PROGRAMA DE PÓS-GRADUAÇÃO STRICTO SENSU

PROFISSIONAL EM EXERCÍCIO FÍSICO NA PROMOÇÃO DA SAÚDE

LYSA MELINA BARRIOS CABREIRA

LEDTERAPIA NO CONTEXTO DO EXERCÍCIO FÍSICO

PARA PROMOÇÃO DA SAÚDE

Londrina - Paraná
2020
 LYSA MELINA BARRIOS CABREIRA

LEDTERAPIA NO CONTEXTO DO EXERCÍCIO FÍSICO

PARA PROMOÇÃO DA SAÚDE
Cidade
ano
AUTOR

Relatório Técnico apresentado à Universidade

Pitágoras UNOPAR, como requisito parcial para a
obtenção do título de Mestre Profissional em Exercício
Físico na Promoção da Saúde.

Orientador: Dr. Andreo Fernando Aguiar

Londrina - Paraná
2020
 LYSA MELINA BARRIOS CABREIRA

LEDTERAPIA NO CONTEXTO DO EXERCÍCIO FÍSICO PARA PROMOÇÃO DA

SAÚDE

Relatório Técnico apresentado à Pitágoras UNOPAR, referente ao Curso de

Mestrado Profissional em Exercício Físico na Promoção da Saúde, Área e
Concentração ‘Dimensões Preventivas do Exercício Físico’ como requisito parcial
para a obtenção do título de Mestre Profissional conferido pela Banca Examinadora:

_________________________________________
Prof. Dr. Andreo Fernando Aguiar
(Orientador)

_________________________________________
Prof. Dr. Juliano Casonatto
(Membro Interno)

_________________________________________
Prof. Dr. Lúcio Flávio Soares Caldeira
(Membro Externo)

_________________________________________
Prof. Dr. Dartagnan Pinto Guedes
(Coordenador do Curso)

Londrina, 02 de julho de 2020.

AUTORIZO A REPRODUÇÃO TOTAL OU PARCIAL DESTE TRABALHO, POR
QUALQUER MEIO CONVENCIONAL OU ELETRÔNICO, PARA FINS DE
ESTUDO E PESQUISA, DESDE QUE CITADA A FONTE.

Dados Internacionais de Catalogação na Publicação (CIP)

Universidade Pitágoras Unopar
Biblioteca CCBS/CCECA PIZA
Setor de Tratamento da Informação

Cabreira, Lysa Melina Barrios

C117l Ledterapia no contexto do exercício físico para promoção
da saúde. / Lysa Melina Barrios Cabreira. ̶ Londrina: [s.n.],
2020.
27 f.

Relatório Técnico (Mestrado Profissional em Exercício

Físico na Promoção da Saúde).
Universidade Pitágoras Unopar.
Orientador: Prof. Dr. Andreo Fernando Aguiar.

1. Laser - Relatório técnico - UNOPAR. 2.

Fotobiomodulação. 3. Laserterapia. 4. Aptidão física. 5.
Função muscular. 6. Ledterapia. 7. Promoção da saúde. I.
Aguiar, Andreo Fernando; orient. II. Universidade Pitágoras
Unopar. III. Título.

CDD 615.84
Andressa Fernanda Matos Bonfim - CRB 9/1643
CABREIRA, Lysa Melina Barrios. Ledterapia no contexto do exercício físico para
promoção da saúde. Relatório Técnico. Mestrado Profissional em Exercício Físico
na Promoção da Saúde. Centro de Pesquisa em Ciências da Saúde. Universidade
Pitágoras UNOPAR, Londrina. 2020.

