Photobiomodulation Therapy Combined with Static Magnetic Field (PBMT-SMF) on Spatiotemporal and Kinematics Gait Parameters in Post-Stroke: A Pilot Study.

Arislander Jonathan Lopes Dumont,Shaiane Silva Tomazoni,Ernesto Cesar Pinto Leal-Junior,Manuela Galli,Heliodora Leão Casalechi,Claudia Santos Oliveira,Luanda Collange Grecco

doi:10.3390/life12020186

Arislander Jonathan Lopes Dumont, Shaiane Silva Tomazoni + Show 5 more

Open Access

https://doi.org/10.3390/life12020186

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Abstract

Background: Gait deficit is a major complaint in patients after stroke, restricting certain activities of daily living. Photobiomodulation therapy combined with a static magnetic field (PBMT-SMF) has been studied for several diseases, and the two therapies are beneficia. However, their combination has not yet been evaluated in stroke. Therefore, for PBMT–SMF to be used more often and become an adjunctive tool in the rehabilitation of stroke survivors at physical therapy rehabilitation centers and clinics, some important aspects need to be clarified. Purpose: This study aimed to test different doses of PBMT–SMF, to identify the ideal dose to cause immediate effects on the spatiotemporal and kinematic variables of gait in post-stroke patients. Methods: A randomized, triple-blinded, placebo-controlled crossover pilot study was performed. A total of 10 individuals with hemiparesis within 6 months to 5 years since the occurrence of stroke, aged 45–60 years, were included in the study. Participants were randomly assigned and treated with a single PBMT–SMF dose (sham, 10 J, 30 J, or 50 J) on a single application, with one dose per stage at 7-day intervals between stages. PBMT–SMF was applied with a cluster of 12 diodes (4 of 905 nm laser, 4 of 875 nm LEDs, and 4 of 640 nm LEDs, SMF of 35 mT) at 17 sites on both lower limbs after baseline evaluation: plantar flexors (2), knee extensors (9), and flexors (6). The primary outcome was self-selected walking speed, and the secondary outcomes were kinematic parameters. Gait analysis was performed using SMART-D 140® and SMART-D INTEGRATED WORKSTATION®. The outcomes were measured at the end of each stage after the single application of each PBMT–SMF dose tested. Results: No significant differences (p > 0.05) in spatiotemporal variables were observed between the different doses, compared with the baseline evaluation. However, differences (p < 0.05) were observed in the kinematic variable of the hip in the paretic and non-paretic limbs, specifically in the minimum flexion/extension angulation during the support phase (HMST–MIN) in doses 10 J, 30 J, and 50 J. Conclusions: A single application of PBMT–SMF at doses of 10 J, 30 J, and 50 J per site of the lower limbs did not demonstrate positive effects on the spatiotemporal variables, but it promoted immediate effects in the kinematic variables of the hip (maximum and minimum flexion/extension angulation during the support phase) in the paretic and non-paretic limbs in post-stroke people.

Highlights

Stroke is classified as a neurological deficit caused by an acute focal lesion of the central nervous system resulting from a vascular cause [1]
Recent studies [23,28] determined that the technology of the equipment we used in the present study demonstrated that the ergogenic effects do not last longer than 54 h after irradiation; the 7-day washout used in the present study was adequate
All people received a treatment dose according to randomization

Summary

Introduction

Stroke is classified as a neurological deficit caused by an acute focal lesion of the central nervous system resulting from a vascular cause [1]. Post-stroke sequelae are heterogeneous; after injury, people may experience sensorimotor changes, usually on one side of the body, such as hemiparesis, which results in muscle weakness, eventually leading to muscle spasticity and joint stiffness [3,4] These changes directly influence the gait of post-stroke individuals, which affects their level of activity, restricting their participation in the community and impacting their quality of life [5,6,7]. Purpose: This study aimed to test different doses of PBMT–SMF, to identify the ideal dose to cause immediate effects on the spatiotemporal and kinematic variables of gait in post-stroke patients. Conclusions: A single application of PBMT–SMF at doses of 10 J, 30 J, and 50 J per site of the lower limbs did not demonstrate positive effects on the spatiotemporal variables, but it promoted immediate effects in the kinematic variables of the hip (maximum and minimum flexion/extension angulation during the support phase) in the paretic and non-paretic limbs in post-stroke people

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