Efeitos da fotobiomodulação e cinesioterapia no tratamento da osteoartrite de joelho: estudo clínico, prospectivo e randomizado

Abstract

Osteoarthritis is a chronic joint disease characterized by gradual destruction of cartilage, which can generate pain, muscle weakness, deficit in the range of motion, stiffness and impairment in function. The aim of this study was to compare the effects of kinesiotherapy associated or not with photobiomodulation on the intensity of pain, range of motion, physical function and muscle strength of the quadriceps femoris and hamstrings in patients diagnosed with knee osteoarthritis (KOA). 28 patients participated in this study, randomly divided into 2 treatment groups, performed 3 times a week, for 6 weeks: Kinesiotherapy Group (KG), submitted to stretching, self mobilization, muscle strengthening and sensorimotor training and Kinesiotherapy and Photobiomodulation Group (KPG), submitted to the same program as the KG followed by infrared laser irradiation (808 nm, 100mW - 5 points in the medial joint region of Joelho and 4 points lateral, 3J / point; 30 s per point). Blinded evaluators assessed pain at rest and movement and range of motion using the visual analog scale (VAS) and goniometry, respectively. To assess physical function, the WOMAC questionnaire (Western Ontario and MacMaster University Osteoarthritis Index) and functional tests were used: Sit and stand test; 2 min walk test. The muscular strength of the quadriceps and hamstrings were measured using an isometric dynamometer. The evaluations were performed in 4 moments: before (EV0), during (EV1: 3 weeks of treatment), at the end (EV2: after 6 weeks of treatment) and 30 days after the end of treatment (follow-up). When comparing treatments, the combination of treatments showed a reduction in joint pain intensity at rest, an increase in knee flexion amplitude, an improvement in physical function and an increase in muscle strength of quadriceps femoris when compared to KG (p <0.05). In the intra-group analysis, our results showed a significant improvement in all variables studied (p <0.05), and in some variables only after 3 weeks of intervention. we can conclude that a kinesiotherapy associated with photobiomodulation can be a good adjunctive treatment in OAJ.