Effects of low-level laser therapy on hamstring strain injury rehabilitation: A randomized controlled trial

Medeiros, Diulian Muniz; Aimi, Mateus Alves; Vaz, Marco Aurélio; Baroni, Bruno Manfredini

doi:10.1016/j.ptsp.2020.01.006

Cited by 21 publications

(58 citation statements)

References 41 publications

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“…3 A neurologically based approach was also examined by Kornberg and Lew, 49 who reported that slump stretching resulted in fewer games missed after grade 2 injury in Australian Rules football players. Last, an RCT by Medeiros et al 57 investigating low-level laser therapy revealed no effect in any reported outcome measure. Surgical intervention for muscular injury was examined in 2 studies.…”

Section: Synthesis Of Resultsmentioning

confidence: 94%

“…of days to walk pain-free 42,57 Muscle (most) involved 24,29,30,37,42,57,61,75,82 No. of days to ascend stairs pain-free 83 Injury CSA as % of total muscle CSA 26,42,57 Mechanism of injury 2,42,57,82,83 Distance of injury from ischium 7,8,42,57,82 History of low back pain 42,82 Intra-or intermuscular hemorrhage 66 History of lower limb injury 42 Site of injury within the muscle 23,30,61,75 History of lower limb surgery 42 Grade 1 vs grade 2 injury 29,61 Pain on 1-or 2-leg squat 42 MRI grade of injury 57 Pain on palpation of injured area 35,42 Presence of extramuscular fluid 57 Craniocaudal length of palpated pain 1,6,7,42,57 Partial disruption of the central tendon 80 Mediolateral width of palpated pain 42 Amount of central tendon retraction 80 Distance of palpated pain from ischium…”

Section: Discussionmentioning

confidence: 99%

“…of muscles injured 2 Positive vs negative slump test 82,83 Frequency of physiotherapy 2 Grade of injury 2,43 (continued) Greater craniocaudal length of injury 9,10,23,30,66,73 Greater peak torque angle in knee extension 42 Greater width of edema 30 Higher grade of injury 66 Greater length of lesion as % of height 33 Injury to biceps femoris 66 Greater depth of injury 6 Shorter distance of pain to ischium 7,9,10 Longer radiologist-predicted time to RTP 66 Stretching-type vs sprintingtype injury 5,10 Larger injury CSA 6,33,62,66,75 Greater maximum pain at time of injury 42,82 Involvement of proximal tendon 6,10 Worst VAS pain score >6 35 Proximal vs distal injuries 6 Higher VAS pain score at initial examination 81 Shorter distance of injury to ischium 6,9,10 "Popping" sound at time of injury 35 Higher Cohen MRI score 23 /score >10 39 Bruising 35 MRI-positive injury 81 Greater deficit in passive SLR 57 Greater % of muscle/tendon involvement 23 Longer clinician-predicted time to RTP 66,81 Complete tendinous/ myotendinous rupture 62 Forced to cease activity within 5 min 82 Complete central tendon disruption 24,80 Greater length of palpated pain 82 Presence of central tendon waviness 80 Pain on resisted knee flexion…”

Section: Discussionmentioning

confidence: 99%

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Evidence-Based Management and Factors Associated With Return to Play After Acute Hamstring Injury in Athletes: A Systematic Review

Rudisill

Kucharik

Varady

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Considering the lengthy recovery and high recurrence risk after a hamstring injury, effective rehabilitation and accurate prognosis are fundamental to timely and safe return to play (RTP) for athletes. Purpose: To analyze methods of rehabilitation for acute proximal and muscular hamstring injuries and summarize prognostic factors associated with RTP. Study Design: Systematic review; Level of evidence, 4. Methods: In August 2020, MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials, and SPORTDiscus were queried for studies examining management and factors affecting RTP after acute hamstring injury. Included were randomized controlled trials, cohort studies, case-control studies, and case series appraising treatment effects on RTP, reinjury rate, strength, flexibility, hamstrings-to-quadriceps ratio, or functional assessment, as well as studies associating clinical and magnetic resonance imaging factors with RTP. Risk of bias was assessed using the Cochrane Risk-of-Bias Tool for Randomized Trials or the Methodological Index for Non-Randomized Studies (MINORS). Results: Of 1289 identified articles, 75 were included. The comparative and noncomparative studies earned MINORS scores of 18.8 ± 1.3 and 11.4 ± 3.4, respectively, and 12 of the 17 randomized controlled trials exhibited low risk of bias. Collectively, studies of muscular injury included younger patients and a greater proportion of male athletes compared with studies of proximal injury. Surgery for proximal hamstring ruptures achieved superior outcomes to nonoperative treatment, whereas physiotherapy incorporating eccentric training, progressive agility, and trunk stabilization restored function and hastened RTP after muscular injuries. Platelet-rich plasma injection for muscular injury yielded inconsistent results. The following initial clinical findings were associated with delayed RTP: greater passive knee extension of the uninjured leg, greater knee extension peak torque angle, biceps femoris injury, greater pain at injury and initial examination, “popping” sound, bruising, and pain on resisted knee flexion. Imaging factors associated with delayed RTP included magnetic resonance imaging-positive injury, longer lesion relative to patient height, greater muscle/tendon involvement, complete central tendon or myotendinous junction rupture, and greater number of muscles injured. Conclusion: Surgery enabled earlier RTP and improved strength and flexibility for proximal hamstring injuries, while muscular injuries were effectively managed nonoperatively. Rehabilitation and athlete expectations may be managed by considering several suitable prognostic factors derived from initial clinical and imaging examination.

