posterior deltoid fibres (± 95%). The great demand from the deltoid muscles (posterior fibres) infers a very high level of recruitment from the rotator cuff muscle, which may explain the discomfort in the pilots’ shoulder during the flight manoeuvre., Conclusion: The mutual analysis of both methods not only does it demonstrate a correlation between symptoms and muscle recruitment, but also provides data to implement intervention measures for pilots’ physical training in order to minimise the discomfort symptoms during flights.

Objectives: To examine the cellularity and thickness of the articular cartilage of the femur in rats with arthritis after treatment with iontophoresis., Methods: To evaluate these objectives, a histological analysis was performed on hematoxylin and eosin, where cellularity and cartilage thickness were observed and evaluated qualitatively and quantitatively by manual counting by 700.09µm² area., Results: The group treated with IAA had normal cellularity (40.1 cells/μm(2)) and maintenance of non-calcified cartilage (75.5μm), suggesting normal thickness. The non-treated group C+, on the other hand, had a lower mean number of chondrocytes (13.0μm(2)) (P <0.05) and, when the cartilage thickness was compared, it showed higher average thickness of calcified cartilage (104.8 mm) and lower mean of non-calcified cartilage (53.3μm)., Conclusion: The use of iontophoresis with L-ascorbic acid by continuous electric current contributed to a quantitative gain of chondrocytes and improved the thickness distribution of calcified and non-calcified cartilage. Level of Evidence III, Case Control Study.

Peripheral nerve lesions caused sensory and motor deficits along the distribution of the injured nerve. Numerous researches have been carried out to enhance and/or accelerate the recovery of such lesions. The objective of this study was to assess the functional recovery of sciatic nerve in rats subjected to different fluences of low-level laser therapy (LLLT). Thirty-six animals were randomly divided into four groups: one consisting of sham rats and three others irradiated with progressive fluencies of 10 J/cm(2), 40 J/cm(2) and 80 J/cm(2) of laser AsGaAl (830 nm) for 21 consecutive days. They were evaluated by the Sciatic Functional Index (SFI) method. The crush injury was performed by using a portable device with dead weight of 5,000 g whose load was applied for 10 min. A digital camera was used to record the footprints left on the acrylic track, before surgery and after, on the 7th, 14th, and 21st days. The results also showed that on the 7th day, there was a difference between the groups irradiated with 40 J/cm(2), when compared with the sham group (p < 0.05). On the 14th day the groups irradiated with 40 J/cm(2) and 80 J/cm(2) also presented better results when compared with sham, however, on the 21st day, no inter-group difference was found (p > 0.05). It was possible to observe that the LLLT at fluency of 40 J/cm(2) and 80 J/cm(2) had a positive influence on the acceleration of the functional nerve recovery.

Objective: To evaluate the activity of wrist extensor muscle, correlating with wrist motion during gripping after flexor tendon repair., Design: Cross-sectional clinical measurement study., Setting: Laboratory for biomechanics and rehabilitation., Subjects: A total of 11 patients submitted to rehabilitation by early passive motion of the fingers with wrist flexion position were evaluated after 8 weeks of fingers flexor tendon repair and 11 healthy volunteers, all ranging from 20 to 37 years of age., Intervention: Volunteers performed an isometric standardized gripping task., Main Measures: We used electrogoniometry to analyze wrist range of motion and surface electromyography, considering 100% maximum voluntary contraction to represent the amplitude of electromyographic activity of the extensor carpi radialis and flexor digitorum superficialis., Results: Patients with flexor tendon repair showed co-activation deficit between wrist extensor (extensor carpi radialis) and flexor finger muscles (flexor digitorum superficialis) during gripping in the intermediate phase of rehabilitation, despite some recovering mobility for wrist extension (p ≤ 0.05). A moderate correlation between range of motion and extensor carpi radialis was present only for injured group (r = 0.32). Total active motion score, which represents finger active excursion, was regular or poor in 65% of cases, all with nerve repair associated., Conclusion: Wrist extensors have an important synergist role at handgrip, although some imbalance can be present after flexor tendon repair. These preliminary findings suggest that emphasis could be directed to add synergistic wrist motion in rehabilitation protocols after flexor tendon repair. Future studies with early active rehabilitation are necessary.

