Photobiomodulation therapy associated with supervised therapeutic exercises for people with knee osteoarthritis: a randomised controlled trial protocol

Photobiomodulation does not provide incremental benefits to patients with knee osteoarthritis who receive a strengthening exercises program: a randomized controlled trial

BACKGROUND

There is lack of agreement in the literature about the effectiveness of photobiomodulation (PBM) for reducing pain-related symptoms in patients with knee osteoarthritis (OA).

OBJECTIVE

To evaluate whether PBM, when combined to exercises, provides incremental therapeutic benefits for pain, physical function, and quality of life (QoL) in patients with knee OA.

METHODS

A six-month double-blind placebo-controlled randomized trial was conducted. Patients with knee OA were randomly assigned to one of three treatment groups: Exercise, Exercise plus Active PBM, or Exercise plus Placebo PBM. Treatment was provided over an eight-week period, three times per week. The primary outcomes were pain at rest and upon movement, assessed by a visual analogue scale (VAS). WOMAC global score, QoL, and a core-set of performance-based tests were measured as secondary outcomes. All outcomes were collected at baseline, immediately after treatment, and after three- and six-month post-treatment.

RESULTS

127 participants were allocated as follows: Exercise, N = 41; Exercise plus Active PBM, N = 44; and Exercise plus Placebo PBM, N = 42. There was no between-groups difference in improvement in pain, physical function, and QoL for all follow-up times. However, all groups presented significant, clinically relevant improvements in pain, physical function, and QoL immediately and three months after treatment compared with baseline measures.

CONCLUSION

Patients with knee OA who received a strengthening exercises program did not experience incremental benefits regarding pain, physical function, or QoL when adding PBM to their therapeutic exercises.

Photobiomodulation for knee osteoarthritis: a model-based dosimetry study

LED-based photobiomodulation (LED-PBM) for the treatment of knee osteoarthritis (KOA) is a promising technology. However, the light dose at the targeted tissue, which dominates the phototherapy effectiveness, is difficult to measure. This paper studied the dosimetric issues in the phototherapy of KOA by developing an optical model of the knee and performing Monte Carlo (MC) simulation. The model was validated by the tissue phantom and knee experiments. In the study, we investigated the effect of luminous characteristics of the light source, such as divergence angle, wavelength and irradiation position, on the treatment doses for PBM. The result showed that the divergence angle and the wavelength of the light source have a significant impact on the treatment doses. The optimal irradiation location was on both sides of the patella, where the largest dose could reach the articular cartilage. This optical model can be used to determine the key parameters in phototherapy and help the phototherapy of KOA patients.

Effect of compression by elastic bandages on pain and function in individuals with knee osteoarthritis: protocol of a randomised controlled clinical trial

INTRODUCTION

Although compression is used to control pain in knee osteoarthritis (KOA), its clinical application is poorly supported, and there is a lack of scientific evidence to support its clinical use. As a low-cost and accessible protocol, compression using elastic bands could be a non-pharmacological intervention to reduce pain and improve physical function in individuals with KOA. This study aims to evaluate the effects of compression on pain and function in individuals with KOA.

METHODS AND ANALYSIS

A randomised controlled clinical trial will be conducted. Individuals with KOA (n=90; both sexes; between 40 and 75 years old) will be allocated to three groups (n=30/group): compression (compression by the elastic bandage on the affected knee, once a day for 20 min, on four consecutive days); sham (same protocol, but the elastic band is placed around the affected knee without compression) and control (no intervention). The individuals in the three groups will be evaluated 1 day before the first intervention, 1 day after the last intervention, and at the 12th and 24th weeks after the end of the intervention. Pain intensity by the Visual Analogue Scale and pain scale from Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC) will be the primary outcomes. The secondary variables will be physical function assessed by the WOMAC questionnaire and physical tests (step test; 30 s sit and stand test; 40 m accelerated walk test). The Global Rating of Change Scale (GRC) will also be applied to quantify the volunteers' perceived change.

ETHICS AND DISSEMINATION

The project was approved by the Human Research Ethics Committee of the Federal University of São Carlos, São Paulo, Brazil (3955692). The results will be published in peer-reviewed journals.

TRIAL REGISTRATION NUMBER

NCT04724902.

Analysis of the Application Effect of Exercise Rehabilitation Therapy Based on Data Mining in the Prevention and Treatment of Knee Osteoarthritis

Objective. To analyze the application effect of exercise rehabilitation therapy based on data mining in the prevention and treatment of knee osteoarthritis. Methods. Based on clinical data mining technology, that is, using complex network technology and association rules, the medical records of 1612 patients with KOA in the Department of Rheumatology and Immunology of our hospital were retrospectively analyzed, and they were divided into groups according to whether they used exercise rehabilitation therapy ( $n=786$ ), and the control treatment group ( $n=826$ ), the curative effect, the improvement of inflammatory factors and immune factors, the visual analogue scale (VAS), the knee joint function score (Lysholm), and the quality of life (WOMAC) scale were compared between the two groups score, analyze the relationship between VAS and Lysholm score and prognosis quality of life, and compare the recurrence within 12 months between the two groups. Results. The data mining results showed that the curative effect of the exercise rehabilitation therapy group was significantly higher than that of the control treatment group ( $P<0.05$ ); the improvement of VAS and Lysholm scores of the exercise rehabilitation therapy group was significantly better than that of the control treatment group ( $P<0.05$ ). The improvement effect of inflammatory indexes and immune cytokines was significantly better than that of the control treatment group ( $P<0.05$ ); the improvement of WOMAC in the exercise rehabilitation therapy group was significantly better than that of the control treatment group ( $P<0.05$ ); VAS and WOMAC scores were significantly positively correlated ( $r=0.579$ , $P<0.05$ ); Lysholm score was positively correlated with WOMAC score ( $r=-0.563$ , $P<0.05$ ); the recurrence rate of exercise rehabilitation therapy group was 5.09%, which was significantly lower than that of control treatment group (17.63% ( ${\chi }^2=11.967$ ), $P<0.05$ ). Conclusion. Exercise rehabilitation therapy for KOA patients can effectively improve inflammatory and immune factors in patients, enhance knee joint function and prognosis quality of life, and reduce readmission rate, which is worthy of clinical application.