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Section: Synthesis Of Resultsmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Evidence-Based Management and Factors Associated With Return to Play After Acute Hamstring Injury in Athletes: A Systematic Review

Rudisill

Kucharik

Varady

et al. 2021

Orthopaedic Journal of Sports Medicine

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“…The use of PBM in experimental models began immediately, i.e., in the first 24 h after muscle injury, the time essential for intervention on the inflammatory process [49]. This hypothesis could explain the inefficiency of PBMT reported by Medeiros et al [50] following a randomized controlled study with 24 amateur athletes who received adjunct therapy PMB (859 nm, 100 mW, CW, 5 diodes, 30 J site for 3 sites) for functional rehabilitation of the HSI produced through an intense program of physical exercises, 48 to 96 h ago. As the authors point out, the published study has limitations: first, the two-arm design prevented them from identifying whether other doses of PBM would have had different effects on the results; second, no patient-reported outcome measures were used, and ultimately, the number of participants did not constitute a large-scale study.…”

Section: Studies With No Effects Of Pbmmentioning

confidence: 99%

Photobiomodulation and Sports: Results of a Narrative Review

Ailioaie

Litscher

2021

Life

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Benefits of photobiomodulation (PBM) have been known for several decades. More recently, PBM applied in sports offers a special chance to support the modeling of the performance and recovery. Increasingly complex physical activities and fierce competition in the world of sports generate a state of psycho-emotional and physical stress that can induce chronic fatigue syndrome, failure in physical training, predisposition to muscle damage, physical and emotional exhaustion etc., for which PBM could be an excellent solution. To evaluate and identify all risk factors and the influence of PBM on health and performance in sport and for a better understanding of its effects, we did a search for “Photobiomodulation and Sports” on PubMed, to update the PBM science applied in sports, and we retained for analysis the articles published from 2014 to date. The term “PBM” is recent, and we did not include previous studies with “low level laser therapy” or “LLLT” before 2014. In the present research, PBM has been shown to have valuable protective and ergogenic effects in 25 human studies, being the key to success for high performance and recovery, facts supported also by 22 animal studies. PBM applied creatively and targeted depending on sport and size of the level of physical effort could perfectly modulate the mitochondrial activity and thus lead to remarkable improvements in performance. PBM with no conclusive results or without effects from this review (14 studies from a total of 39 on humans) was analyzed and we found the motivations of the authors from the perspective of multiple causes related to technological limitations, participants, the protocols for physical activity, the devices, techniques and PBM parameters. In the near future, dose–response experiments on physical activity should be designed and correlated with PBM dose–response studies, so that quantification of PBM parameters to allow the energy, metabolic, immune, and neuro-endocrine modulation, perfectly coupled with the level of training. There is an urgent need to continuously improve PBM devices, delivery methods, and protocols in new ingenious future sports trials. Latest innovations and nanotechnologies applied to perform intracellular signaling analysis, while examining extracellular targets, coupled with 3D and 4D sports motion analysis and other high-tech devices, can be a challenge to learn how to maximize PBM efficiency while achieving unprecedented sports performance and thus fulfilling the dream of millions of elite athletes.

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“…1 Cohort studies have supported that athletes with low eccentric knee flexor strength are more prone to sustain an HSI. [2][3][4][5][6] In addition, although restoring strength is a widely used criterion for discharge from rehabilitation, 7 it is not uncommon for players to return to play with residual strength deficits following an HSI. 8 Therefore, eccentric knee flexor strength assessments have a key role in both prevention and rehabilitation of HSI.…”

mentioning

confidence: 99%

Reliability of a Clinical Test for Measuring Eccentric Knee Flexor Strength Using a Handheld Dynamometer

Oliveira¹,

Ribeiro-Alvares²,

Lima-E-Silva³

et al. 2022

Journal of Sport Rehabilitation

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Context: Eccentric knee flexor strength assessments have a key role in both prevention and rehabilitation of hamstring strain injuries. Objective: To verify the reliability of a clinical test for measuring eccentric knee flexor strength during the Nordic hamstring exercise using a commercially available handheld dynamometer. Design: Reliability study. Setting: Physical Therapy Laboratory, Federal University of Health Sciences of Porto Alegre (Brazil). Participants: Fifty male amateur athletes (soccer or rugby players; 24 [3] y). Main Outcome Measures: Eccentric knee flexor strength. Results: When compared with a load cell–based device, the clinical test using a handheld dynamometer provided smaller force values (P < .05) with large effect sizes (.92–1.21), moderate intraclass correlation (.60–.62), typical error of 30 to 31 N, and coefficient of variation of 10% to 11%. Regarding the test–retest reproducibility (2 sessions separated by 1 week), the clinical test provided similar force values (P > .05) with only small effect sizes (.20–.27), moderate to good correlation (.67–.76), typical error of 23 to 24 N, and coefficient of variation of 9% to 10%. Conclusion: The clinical test with handheld dynamometer proposed by this study can be considered an affordable and relatively reliable tool for eccentric knee flexor strength assessment in the clinical setting, but results should not be directly compared with those provided by load cell–based devices.

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Effects of low-level laser therapy on hamstring strain injury rehabilitation: A randomized controlled trial

Cited by 21 publications

References 41 publications

Evidence-Based Management and Factors Associated With Return to Play After Acute Hamstring Injury in Athletes: A Systematic Review

Evidence-Based Management and Factors Associated With Return to Play After Acute Hamstring Injury in Athletes: A Systematic Review

Photobiomodulation and Sports: Results of a Narrative Review

Reliability of a Clinical Test for Measuring Eccentric Knee Flexor Strength Using a Handheld Dynamometer

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