{
  "abstract": "Introduction: Postoperative pain after cesarean section may delay recovery and impair function. Transcutaneous electrical nerve stimulation (TENS) and low-level laser photobiomodulation (PBM) are used for pain control, but the additional effect of combining these therapies remains unclear. This study investigated this effect. Methods: A randomized clinical trial with four groups: combined TENS + low-level laser photobiomodulation (PBM), TENS alone, placebo, and control. Assessments were performed at 8–12 h (t1), 20–24 h (t2), and 44–48 h postpartum (t3). Outcomes included pain intensity, functional independence, functional capacity assessed by the Two-Minute Walk Test (2MWT), and cardiorespiratory variables. Two intervention sessions were applied after t1 and t2, except in the control group. Data were analyzed using mixed ANOVA and nonparametric equivalents when appropriate. Statistical significance was set at p < 0.05. Results: A total of 88 women were included. Pain intensity decreased significantly over time in the combined TENS + PBM group (1.82 ± 1.18 at t2 vs 1.30 ± 0.86 at t3; p = 0.008) and in the TENS group (1.59 ± 1.05 at t2 vs 0.95 ± 1.05 at t3; p = 0.025). Functional independence increased in the combined therapy group (14.9 ± 3.3 at t1 vs 17.1 ± 3.6 at t3; p = 0.034) and in the TENS group (15.2 ± 3.0 at t1 vs 17.5 ± 3.4 at t3; p = 0.028). Functional capacity improved in all groups between t2 and t3 in the Two-Minute Walk Test (Control: 63.5 vs 76.8 m, p = 0.002; Placebo: 50.3 vs 63.9 m, p = 0.002; Combined: 48.3 vs 65.2 m, p = 0.0006; TENS: 61.1 vs 72.2 m, p = 0.005). No significant differences were observed between groups (p > 0.05). A significant time effect was found for pain (p < 0.05) and functional independence (p < 0.001). Conclusion: Pain decreased and functional independence improved during the postoperative period. However, the combination of TENS and low-level laser photobiomodulation did not provide additional benefits compared with the other groups.",
  "abstract_shown": true,
  "affiliations": [
    "Postgraduate Program in Physiotherapy (PPGFIS), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil.",
    "Department of Physical Therapy, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil.",
    "Faculdade Estácio de Natal, Natal, Rio Grande do Norte, Brazil."
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Alane Macatrão Pires de Holanda Araújo Sena",
      "orcid": "0000-0002-3832-8808"
    },
    {
      "affs": [
        1
      ],
      "name": "Ivan Daniel Bezerra Nogueira"
    },
    {
      "affs": [
        2
      ],
      "name": "Kássio Rafael Rocha de Sena"
    },
    {
      "affs": [
        1
      ],
      "name": "Íllia Nadinne Dantas Florentino Lima"
    },
    {
      "affs": [
        1
      ],
      "name": "Patrícia Angélica de Miranda Silva Nogueira",
      "orcid": "0000-0002-3763-2410"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/8mnwaa529185h.bib",
  "cited_by": 0,
  "doi": "10.1371/journal.pone.0360761",
  "fulltext_url": "https://europepmc.org/articles/PMC13690222",
  "id": "8mnwaa529185h",
  "issns": [
    "1932-6203"
  ],
  "landing_url": "https://doi.org/10.1371/journal.pone.0360761",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2741|Laser Applications in Dentistry and Medicine"
    ],
    [
      "plos",
      "/Biology and life sciences/Physiology/Respiratory physiology"
    ],
    [
      "plos",
      "/Engineering and technology/Equipment/Optical equipment/Lasers"
    ],
    [
      "plos",
      "/Medicine and health sciences/Cardiology/Heart rate"
    ],
    [
      "plos",
      "/Medicine and health sciences/Clinical medicine/Signs and symptoms/Pain"
    ],
    [
      "plos",
      "/Medicine and health sciences/Public and occupational health/Physical activity"
    ],
    [
      "plos",
      "/Medicine and health sciences/Surgical and invasive medical procedures/Functional electrical stimulation"
    ],
    [
      "plos",
      "/Medicine and health sciences/Surgical and invasive medical procedures/Obstetric procedures/Cesarean section"
    ],
    [
      "plos",
      "/Medicine and health sciences/Vascular medicine/Blood pressure"
    ]
  ],
  "openalex": "W7223241060",
  "pdf_url": "https://europepmc.org/articles/PMC13690222?pdf=render",
  "pmcid": "PMC13690222",
  "pmid": "42911935",
  "published": "2026-10-22",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/8mnwaa529185h.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:23Z",
      "native_id": "10.1371/journal.pone.0360761",
      "source": "plos",
      "url": "https://doi.org/10.1371/journal.pone.0360761"
    },
    {
      "first_seen": "2026-10-30T12:20:10Z",
      "native_id": "MED:42911935",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42911935"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "plos:cardiology",
      "subfield": "cardiovascular"
    },
    {
      "field": "medicine",
      "origin": "plos:physiology",
      "subfield": "physiology"
    },
    {
      "field": "medicine",
      "origin": "plos:surgical and invasive medical procedures",
      "subfield": "surgery"
    }
  ],
  "title": "Combined transcutaneous electrical nerve stimulation and low-level laser photobiomodulation for postoperative pain after cesarean section: A randomized controlled trial",
  "title_text": "Combined transcutaneous electrical nerve stimulation and low-level laser photobiomodulation for postoperative pain after cesarean section: A randomized controlled trial",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:10Z",
  "url": "https://research.draconitic.com/paper/8mnwaa529185h",
  "venue": "PLOS One",
  "versions": []
}