Combination of Light and Ultrasound to Reduce Abdominal Fat

This outcome will be measured in millimeters (mm) by direct reading using adipometer (Sanny, American Medical do Brasil Ltda., São Bernardo do Campo, Brazil).

Body weight will be measured in kilograms (kg) using a calibrated digital scale.

Height will be measured in centimeters (cm) and will be collected using a standard stadiometer.

The body mass index (BMI) will be calculated from data obtained from the weight (in kilograms) and height (in centimeters) of each participant. The final value will be provided in kg/cm².

A properly trained researcher will measure the waist circumference in centimeters (cm), respecting the reference points according to the World Health Organisation (WHO).

A properly trained researcher will measure the hip circumference in centimeters (cm), respecting the reference points according to the World Health Organisation (WHO).

The waist/hip circumference ratio will be obtained by dividing the values obtained in centimeters in order to verify a possible change in the cardiovascular risk profile.

A properly trained researcher will realize the skinfolds evaluation that allows to assess the prediction of body fat based on subcutaneous fat and body density and these will be collected using an adipometer according to the methodology proposed by Pollock and Wilmore (1993) for the measurements referring to the seven skinfolds - tricipital, subscapular, bicipital, suprailiac, abdominal, thigh and leg (medial calf) locations, which will be obtained in millimeters (mm).

Thermographic image will be captured using a Compact Thermal Camera (C2, FLIR Systems, Oregon, USA), which calculates the temperature of a given surface through the infrared emission and it will allow verify if there will be any change in local temperature after treatment.

The weight (in kilograms) will be obtained from bioimpedance analysis (Biodynamics Corp., Shoreline - WA, USA) that will allow estimation of body components in a non-invasive way. To obtain legitimate values, each participant will be instructed to drink an average of 2 litres of water and avoid the use of diuretic medication on the day before the exam, do not perform physical activity for at least 12 hours before the test, do not drink alcohol or drinks containing caffeine, not having a menstrual period and, on the day of the exam, fasting of at least 4 hours will be necessary.

The fat mass percentage (%) will be obtained from bioimpedance analysis (Biodynamics Corp., Shoreline - WA, USA) that will allow estimation of body components in a non-invasive way. To obtain legitimate values, each participant will be instructed to drink an average of 2 litres of water and avoid the use of diuretic medication on the day before the exam, do not perform physical activity for at least 12 hours before the test, do not drink alcohol or drinks containing caffeine, not having a menstrual period and, on the day of the exam, fasting of at least 4 hours will be necessary.

The lean mass percentage (%) will be obtained from bioimpedance analysis (Biodynamics Corp., Shoreline - WA, USA) that will allow estimation of body components in a non-invasive way. To obtain legitimate values, each participant will be instructed to drink an average of 2 litres of water and avoid the use of diuretic medication on the day before the exam, do not perform physical activity for at least 12 hours before the test, do not drink alcohol or drinks containing caffeine, not having a menstrual period and, on the day of the exam, fasting of at least 4 hours will be necessary.

The nutritional routine will be documented as follows: the 24-hour food recall will be collected at the time of the initial evaluation (D0); during treatment, participants will have to fill their daily diet at least three times a week on a nutritional planner, which should contain all the food eaten on those chosen days; and after the end of treatment (D30) the participants will answer again the 24-hour food recall.

The physical exercises performed by the participants during the study will be registered using the International Physical Activity Questionnaire (IPAQ), short version.

The WHOQOL-BREF (Brief version of the World Helath Organization quality of life questionanaire) is the smaller version of the WHOQOL-100 quality of life questionnaire. WHOQOL-BREF consists of 26 questions, whose answers follow a Likert scale (from 1 to 5, the higher the score, better is the quality of life). This questionnaire has 2 questions that assess quality of life in general, being that the others make up 4 domains (physical, psychological, social relations and environment).

The body shape questionnaire (BSQ) has 34 questions and each question has six possible answers, as follows: 1) Never, 2) Rarely, 3) Sometimes, 4) Often, 5) Very often and 6) Always. Quantification of the level of concern in relation to self-image is done through a sum of responses. Result less than or equal to 110 points indicates there is no concern; greater than 110 and less than or equal to 138 points indicates a slight concern; greater than 138 and less than or equal to 167 points indicates moderate concern and if greater than 168 points indicates serious concern.

Visual change assessment will be investigated from standardized photograph captures. Participants will be instructed to wear bathing or gym clothes and they will be positioned with their backs to a black background wall, at a distance of 0.7 m from it, on a paper template fixed to the ground, as suggested by Dias et al., (2017). Then, a professional trained for this purpose will be positioned at a distance of 1 m from the participant and will capture four records of her, these being in the anterior, posterior and lateral positions (90° to the right and to the left). Focal length, room lighting and recording mode will also be standardized.

The participants satisfaction grade with the treatment will be verified by means of a questionnaire containing seven multiple choice questions prepared by our research group based on data contained in the literature. The degree of discomfort during the treatment will be evaluated; if discomfort occurred, for how long did it persist; the degree of satisfaction in relation to the results achieved; the percentage degree of improvement of the complaint; whether the observed effects were below, within or above what was expected; whether she would do the treatment again; and how much would it indicate the treatment for someone close to it with the same complaint.