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Effects of photobiomodulation and deep water running in patients with chronic non-specific low back pain: a randomized controlled trial

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Abstract

Photobiomodulation therapy (PBM) is often used to treat musculoskeletal disorders such as chronic non-specific low back pain (NSCLBP) as it can have positive effects on biomarkers—creatine kinase (CK) and serum cortisol levels—related to stress caused by physical exercise, such as deep water running (DWR) or by pain. The aim of this study was to evaluate the effects of the combination of PBM and aquatic exercise (DWR) on the intensity of pain, disability, 6-min walk test adapted (6WTA), and on cortisol and creatine kinase (CK) levels in a population with NSCLBP. The participants were allocated into three groups: TGPBM (Photobiomodulation and Training Group), TGPLA (Placebo Photobiomodulation and Training Group), and the GPBM (Photobiomodulation Group). Information regarding anthropometric data, blood pressure, and heart rate were collected, and the questionnaires were applied: IPAQ-Short Form, Oswestry Disability Index, and the Visual Analog Scale for Pain. The submaximal exercise test (6WTA) was performed. Blood was collected for analysis of cortisol and CK levels. The training sessions were performed twice a week, for 4 weeks. In the intragroup comparisons, there were statistically significant changes in the TGPBM and GPBM groups in the outcomes pain intensity, disability (reductions in both groups), and in cortisol (increased in the TGPBM and reduced in the GPBM); in the TGPLA group, there was a statistically significant reduction only in the outcome of pain intensity. In the intergroup comparison, in the comparison between TGPBM and TGPLA, there was a statistically significant difference in the level of cortisol, as well as in the comparison between TGPBM and GPBM, in which there was a statistically significant difference for this same outcome (cortisol) and for the 6WTA outcome. The effects of the combination of PBM and aquatic exercise have positive effects on reducing pain intensity, disability, and cortisol levels, but its effects on other variables (6WTA and CK) are too small to be considered significant. Trial registration number: NCT03465228—April 3, 2019; retrospectively registered (ClinicalTrials.gov).

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Authors and Affiliations

  1. Program Stricto Sensu in Rehabilitation Sciences, Research and Postgraduate Center, UNOPAR/UEL, Londrina, Brazil

    Daniele Mayumi Kurata Nardin, Marieli Ramos Stocco, Andreo Fernando Aguiar, Raphael Gonçalves de Oliveira & Rodrigo Antonio Carvalho Andraus

  2. Program Stricto Sensu in Physical Education, Research and Postgraduate Center, UEM/UEL, Maringá, Brazil

    Fabiana Andrade Machado

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  1. Daniele Mayumi Kurata Nardin
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Contributions

The authors of the article confirm that (1) all authors have participated sufficiently in this paper to take public responsibility for its content and claim that they reviewed the final version of the manuscript and approved it for publication; (2) that no manuscript with similar content under their authorship and other authors have been published or submitted for publication in another journal; (3) the author(s) confirm that this manuscript was presented with the full knowledge and approval of the institution or organization as determined affiliation(s) of author(s).

Daniele Mayumi Kurata Nardin (DMKN): Contributed to the design and development of the study, data collection, and analysis and to the preparation of the study and its development, acquisition and analysis of data, critical review of the final content, and approval of the final version.

Marieli Ramos Stocco (MRS): Contributed to the design and development of the study, data collection, and analysis and to the preparation of the study and its development, acquisition and analysis of data, critical review of the final content, and approval of the final version.

Fabiana Andrade Machado (FAM): Contributed to the elaboration of the study design and development, data collection, and analysis.

Raphael Gonçalves de Oliveira (RGO): Contributed to the design and development of the study and approved the final version.

Rodrigo Antonio Carvalho Andraus (RACA): Contributed to the elaboration of the study design and development and the processes for obtaining approval from the Research Ethics Committee involving human beings, data acquisition and analysis, critical review of the final content, and approval of the final version.

Corresponding author

Correspondence to Marieli Ramos Stocco.

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Ethics approval

Our study is a controlled, randomized clinical trial, previously registered at ClinicalTrials.gov (trial registration number: NCT03465228—retrospectively registered). In compliance with Resolution 466/12, this research was approved by the Research Ethics Committee of Universidade Norte do Paraná (UNOPAR), under number 2183951, and carried out in accordance with the Declaration of Helsinki.

Consent to participate

The authors declare that all participants in the research signed the Free and Informed Consent Form and agreed to participate in the research after being informed about all the procedures, evaluations, and interventions of the study, as well as about its risks and benefits. Any doubts in the course of the study were promptly clarified by the researchers involved.

Consent for publication

All participants in this study signed (before a witness) a term in which they agreed that the results of the study can be published in magazines, books, or scientific events and that the authors kept their identity completely confidential, and the data collected will be used only for educational and research purposes. The entire procedure was based on the literature on the topic, in addition to respecting the individuality of each participant. All participants were aware of the risks and benefits of the study; they were not required to participate in the research and can withdraw at any time by withdrawing their consent in the same way that they did not receive financial compensation to participate in this research.

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Nardin, D.M.K., Stocco, M.R., Aguiar, A.F. et al. Effects of photobiomodulation and deep water running in patients with chronic non-specific low back pain: a randomized controlled trial. Lasers Med Sci 37, 2135–2144 (2022). https://doi.org/10.1007/s10103-021-03443-6

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