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Acute effect of photobiomodulation using light-emitting diodes (LEDs) on baroreflex sensitivity during and after constant loading exercise in patients with type 2 diabetes mellitus

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To evaluate the photobiomodulation (PBM) effect on the cardiovascular autonomic control, analyzed by baroreflex sensitivity (sequence method), during constant load exercise and recovery in diabetic men, we evaluated 11 men with type 2 diabetes (DM2) (40–64 years). The constant workload exercise protocol (TECC) was performed on two different days, 14 days apart from each other, to guarantee PBM washout period. After PBM by light-emitting diode (LED) irradiation (150 J or 300 J or placebo), 10 min of rest (REST) was performed. After this period, the volunteer was positioned on a cycloergometer to start the test (1-min rest, 3-min free-load heating, 6-min constant workload–EXERCISE, 6-min free-load cool-down, 1-min rest) followed by a sitting period of 10 min (RECOVERY). The constant workload corresponded to 80%VO2GET (gas exchange threshold) identified by a previous cardiopulmonary exercise test (CPET). PBM was applied in continuous mode, contact technique, bilaterally, on both femoral quadriceps and gastrocnemius muscle groups. The electrocardiogram R-R intervals (BioAmp FE132) and the peripheral pulse pressure signals (Finometer PRO) were collected continuously throughout the protocol. Stable sequences of 256 points were chosen at REST, EXERCISE, and RECOVERY. The baroreflex sensitivity (BRS) was computed in time domain according to the sequence method (αseq). The comparison between therapies (150 J/300 J/placebo) and condition (REST, EXERCISE, and RECOVERY) was performed using the ANOVA two-way repeated measures test. There was no interaction between therapy and conditions during the TECC. There was only the condition effect (p < 0.001), showing that the behavior of αseq was similar regardless of the therapy. Photobiomodulation with 150 J or 300 J applied previously to a moderate-intensity TECC in DM2 was not able to promote cardiovascular autonomic control changes leading to an improvement in BRS.

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The study was supported by the São Paulo Research Foundation (FAPESP) (grant no. 2013/07953-3), National Council for Scientific and Technological Development (CNPq) (grant no. 140164/2015 and 169796/2018-3), and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior-Brasil (CAPES) (Finance Code 001).

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Correspondence to Juliana Cristina Milan-Mattos.

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The crossover, double-blind, randomized, placebo-controlled clinical trial study was performed according to the principles of the Declaration of Helsinki for medical research involving humans.

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The authors declare that they have no conflict of interest.


The founders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Milan-Mattos, J.C., de Oliveira Francisco, C., Ferroli-Fabrício, A.M. et al. Acute effect of photobiomodulation using light-emitting diodes (LEDs) on baroreflex sensitivity during and after constant loading exercise in patients with type 2 diabetes mellitus. Lasers Med Sci 35, 329–336 (2020).

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  • Phototherapy
  • Physical exercise
  • Type 2 diabetes mellitus
  • Cardiovascular autonomic control
  • Baroreflex sensitivity
  • Sequence method