***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The objective of this study is to evaluate the effectiveness of laser and LED therapies , associated with lateral decubitus position and flexion exercises of the lower limbs in patients with lumbar disk herniation ( LDH ) . It is a r and omized blinded clinical trial . Fifty-four subjects with LDH L4-L5 and L5-S1 were selected and r and omly allocated into groups : laser 904 nm , placebo , and LED 945 nm . The numbers of subjects for each group that completed the treatment were 18 , 13 , and 18 , respectively . Twelve points over the lumbar spine region ( L2 to S1 ) and eight points on the injured thigh in the path of the lumbar roots L5 and S1 were irradiated . Irradiation parameters for each point were as follows : laser wavelength 904 ± 10 nm , average power 0.038 ± 20 % W , irradiated area 0.16 cm2 , energy per point 4 J , and treatment time per point 104 s ; LED wavelength 945 ± 15 nm , power 0.1 W , irradiated area 1.0cm2 , energy per point 4 J , and treatment time per point 40 s. Lateral decubitus opposite to the side of the radicular was the st and ard position for all patients . After phototherapy and laser placebo sessions , the subjects performed sequences of flexion exercises of the lower limbs ( ten per session ) for 15 daily sessions . Variables studied : pain intensity assessed by visual analog scale ( VAS ) , degree of flexion of the affected hip measured by the universal goniometer and functional capacity assessed by the Oswestry Disability Index . The three groups had statistically significant improvement in lumbar and radicular pain , in hip mobility , and in the functional disability index ( p ≤ 0.001 ) . There was a statistically significant difference ( p = 0.024 ) in radicular pain between the groups , gait claudication and Oswestry Disability Index . We can conclude that in the treatment of L4-L5 and L5-S1 LDH with radiculopathy , LED , associated with lateral decubitus position and flexion exercises of the lower limbs , showed better therapeutic performance for radicular pain , gait claudication , and functional disability Purpose Eccentric training has been popularized for physical conditioning and prevention/rehabilitation of musculoskeletal disorders , especially due to the expressive responses in terms of muscular strength gain . In view of evidence that low-level laser therapy ( LLLT ) is able to increase exercise performance and accelerate post-exercise recovery , the aim of this study was to verify the effect of LLLT on hypertrophy and strengthening of knee extensor muscles su bmi tted to eccentric training . Method Thirty healthy male subjects were r and omized into three groups : Control Group ( CG ) , Training Group ( TG ) and Training + LLLT Group ( TLG ) . CG received no intervention , while TG and TLG were engaged on an 8-week knee extensor isokinetic eccentric training program . Only subjects from TLG were treated with LLLT ( wavelength = 810 nm ; power output = 200 mW ; total dosage = 240 J ) before each training session . Knee extensor muscle thickness and peak torque were assessed through ultrasonography and isokinetic dynamometry , respectively . Results CG presented no changes in any variable throughout the study , while eccentric training led to significant increases in muscle thickness and peak torque in TG and TLG . Subjects from TLG reached significantly higher percent changes compared to subjects from TG for sum of muscles ’ thicknesses ( 15.4 vs. 9.4 % ) , isometric peak torque ( 20.5 vs. 13.7 % ) , and eccentric peak torque ( 32.2 vs. 20.0 % ) . Conclusion LLLT applied before eccentric training sessions seems to improve the hypertrophic response and muscular strength gain in healthy subjects Evidence indicates that low-level laser therapy ( LLLT ) minimizes fatigue effects on muscle performance . However , the ideal LLLT dosage to improve athletes'performance during sports activities such as cycling is still unclear . Therefore , the goal of this study was to investigate the effects of different LLLT dosages on cyclists'performance in time-to-exhaustion tests . In addition , the effects of LLLT on the frequency content of the EMG signals to assess fatigue mechanisms were examined . Twenty male competitive cyclists participated in a crossover , r and omized , double-blind , placebo-controlled trial . They performed an incremental cycling test to exhaustion ( on day 1 ) followed by 4 time-to-exhaustion tests ( on days 2 - 5 ) at their individual maximal power output . Before each time-to-exhaustion test , different dosages of LLLT ( 135 , 270 , and 405 J/thigh , respectively ) or placebo were applied at the quadriceps