Background: Both physical activity and low-level laser therapy (LLLT) can reduce knee osteoarthritis (KOA) inflammation. We conducted a randomized clinical trial to investigate the short- and long-term effectiveness of LLLT combined with strength training in persons with KOA. Methods: Fifty participants were randomly divided in two groups, one with LLLT plus strength training (n = 26) and one with placebo LLLT plus strength training (n = 24). LLLT and strength training were performed triweekly for 3 and 8 weeks, respectively. In the laser group, 3 joules 904 nm wavelength laser was applied to fifteen points (45 joules) per knee per session. Patient-reported outcomes, physical tests, and ultrasonography assessments were performed at baseline and 3, 8, 26, and 52 weeks after initial LLLT or placebo therapy. The primary outcomes were pain on movement, at rest, at night (Visual Analogue Scale), and globally (Knee injury and Osteoarthritis Outcome Score (KOOS) subscale). Parametric data were assessed with analysis of variance using Šidák’s correction. Results: There were no significant between-group differences in the primary outcomes. However, in the laser group there was a significantly reduced number of participants using analgesic and non-steroidal anti-inflammatory drugs and increased performance in the sit-to-stand test versus placebo-control at week 52. The joint line pain pressure threshold (PPT) improved more in the placebo group than in the laser group, but only significantly at week 8. No other significant treatment effects were present. However, pain on movement and joint line PPT were worse in the placebo group at baseline, and therefore, it had more room for improvement. The short-term percentage of improvement in the placebo group was much higher than in similar trials. Conclusions: Pain was reduced substantially in both groups. LLLT seemed to provide a positive add-on effect in the follow-up period in terms of reduced pain medication usage and increased performance in the sit-to-stand test.

Physical activity and low-level laser therapy (LLLT) can reduce knee osteoarthritis (KOA) inflammation. We are conducting a randomized placebo-controlled trial to investigate the long-term effectiveness of LLLT combined with strength training (ST) in persons with KOA, since it, to our knowledge, has not been investigated before. Fifty participants were enrolled. LLLT and ST was performed 3 times per week over 3 and 8 weeks, respectively. In the LLLT group, 3 Joules of 904 nm wavelength laser was applied to 15 spots per knee (45 Joules/knee/session). The primary outcomes are pain during movement, at night and at rest (Visual Analogue Scale) and global pain (Knee injury and Osteoarthritis Outcome Score, KOOS) pain subscale. The secondary outcomes are KOOS disability and quality-of-life, analgesic usage, global health change, knee active range of motion, 30 s chair stand, maximum painless isometric knee extension strength, knee pain pressure threshold and real-time ultrasonography-assessed suprapatellar effusion, meniscal neovascularization and femur cartilage thickness. All the outcomes are assessed 0, 3, 8, 26 and 52 weeks post-randomization, except for global health change, which is only evaluated at completed ST. This study features the blinding of participants, assessors and therapists, and will improve our understanding of what occurs with the local pathophysiology, tissue morphology and clinical status of persons with KOA up to a year after the initiation of ST and a higher 904 nm LLLT dose than in any published trial on this topic.

O tendão do calcâneo (TC) é o mais forte tendão do corpo humano, com grande capacidade de suportar carga. O TC é vulnerável a lesões por esforço repetitivo por receber muita carga, responsável por 18% de todas as lesões no esporte. O ultrassom (US) diagnóstico é uma técnica barata, dinâmica e rápida para avaliação de tecidos tendíneos, que pode ser associada a testes clínicos para diagnóstico de tendinopatias. Considerando que a simetria do organismo está relacionada com bom estado geral de saúde, objetivou-se neste trabalho avaliar a morfologia e aspectos clínicos do TC de indivíduos com e sem tendinopatia do TC. Participaram do estudo 28 indivíduos: 15 no grupo controle (GC) e 13 no grupo tendinopatia (GT). Os participantes passaram por avaliações específicas do TC: Exame de US, testes à palpação e clínicos. Os sujeitos do GC apresentam média de 0,407cm e 0,389cm da espessura do TC (TC direito e TC esquerdo), e não foram demonstradas anormalidades que indicassem inflamação nas imagens de US e nos testes clínicos. Nos indivíduos do GT, os valores da espessura do TC foram maiores, atingindo até 0,563cm, além de apresentarem alterações nas imagens de US para inflamação. A diferença da espessura do TC entre membros dos indivíduos do GC foi de 10%, enquanto no GT foi de 22%. Por meio dos resultados, sugere-se que diferenças da espessura do TC superiores a 20% indiquem a presença de tendinopatia, comprovadas pelos achados nas imagens de ultrassom e pelos resultados positivos dos testes à palpação e clínicos.