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Low-level laser therapy (LLLT) is used in chronic wounds due to its healing effects. However, bacterial species may colonize these wounds and the optimal parameters for effective bacterial inhibition are not clear. The aim of this study was to analyze the effect of LLLT on bacterial growth in vitro. Bacterial strains including Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa were suspended in saline solution at a concentration of 10(3) cells/ml and exposed to laser irradiation at wavelengths of 660, 830, and 904 nm at fluences of 0 (control), 3, 6, 12, 18, and 24 J/cm(2). An aliquot of the irradiated suspension was spread on the surface of petri plates and incubated at 37 °C for quantification of colony-forming unit after 24, 48, and 72 h. Laser irradiation inhibited the growth of S. aureus at all wavelengths and fluences higher than 12 J/cm(2), showing a strong correlation between increase in fluence and bacterial inhibition. However, for P. aeruginosa, LLLT inhibited growth at all wavelengths only at a fluence of 24 J/cm(2). E. coli had similar growth inhibition at a wavelength of 830 nm at fluences of 3, 6, 12, and 24 J/cm(2). At wavelengths of 660 and 904 nm, growth inhibition was only observed at fluences of 12 and 18 J/cm(2), respectively. LLLT inhibited bacterial growth at all wavelengths, for a maximum of 72 h after irradiation, indicating a correlation between bacterial species, fluence, and wavelength.

Infections caused by Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli are among the microorganisms that often lead to infection in pressure ulcers. Polarized current has emerged as a possible intervention to limit bacterial proliferation. We analyzed the effect of fixed diphasic - Bernard (FD-B) and high voltage monophasic pulsed (HVMP) currents on bacteria S. aureus ATCC 25923 (Gram +), P. aeruginosa ATCC 27853 (Gram -), and E. coli ATCC 25922 (Gram -). After the bacterial strains were activated the bacteria were suspended in physiological solution (0.9%) and the concentration adjusted to 1.5 × 10(3) CFU/mL. The cultures were stimulated with FD-B current at (3, 6, and 9 mA, 100 Hz, 15 and 30 minutes) and HVMP (32, 64, and 95 V, 100 Hz, 30 and 60 min) while monitoring the pH and temperature. After the stimulation, the suspensions were plated and incubated for 24 hours at 37°C. Then the counts were made of colony forming units (CFU). Data were submitted to normality Shapiro-Wilk test followed by nonparametric ANOVA test and post hoc Tukey test with p < 0.05. There was a decrease in the CFU for the two currents, but the most effective reduction was in FD-B. The temperature remained constant and the pH measured alkaline at the negative pole and acid at the positive pole during stimulation. The application of FD-B and HVMP currents promoted inhibition of bacterial proliferation when stimulated in vitro, acting as an adjuvant resource in the healing process., (© 2015 by the Wound Healing Society.)

Objective: The purpose of this study was to analyze the influence of blue laser on bacterial growth of the main species that usually colonize cutaneous ulcers, as well as its effect over time following irradiation., Background Data: The use of blue laser has been described as an adjuvant therapeutic method to inhibit bacterial growth, but there is no consensus about the best parameters to be used., Methods: Strains of Staphylococcus aureus ATCC 25923, Pseudomonas aeruginosa ATCC 27853, and Escherichia coli ATCC 25922 were suspended in saline solution at a concentration of 1.5×10(3) colony forming units (CFU)/mL. Next, 300 μL of this suspension was transferred to a microtitulation plate and exposed to a single blue laser irradiation (450 nm) at fluences of 0 (control), 3, 6, 12, 18, and 24 J/cm(2). Each suspension was spread over the surface of a Petri plate before being incubated at 37°C, and counts of CFU were determined after 24 and 48 h., Results: Blue laser inhibited the growth of S. aureus and P. aeruginosa at fluences >6 J/cm(2). On the other hand, E. coli was inhibited at all fluences tested, except at 24 J/cm(2)., Conclusions: Blue laser light was capable of inhibiting bacterial growth at low fluences over time, thus presenting no time-dependent effect.