RESUMO

O objetivo da presente produção técnica foi apresentar um compilado de

informações científicas relacionadas a aplicabilidade da terapia de fotobiomodulação
(FBM) com Diodos Emissores de Luz (LEDs - Ledterapia) no contexto preventivo e
terapêutico do exercício físico. O material foi estruturado em 5 tópicos: (1)
Introdução, (2) Ledterapia no contexto do exercício físico para promoção da saúde,
(3) Evidências científicas, (4) Considerações gerais, e (5) Referências bibliográficas.
O conteúdo do material aborda tópicos quanto à definição de LED, principais
músculos e populações estudadas, contexto histórico, aplicabilidade no contexto do
exercício físico, mecanismos de ação, evidências científicas relacionadas a aptidão
muscular (função, dor e recuperação), precauções e contraindicações, e
considerações gerais. Espera-se que o presente guia prático forneça subsídios
teórico-práticos que possam auxiliar os diversos profissionais deste segmento da
área de saúde na tomada de decisão em relação ao uso deste instrumento no
contexto da promoção da saúde e qualidade de vida.

Palavras-chave: fotobiomodulação, aptidão física, laserterapia, função muscular.

CABREIRA, Lysa Melina Barrios. LED therapy in the context of physical exercise
for health promotion. Technical Report. Professional Master´s in Exercise in Health
Promotion. Research Center on Health Sciences. Pitágoras UNOPAR University,
Londrina. 2020.

ABSTRACT

The purpose of this technical production was to present a compilation of scientific

information related to the applicability of photobiomodulation (PBM) therapy with
Light Emitting Diodes (LEDs - Led therapy) in the preventive and therapeutic context
of physical exercise. The material was structured in 5 topics: (1) Introduction, (2) Led
therapy in the context of physical exercise for health promotion, (3) Scientific
evidence, (4) General considerations, and (5) References. The content of the
material addresses topics regarding the definition of LED, main muscles and
populations studied, historical context, applicability in the context of physical
exercise, mechanisms of action, scientific evidence related to muscle fitness
(function, pain and recovery), precautions and contraindications, and general
considerations. It is hoped that this practical guide will provide theoretical-practical
support that can assist the various professionals in this segment of the health field in
making decisions regarding the use of this instrument in the context of health
promotion and quality of life.

Keywords: photobiomodulation, physical fitness, laser therapy, muscle function.

 Artigo Científico

Photobiomodulation therapy with Light-emitting diode does not improve

lower-body muscle performance and delayed onset muscle soreness in
resistance-trained women: A randomized, controlled, crossover trial.

Lysa Melina Barrios Cabreira1, Andreo Fernando Aguiar1.

1
Center of Research in Health Sciences, Northern University of Paraná (UNOPAR),
Londrina, Paraná, Brazil.

ABSTRACT

Objective: The purpose of this study was to investigate the effects of light-emitting diode
therapy (LEDT) at 940 nm on lower-body muscle performance, rating of perceived exertion
(RPE), and delayed onset muscle soreness (DOMS) in resistance-trained women. Methods:
Ten young women (20.4 ± 3.3 years) participated in a crossover study in which they received,
in a counterbalanced manner, active and placebo LEDT on two occasions (T1 and T2),
separated by a 7-day washout period. LEDT (130 mW output power, power density of 45
mW.cm-2, and total energy of 48 J per leg) was applied on the quadriceps muscle immediately
before the repetitions-to-failure test (6 sets at 80% of 1RM until failure) for leg press exercise.
Maximum number of repetitions and RPE over the 6 sets, and DOMS at 24 and 48 hours after
fatigue test were recorded. Results: There was a significant (time p < 0.05) reduction in the
maximum number of repetitions and a reciprocal increase in RPE over the 6 sets, with no
statistical differences (treatment x time p > 0.05) between placebo and active LEDT
conditions. DOMS increased from 24 to 48 hours after fatigue test in both conditions (time p
< 0.05; treatment x time p > 0.05). Conclusion: Our results indicate that acute LEDT at 808
nm does not improve lower-body muscle performance, RPE, and DOMS in resistance-trained
women.
Keywords: Light-emitting diode therapy, muscle performance, physical exercise, muscle
pain, muscle endurance, resistance training.
INTRODUCTION

