Journal of Novel Physiotherapies
Open Access

Vo2 max; Photobiomodulation; Pneumatic compression; Athletes

Introduction

The training and competition routine for athletes is a reality for many, which usually generates a heavy burden on exercises, some using illicit methods, such as anabolic substances and drugs, with the aim of obtaining a faster improvement in development and performance. Despite all these efforts, many athletes are predisposed to a variety of problems, both physical, such as musculoskeletal, hepatic, endocrine disorders, etc., and psychological, depression, bipolar disorder, among other personality disorders [1,2].

Recent research has exposed the effects of various interventions to improve performance in athletes, helping to improve performance and physical well-being, without the use of these medications as mentioned above, including massages, low-intensity exercises, cryotherapy, contrast baths, electrophysical resources, stretching, among others [3].

Among the electrophysical resources that are non-invasive physical modalities, which use electrical, thermal and photochemical energy with a therapeutic function, there are resources such as transcutaneous electrical nerve stimulation, interferential current, pneumatic boot, Russian current, functional electrical stimulation or neuromuscular electrical stimulation, radiofrequency diathermy, short waves, therapeutic ultrasound and photobiomodulation [4], with the aim of reducing pain, edema, muscle spasms, increasing joint mobility, increased muscular performance, tissue repair and return of neuromuscular activity, in addition to preventing atrophy due to disuse [5].

The resources studied in this work were photobiomodulation and the pneumatic boot. The pneumatic compression boot has its proper function of promoting progressive compression of the lower limbs, that is, it reduces the stagnation of blood or lymph present in the area, which will lead to an improvement in venous return, leading to a reduction in pain and edema, consequently preventing stasis [6]. Since athletes have a high intensity routine, the use of the pneumatic compression boot can be of great importance and bring good results compared to passive recovery, with a drop in blood lactate concentration, as well as the application of the boot can lead to a reduction in markers of damage that affect muscle tissue [7].

Photobiomodulation with infrared wavelengths is the most used clinically for therapeutic purposes8. The laser acts on tissue microcirculation and the removal of lactate, consequently helping to reduce reactive oxygen substances. Since in studies with athletes, after activity there is a decrease in lactate in the blood, providing better recovery from the activity performed, as well as reduced levels of Creatine Kinase (CK).

The objective of this research was to evaluate the changes promoted by the use of photobiomodulation, pneumatic compression and the combined action of the two resources in athletes' performance by quantifying Vo2 max.

Methods

Research ethics committee approval

The project was approved by the Ethics Committee for Human Beings of Santa Casa de Misericórdia de São Carlos, under responsibility number CAAE 51737921.7.0000.8148, according to resolution 466/2012. The procedure was obtained through free and informed consent.

Equipment

The prototype was developed by the Technological Support Laboratory (LAT) of the São Carlos Physics Institute (IFSC), being a combination of two resources, the pneumatic compression boot that involves the entire region of the calves and feet, leading to compression of the limb, consequently improving venous return and reabsorption of edema and fluids located in the interstitial spaces of the vascular and lymphatic system, and photobiomodulation with the spectra and their respective wavelengths 660nm and 808nm, acting on the inflammatory processes present. The patent process is under number BR 10 2021 009139 8 (Figure 1).

Figure 1: A) and B) tests carried out on a treadmill. C) Application of the compression boot and photobiomodulation.

Clinical research and protocol

The present work has n =18 being divided into 3 groups: 1) pneumatic compression (n=6), photobiomodulation (n=6) and pneumatic compression + photobiomodulation (n=6). The time of intervention will be 30 minutes. The interval between compressions will be 30 seconds. The emission of the laser was continuous. Wavelave 660nm and 830nm and 100mW of power. Assessments will be carried out before and after 8 interventions, twice a week, always after the training sessions. The assessment will be carried out using the Bruce treadmill test9, making it possible to measure Vo2 max.

Statistical analysis

Analyses of the data collected before and after the interventions were carried out, first using the Kolmogorov-Smirnov normality test and later the Tukey-Kramer post-hoc test to analyse the variables. P<0.05 was considered. The Statistical software version 14.0 was used.

Results

The results observed in the evaluation of the Bruce treadmill test, in the different groups analysed, pneumatic compression, photobiomodulation and pneumatic compression + photobiomodulation point to significant results between pneumatic compression x pneumatic compression + photobiomodulation (p<0.03) and photobiomodulation x pneumatic compression + photobiomodulation (p<0.01).

Discussion

High-performance athletes have a high-intensity routine, some seek illicit means, such as anabolic substances and drugs to improve performance, resulting in systemic disorders of the body [1,2], and other athletes aiming for the same objective, use physiotherapeutic means, such as massage, cryotherapy, electrophysical resources, among others.

In this present study, with the new combined technology developed by the Physics Institute of São Carlos with two therapeutic resources, having the combined action of the pneumatic boot and photobiomodulation, the red and infrared wavelengths being used for therapeutic purpose.

The pneumatic boot performs the function of manual lymphatic drainage, which assists the physiological drainage of interstitial fluids. In this context, the pneumatic boot favours venous return and also the elimination of toxins that can interfere with mobility and joints, consequently contributing to the improvement of Vo2 max and the athlete's early recovery [8-10].

The laser applied in a specific way performs photobiomodulation, which makes the difference between a systemic action and a local application. Everything happens through the action of the low-power laser, through the emission of 660mm and 808mm waves, both absorbed by structures such as cytochrome C oxidase, which leads to advantages such as the reduction of edema and inflammatory processes, analgesia, production of ATP [11,12].

Given these concepts, the combination of combined compression boot therapy with photobiomodulation has shown significant results. Eight sessions were carried out with just the effect of the pneumatic compression boot, with a post-session result of 3.04. As well as 10 sessions with the laser, obtaining a result of 1.9. The combined therapy of these two resources had a significant improvement in the Vo2 max index, reaching an improvement of 6.08 (Figure 2). Which leads us to see that the present study with the combination of these two therapies proved to be very effective in improving athletes, enabling better professional performance?

Figure 2: Comparison between different interventions (pneumatic compression, photobiomodulation and pneumatic compression + photobiomodulation) in relation to the Vo2 max observed in bruce treadmill test. It is possible to observe the significant difference in relation pneumatic compression x pneumatic compression + photobiomodulation (p<0,03) and photobiomodulation and pneumatic compression + photobiomodulation (p<0.01). It used the Kolmogorov-Smirnov normality test and later Tukey-Kramer post-hoc test for analysis of variables. It was considered p<0.05. The Statistica software version 14.0 was used.

The conclusion of this pilot study is that the combined action seems to favour the removal of toxins and the modulation of lactic acid concentration (leal Junior 2009), which, chronically (8 sessions), made it possible to measure a difference in performance through an increase in vo2 max during comparative action in specific tests.

Conclusion

The present work showed that the use of technologies in conjunction, in this case pneumatic compression and photobiomodulation, provided better results for the patient after a comparative period of interventions, improving the athletes' performance.

Author Contributions

All authors had equal contribution

Acknowledgements

This work was supported by São Paulo Research Foundation (FAPESP-grants n◦2013/07276-1 and 2014/50857-8) and by National Council for Scientific and Technological Development (CNPq-grant n◦ 465360/2014-9).

Conflict of Interest Statement

The authors declare no conflict of interest.

Data Availability Statement

All the data are available in the text.

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