Background: Carpal tunnel syndrome is the most common neuropathy in the upper extremity, resulting from the compression of the median nerve at wrist level. Clinical studies are essentials to present evidence on therapeutic resources use at early restoration on peripheral nerve functionality. Low-level laser therapy has been widely investigated in researches related to nerve regeneration. Therefore, it is suggested that the effect of low-level laser therapy associated with other conservative rehabilitation techniques may positively affect symptoms and overall hand function in compressive neuropathies such as carpal tunnel syndrome. The aim of this study is to evaluate the effectiveness of low-level laser therapy in addition to orthoses therapy and home orientations in patients with carpal tunnel syndrome., Methods/design: Patients older than 18 years old will be included, with clinical diagnosis of carpal tunnel syndrome, excluding comorbidies. A physiotherapist will conduct intervention, with a blinding evaluator. Randomization will be applied to allocate the patients in each group: with association or not to low-level laser therapy. All of them will be submitted to orthoses therapy and home orientations. Outcome will be assessed through: pain visual analogic scale, Semmes Weinstein monofilaments™ threshold sensibility test, Pinch Gauge™, Boston Carpal Tunnel Questionnaire and two point discrimination test., Discussion: This paper describes the design of a randomized controlled trial, which aim to assess the effectiveness of conservative treatment added to low-level laser therapy for patients with carpal tunnel syndrome., Trial Registration: Brazilian Clinical Trials Registry (ReBec) - 75ddtf / Universal Trial Number: U1111-1121-5184.

Objective: To evaluate the effects of varying numbers of layers of plaster of Paris bandages on the mechanical properties of specimens used on the construction of orthopedic splints., Methods: Rectangular plate-shaped and cylinder-shaped specimens were constructed and assigned to two groups simulating plaster slabs and cast and further divided into six subgroups according to the number of layers used: 3, 6, 8, 10, 12 and 14 layers. The specimens were subjected to either a three-point bending test (plates/slab) or compressive strength test (cylinders/cast). The following mechanical properties were evaluated: maximum load, elastic limit load and stiffness. Specimen weight was also calculated. Data was analyzed using Kruskal-Wallis and the least significant difference (LSD) tests., Results: Pairwise comparisons of the subgroups 10x12 and 10x14 revealed significant differences for all mechanical properties (p<0.05). The results of this study suggest that when the goal is to construct appliances with high mechanical strength, regardless of weight, such as serial plaster slabs splints for stimulating tissue growth through the application of gradual load, splints made with plaster of Paris bandages with 12 or 14 layers should be preferred. For orthotic devices such as positioning orthotics, the use of 10 layers plaster bandages slab splints is advisable as they were found to have better correlation between mechanical strength and weight in comparison to those made wtih 6 or 8 layers., Conclusion: Based on the findings of this study, we suggest the use of 10 layers of plaster of Paris for the construction of orthopedic splints.

Objective: The purpose of this study was to evaluate the effect of 830-nm laser in blocking the action of nicotine on the viability of skin flap., Background Data: The authors have analyzed the deleterious effect of cigarette smoke or nicotine on the skin flap alone with evidence of increased skin necrosis in the flap., Materials and Methods: Twenty-four Wistar-albino rats were divided into three groups of eight animals each: Group 1 (control), subjected to a surgical technique to obtain a flap for cranial base, laser irradiation simulation, and a subcutaneous injection of saline; Group 2, similar to Group 1, with subcutaneous injection of nicotine (2  mg/kg/day) for a period of 1 week before and 1 week after surgery; and Group 3, similar to Group 2, with skin flaps subjected to a λ 830-nm laser irradiation. The laser parameters used were: power 30 mW, beam area 0.07 cm(2), irradiance 429 mW/cm(2), irradiation time 84  sec, total energy 2.52  J, and energy density 36 J/cm(2). The laser was used immediately after surgery and for 4 consecutive days, in one point at 2.5  cm of the flap cranial base. The areas of necrosis were examined by two macroscopic analyses: paper template and Mini-Mop(®). The pervious blood vessels were also counted., Results: The results were statistically analyzed by ANOVA and post-test contrast orthogonal method (multiple comparisons), showing that the laser decreased the area of necrosis in flaps subjected to nicotine, and consequently, increased the number of blood vessels (p < 0.05)., Conclusions: The laser proved to be an effective way to decrease the area of necrosis in rats subjected to nicotine, making them similar to the control group.

Peripheral nerves are structures that, when damaged, can result in significant motor and sensory disabilities. Several studies have used therapeutic resources with the aim of promoting early nerve regeneration, such as the use of low-power laser. However, this laser therapy does not represent a consensus regarding the methodology, thus yielding controversial conclusions. The objective of our study was to investigate, by functional evaluation, the comparative effects of low-power laser (660 nm and 830 nm) on sciatic nerve regeneration following crushing injuries. Twenty-seven Wistar rats subjected to sciatic nerve injury were divided into three groups: group sham, consisting of rats undergoing simulated irradiation; a group consisting of rats subjected to gallium-aluminum-arsenide (GaAlAs) laser at 660 nm (10 J/cm(2), 30 mW and 0.06 cm(2) beam), and another one consisting of rats subjected to GaAlAs laser at 830 nm (10 J/cm(2), 30 mW and 0.116 cm(2)). Laser was applied to the lesion for 21 days. A sciatic functional index (SFI) was used for functional evaluation prior to surgery and on days 7, 14, and 21 after surgery. Differences in SFI were found between group 660 nm and the other ones at the 14th day. One can observe that laser application at 660 nm with the parameters and methods utilised was effective in promoting early functional recovery, as indicated by the SFI, over the period evaluated.