http://bibliotecatede.uninove.br/handle/tede/34 2026-06-09T09:38:10Z 2026-06-09T09:38:10Z Freitas, Luiz Cláudio de http://bibliotecatede.uninove.br/handle/tede/3983 2026-05-26T14:48:31Z 2025-12-03T00:00:00Z

Título: Impacto da fotobiomodulação com dispositivo de led de uso domiciliar na reabilitação de fraturas de úmero proximal: estudo clínico controlado randomizado duplo cego Autor: Freitas, Luiz Cláudio de Primeiro orientador: Ferrari, Raquel Agnelli Mesquita Abstract: Pain and joint stiffness are frequent complications after proximal humerus fractures (PHF), resulting in important functional limitation. Photobiomodulation (PBM) has shown benefits in fracture rehabilitation. This double-blind, randomized clinical trial evaluated the effects of PBM on the functional recovery of surgically treated PHF. Forty-two participants were randomized (1:1) into a Control group (physiotherapy + simulated PBM) and a PBM group (physiotherapy + active PBM). PBM was applied daily at home for 10 minutes using a device with 318 LEDs (159 LEDs at 660 nm: 28.5 mW, 12 J/cm², 17 J; and 159 LEDs at 850 nm: 23 mW, 10 J/cm², 14 J). PBM and physiotherapy sessions were conducted for 12 weeks. Participants and evaluators remained blinded to allocation, and assessments occurred at 24 h, 1, 2, 4, 8, and 12 weeks after surgery and daily through telephone contact. The primary outcome was shoulder function (QuickDASH). Secondary outcomes included range of motion, muscle strength, pain, analgesic consumption, quality of life (SF-6D), bone consolidation, occurrence of adverse events, and cost-effectiveness. Disability (QuickDASH) decreased over time in both groups, with a more pronounced reduction in the PBM group, although without significant interaction. There were no differences between groups in the evolution of range of motion, except for medial rotation, which showed lower values in the PBM group when comparing weeks 2, 8, and 12 versus day 1, without significant interaction. The PBM group showed fewer days with pain at weeks 8 and 12, with significant group–time interaction. Functional pain intensity showed significant interaction at weeks 4, 8, and 12, with lower intensity in the PBM group at week 12. For nighttime pain, there was significant interaction at week 12, with reduction in the PBM group and increase in the control. Both groups presented a progressive increase in pressure tolerated until the sensation of pain, without differences or significant interaction. Dipyrone consumption (days and tablets) showed significant interaction at weeks 8 and 12, with an increase in the control and lower values in the PBM group; this group also showed a lower mean number of days of dipyrone use. Tramadol use showed no differences or significant interactions. The SF-6D showed significant interactions at weeks 8 and 12, with a trend toward improvement in the PBM group. No differences were observed between groups in bone consolidation or muscle strength, and no adverse events related to PBM were reported. In the cost-effectiveness analysis, PBM demonstrated greater mean effectiveness in reducing QuickDASH scores and days with pain, although associated with incremental cost. PBM proved to be safe and associated with improvements in important clinical parameters, especially in reducing pain and dipyrone consumption between weeks 8 and 12, in addition to a trend toward improved quality of life. Although it did not alter global function, range of motion, muscle strength, or bone consolidation and generated financial increment, its analgesic effects suggest usefulness as an adjuvant to physiotherapy in the postoperative recovery of surgically treated PHF, indicating that PBM incorporation should simultaneously consider clinical gain and cost. Instituição: Universidade Nove de Julho Tipo do documento: Tese

2025-12-03T00:00:00Z Mello, Érika da Silva http://bibliotecatede.uninove.br/handle/tede/3949 2026-03-24T20:24:28Z 2021-06-01T00:00:00Z

