Comparative assessment of distance covered, lung function and quality of life after cardiorespiratory rehabilitation with and without transcranial photobiomodulation in individuals with spasticity – Pilot study




Spasticity; Neurological diseases; Cardiorespiratory rehabilitation; Aerobic exercise; Transcranial photobiomodulation.


The aim of the study was to evaluate the effects of cardiorespiratory rehabilitation (CR) alone and associated with transcranial photobiomodulation (PBMt) on distance walked (WD), pulmonary function and quality of life in individuals with spasticity. Participants were divided into two groups: Transcranial photobiomodulation group (PBMtG, CR + active PBMt, n=8) and placebo group (PG, CR + sham PBMt, n=7). The CR consisted of 12 weeks of treatment, 2x week for 1 hour, including aerobic, respiratory and resistance exercises of the lower limbs. For PBMt, the laser cluster was used (λ= 680 nm and 3 lasers at λ= 808 nm, total energy of 36 J/point) at points F7, F8, AFz. WD, spirometry, manovacuometry and SF-36 were evaluated at baseline and reassessment at 8 and 12 weeks. The WD increased by 165.43 meters and 222.46m at 12 weeks for PBMtG and PG, respectively, with intragroup statistical differences (p<0.05) and no intergroup difference (p>0.05). An increase in the peak expiratory flow index was observed only in the FG in the baseline analysis x12 weeks (p<0.05). The PBMtG showed an increase in MIP and MEP by 20% (8 weeks) and 15% (12 weeks). In the SF-36, the difference in relation to the baseline, the physical aspects and pain domains were verified for the growth behavior PBMtG, and for the decrease PG. It was concluded that the WD improved in the PBMtG and PG after the intervention, without a potentiating effect on the performance in the PBMtG and that PBMt seems to have influenced the respiratory mechanics of the PBMtG and the physical aspects and pain of the SF-36.


Akoglu, H. (2018). User's guide to correlation coefficients. Turk J Emerg Med. 7;18(3):91-93.

American Thoracic Society (ATS) (2002). ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 166(1):111-7.

Block, V. A., et al. (2016). Remote Physical Activity Monitoring in Neurological Disease: A Systematic Review. PLoS One., 28;11(4):e0154335.

Bonnefoy-Mazure, A., De Coulon, G., & Armand, S. (2020). Self-perceived gait quality in young adults with cerebral palsy. Dev Med Child Neurol., 62(7):868-873.

Borella, M. P., & Sacchelli, T. (2009). The effects of motor activities practice on neural plasticity. Rev. Neurocienc., 17 (2): 61-9, 2009.

Brainmov. Equipamentos. Estação de Reabilitação e Atividade Física BrainMov. <>.

Ciconelli, R. M., et al. (1999). Tradução para a língua portuguesa e validação do questionário genérico de avaliação de qualidade de vida SF-36 (Brasil SF-36). Revista Brasileira de Reumatologia, 39 (3):143-150.

Chin, L. M. K., et al (2019). Oxygen uptake on-kinetics before and after aerobic exercise training in individuals with traumatic brain injury. Disabil Rehabil, (24):2949-2957.

Chohan, S. A., Venkatesh, P. K., How, C. H. (2019). Long-term complications of stroke and secondary prevention: an overview for primary care physicians. Singapore Med J., 60(12):616-620.

Colebatch, J. G., et al. (1991). Regional cerebral blood flow during volitional breathing in man. J Physiol., 443:91-103.

Delmas, S., et al. (2018). Motor planning perturbation: muscle activation and reaction time. Journal of Neurophysiology, 120 (4): 2059–2065.

Duncan, P. W., et al. (2011). Body-Weight–Supported Treadmill Rehabilitation after Stroke. N Engl J Med, 364:2026-2036.

Flanigan, M., et al. (2020). Spasticity and pain in adults with cerebral palsy. Dev Med Child Neurol. 62(3):379-385.

Foreman, K. J., et al. (2018). Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 2016-40 for 195 countries and territories. Lancet. 392(10159):2052-2090.

Fulk, G. D., & He, Y. (2018). Minimal Clinically Important Difference of the 6-Minute Walk Test in People With Stroke. Journal of Neurologic Physical Therapy, 42(4): 235-240.

Gillett, J. G., et al. (2018). Functional Anaerobic and Strength Training in Young Adults with Cerebral Palsy. Medicine & Science in Sports & Exercise, 50 (8): 1549-1557.

Hall, J. E. Tratado de Fisiologia Médica. (12ª ed.): Elsevier, 2011, 1173p.

Hamel, R. N., & Smoliga, J. M. (2019). Physical Activity Intolerance and Cardiorespiratory Dysfunction in Patients with Moderate-to-Severe Traumatic Brain Injury. Sports Med, 49, 1183–1198.

Hennessy, M., & Hamblin, M. R. (2017). Photobiomodulation and the brain: a new paradigm. J Opt., 19(1):013003.

Herdy, A. H., et al. (2014). South American Guidelines for Cardiovascular Disease Prevention and Rehabilitation. Arquivos Brasileiros de Cardiologia, 103(2): Suppl 1, 1-31.

Hwang, J., Castelli, D. M., & Gonzalez-Lima, F. (2016). Cognitive enhancement by transcranial laser stimulation and acute aerobic exercise. Lasers Med Sci., 31, 1151–1160.

Karvonen, J., & Vuorimaa, T. (1988). Heart rate and exercise intensity during sports activities. Practical application. Sports Med. 5(5):303-11.

Khan, F., et al. (2019). Non-pharmacological interventions for spasticity in adults: An overview of systematic reviews. Annals of Physical and Rehabilitation Medicine, 62 (4): 265-273.