Athletes and recreational exercise practitioners commonly use ergogenic aids to improve
performance and body composition [1-3]. An ergogenic aid is defined as any mechanical,
psychological, physiological, pharmacological, or nutritional substance or treatment that
enhances energy production and utilization [4] in an attempt to make muscles more efficient for
performance (e.g., power, strength, or fatigue resistance) and recovery from exercise, as well as
for preventing injury during intense training [5]. In this context, nutritional supplements are the
class of legal ergogenic aids most frequently used to improve muscle performance in different
populations related to sport and health. However, more recently, photobiomodulation (PBM),
also known as low-level laser therapy (LLLT) and light-emitting diode therapy (LEDT) [6], has
emerged as an important non-pharmacological strategy for improving performance [6-8] and
recovery [9, 10] from exercise in young adults.
The theoretical basis underlying the ergogenic effects of PBM on muscle tissue is
related to several mechanisms, including: i) increased production of adenosine triphosphate via
modulation of mitochondrial activity, ii) stimulation of defenses against oxidative stress; iii)
improvement of regenerative capacity by stimulation of satellite cells; iv) possible increased
muscle fiber excitability, and v) increased gene expression related to protein synthesis, cell
migration and proliferation, anti-inflammatory signaling, anti-apoptotic proteins, and
antioxidant enzymes (For more details, see the reviews: [6, 11, 12]).
Despite the proposed beneficial mechanisms and the growing number of publications
involving PBM therapy, no study to date have investigated the ergogenic effects of LEDT on
quadriceps muscle performance and recovery from resistance exercise in resistance-trained
women. Previous studies involving male subjects (trained or not) have shown beneficial effects
of LEDT on increasing maximum voluntary contraction and number of repetitions performed
and attenuating fatigue-related markers [7, 13-16]. The LEDT was also beneficial for
attenuating CK levels and delayed-onset muscle soreness (DOMS) following lower-limb
resistance exercises [9, 13, 14, 17]. In addition, LEDT applied on hip and quadriceps muscles
during training sessions of a 3-month treadmill exercise program improved muscle power and
delayed leg fatigue in postmenopausal women aged 50-60 years [18]. The same authors
reported an improvement in the maximal performance and post-exercise recovery in
postmenopausal women that received LEDT on hip and quadriceps muscles during training
sessions of a 6-month treadmill exercise program [19].
It is important to note that, although positive findings have been observed for
performance and recovery, the studies mentioned above included only men [7, 13-15, 17] or
postmenopausal women [18, 19]. Moreover, the studies with postmenopausal women did not
evaluate measures of muscle performance and recovery from resistance exercise. Given that
women generally have lower relative loss of strength and greater resistance to fatigue than men
[20], as well as moderately lower muscle pain after eccentric exercise [21], it is possible that a
small ergogenic effect of LEDT may not be so effective in women, mainly in trained young
women with a high level of muscle fitness. The same supposition may also be applied to the
positive results found in postmenopausal women [18, 19], since the ergogenic effects of LEDT
may be more evident in this population, as opposed to trained young women, due to the
accentuate age-related decline of strength and muscle mass [22]. Therefore, it remains unclear
whether LEDT could improve muscle performance and recovery (e.g., DOMS) from resistance
exercise in young adult women, especially in trained ones; thus, it requires further
investigations.
Therefore, the aim of this study was to investigate the effects of LEDT on lower-body
muscle performance and DOMS in resistance-trained women. Based on previously reported
results in men subjects, we hypothesized that LEDT would increase the number of repetitions
performed, reduce perceived exertion, and attenuate DOMS when compared to placebo
treatment.