Título: Preparo dos tecidos orofaciais envolvidos nas cirurgias de terceiros molares inferiores retidos com LED infravermelho para o controle da dor, trismo e edema: ensaio clínico, randomizado, duplo-cego, controlado Autor: Mello, Érika da Silva Primeiro orientador: Deana, Alessandro Melo Abstract: The removal of impacted lower third molars is indicated to avoid further complications such as pericoronitis and cysts. This removal can generate unwanted events such as pain, trismus and edema. For the control of these events, the preemptive use of corticosteroids, analgesics, anti-inflammatories and physiotherapy measures are recommended. Photobiomodulation has been shown to be effective in reducing pain, edema and trismus. This study evaluates the efficacy of photobiomodulation in conditioning the tissues involved in surgeries of retained lower third molars, aiming at the reduction or absence of postoperative pain, trismus and edema. A clinical trial, randomized, double-blind, and placebo control wanted to evaluate the pain, edema, and trismus in impacted lower thirty molar third surgery on preconditioning orofacial tissues with infrared LED 850nm, 08J during 80 seconds. After facial measures and 01 hour before surgery, the treatment group (n=31) was irradiated with infrared LED, and in the sham group, a similar device without radiation was used. The participants were evaluated and receive randomized treatment on the second and seventh day after surgery. The comparison between groups demonstrated a significant reduction for pain in the photobiomodulation group on the second day after surgery in relation to the placebo group (p = 0.006, Mann-Whitney), however it showed a lack of significant difference for the assessment of trismus. The evaluation of the edema showed that after 7 days of the surgery, the facial measurements were statistically equal to the pre-surgical values. In conclusion, he demonstrated that the conditioning of the orofacial tissues involved in third molar surgeries using an infrared LED with 850nm wavelength, performed one hour before the surgical procedure, showed positive results in reducing postoperative pain. Instituição: Universidade Nove de Julho Tipo do documento: Dissertação

2021-06-01T00:00:00Z Fernandes, Sirléia Mendes http://bibliotecatede.uninove.br/handle/tede/3948 2026-03-24T20:19:03Z 2025-11-25T00:00:00Z

Título: Efeito da fotobiomodulação vascular como adjuvante ao tratamento da dor lombar: ensaio clínico piloto randomizado triplo cego Autor: Fernandes, Sirléia Mendes Primeiro orientador: Motta, Lara Jansiski Abstract: Low back pain (LBP) is a public health problem that directly impacts quality of life, being one of the main causes of functional disability, absenteeism from work, reduced social interaction, and high costs associated with long-term treatments, with the potential to affect the individual's mental health. Currently, the management of LBP involves the use of anti-inflammatory drugs, analgesics, physiotherapy, and, in specific cases, surgery. Recent studies indicate that Vascular Photobiomodulation (VPM), which prioritizes the irradiation of blood components, is a promising strategy, as it stimulates mitochondrial ATP (Adenosine Triphosphate) production, increasing blood oxygenation, promoting tissue repair, and exerting anti-inflammatory and analgesic effects. This study had as its primary objective to evaluate the efficacy of VPM in patients with low back pain. This was a pilot, randomized, triple-blind clinical trial. Participants were recruited through the principal investigator's contact network. Twenty individuals, aged between 18 and 65 years, presenting with complaints of low back pain lasting between the 1st and 5th week, were included in the study. Participants were randomly assigned to two groups (n=10 per group): Placebo Group (G1) and Treatment Group (G2). The treatment lasted four weeks, with two sessions per week (total of 8 sessions). Both groups received Manual Myofascial Release, lasting 15 minutes, and therapeutic mobility exercises for the lower and upper limbs and trunk. G1 was subjected to an inactive device (sham) that simulated light projection, and G2 received active MVFB application, with a wavelength of 660 nm; continuous mode; power of 100 mW; irradiated energy of 180 J per session; exposure time of 1800 seconds. Data collection included the application of the Oswestry Disability Index 2.0 and the Roland Morris Disability Questionnaire at the first and last consultations, and the Numerical Pain Scale (NPS) at all consultations before and after treatment. Data were collected and recorded in an Excel spreadsheet. For statistical analysis, the Student's t-test, adjustment to the Poisson distribution, Shapiro-Wilk test, Chi-square test, Wald multiple comparison, and repeated measures model were used. A significance level of 5% (α=0.05) was adopted for all analyses. The findings of this pilot study indicated a significant difference between the groups in the Oswestry Disability Index (p=0.0322) and the Roland Morris Disability Questionnaire (p=0.007), results that demonstrate that Vascular Photobiomodulation contributed to the improvement of the participants' functionality. In the pain analysis assessed through the NDS, no significant difference was found between the groups (p=0.1392). However, Group 2 (treatment), which started treatment with a higher average than Group 1 (placebo), showed a significant decrease in post-treatment pain scores during the initial sessions. Both groups showed a statistically significant intragroup difference in pain. Subsequent studies with a larger sample size are crucial for the validation and generalization of these preliminary findings. Instituição: Universidade Nove de Julho Tipo do documento: Dissertação

