Research indicates that exercise programs and PBM may aid in modulating the inflammatory process of minimizing functional disability due to OA. In a recent study published in Advances in Rheumatology, researchers sought to investigate the effects of PBM (via cluster) with a physical exercise program in functional capacity, serum inflammatory, and cartilage degradation biomarkers in patients with knee OA.

Participants were recruited via social media and advertisements in this single-blind, randomized, controlled trial designed to evaluate the impact of physical activity on patients with knee OA. The study included eligible patients between age 55 and 70 years who had symptomatic OA within the previous 6 months, bilateral or unilateral knee OA, and radiographic confirmation of OA.

In the study, 42 patients were randomly assigned to three groups: ESP: (exercise + sham PBM); EAP: (exercise + active PBM); and CG: (control group). Six patients (one from ESP, one from EAP, and four from CG) were excluded from the study due to their absence in two of the consecutive treatment sessions. The analyzed outcomes in baseline and at 8 weeks were the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) and the evaluation of serum biomarkers concentration (IL-1B, IL-6, IL-8, IL-10 e TNF-a, and CTX-II).

The researchers observed an increase in the functional capacity in the WOMAC total score for both treated groups (P <.001), and ESP presented a lower value compared with CG (P <.05) at 8 weeks post treatment. In addition, there was a significant boost in IL-10 concentration of EAP (P <.05) and a higher value compared with CG (P <.001) at 8 weeks post treatment. Moreover, an increase in IL-1B concentration was observed for CG (P <.05). No other difference was observed compared with the other groups.

The authors noted that a physical exercise program could expand the functional capacity in the patients, and the associated treatments increased IL-10 expression compared with CG after the experimental period. In addition, IL-1B expression was higher for CG when comparing the values in the baseline and at 8 weeks. No differences in the other biomarkers were observed.

The authors concluded that physical exercise therapy could be a strategy for improving functional capacity and, in association with PBM, for increasing IL-10 levels in individuals with knee OA. They also concluded that PBM did not promote an additional positive effect of exercise in improving proinflammatory and cartilage degradation biomarkers and functional capacity in women with knee OA.

Since the literature demonstrates heterogeneity in the parameters of treatment with PBM when associated with physical exercise for the consolidation of an intervention protocol for patients with knee OA, more studies are needed using other parameters.

The authors indicated that their study revealed the following key clinical messages: (1) Patients who engaged in a physical exercise program in association with PBM for 8 weeks showed improvement in IL-10 levels after treatment when compared with the control group who did not have any intervention; (2) The function capacity was enhanced in patients undergoing a physical exercise program; (3) Only the control group had an increase in the proinflammatory marker (IL-1B); and (4) Physical exercise programs and their association with PBM had no effect on other proinflammatory and cartilage-degradation biomarkers.

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