METHODS

Participants

Ten resistance-trained women were recruited from a professional futsal team from Londrina,
Paraná, Brazil, and all participants completed the intervention. We choose a sample of young
women with extensive experience in resistance-training program (> 2 years) and a high level
of muscle fitness to minimize any potential impact of familiarization with resistance exercise
test on dependent variables. The descriptive characteristics of the participants are presented in
Table 1. Sample size calculation for an F test (G*Power software, version 3.0.1; Dusseldorf,
Germany) was based on previous studies that analyzed the effects of LEDT on the number of
repetitions performed [15, 16]. Based on a statistical power (1-β) of 0.80, a moderate effect
size (0.45) [15, 16], and an overall level of significance of 0.05, at least 8 subjects were
required for this study. The inclusion criteria were: (1) aged 18-35 years old, (2) classified as
eutrophic (i.e., body mass index [BMI] range: 18 to 25 kg/m2), and (3) classified low risk for
vigorous exercising and testing, as categorized by the American College of Sports Medicine
[23]. Based on the weight lifted to body weight ratio (WL-to-BW ratio), all participants were
above the 90th percentile for leg press strength, indicating a high level of lower-body muscle
fitness and resistance-training experience [23]. Participants consuming any kind of ergogenic
supplement, medication, or hormonal contraceptive agents within the last year were excluded
from the study. All women were eumenorrheic with a normal menstrual cycle length of 25-32
days and were in the follicular phase of their menstrual cycle. All participants were informed
of the procedures, risks, and benefits of the investigation and signed an informed consent
document approved by the Institutional Review Board of the University. All procedures were
carried out in accordance with the ethical standards as laid down in the 1964 Declaration of
Helsinki and its later amendments. No participant reported adverse effects of irradiation
throughout the study.

Table 1. Characteristics of the sample (n = 10).

Age (years) 20.4 ± 3.3
Height (cm) 162.8 ± 5.2
Weight (kg) 57.7 ± 9.6
BMI (kg.m-2) 21.9 ± 2.8
Leg-press 1RM (kg) 182.5 ± 19.3
WL-to-BW ratio (a.u.) 3.2 ± 0.4
Data are mean ± SD. BMI, body mass index;
1RM, one repetition maximum; WL-to-BW
ratio, weight lifted to body weight ratio.

Experimental design

A crossover, double-blind, randomized, and placebo-controlled study was performed to

examine the effects of LEDT (λ: 940 nm) on lower-muscle performance to exhaustion, RPE,
and DOMS in resistance-trained women. A schematic representation of the experimental
design is shown in Fig. 1. All participants performed 3 familiarization sessions for leg press
exercise (3 sets of 10 repetitions with 1 min rest between sets) and one-repetition maximum
(1RM) tests to minimize any potential learning effect. Thereafter, all participants were
randomized (via a computer-generated sequence in the website https://www.random.org) and
counterbalanced to receive 1 of 2 treatments (active or placebo LEDT) on two occasions (T1
and T2) separated by a 7-day washout period. In this design, participants served as their own
controls. During T1 and T2, participants received their respective treatments (active or
placebo LEDT) on the quadriceps muscle of both legs immediately before the repetitions-to-
failure test (6 sets at 80% of 1RM until failure) for leg press exercise. Rating of perceived
exertion (RPE) via the OMNI-RES scale [24] was recorded immediately after the completion
of each set and after the timed 60-second rest (before the next set began). Finally, DOMS via
a visual analog scale (VAS) was recorded at 24 and 48 hours after the repetitions-to-failure
test to analyze the muscle recovery.

Fig. 1. Experimental design.

Photobiomodulation protocol

Participants received placebo or active LEDT on the quadriceps muscle of both legs
immediately before repetitions-to-failure tests during T1 and T2. The irradiation parameters
are shown in Table 2. A therapist blinded to the treatment conditions applied the irradiation
on four points distributed over the belly of the vastus lateralis and rectus femoris muscles
(Fig. 2), using a custom-made infrared probe (940 nm) developed by the Laboratory of Optics
and Optoelectronics from State University of Londrina, Londrina, Brazil. The points were
placed at 50 and 75% of the total distance between the anterior superior iliac spine and
superior border of the patella, bilaterally, with 2 cm of distance between each point (Fig. 2).
The irradiation parameters were chosen based on a previous review study [6] that showed a
large range in dose (18–240 J) applied on quadriceps muscle for chronic response of the
following outcomes: one-repetition maximum (1-RM), torque, fatigue resistance,
hypertrophy, and muscle work. Participants and therapists were blinded by the use of opaque
goggles during the PBM procedures. The goggles also served to protect the eyes against
irradiation. In addition, a researcher who was not involved in LEDT application was
responsible for preparing the probe parameters (active or placebo), and an adhesive tape was
used to cover the specifications written in the LED device.

Table 2. Photobiomodulation parameters.