Background: Transcutaneous electrical stimulation (ES) is a therapeutic procedure used in rehabilitation. However, the effectiveness of it depends on sensory responses to pain and motor control in neuromuscular recruitment, considering the differences related to gender and age of the subjects treated, as well as the intensity and frequency of ES., Objective: To determine the threshold of sensory perception (TSP) and the threshold of motor response (TMR) in young and elderly individuals of both genders., Design: Randomized controlled clinical trial., Setting: General community., Participants: Eighty volunteers with no history of systemic diseases were selected to participate in the study: 40 men and 40 women were subdivided by convenience sampling and age group into young male and female (age 21.6 ± 2.4 years) groups as well as into elderly female and male groups (age 72.6 ± 6.1 years)., Interventions: The participants received electrical stimulation (ES) at 5 and 50 Hz, with pulse durations of 20, 100, 400, 1000, and 3000 μs applied on the flexor muscle bellies of the wrist and fingers., Main Outcome Measures: TSP was identified as the first sensation of increased current intensity and TMR as the minimum muscle contraction detected. The results were submitted to analysis of variance, followed by the Tukey's test, with a significance level of 5%., Results: TSP was lower than TMR for all pulse durations, regardless of gender and age. In women, TSP was lower than that in young and elderly men at both frequencies. However, TSP was higher in elderly subjects than in younger subjects at 50 Hz for both genders. Age also affected the TMR, presenting higher thresholds in elderly subjects of both genders at 50 Hz; however the same occurred only in male subjects at 5 Hz., Conclusion: Age and gender interfere directly with ES. These variables should be considered during rehabilitation because they indicate that electrical stimulation in elderly women should be carefully performed, as they have lower thresholds than elderly men when polarized currents are used, and there is a risk of skin lesion because of their high thresholds., (Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.)

Although shortwave diathermy has been widely used by physiotherapists, there are a few studies assessing the performance of the equipment in use. The aim of the present study was to evaluate the procedures adopted by physiotherapists as users of shortwave diathermy continuous (CSWD), as well as to measure the power output and frequency of CSWD equipment. [Subjects and Methods] Twenty-three physical therapists were interviewed and 23 CSWD equipment were evaluated. Admeasurement was carried out by using a standard phantom to simulate the electrode-skin distance, which ranged from 0.5 to 3.0 cm. Data analysis was performed by using descriptive statistics, ANOVA, and a post-hoc Tukey's test or Pearson's correlation coefficient. [Results] The questionnaires showed that 48% of the interviewees use the correct electrode-skin distance, 70% use a single electrical outlet, and 35% use a grounded electrical outlet, and that 48% of the physiotherapy tables and 61% of the plinths were made of wood. However, only 13% of the interviewees perform yearly preventive maintenance. The highest power (95.56 W) was achieved at electrode-skin distances ranging from 1.0 to 1.5 cm, with distances of 2.5 cm and 3.0 cm being null in four and eight equipment, respectively. There was a negative correlation between power output and electrode-skin distance as well as between power output and purchase date. [Conclusion] The physiotherapists involved in this study had inadequate knowledge about the correct use of CSWD equipment, which may adversely affect its performance and patient safety.

Objective: The objective of this study was to analyze the bacterial morphology by atomic force microscopy (AFM) after the application of low-level laser therapy (LLLT) in in vitro culture of Staphylococcus aureus ATCC 29213., Background Data: Infections caused by S. aureus are among the highest occurring in hospitals and can often colonize pressure ulcers. LLLT is among the methods used to accelerate the healing of ulcers. However, there is no consensus on its effect on bacteria., Materials and Methods: After being cultivated and seeded, the cultures were irradiated using wavelengths of 660, 830, and 904 nm at fluences of 0, 1, 2, 3, 4, 5, and 16 J/cm(2). Viable cells of S. aureus strain were counted after 24 h incubation. To analyze the occurrence of morphological changes, the topographical measurement of bacterial cells was analyzed using the AFM., Results: The overall assessment revealed that the laser irradiation reduced the S. aureus growth using 830 and 904 nm wavelengths; the latter with the greatest inhibition of the colony-forming units (CFU/mL) (331.1±38.19 and 137.38±21.72). Specifically with 660 nm, the statistical difference occurred only at a fluence of 3 J/cm(2). Topographical analysis showed small changes in morphological conformity of the samples tested., Conclusions: LLLT reduced the growth of S. aureus with 830 and 904 nm wavelengths, particularly with 904 nm at a fluence of 3 J/cm(2), where the greatest topographical changes of the cell structure occurred.