Acute Effect of Photobiomodulation on Quadriceps Muscle Strength in Patients With Chronic Kidney Failure on Hemodialysis
Condition: Renal Insufficiency, Chronic; Renal Dialysis
MeSH terms: Renal Insufficiency; Renal Insufficiency, Chronic; Kidney Failure, Chronic
Study type: Interventional

Summary: 
      Chronic kidney disease (CKD) consists of kidney damage and progressive and irreversible loss
      of kidney function. The aim of this study is to evaluate the acute effect of different doses
      of photobiomodulation therapy on quadriceps isometric muscle strength, pain and muscle
      fatigue of lower limbs and to establish the ideal dose for patients with CKD on hemodialysis.
      Patients will be submitted to application of photobiomodulation therapy in the quadriceps
      muscle. Immediately after, the maximum isometric strength test of the quadriceps will be
      performed.
    

Detailed description: 
      Chronic kidney disease (CKD) consists of kidney damage and progressive and irreversible loss
      of kidney function. In the most advanced stage of the disease the patients require
      hemodialysis (HD) and present alterations such as: sarcopenia, cardiovascular disorders,
      increased systemic inflammation, muscle weakness and fatigue. These factors negatively affect
      the individual's functionality, impacting the increase in hospitalization and mortality
      rates. Photobiomodulation (FBM) has shown positive results in different populations on
      improving performance during exercise, reducing fatigue and markers of muscle damage. The aim
      of this study is to evaluate the acute effect of FBM therapy on quadriceps muscle strength,
      pain and muscle fatigue in patients with CKD on HD and to establish the ideal therapeutic
      dose. Patients will be submitted to application of four applications with different doses of
      FBM (30J, 60J, 90J and placebo) in the quadriceps muscle, in random order and one week
      interval between them for washout. Patients and evaluators will be blinded to the
      intervention protocol. The following assessments will be performed prior to FBM: subjective
      perception of exertion (by modified Borg scale), muscle fatigue (by analysis of blood
      lactate) and pain perception (by numeric pain scale). After the FBM application, the maximum
      isometric strength test of the quadriceps will be performed by dynamometry. Immediately after
      performing the strength test, all assessments will be repeated.
    

Intervention name(s): Photobiomodulation
Intervention type(s): Other
Intervention description(s): It will be applied a dose of laser radiation through a cluster with four diodes, wavelength of 830 nm and power of 800mW (200mW/diode), HTM® (model Fluence MAXX, São Paulo, Brazil). For application, the patient will be positioned in a sitting position and the treatment will be performed with the fixed probe in contact with the skin at an angle of 90º, using the continuous emission mode. The therapy will be applied to the quadriceps muscle, bilaterally.
Other intervention name(s): Low level laser therapy
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Low-Level Light Therapy; Renal Insufficiency, Chronic; Randomized Controlled Trial