Wavelengths LEDT 940 nm
LEDT frequency Continuous
Output power 130 mW
Spot size area 3.1 cm2
Power density 45 mW/cm2
Energy per point 12 J
Total energy per leg 48 J
Number of points 4
Irradiation area 12.4 cm2
Energy density 4.0 J/cm2
Irradiation time per point 92 seconds
Total irradiation time 368 seconds
Application mode Stationary in skin contact

Fig. 2. Treatment points (black circles) over quadriceps muscle.

Repetitions-to-failure test

The repetitions-to-failure test consisted of 6 sets at 80% of 1RM until failure, with 60-second
rest intervals between sets, for leg press exercise (Nakagym equipment, São Paulo, Brazil).
For each set, participants performed as many repetitions as possible until failure (when the
participant could no longer complete a repetition with proper technique and range of motion),
and the maximum number of repetitions in each set was recorded. Participants were
monitored and verbally encouraged by a blind evaluator to treatment during all sets. The test
sessions were performed between 8:00 and 10:00 a.m during T1 and T2.

Rating of perceived exertion

RPE was recorded immediately after the completion of each set and after the timed 60-second
rest (before the next set began) using the OMNI-RES scale [24]. The participants were
instructed to report the perceived exertion value by indicating a number on the OMNI-RES
scale (0 for “no effort” and 10 for “maximal effort”) that best represented their overall
muscular effort [24]. The score was the value (0–10) reported on the OMNI-RES scale. All
participants were familiar with the OMNI-RES scale before starting the study.

Delayed onset muscle soreness

DOMS was assessed at 24 and 48 h after repetitions-to-failure-test using a 10-cm VAS, with
‘‘no soreness’’ (0 mm) and ‘‘severe soreness’’ (100 mm) as the left and right anchors,
respectively [25]. Participants were asked to perform the movement of walk up a flight of
stairs and then mark a vertical line at a scale point that best represented their rating of
momentary soreness on quadriceps muscle [26]. The score was the distance (in centimeters)
from the left side of the scale to the point marked. The ICC of the VAS for acute soreness was
≥ 0.97 [25].

Statistical analysis

All values are reported as mean and standard deviation (SD). The normality and homogeneity
for outcome measures were tested using Shapiro-Wilk’s and Levene’s tests, respectively. The
independent variables included the experimental conditions (i.e., placebo and active LEDT).
Dependent variables were consisted of repetitions-to-failure, RPE, and DOMS. Repeated
measures analysis of variance (ANOVA) was used to assess the differences between
conditions (placebo vs. active LEDT) over time for all dependent variables. Violation of
sphericity was corrected using the Greenhouse–Geisser method. When significant differences
were confirmed with ANOVA, multiple comparisons testing were performed using
Bonferroni post hoc correction to identify these differences. The significance level was set at
P ≤ 0.05. Statistical analyses were performed using SPSS Statistics for Windows version 20.0
(IBM Corp., Armonk, NY, USA).

RESULTS

All participants were classified as eutrophic (i.e., BMI: 20.4 ± 3.3 kg/m2) and had high level
of muscle strength (WL-to-BW ratio: 3.2 ± 0.4), indicating that body composition and
familiarization with resistance exercise had no negative effect on overall results. To ensure
there was no order effect associated with treatments (placebo or active LEDT), the sequence
of conditions was randomized and counterbalanced between visits (T1: active, T2: placebo vs.
T1: placebo, T2: active). No participant reported adverse effects of irradiation throughout the
study.

Repetitions-to-failure

A significant main effect for time (P < 0.05) indicated a reduction in the maximum number of
repetitions among the sets, with no significant differences (P > 0.05) between active and
placebo LEDT conditions (Fig. 3A). Total number of repetitions (active: 75.9 ± 16.3 vs.
placebo: 75.9 ± 24.5) over the 6 sets (Fig.3 B) and the corresponding area under curve (AUC)
(active: 3690 ± 793 vs. placebo: 3654 ± 1167) were similar (P > 0.05) between placebo and
active LEDT conditions.
Fig. 3. Number of repetitions to failure over 6 sets (S1-S6) (A) and total repetitions (sum of
all sets) (B) during leg press exercise in the active and placebo LEDT conditions (N = 13).
Data are means ± SD. Difference letters indicate significant difference over time at p < 0.05.