muscle bilaterally . Power output and muscle activation from both lower limbs were recorded throughout the tests . Increased performance in time-to-exhaustion tests was observed with the LLLT-135 J ( ∼22 s ; P < .01 ) , LLLT-270 J ( ∼13 s ; P = .03 ) , and LLLT-405 J ( ∼13 s ; P = .02 ) compared to placebo ( 149 ± 23 s ) . Although LLLT-270 J and LLLT-405 J did not show significant differences in muscle activation compared with placebo , LLLT-135 J led to an increased high-frequency content compared with placebo in both limbs at the end of the exhaustion test ( P ≤ .03 ) . In conclusion , LLLT  increased time to exhaustion in competitive cyclists , suggesting this intervention as a possible nonpharmacological ergogenic agent in cycling . Among the different dosages , LLLT-135 J seems to promote the best effects The aim of the present study was to evaluate the efficiency of high intensity laser and ultrasound therapy in patients who were diagnosed with lumbar disc herniation and who were capable of performing physical exercises . 65 patients diagnosed with lumbar disc were included in the study . The patients were r and omly divided into three groups : Group 1 received 10 sessions of high intensity laser to the lumbar region , Group 2 received 10 sessions of ultrasound , and Group 3 received medical therapy for 10 days and isometric lumbar exercises . The efficacy of the treatment modalities was compared with the assessment of the patients before the therapy at the end of the therapy , and in third month after the therapy . Comparing the changes between groups , statically significant difference was observed in MH ( mental health ) parameter before treatment between Groups 1 and 2 and in MH parameter and VAS score in third month of the therapy between Groups 2 and 3 . However , the evaluation of the patients after ten days of treatment did not show significant differences between the groups compared to baseline values . We found that HILT , ultrasound , and exercise  were efficient therapies for lumbar discopathy but HILT and ultrasound  had longer effect on some parameters UNLABELLED Increased expression of degenerative disease of the lumbar spine is an onerous task , which reduces the efficiency of the activity and life of many population s. It is the most common cause of medical visits . In 95 % of cases the cause of complaints is a destructive process in the course of degenerative intervertebral disc called a lumbar disc herniation . Protrusion of the nucleus pulposus causes severe pain and impaired muscle tone , often more chronic and difficult to master . Successful treatment of lumbar disc herniation constitutes a serious interdisciplinary problem . It is important to properly planned and carried out physiotherapy . Based on the number of non-invasive methods , to reduce muscle tension , mute pain and alleviation of inflammation . It is the treatment safe , effective , and at the same time , which is their big advantage , readily available and cheap . It is worth noting that not every method has the same efficiency . The question that the methods are effective in relieving pain and helping to effectively increase the range of motion led to a comparison of two methods - Low Level Laser Therapy ( LLLT ) and pulsating magnetic field therapy . AIM The aim of the study was to compare the efficacy of LLLT and pulsating magnetic field therapy in combating pain and increase range of motion of the spine of people with degenerative spine disease of the lower back . MATERIAL S AND METHODS 120 patients with diagnose lumbar disc herniation whit no nerve roots symptoms . Patients were divided into two Groups : A and B. Group A of 60 patients were subjected to laser therapy ( λ=820 nm , P=400mW , Ed=6 - 12 J/cm² ) and the second Group B of 60 patients too , to pulsating magnetic fields procedures ( 5mT , 30 Hz , 15 minutes ) . Every patient before rehabilitation started and right after it has finished has undergone examination . Subjective pain assessment was carried out using a modified Laitinen question naire and Visual Analogue Scale of Pain intensity . Spine mobility was evaluated whit the Schober test and the Fingertip-to-floor-test . The obtained results were subjects to statistical analysis . RESULTS Research shows that both low energy laser and pulsating magnetic field physical attributes are effective methods for the treatment of pain and restricted mobility of the spine caused by disc herniation . Careful analysis emphasizes greater efficiency laser for pain . In contrast , a statistically greater improvement in global mobility of the spine , as well as flexion and extension of the lumbar recorded in group B , where the applied pulsating magnetic field . CONCLUSIONS Both laser and magnet therapy reduces pain and improves mobility of the spine of people with degenerative spine disease of the lower back . Comparison of the effectiveness of both methods showed a greater analgesic effect of laser treatment , and greater mobility of the spine was observed under the influence of pulsating magnetic field therapy QUESTION Is low level laser therapy an effective adjuvant intervention for chronic low back pain ? DESIGN R and omised trial with concealed allocation , blinded assessors and intention-to-treat analysis . PARTICIPANTS Sixty-one patients who had low back pain for at least 12 weeks . INTERVENTION One group received laser therapy alone , one received laser therapy and exercise , and the third group received placebo laser therapy and exercise . Laser therapy was performed twice a week for 6 weeks . OUTCOME MEASURES Outcomes were pain severity measured using a 10-cm visual analogue scale , lumbar range of motion measured by the Schober Test and maximum active flexion , extension and lateral flexion , and disability measured with the Oswestry Disability Index on admission to the study , after 6 weeks of intervention , and after another 6 weeks of no intervention . RESULTS There was no greater effect of  laser therapy compared with exercise for any outcome , at either 6 or 12 weeks . There was also no greater effect of laser therapy plus exercise  compared with exercise for any outcome at 6 weeks . However , in the laser therapy plus exercise group pain had reduced by 1.8 cm ( 95 % CI 0.1 to 3.3 , p = 0.03 ) , lumbar range of movement increased by 0.9 cm ( 95 % CI 0.2 to 1.8 , p < 0.01 ) on the Schober Test and by 15 deg ( 95 % CI 5 to 25 , p < 0.01 ) of active flexion , and disability reduced by 9.4 points ( 95 % CI 2.7 to 16.0 , p = 0.03 ) more than in the exercise group at 12 weeks . CONCLUSION In chronic low back pain low level laser therapy combined with exercise is more beneficial than exercise alone in the long term BACKGROUND Low back pain ( LBP ) is a common musculoskeletal disorder that is highly prevalent in the general population . Management of this pathology includes numerous interventions depending on pain severity : analgesic , nonsteroidal anti-inflammatory drugs , steroid injections . However , the effect size and duration of symptom relief are limited . Physical therapy ( ultrasound [ US ] , laser therapy , manual therapy , interferential current therapy , Back School , aerobic work , therapeutic aquatic exercise acupuncture ) have been reported often with mixed results . AIM To evaluate the short-term effectiveness of high-intensity laser therapy ( HILT ) versus ultrasound ( US ) therapy in the treatment of LBP . DESIGN R and omized clinical trial . SETTING University hospital . POPULATION Thirty patients with LBP were r and omly assigned to a HILT group or a US therapy group . METHODS Study participants received fifteen treatment sessions of HILT or US therapy over a period of three consecutive weeks ( five days/week ) . RESULTS For the 30 study participants there were no between-group differences at baseline in Visual Analogic Scale ( VAS ) and Oswestry Low Back Pain Disability Question naire ( OLBPDQ ) scores . At the end of the 3-week intervention , participants in the HILT group showed a significantly greater decrease in pain ( measured by the VAS ) and an improvement of related disability ( measured by the OLBPDQ ) compared with the group treated with US therapy . CONCLUSION Our findings obtained after 15 treatment sessions with the experimental protocol suggested greater effectiveness of HILT than of US therapy in the treatment of LBP , proposing HILT as a promising new therapeutic option into the rehabilitation of LBP OBJECTIVE The purpose of this study was to compare the effectiveness of two different laser therapy regimens on pain , lumbar range of motions ( ROM ) and functional capacity in patients with chronic low back pain ( CLBP ) . METHODS Forty nine patients with CLBP were r and omly assigned into 
    Output:
    
Laser procedures led to more balanced posture stability in patients , although these positive changes were significant mainly for short-term observation ( after 4-week therapy ) .
In the follow-up analysis , the parameters were gradually impaired .
Kruskal-Wallis analysis of variance ( ANOVA ) for independent variables did not show any difference between the studied groups .
Low- and high-intensity laser therapy does not lead to a significant improvement in postural sway in patients with NSLP compared with st and ard stabilization training based on short- and long-term observations