Banca de DEFESA: LIVIA OLIVEIRA BEZERRA

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : LIVIA OLIVEIRA BEZERRA
DATE: 07/03/2025
TIME: 08:00
LOCAL: remoto
TITLE:

EFFECT OF PHOTOBIOMODULATION THERAPY ON
GENITOURINARY SYNDROME OF MENOPAUSE

 

KEY WORDS:

Genitourinary Syndrome of Menopause, Pelvic Floor, Low-Intensity
Light Therapy, Controlled Clinical Trial, Systematic Review.

 

PAGES: 118
BIG AREA: Ciências da Saúde
AREA: Fisioterapia e Terapia Ocupacional
SUMMARY:

Introduction: Aging is a universal and inevitable process that is
attracting interest in many areas around the world. In women, in
addition to the physiological changes resulting from age, other changes
occur due to ovarian failure that culminates in menopause. During
menopause, there is a decrease in the levels of female sexual steroids
and, as a consequence, a spectrum of genitourinary symptoms and signs
known as Genitourinary Syndrome of Menopause (GMS) is observed.
GMS involves numerous urogenital changes, which imply changes in
sexual and urinary functions. Objective: Article 1 - To conduct a
systematic review with meta-analysis of clinical trials to evaluate the
impact of photobiomodulation therapy (PBMT) on functional performance, covering aspects such as fatigue, strength and functional
capacity in healthy individuals. Article 2 - To evaluate the effects of
PBMT, both alone and in combination with pelvic floor muscle training
(PFMT), on pelvic floor muscle (PFM) function, as well as on sexual
function, urinary function and quality of life (QOL) in women affected

by GMS. Methodology: Article 1 - A systematic review with meta-
analysis was carried out from June to October 2022 in electronic

databases, including Web of Science, Lilacs, Scielo, PubMed,
Cochrane, Pedro, Embase, Science Direct, Scopus, Clinical Trials,
Google Scholar, Open Gray and Trials Central, in addition to an active
search in references of relevant studies. The following descriptors were
used in combination: "Photobiomodulation Therapies" OR "Therapies

Photobiomodulation" OR "Therapy Photobiomodulation" OR "Low-
Level Light Therapy" OR "Diode Laser" AND "Muscle Strength" OR

"Pain" OR "functionality" AND "Functional Capacity". There were no
time and language restrictions in the search. Randomized clinical trials
that used TFBM, Laser or LED as the only intervention and evaluated
functional performance were included, while studies that compared
other therapeutic modalities or involved participants with chronic
diseases or acute injuries were excluded. Study selection was
conducted by three independent reviewers via Rayyan, and data
extraction was performed using a standardized form. Risk of bias was
assessed using Risk of Bias 2 (RoB 2), and confidence in the evidence
was assessed using Grading of Recommendations Assessment,
Development and Evaluation (GRADE). Meta-analysis was conducted
using RevMan software. Article 2 - Randomized, blinded clinical trial.
Women aged 45 to 65 years with a diagnosis of sexual and urinary
dysfunction participated in the study and were randomly divided into
three groups: PFMT isolated group (GTMAP isolated, n=18), PFMT
associated with active photobiomodulation (PBM) group (GTMAP +
active PBM, n=18) and PFMT associated with sham PBM group
(GTMAP + sham PBM, n=18). The volunteers were evaluated before
the intervention and after eight weeks. The Female Sexual Function Index (FSFI) was applied to assess sexual function, the International
Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF)
for urinary loss, the Patient Global Impression of Improvement (PGI-I)
for the level of satisfaction after the intervention and vaginal
manometry was also performed to assess pelvic floor muscle (PFM)
functionality. The sample data were analyzed using the Jamovi
statistical software (version 2.3.28). Results: Article 1 - Sixteen
studies were included, totaling 340 participants (183 men and 157
women). Most studies had a low risk of bias and heterogeneity was
observed in devices and application parameters. It was observed that
BMFT improved recovery from fatigue (mean difference: 5.87; 95% CI
3.83, 7.91). There was no improvement in strength: peak torque (mean
difference: 12.40; 95% CI -5.55, 30.55); one repetition maximum test
(mean difference: 39.97, 95% CI -2.44, 82.38); isometric and isokinetic
strength (mean difference: 2.77, 95% CI -14.90, 20.44) and there was
also no improvement in short-term (mean difference: 0.67, 95% CI -
0.58, 1.91) and long-term (mean difference: 18.44, 95% CI -55.65,
92.54) functional capacity. Article 2 - Significant differences were
observed between groups over time for the ICIQ-SF (p=0.02), the FSFI
(p=0.002) and their subscales: arousal (p=0.01), lubrication (p<0.001),
orgasm (p=0.04) and satisfaction (p=0.007). The final manometry
results showed significant differences between the groups: GPFMT +
active PBM and GPFMT + sham PBM (mean difference 3.71; CI: 0.02,
7.40; d: 0.28) and GPFMT + sham PBM versus GIPFMT (mean
difference: -1.05; CI: -2.06, -0.04; d: 0.07). Conclusion: Article 1 -
TFBM is a resource that can help promote recovery from fatigue in
healthy individuals; however, there is no evidence to support that the
use of PBM can enhance strength and improve functional capacity in
the short and long term. Article 2 - Treatment with active PBM
combined with PFMT had a superior trend towards improving sexual
function, urinary function and QOL in women with SGM. Although
PBM has relevant therapeutic potential, its integration into
conventional practice remains cautious due to the need for more research to establish standardized guidelines to establish long-term
efficacy.

 

 

 

 

COMMITTEE MEMBERS:
Interna - 2212151 - ELIZABEL DE SOUZA RAMALHO VIANA
Externa à Instituição - GABRIELA MARINI PRATA - UNISAGRADO
Externa ao Programa - 2446479 - LILIAN LIRA LISBOA - nullPresidente - 2786809 - MARIA THEREZA ALBUQUERQUE BARBOSA CABRAL MICUSSI
Externo à Instituição - NIVALDO ANTONIO PARIZOTTO - UFSCAR