Rating of perceived exertion

A significant main effect for time (P < 0.05) indicated an increase in RPE immediately after
each set (Fig. 4A) and after 60-s rest interval (before the next set began) (Fig. 4B), with no
significant differences (P > 0.05) between active and placebo LEDT conditions. Total RPE
(sum of all sets) was similar (P > 0.05) between active and placebo LEDT conditions at
immediately after each set (active: 48.5 ± 5.7 vs. placebo: 49.4 ± 6.6) and after 60-s rest
interval (before the next set began) (active: 39.9 ± 8.1 vs. placebo: 38.3 ± 7.3).

Fig. 4. Rating of perceived exertion (RPE) during leg press exercise immediately after
completion (A) and after 60-second rest interval of each exercise set (B) in the active and
placebo LEDT conditions (N = 13). Data are means ± SD. Difference letters indicate
significant difference over time at p < 0.05.
Delayed-onset muscle soreness
A significant main effect for time (P < 0.05) indicated an increase in DOMS from 24 to 48 h
post-exercise, with no significant differences (P > 0.05) between active and placebo LEDT
conditions (Fig. 5). The AUC was similar (P > 0.05) between active (158 ± 78) and placebo
(162 ± 79) LEDT conditions.

Fig. 5. DOMS at 24 and 48 hours after repetitions-to-failure test in the active and placebo
LEDT conditions (N = 13). Data are means ± SD. Difference letters indicate significant
difference over time at p < 0.05.

