Reuters Health

For decades the Cold Laser / LLLT pioneers have preached to each-other about their work and published in LLLT dedicated journals. It is nice to see more LLLT being reported in other medical journals and in the main stream press. In my bi-monthly Literature Review for PMLS 30 papers were published outside the Laser press

Today Reuters Health Interviewed Jan Bjordal about a paper he co-authored and published in the American Journal of Sports Medicine

http://www.reutershealth.com/archive/2008/05/14/eline/links/20080514elin001.html

Laser therapy may speed Achilles tendon healing

Last Updated: 2008-05-14 16:07:36 -0400 (Reuters Health)

By Amy Norton

NEW YORK (Reuters Health) - People with overuse injuries of the Achilles tendon may heal faster with a combination of exercise and low-level laser therapy, the results of a new study suggests.

Researchers found that among 52 active adults with Achilles tendinopathy, those treated with exercise and laser therapy for eight weeks improved more quickly than those treated with exercise therapy alone.

The findings are published in the American Journal of Sports Medicine.
Achilles tendinopathy is a general term for chronic, overuse injuries to the strong band of tissue that connects the calf muscles to the heel bone. Calf-muscle exercises are a standard treatment, but the benefits are often slow to appear, and the exercises themselves can initially worsen the pain of the injury.

This is where low-level laser therapy could be helpful, according principal investigator Dr. Jan Magnus Bjordal of Bergen University College in Norway and colleagues.

The therapy involves placing a laser probe, which emits infrared light, on various points of the skin around the Achilles tendon. There is evidence that this may both reduce inflammation in the area and stimulate the body’s natural healing process — helping to trigger the synthesis of collagen fibers in the tendon.

Bjordal and colleagues in Norway, Greece and Brazil randomly divided 52 recreational athletes with chronic Achilles tendinopathy to undergo eccentric exercise training plus laser therapy, or exercise training plus “placebo” laser therapy, in which the probe did not emit infrared energy. The patients also underwent laser therapy twice a week for four weeks, then once weekly for another four weeks.

“Eccentric” exercise refers to activities that cause a muscle to contract at the same time it is being lengthened. In this case, all of the patients performed eccentric exercises for the calf muscles four times per week for eight weeks, under supervision.

At the end of the study, the researchers found that the combination therapy group reported less pain during physical activity than their counterparts. They also tended to have less morning stiffness in the ankle, less tenderness and greater flexibility in the joint.

The results suggest that laser therapy may accelerate the benefits of eccentric exercise, which is becoming the “gold standard” treatment for Achilles tendinopathy, according to Bjordal’s team.

The additional treatment “may be worth a try” for people already undergoing exercise therapy, Bjordal told Reuters Health.

Whether laser therapy will be available to those interested is another matter. In the U.S., Bjordal noted, relatively few physical therapists use low-level laser therapy, and it is generally not covered by insurance.

By contrast, Norway’s health system pays for the therapy, and about one third of physical therapy clinics offer it.

Larger, longer-term studies should continue looking at laser therapy for Achilles tendinopathy, Bjordal said. As more results emerge in favor of the treatment, the researcher noted, it may become more widely used.

SOURCE: American Journal of Sports Medicine, May 2008.

Top prize for laser paper

Not much I can add to this other than it is his second award this year from an orthopaedic conference for best paper.

Fra: Jan Magnus Bjordal
Sendt: lø 12.04.2008 11:37
Til: Roberta Chow; Rodrigo Alvaro B. Lopes Martins; M.Johnson
Emne: SV: SV: Your Submission to The Lancet

Dear all
Our neck pain review with laser therapy won the main award (!) of the joint national neck and back pain congress in Oslo (400 physicians, spinal surgeons, physios, manual terapists and chiropractors are attending there).

I went home to Bergen yesterday because I did not expect it. They have just annonouced it in Oslo. I tried to get a plane back to receive it but I could not find one.

Jan M

Cold Laser - whats in a name ?

At the NZ2008 laser meeting last week we debated the nomenclature surrounding the popularly named “Cold Laser Therapy” as it seems most often called in the USA. In the UK the most common phrase now is Laser Therapy though for a while it was Laser Biostimulation, US government employed scientists call it Photobiomodulation, it used to be called Laser Biostimulation by the American Society for Lasers in Surgery and Medicine, who last year adopted Photobiomodulation instead. Pubmed have chosen LLLT (stands for Low Level Laser Therapy) as the MeSH term (MeSH stands for Medical Subject Heading) however they lave used that label for almost every form of medical laser treatment (low level or otherwise). This was a term coined by Oshiro and Calderhead back on the 1980’s. For the record I am fan of calling it Photobiomodulation and I have managed to get that as the term adopted on Wikipedia a couple of years back (hooray for me).

This exercise was triggered by an article in the Independant newspaper today “Doctors warn of ‘cowboy clinics’ if laser therapy is deregulated“. It is an article about government deregulation of IPL for hair removal and is just one tiny example of how the distinctions around medical laser devices are not being made. I wonder if the journalist has any idea that at another end of the scale lasers improve tissue repair, reduce inflammation, reduce pain and some would argue even stimulate hair growth (Mester to name but one example).

