Efeitos da terapia de fotobiomodulação de corpo inteiro avaliado por meio da dispneia, fadiga muscular de membros inferiores e desempenho funcional nos testes de sentar e levantar de 1 minuto e teste de marcha estacionária de 2 minutos em indivíduos com dpoc.

Abstract

Chronic Obstructive Pulmonary Disease (COPD) is a common disease characterized by respiratory symptoms and decreased airflow due to inflammation of the airways and/or alveolar airways, usually caused by inhalation of harmful particles or gases, mainly due to the effect of tobacco. Peripheral muscle weakness affects about 20% of patients diagnosed with mild and moderate COPD and 40% in severe disease. Reduced muscle strength, decreased aerobic capacity, dependence on glycolytic metabolism and large amounts of lactate during exercise may be responsible for early muscle fatigue in these patients. An alternative that emerged to improve muscle performance and recovery was photobiomodulation therapy (PBMT). PBMT can stimulate mitochondrial activity, energy synthesis (adenosine triphosphate - ATP), stimulate muscle glycogen synthesis, and intensify the activity of antioxidant enzymes. Therefore, PBMT can benefit COPD patients in their performance in functional activities performed in their daily lives. Objectives: To determine whether the application of whole-body PBMT in a single session in patients with moderate to severe COPD promotes an improvement in dyspnea, lower limb fatigue, and functional performance as assessed by the one-minute sit-to-stand test (1SST) and the two-minute stationary gait test (SMT2'). Methods: This was a randomized, crossover and single-blind, sham-controlled clinical trial conducted in the city of São Carlos, São Paulo, Brazil, at the Laboratory of Spirometry and Respiratory Physiotherapy of UFSCar. We evaluated 22 patients with moderate to severe COPD, who underwent an assessment of functional performance and perception of dyspnea and fatigue of the lower limbs by means of 1SST and SMT2', before and after a single application of whole-body PBMT and sham. Results: After the application of whole-body PBMT, the patients' perception of lower limb fatigue decreased significantly compared to the sham application (p≤0.01) with medians 1 (0.5-0.0) and 2 (1.64 -2) respectively, in 1SST. Dyspnea and functional performance did not show significant changes (p>0.01) between whole-body PBMT and sham in 1SST. Dyspnea at SMT2’ decreased significantly (p≤0.01) compared to sham with medians 1 (0.5-1.75) and 2 (1.25-3), as well as muscle fatigue at lower limbs, 0 (0-1) and 3 (1.25-3), respectively. There was an improvement in the functional performance of SMT2’ comparing pre- and post- PBMT and sham (p≤0.01), but there was no significant change between whole-body PBMT and sham. Conclusion: Whole-body PBMT significantly reduced muscle fatigue in the lower limbs in 1SST and SMT2’ and significantly reduced dyspnea in the SMT2’. It did not significantly increase functional performance in 1SST and SMT2’, in a single session of whole-body PBMT of participants with moderate to severe COPD.