DISCUSSION

To our knowledge, this is the first study that investigated the effects of LEDT on muscle
performance to exhaustion and DOMS in resistance-trained women. Based on previous
findings reported in male subjects, we had hypothesized that LEDT would increase muscle
performance to exhaustion and attenuate DOMS when compared to placebo. However,
contrary to our hypothesis, no beneficial effect of LEDT was observed on maximum number
of repetitions, RPE, and DOMS.
There is still no consensus on the most appropriate parameters of PBM to improve
muscle performance and reduce DOMS in different populations related to health and
performance. This limitation can be attributed mainly to the vast heterogeneity of methods,
protocols, and samples of participants in published studies, as well as to confounding factors
related to the lack of familiarization of participants with the physical tests, and non-dissimilar
discussions of PBM parameters (i.e., LLLT vs. LEDT), time of irradiation (i.e., acute vs.
chronic), and type of muscles (i.e., lower- vs. upper-body muscles). Therefore, to avoid these
confounding factors, we recruited young women experienced in resistance training and
conducted a more in-depth comparative analysis from our data only with studies that applied
the LEDT in lower-body muscles.
The lack of positive effects of LEDT (dose: 4.0 J/cm2) on the maximum number of
repetitions observed in our study is contradictory to a previous study conducted by Hemmings
et al. [16]. The authors investigated the effects of 3 doses of LEDT (1.5, 3.0, and 6.0 J/cm2) in
resistance-trained individuals (18 male and 16 female) submitted to a fatiguing protocol and
found a positive effect of LEDT (doses: 3.0 and 6.0 J/cm2) on the maximum number of
repetitions compared to placebo treatment. Given that the LEDT dose was similar between
studies (4.0 J/cm2 vs. 3.0 and 6.0 J/cm2), the discrepancy in the results cannot be explained by
the dose. A likely explanation for the lack of effect in our study in contrast to the Hemming’s
study [16] may be the different fatigue protocols (i.e., repetitions-to-failure test). The authors
used a unilateral single-joint exercise (1 set of knee extension involving eccentric
contractions), whereas in our study it was applied a bilateral multi-joint exercise (6 sets of leg
press involving concentric and eccentric contractions), which resulted in fewer repetitions
performed in the first set of our study (mean placebo, 20.4 ± 6.2 vs. 48.6 ± 32.0 repetitions)
than in the study by Hemming et al. [16]. Therefore, given the more fatiguing nature of our
protocol compared to the Hemming’s study [16], it is possible to suggest that the effects of
LEDT on muscular endurance (repetitions performed) may be more evident in unilateral,
single-joint, and less intense exercises. However, due to the scarcity of findings, this
suggestion remains speculative and awaits further studies.
Similar to our findings in young women, previous studies [7, 9, 27-29] involving only
men reported no beneficial effect of LEDT on results of isokinetic (i.e., peak torque, average
power, total work, and work fatigue index) [7] and anaerobic (i.e., peak power, mean power,
time to exhaustion) [9, 28, 29] performance, as well as in markers of recovery (i.e., lactate
clearance, peak power output, and fatigue index) [27]. Therefore, the lack of positive effects
of LEDT on muscle performance in our study and others [7, 27-29] does not seem to be
associated with sex-related specific aspects. This hypothesis was supported by previous
findings of a positive effect of LEDT on muscle performance in a mixed sample of men and
women (18 male and 16 female) [16] and postmenopausal women [18, 19]. Together, these
results indicate that the effects of LEDT may not be influenced by sex and age. In addition, it
seems that the positive effects of LEDT alone on lower-body muscles appear to be more
associated with post-exercise recovery than acute performance [7, 9, 17, 29]. Therefore,
further well-controlled studies with women only are required to determine how LEDT alone
may contribute to lower-limb muscle performance.
Our study was also the first to investigate the effects of LEDT alone on the rating of
perceived exertion (RPE) after intense exercise in resistance-trained women. RPE is a tool
commonly used to measure subjective effort perception during a physical exercise, and it can
be a valuable complementary strategy for determining the positive effects of LEDT on muscle
performance. We found an increase in RPE among the 6 sets of repetitions-to-failure test, but
no significant difference was found between active and placebo LEDT conditions. Few
studies involving LEDT examined RPE after physical testing, and contradictory results were
reported. LEDT was effective in reducing RPE and perceived fatigue in patients with chronic
obstructive pulmonary disease (COPD) [30] and in high-level rugby athletes [31], but no
positive effect has been reported in moderately active [29] and untrained [32] males.
Moreover, most of the aforementioned studies used the LEDT combined with laser therapy
[30-32], which precludes determining the isolated effects of the LEDT on post-exercise RPE.
Consistent with our findings, the single study that used the LEDT alone did not find a positive
effect on RPE in moderately active males [29]. Therefore, in light of our evidence and others
[29, 32], it seems premature to confirm the effectiveness of LEDT on RPE after intense
physical exercise in young active individuals.
Finally, we found no beneficial effect of LEDT on DOMS up to 48 hours post-exercise.
To date, few studies have analyzed the impact of LEDT on DOMS in lower-limb muscles [13,
33, 34] and contradictory results were reported. Antonialli et al. [13] applied a device with
laser diodes (905 nm) and LEDs (640 nm and 875 nm) on the quadriceps muscle 3 minutes
before (i.e., preconditioning protocol) an isokinetic fatigue protocol to stimulate muscle
recovery. The authors reported a decrease in DOMS with light energies of 30 J and 50 J when
compared with the placebo condition. Similarly, de Paiva et al. [33] investigated the effects of
a cluster with 1 laser diode (905 nm) and 8 LEDs (640 – 875 nm) as a single or combined
treatment with cryotherapy on the quadriceps DOMS following a isokinetic fatigue protocol.
A reduction in DOMS from 1 to 96 hours was observed after fatigue protocol in the active
treatment when compared to placebo. On the other hand, Malta et al. [34] reported no
beneficial effect of LEDT alone (660- 850 nm) on DOMS in lower-limb muscles (i.e.,
quadriceps, biceps femoris, and a region between the soleus and gastrocnemius muscles) after
two sprint interval training sessions. It is worth mentioning that the studies which found
positive effects used a cluster with laser diodes and LEDs [13, 33], while our study and that of
Malta et al. (2019) applied LEDT alone. Therefore, it is feasible that LEDT may be dependent
on other stimuli (e.g., laser) to induce beneficial effects on post-exercise DOMS.
This study has some limitations that should be mentioned. First, we have analyzed the
acute effects of LEDT on muscle performance and muscle soreness, so we cannot rule out the
possibility of a beneficial effect if the laser is applied chronically or in combination with a
resistance exercise program. Second, we have only analyzed the performance of the
quadriceps, so we cannot rule out the possibility of a beneficial effect if the laser is applied to
upper-extremity muscles (e.g., biceps brachii). Finally, we did not use physiological fatigue
(e.g., lactate and electromyography [EMG ] signal) and recovery (e.g., blood CK levels)
markers to corroborate functional performance data, but previous studies have shown that
LEDT does not improve the lactate levels and EMG fatigue index in young women.
Moreover, it should be noted that our sample of healthy trained women might reach the
maximum exertion during repetitions-to-failure tests, which may mask a small beneficial
effect of the laser PBM. Therefore, we cannot rule out the possibility of a beneficial effect on
other populations of untrained individuals. Future studies are required to address these issues.
In conclusion, our results indicate that acute LEDT does not improve lower-body
performance to exhaustion and DOMS in resistance-trained women. Therefore, it seems
premature to consider acute LEDT as a potential strategy to enhance muscular endurance and
recovery of DOMS in this population. Further studies are warranted to confirm whether other
LEDT settings (e.g., wavelength, energy density, and total dose) may provide some benefit in
this population or others (e.g., men and elderly), in different muscles (e.g., upper-body
muscles), under different clinical (e.g., healthy or not), and training conditions (e.g., trained
vs. untrained).
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 APÊNDICE B – Trabalho Apresentado em Evento Científico

