title: Low-Level Laser Therapy and Cryotherapy as Mono- and Adjunctive Therapies for Achilles Tendinopathy in Rats.
abstract: OBJECTIVE
  Low-level laser therapy (LLLT) and cryotherapy are widely used treatments in the acute phase of tendon injury. The aim of this study was to investigate the interaction of these two treatments on tendon inflammation and mechanical properties.
  
  
  METHODS
  Six groups of six Wistar rats were used in this study. The Achilles tendons of the healthy control group were not subjected to injury or treatment. The tendons of the injured nontreated group (ING) were injured, but not treated. The remaining four groups were injured and subjected to LLLT, cryotherapy, LLLT first/cryotherapy, or cryotherapy first/LLLT. All treatments were performed at 1 h post-trauma. Inflammatory mediators, tendon histology, and biomechanical properties were assessed at 24 h post-trauma by comparing the treatment groups with the ING.
  
  
  RESULTS
  In all treatment groups, the inflammatory process shifted in an anti-inflammatory direction compared with the ING. Significant alterations in cytokine expression were found in only the LLLT group (↓IL-1β) and the combined intervention groups (↓IL-1β, ↓TNF-α, ↑IL-6). It was also found that cryotherapy followed by LLLT was the only treatment that significantly (p < 0.05) improved the biomechanical parameters of force (N) and displacement (mm) at the tendon rupture and corresponded with the best histological scores of all of the treatment groups.
  
  
  CONCLUSIONS
  Our results demonstrate that cryotherapy in combination with LLLT can produce an anti-inflammatory "add-on" effect. The order of therapy administration seems essential, as superior histology and biomechanical results were found in the cryotherapy first/LLLT group.
authors.affiliation: 1 NorPhyPain Research Group, Faculty of Health and Social Sciences, Centre for Evidence Based Practice, Bergen University College , Bergen, Norway .|2 Physiotherapy Research Group, Department of Global Public Health and Primary Care, University of Bergen , Bergen, Norway .
authors.forename: Sturla
authors.initials: S
authors.lastname: Haslerud
authors.affiliation: 3 Nucleus of Technological Research-NPT, Post-Graduate Program in Biomedical Engeneering, University of Mogi das Cruzes (UMC) , São Paulo, Brazil .
authors.forename: Rodrigo Alvaro Brandão
authors.initials: RA
authors.lastname: Lopes-Martins
authors.affiliation: 4 Centro de Ciências da Saúde, Universidade Cruzeiro do Sul , São Paulo, Brazil .
authors.forename: Lúcio
authors.initials: L
authors.lastname: Frigo
authors.affiliation: 1 NorPhyPain Research Group, Faculty of Health and Social Sciences, Centre for Evidence Based Practice, Bergen University College , Bergen, Norway .|2 Physiotherapy Research Group, Department of Global Public Health and Primary Care, University of Bergen , Bergen, Norway .
authors.forename: Jan Magnus
authors.initials: JM
authors.lastname: Bjordal
authors.affiliation: 5 Programa de Pós-Graduação em Biofotônica Aplicada as Ciências da Saúde, Universidade Nove de Julho , São Paulo, Brazil .
authors.forename: Rodrigo Labat
authors.initials: RL
authors.lastname: Marcos
authors.affiliation: 2 Physiotherapy Research Group, Department of Global Public Health and Primary Care, University of Bergen , Bergen, Norway .
authors.forename: Ingvill Fjell
authors.initials: IF
authors.lastname: Naterstad
authors.affiliation: 2 Physiotherapy Research Group, Department of Global Public Health and Primary Care, University of Bergen , Bergen, Norway .|6 Department of Occupational Therapy, Physiotherapy and Radiography, Faculty of Health and Social Sciences, Bergen University College , Bergen, Norway .
authors.forename: Liv Heide
authors.initials: LH
authors.lastname: Magnussen
authors.affiliation: 2 Physiotherapy Research Group, Department of Global Public Health and Primary Care, University of Bergen , Bergen, Norway .|6 Department of Occupational Therapy, Physiotherapy and Radiography, Faculty of Health and Social Sciences, Bergen University College , Bergen, Norway .
authors.forename: Jon
authors.initials: J
authors.lastname: Joensen
mesh_terms: D000125:Achilles Tendon; D000818:Animals; D017679:Cryotherapy / Q000379:methods; D028022:Low-Level Light Therapy / Q000379:methods; D051381:Rats; D017208:Rats, Wistar; D052256:Tendinopathy / Q000628:therapy*
keywords: animal; low-level laser therapy; photobiomodulation; tendinopathies and tendinitis