2025-11-25T00:00:00Z Pereira, Silvia Regina dos Santos http://bibliotecatede.uninove.br/handle/tede/3947 2026-03-24T20:14:54Z 2025-06-24T00:00:00Z

Título: Terapia de fotobiomodulação no tratamento da síndrome geniturinária em mulheres pós - menopausadas com incontinência urinária de esforço: estudo clínico duplo-cego randomizando controlado Autor: Pereira, Silvia Regina dos Santos Primeiro orientador: Deana, Alessandro Melo Abstract: INTRODUCTION: Genitourinary Syndrome of Menopause (GSM), defined in 2013 by the International Society for the Study of Women’s Sexual Health (ISSWSH) and the North American Menopause Society (NAMS), encompasses a set of signs and symptoms resulting from estrogen deficiency, manifested by urinary, genital, and sexual changes. OBJECTIVE: To evaluate the effect of photobiomodulation (PBM) on reducing urinary loss in postmenopausal women with GSM. METHODS: A randomized, double-blind, placebo-controlled clinical trial involving 65 women over 50 years of age, postmenopausal, and with urinary incontinence. The study was approved by the Ethics Committee of Universidade Nove de Julho (approval no. 5.628.333). Participants were randomly allocated into two groups: Group A (n=33) underwent PBM with a diode laser applied externally to the vaginal area, while Group B (n=32, placebo) received the same procedure with the device switched off. The therapeutic protocol consisted of four weekly sessions using a DMC diode laser (808 nm), with 4 J per point, 100 mW power, power density of 510 mW/cm², and a beam area of 0.2 cm², totaling eight irradiated points, with 40 seconds per point. Outcome variables included FSFI-6 (Female Sexual Function Index – short version), ICIQ-SF (International Consultation on Incontinence Questionnaire – Short Form), menopausal symptoms, and VHI (Vaginal Health Index). In addition, vaginal temperature, pelvic floor strength measured by dynamometry, and urinary loss assessed by the 1-hour Pad Test were evaluated. Data normality was verified using the Shapiro-Wilks test. RESULTS: The PBM group showed a significant reduction in urinary loss compared with the placebo group (p=0.02155). Intragroup analysis revealed significant improvement in the PBM group (p=0.0085), but not in the placebo group (p=0.0747). No significant differences were observed between groups in pelvic floor strength or pelvic pressure (p>0.05). The ICIQ-SF indicated greater symptom reduction in the PBM group. Improvements in vaginal dryness and burning were also reported, although no relevant differences were found in sexual function between groups. CONCLUSION: PBM demonstrated significant efficacy in reducing urinary loss and improving symptoms of dryness and burning in postmenopausal women with GSM. However, no significant changes were observed in pelvic pressure, vaginal temperature, or sexual function. Overall, laser therapy appears to be a viable and non-invasive therapeutic option for specific symptoms associated with GSM. Instituição: Universidade Nove de Julho Tipo do documento: Tese

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