Abstract
BackgroundThe knee osteoarthritis (OA) is a joint disease characterized by degradation of articular cartilage that leads to chronic inflammation. Exercise programs and photobiomodulation (PBM) are capable of modulating the inflammatory process of minimizing functional disability related to knee OA. However, their association on the concentration of biomarkers related to OA development has not been studied yet. The aim of the present study is to investigate the effects of PBM (via cluster) with a physical exercise program in functional capacity, serum inflammatory and cartilage degradation biomarkers in patients with knee OA.MethodsForty-two patients were randomly allocated in 3 groups: ESP: exercise + sham PBM; EAP: exercise + PBM and CG: control group. Six patients were excluded before finished the experimental period. The analyzed outcomes in baseline and 8-week were: the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) and the evaluation of serum biomarkers concentration (IL-1β, IL-6, IL-8, IL-10 e TNF-α, and CTX-II).ResultsAn increase in the functional capacity was observed in the WOMAC total score for both treated groups (p < 0.001) and ESP presents a lower value compared to CG (p < 0.05) the 8-week post-treatment. In addition, there was a significant increase in IL-10 concentration of EAP (p < 0.05) and higher value compared to CG (p < 0.001) the 8-week post-treatment. Moreover, an increase in IL-1β concentration was observed for CG (p < 0.05). No other difference was observed comparing the other groups.ConclusionOur data suggest that the physical exercise therapy could be a strategy for increasing functional capacity and in association with PBM for increasing IL-10 levels in OA knee individuals.Trial registration: ReBEC (RBR-7t6nzr).
Highlights
Osteoarthritis (OA) leads to degradation of articular cartilage, formation of osteophytes, decrease of joint space and degeneration of subchondral bone and is characterized as a chronic joint disease [1]
All the positive effects of physical exercise programs for treatment of OA, its association with PBM via a cluster device on the expression of ILs and biomarkers related to cartilage degradation in patients with OA has not been studied yet. In this context, based on the need of determining a more appropriate therapeutic intervention to treat patients with OA, the present study aimed to investigate the effects of the incorporation of PBM into a physical exercise program in serum inflammatory biomarkers (IL-1β, interleukin -6 (IL-6), IL-8, IL-10 e Tumor Necrosis Factor alpha (TNF-α)), cartilage degradation biomarker (CTX-II) and functional capacity (WOMAC) in patients with knee OA
The results demonstrated that there was significant difference between Exercise sham photobiomodulation group (ESP), in the baseline compared to ESP in the 8-week (p = 0.00006), between Exercise active photobiomodulation group (EAP) in the baseline and EAP in the 8-week (p = 0.00002) and between ESP and Control group (CG) in the 8-week (p = 0.011)
Summary
Osteoarthritis (OA) leads to degradation of articular cartilage, formation of osteophytes, decrease of joint space and degeneration of subchondral bone and is characterized as a chronic joint disease [1]. These morphological alterations culminate in an increasing of the level of articular pain, loss of function, decrease in the range of motion and muscle weakness, impairing the quality of life of the patients [2]. It has been demonstrated that patients with OA showed high levels of proinflammatory cytokines, which disturb the catabolism and anabolism processes, being responsible by inflammation and consequence articular cartilage degeneration [5]. The aim of the present study is to investigate the effects of PBM (via cluster) with a physical exercise program in functional capacity, serum inflammatory and cartilage degradation biomarkers in patients with knee OA
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