Efeito da fotobiomodulação vascular na cefaleia tipo tensional e nas dores orofaciais em indivíduos pós-covid-19: ensaio clínico randomizado pragmático

Abstract

Orofacial pain and tension headache were symptoms reported in individuals who contracted COVID-19, even after recovery, and are considered chronic pain. The control of the painful sensation in these cases is performed, mostly, through analgesic and anti-inflammatory drugs. However, adjuvant treatments are available that can decrease the amount of drug intake and improve the quality of life of compromised individuals, one of which is photobiomodulation. With the use of laser, successful treatments are performed to control inflammation and pain, but the parameters and methods of application are not yet firmly established. The objective of this research is to evaluate the effect of the application of vascular photobiomodulation with red laser. For this purpose, individuals who contracted COVID-19 and had tension headaches and/or orofacial pain for more than 3 months were selected for convenience. Participants were divided into two groups: G1 - Composed of the placebo group (Control) and G2 - Received vascular photobiomodulation with red laser in the radial artery (660 nm, 100 mW, 30 minutes). The initial protocol was 8 weekly sessions, due to the short time to perform it was changed to 4 weeks with 4 application sessions. The effects were measured using validated questionnaires and scales such as the Brief Pain Inventory, the Visual Analog Scale (VAS) and the Headache Impact Test. Data were collected weekly before and after treatment and were analyzed using the statistical program SPSS 23.0 for Win. Data that did not show normal distribution after the Shapiro-Wilk test for normality. Mann-Whitney, Wilcoxon, ANOVA, chi-square and Fisher's exact tests were used. α= 0.05 was considered as the level of statistical significance. For the painful sensation after the 4 sessions in the FBM and control groups, the P value was 0.001, but in the active group for FBMV, the reduction was gradual and constant when observed per session. The difference in quality of life was not significant. There was an improvement in sleep, in X the ability to enjoy life and in carrying out activities such as working and walking. There is a need for more clinical studies that reproduce protocols with more time for application, evaluation and follow-up.