EFEITOS DA TERAPIA DE FOTOBIOMODULAÇÃO SOBRE A RESISTÊNCIA

MUSCULAR LOCALIZADA EM MULHERES IDOSAS

Lysa Melina Barrios Cabreira1; Ricardo Henrique Esquivel Azuma1; Claudiane Pedro
Rodrigues1; Jeferson Lucas Jacinto1; Mirela Casonato Roveratti1; Lincoln Israel
Dias1; Leidiane Remigio dos Santos1; Andreo Fernando Aguiar1.
1Universidade Norte do Paraná (UNOPAR), Londrina, Paraná, Brasil.. Email:
lysa.cabreira@anhanguera.com

Resumo: Intervenções terapêuticas com a finalidade de aumentar a resistência

muscular localizada (RML) podem contribuir para a melhoria da condição de saúde e
qualidade de vida da população idosa. O objetivo deste estudo foi investigar os
efeitos agudos da fotobiomodulação (FBM) sobre a RML em mulheres idosas.
Dezessete idosas (idade: 73 ± 4 anos) foram recrutadas para este estudo crossover,
randomizado, duplo cego e controlado com placebo. As idosas receberam de modo
contrabalanceado a FBM com laser ativo (λ: 808 nm, 10 mW, energia total: 56 J) e
placebo (aplicação do laser com o aparelho desligado) em dois momentos,
separados por um período 'washout' de 7 dias. O avaliador foi cegado para o
tratamento mediante a utilização de óculos opaco e um invólucro escuro na ponta da
sonda do laser e tela de ajustes do aparelho. O laser foi aplicado em 8 pontos do
músculo reto femoral, imediatamente antes do teste de RML, que consistiu em
realizar o maior número possível de repetições no exercício de extensão de joelhos,
com uma carga à 60% de 1RM. A carga de 1RM foi determinada mediante 3
sessões de testes antes da randomização. Os dados foram analisados por meio do
teste t pareado, considerando como nível de significância P < 0,05. Não houve
diferença significante (P > 0,05) no número de repetições máximas entre as
condições de laser ativo (11,6 ± 2,2) e placebo (11,7 ± 2,8). A terapia aguda de FBM
com laser à 808 nm não melhora a RML em mulheres idosas.

Palavras-chave: Envelhecimento; Aptidão muscular; Saúde

Cabreira LMB, Azuma RHE, Rodrigues CP, Jacinto JL, Roveratti MC, DiaS LI, dos
Santos LR, Aguiar AF. Efeitos da terapia de fotobiomodulação sobre a resistência
muscular localizada em mulheres idosas. XII Congresso Brasileiro de Atividade
Física e Saúde, Bonito, MS. 2019. p.342.