Khellaf, A., Khan, D. Z., & Helmy, A. (2019). Recent advances in traumatic brain injury. J Neurol., 266(11):2878-2889.

Korzhova, J., et al. (2018). Transcranial and spinal cord magnetic stimulation in treatment of spasticity: a literature review and meta-analysis. Eur J Phys Rehabil Med. 54(1):75-84.

Lampe, R., et al. (2014). Lung vital capacity and oxygen saturation in adults with cerebral palsy. Patient Prefer Adherence, 9(8):1691-7.

Landes, S. D. (2019). Mortality risk among adults with cerebral palsy: alarming findings and lingering questions. Dev Med Child Neurol., 61(8):860-861.

Lent, R. Cem Bilhões de Neurônios? Conceitos Fundamentais de Neurociência. (2ª Ed.): Atheneu, 2005, 714 p.

Liaw, M. Y., et al. (2020). Respiratory muscle training in stroke patients with respiratory muscle weakness, dysphagia, and dysarthria - a prospective randomized trial. Medicine, 99(10):e19337.

Liu, J., Zhang, J., & Wang, L. N. (2018). Gamma aminobutyric acid (GABA) receptor agonists for acute stroke. Cochrane Database Syst Rev., 30;10(10):CD009622.

Lopes, T., et al. (2022). Analysis of performance and vital signs in a cardiorespiratory rehabilitation protocol in subjects with central nervous system diseases. Research, Society and Development, 11(8):e50411829668.

Lorenz, L. S., et a. (2018). Healthy body, healthy mind: A mixed methods study of outcomes, barriers and supports for exercise by people who have chronic moderate-to-severe acquired brain injury. Disabil Health J. 11(1):70-78.

Mang, C. S., et al. (2013). Promoting neuroplasticity for motor rehabilitation after stroke: considering the effects of aerobic exercise and genetic variation on brain-derived neurotrophic factor. Phys Ther., 93(12):1707-16.

Montazeri, K., et al. (2021). Transcranial photobiomodulation in the management of brain disorders. J Photochem Photobiol B., 221:112207.

Mossberg, K. A., & Fortini, E. (2012). Responsiveness and validity of the six-minute walk test in individuals with traumatic brain injury. Phys Ther., 92(5):726-33.

Munari, D., et al. (2018). High-intensity treadmill training improves gait ability, VO2peak and cost of walking in stroke survivors: preliminary results of a pilot randomized controlled trial. Eur J Phys Rehabil Med., 54(3):408-418.

Neder, J., et al. (1999). Reference values for lung function tests. II. Maximal respiratory pressures and voluntary ventilation. Braz J Med Biol Res. 32(6):719-27.

Orczykowski, M. E., et al. (2018). Cell based therapy enhances activation of ventral premotor cortex to improve recovery following primary motor cortex injury. Experimental Neurology, 305: 13-25.

Pereira, C. A. C. (2002). Diretrizes para Testes de Função Pulmonar – Espirometria. J Pneumol, 28 (Supl 3), S1-S82.

Peterson, M. D., et al. (2015). Chronic Conditions in Adults With Cerebral Palsy. JAMA; 314(21):2303-5.

Pinto, A. P., et al. (2019). Sensory-motor and cardiorespiratory sensory rehabilitation associated with transcranial photobiomodulation in patients with central nervous system injury: Trial protocol for a single-center, randomized, double-blind, and controlled clinical trial. Medicine, 98(25):e15851.

Salehpour, F., et al. (2018). Brain Photobiomodulation Therapy: a Narrative Review. Mol Neurobiol., 55(8):6601-6636.

Sharpe, A., et al. (2021). Cardiopulmonary Exercise Testing in Stroke Rehabilitation: Benefits and Clinical Utility Perceived by Physiotherapists and Individuals with Stroke. Physiother Can., 73(2):110-117.

Similowski, T., et al. (1996). Impairment of central motor conduction to the diaphragm in stroke. Am J Respir Crit Care Med., 154(2 Pt 1):436-41.

Song, J. Z., et al. (2020). Physical Performance Outcome Measures Used in Exercise Interventions for Adults with Childhood-onset Disabilities: A Scoping Review. NeuroRehabilitation, 47(4): 359 – 380.

Synnot, A., et al. (2017). Interventions for managing skeletal muscle spasticity following traumatic brain injury. Cochrane Database Syst Rev. 22;11(11):CD008929.

Trompetto, C., et al. (2014). Pathophysiology of spasticity: implications for neurorehabilitation. Biomed Res Int. 2014:354906.

World Association for LASER Therapy. WALT standard for conduct of randomized controlled trials. <>.

Wang, X., et al. (2021). Transcranial photobiomodulation and thermal stimulation induce distinct topographies of EEG alpha and beta power changes in healthy humans. Sci Rep., 11, 18917.

Ware, J. E., & Sherbourne, C. D. (1992). The MOS 36-item short health survey (SF-36). I. Conceptual framework and item selection. Medical Care, 30(6):473-483.

Ziaka, M., & Exadaktylos, A. (2021). Brain-lung interactions and mechanical ventilation in patients with isolated brain injury. Crit Care., 13;25(1):358.



How to Cite

PINTO, A. P.; LEMOS, S. L. .; FAGUNDES , A. de A. .; LOPES-MARTINS, R. Álvaro B. .; NEVES , M. F. das; LIMA, F. P. S. .; LIMA, M. O. . Comparative assessment of distance covered, lung function and quality of life after cardiorespiratory rehabilitation with and without transcranial photobiomodulation in individuals with spasticity – Pilot study. Research, Society and Development, [S. l.], v. 11, n. 14, p. e155111435944, 2022. DOI: 10.33448/rsd-v11i14.35944. Disponível em: Acesso em: 9 dec. 2022.



Health Sciences