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      Opinion of speech-language pathologist on the use of photobiomodulation in the vocal clinic

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          ABSTRACT

          Purpose

          to investigate the opinion of Brazilian speech-language pathologists on the training, performance, and parameters used for the application of photobiomodulation (PBM) in the vocal clinic.

          Methods

          observational, cross-sectional, and quantitative study, carried out through a web survey hosted on the Google Forms digital platform, composed of questions related to training, professional performance, and knowledge about PBM in the voice area. Twenty-nine speech-language pathologists of both sexes participated. Data were analyzed using descriptive statistics.

          Results

          all participants knew the theoretical foundations of PBM, and among them, 28 (96.6%) knew its use specifically in the voice area; twenty-five respondents (86.2%) had a device to perform the irradiation, and all of them used it routinely in their clinical practice in voice. The majority (96.6%, 28) participated in a PBM training course, including specific approaches to the voice area. Participants stated that PBM is a resource that can be used in the area of ​​voice to improve performance in sung (86.2%, 25) and spoken (82.8%, 24), in addition to its application in cases of inflammatory processes in the vocal folds (79.3%, 23). As for dosimetry parameters, the most used wavelength was 808 - 830nm (37.9%, 11) and 660/808nm simultaneously (37.9%, 11), with a dose of 3-5 J per point for the patients with inflammatory processes in the vocal folds (51.7%, 15) and 6-9 J (44.8%, 13) per point for patients whose objective was improvement/conditioning.

          Conclusion

          the study participants demonstrated knowledge and training in PBM and its applicability to the voice area.

          Related collections

          Most cited references30

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          Proposed Mechanisms of Photobiomodulation or Low-Level Light Therapy.

          Photobiomodulation (PBM) also known as low-level laser (or light) therapy (LLLT), has been known for almost 50 years but still has not gained widespread acceptance, largely due to uncertainty about the molecular, cellular, and tissular mechanisms of action. However, in recent years, much knowledge has been gained in this area, which will be summarized in this review. One of the most important chromophores is cytochrome c oxidase (unit IV in the mitochondrial respiratory chain), which contains both heme and copper centers and absorbs light into the near-infra-red region. The leading hypothesis is that the photons dissociate inhibitory nitric oxide from the enzyme, leading to an increase in electron transport, mitochondrial membrane potential and ATP production. Another hypothesis concerns light-sensitive ion channels that can be activated allowing calcium to enter the cell. After the initial photon absorption events, numerous signaling pathways are activated via reactive oxygen species, cyclic AMP, NO and Ca2+, leading to activation of transcription factors. These transcription factors can lead to increased expression of genes related to protein synthesis, cell migration and proliferation, anti-inflammatory signaling, anti-apoptotic proteins, antioxidant enzymes. Stem cells and progenitor cells appear to be particularly susceptible to LLLT.
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            Effect of phototherapy (low-level laser therapy and light-emitting diode therapy) on exercise performance and markers of exercise recovery: a systematic review with meta-analysis.

            Recent studies have explored if phototherapy with low-level laser therapy (LLLT) or narrow-band light-emitting diode therapy (LEDT) can modulate activity-induced skeletal muscle fatigue or subsequently protect against muscle injury. We performed a systematic review with meta-analysis to investigate the effects of phototherapy applied before, during and after exercises. A literature search was performed in Pubmed/Medline database for randomized controlled trials (RCTs) published from 2000 through 2012. Trial quality was assessed with the ten-item PEDro scale. Main outcome measures were selected as: number of repetitions and time until exhaustion for muscle performance, and creatine kinase (CK) activity to evaluate risk for exercise-induced muscle damage. The literature search resulted in 16 RCTs, and three articles were excluded due to poor quality assessment scores. From 13 RCTs with acceptable methodological quality (≥6 of 10 items), 12 RCTs irradiated phototherapy before exercise, and 10 RCTs reported significant improvement for the main outcome measures related to performance. The time until exhaustion increased significantly compared to placebo by 4.12 s (95% CI 1.21-7.02, p < 0.005) and the number of repetitions increased by 5.47 (95% CI 2.35-8.59, p < 0.0006) after phototherapy. Heterogeneity in trial design and results precluded meta-analyses for biochemical markers, but a quantitative analysis showed positive results in 13 out of 16 comparisons. The most significant and consistent results were found with red or infrared wavelengths and phototherapy application before exercises, power outputs between 50 and 200 mW and doses of 5 and 6 J per point (spot). We conclude that phototherapy (with lasers and LEDs) improves muscular performance and accelerate recovery mainly when applied before exercise.
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              Assessing the impact of low level laser therapy (LLLT) on biological systems: a review

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                Author and article information

                Contributors
                Role: idealizationRole: collectionRole: analysis of dataRole: writing of the manuscript
                Role: interpretationRole: review of the manuscript
                Role: interpretationRole: review of the manuscript
                Role: designRole: analysisRole: interpretationRole: writing of the manuscriptRole: review of the manuscript
                Journal
                Codas
                Codas
                codas
                CoDAS
                Sociedade Brasileira de Fonoaudiologia
                2317-1782
                18 September 2023
                2023
                : 35
                : 6
                : e20220060
                Affiliations
                [1 ] originalUniversidade Federal da Paraíba - UFPB - João Pessoa (PB), Brasil.
                [2 ] originalCentro de Estudos da Voz - CEV - São Paulo (SP), Brasil.
                [3 ] originalHospital Pronto Socorro Municipal Mário Pinotto - Belém (PA), Brasil.
                [1 ] originalUniversidade Federal da Paraíba - UFPB - João Pessoa (PB), Brasil.
                [2 ] originalCentro de Estudos da Voz - CEV - São Paulo (SP), Brasil.
                [3 ] originalHospital Pronto Socorro Municipal Mário Pinotto - Belém (PA), Brasil.
                Author notes

                Conflict of interests: nothing to declare.

                Correspondence address: Leonardo Wanderley Lopes Departamento de Fonoaudiologia, Centro de Ciências da Saúde, Universidade Federal da Paraíba Cidade Universitária, Campus I, Castelo Branco, João Pessoa (PB), Brasil, CEP: 58051900. E-mail: lwlopes@ 123456hotmail.com

                Conflito de interesses: nada a declarar.

                Endereço para correspondência: Leonardo Wanderley Lopes Departamento de Fonoaudiologia, Centro de Ciências da Saúde, Universidade Federal da Paraíba Cidade Universitária, Campus I, Castelo Branco, João Pessoa (PB), Brasil, CEP: 58051900. E-mail: lwlopes@ 123456hotmail.com
                Author information
                http://orcid.org/0000-0002-8455-016X
                http://orcid.org/0000-0003-2169-2723
                http://orcid.org/0000-0002-3120-9160
                http://orcid.org/0000-0001-9041-7114
                Article
                codasAO20220060_PT 00311
                10.1590/2317-1782/20232022060en
                10547142
                37729333
                240e6a51-4e5e-436f-b095-602403a7f972

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 22 February 2022
                : 01 December 2022
                Page count
                Figures: 8, Tables: 6, Equations: 0, References: 30
                Categories
                Original Article

                voice,low-level light therapy,voice disorders,voice training,laryngeal diseases

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