PBMT Associated With a Pulmonary Rehabilitation Program on the Functional Capacity of Patients With COPD

Description

This study aims to evaluate the effectiveness of photobiomodulation therapy (PBMT) as an adjunct to the pulmonary rehabilitation program on the functional capacity of patients with COPD. This is a randomized, placebo-controlled, double-blind clinical trial conducted with 20 patients from the outpatient clinic of the Integrated Cardiopulmonary and Metabolic Rehabilitation Service of Santa Casa de Porto Alegre. Patients will be allocated to the active PBMT group, receiving photobiomodulation treatment prior to the exercise protocol of the pulmonary rehabilitation program, in the respiratory and peripheral muscles, or the placebo group, which will receive the therapy application at the same points but without the therapeutic dose, prior to rehabilitation. Sixteen PBMT applications will be performed over eight weeks, with a frequency of twice a week. The exercises performed in the institution's pulmonary rehabilitation program by the patients will not be interfered with by the researchers. Evaluations will be carried out in three stages: immediately after recruitment, after 8 interventions, and after 16 interventions.

Interventions

• Intervention Group (Other)
  Will be calibrated Multi Radience Medical® MR5 ACTIV PRO LaserShower superpulsed laser will be used. Will be applied twice a week for eight weeks to the lower limbs and respiratory muscles. In the lower limb, the following will be irradiated: the quadriceps muscle (4 points), the hamstring muscles (3 points), and the gastrocnemius (1 point), bilaterally. Among the respiratory muscles, the diaphragm (6 points) and the sternocleidomastoid (1 point - bilaterally) will be irradiated. In total, the application will be done at 24 points. The energy transmitted to the patient (dose) will be 30J per application point, through a cluster with four wavelengths (905, 850, 630 and 470 nm), with a frequency of 250hz and a peak pulse power of 200 mW. Considering that each application point receives 30J, the knee extensors are solicited around 240J, the knee flexors and diaphragm 180J, the ankle flexors 60J and the sternocleidomastoid 60J.
• control group (Other)
  For the application of placebo PBMT, the patient will be instructed to lie on their back and then on their side, and the properly calibrated Multi Radience Medical® MR5 ACTIV PRO LaserShower superpulsed laser will be used. The treatment will be performed with the beam in contact with the skin at a 90º angle. The therapy will be applied twice a week for eight weeks to the lower limbs and respiratory muscles. In the lower limb, the following will be irradiated: the quadriceps muscle (four points), the hamstring muscles (three points), and the gastrocnemius (one point), bilaterally. Among the respiratory muscles, the diaphragm (six points) and the sternocleidomastoid (one point - bilaterally) will be irradiated. In total, the application will be done at 24 points. In this group, the dose will not be released, however, patients identified the same audible and visual signals, as well as the duration of the device's contact with the skin, as in the treated group.

Eligibility criteria

Conditions

Locations

• Santa Casa de Porto Alegre — Porto Alegre, Rio Grande do Sul, Brazil