Here are some words and phrases I have collected over the years:

Bioregulating Laser
Biostimulating Laser
Broad Band Radiation Therapy
Cold Laser Therapy
Diode Laser Therapy
He-Ne Laser therapy
helium-neon laser irradiation
Infrared laser light
Laser Acupuncture
Laser Biostimulation
Laser Irradiation
Laser Phototherapy
Laser Therapy
LED phototherapy
LED therapy
LELT (Low Energy Laser Therapy)
LEPT (Low Energy Photon Therapy)
Light Therapy
light-emitting diode phototherapy
LILT (Low Intensity Laser Therapy)
LLLT (Low level Laser Therapy)
low fluence diode laser irradiation
low level light treatment
Low Light Laser Therapy
Low Power Laser Irradiation
Low Power Laser Therapy
Low Reactive Level Laser Therapy
lower-level laser therapy
Mid Laser Therapy
Monochromatic Infra Red Energy
Monochromatic Infrared Photo Energy
Monochromatic Light Therapy
Monochromatic phototherapy
near-infrared light therapy
NIR laser therapy
nonablative laser therapy
PBM (Photobiomodulation)
Photo Irradiation
Photobioactivation
Photobiomodulation
Photobiostimulation
Photomedicine
Photon Therapy
Photoradiation
Photostimulation
Phototherapy
Physiotherapy Laser
Polarised Polychromatic Light
Polarised Radiation
Red light phototherapy
Soft Laser Therapy
Therapeutic Laser

P.S. it is also quite common for laser wavelength and / or lasing medium to be added to the title . common examples are 810nm laser diode therapy for xyz. In case you are not familiar with the common wavelengths and materials used they are: 660nm 810nm 830nm 904nm

Full list as follows: 632.8 650nm 635nm 660nm 670nm 680nm 750nm 780nm 705nm 908nm 810nm 820nm 830nm 850nm 870nm 880nm 890nm 904nm 905nm 950nm

Materials: GaAlAs, Gallium Aluminium Arsenide, GaAs, Gallium Arsenide, HeNe, Helium Neon, AlGaInP, Aluminium Gallium Indium Phosphide.

Phil Passy, Founder of MedX Health dies

I was shocked when I heard that Phil Passy died unexpectedly 22nd February 2008. Phil was Founder, President and CEO of MedX Health and a fellow industry pioneer. I first met Phil in the year 2000 in Athens, Greece at the World Association for Laser Therapy meeting when he boldly asserted that one day LLLT products would move from highly individual products competing on technical differences to a near commodity product as industry standards for the technology and treatments were agreed. It was a visionary statement that I thought was crazy but now I believe he will ultimately be proven right. Any new technology requires passionate and persistent personalities behind it striving for years to achieve widespread adoption and Phil was one of bravest and hardest working figures in the industry. He radiated passion and his dogged persistence has created a publicly listed company leaving an indelible mark on the history of LLLT. Medicine is an exceptionally tough field to create a radical breakthrough in and whilst many have resorted to snake oil sales methods, Phil always took the high road and created an ethical company making conservative / realistic claims for the products and services offered. Phil can rest in peace knowing that he was a good man, doing good work for the health of mankind and that he played an important role in establishing LLLT and moving industry forward. Thanks Phil.

Realtime video of cellular response to pulsed near infrared “Light”

Cell signalling governs basic cellular activities and coordinates cell actions. Cells respond to their local microenvironment and these signals may prompt tissue repair or immune response as well as normal tissue homeostasis. Guenter Albrecht-Buehler has conducted a series of experiments on cells with near-infrared light (NIR) and reports on how cells might be communicating with pulsed NIR. He also demonstrates with video how cell motility responds to a pulsed light stimulus .

click here for YouTube look for the movie “Realtime video of cellular responsed to pulsed near infrared “Light”"

Oh no, not another LLLT society

It’s not new, but it is clever. The American Society for Photobiology Kendric Smith makes the case for academics improving their knowledge of photobiological fundamentals.

Laser and LED Therapy is Phototherapy

All too frequently the people in the laser [and light emitting diode (LED)] phototherapy field are untrained in the basics of photobiology. This can lead to bad science and bad clinical trials, and can contribute to conflicting results concerning a given endpoint. Furthermore, it diminishes the stature of the field, and delays the admission of laser (and LED) phototherapy into the mainstream of science and medicine.Kendric C. Smith, Ph.D., Professor Emeritus of Radiation Oncology (Radiation Biology), Stanford University School of Medicine, Founder and First President of American Society for Photobiology.

Continue reading Oh no, not another LLLT society…

No news to report

There has been nothing monumental going on in the world of LLLT this last 7 days (my blog week starts on a Wednesday in case you are wondering). ASLMS and NZlaser2008 are both in April so I chose New Zealand. I subsequently received five separate requests to be in Florida in the last few days so maybe I will concede and see y’all at both.

Literature Watch

Here is my selection for the April 2008 Photomedicine and Laser Surgery

Continue reading Literature Watch…

“The wonders of medical science”

Here is yet another study demonstrating the effect of LLLT for patents suffering from Oral Mucositis - how much longer can oncologists ignore this procedure ?

IF YOU ARE AN ONCOLOGIST READ THIS

Continue reading “The wonders of medical science”…

LASER ACUPUNCTURE DOSE RANGE AND DOSE RATE EFFECTS

I am interested to get feedback on this. If we can suspend the debate about what acupuncture is and how effective it is for a minute …. it is my observation that a wide range of laser devices are used in acupuncture. Red* and near infrared*, 1mW to 500mW.

It is well documented that laser can inhibit as well as stimulate cellular function (read more here). Dose ranging studies and dose-rate (fluence rate) studies have been performed and we find that the thresholds for stimulation are quite low (at the target tissue level) and that they are in the range 5 - 30mW/cm2 (though this depends on what method of beam measurement was used by the original authors)(read more here)(and more here).

I would expect that the same wavelength, dose range and dose-rate issues will be true for acupuncture but do not recall seeing anything published. A quick glance at Pubmed finds 407 articles witeh the words Laser Acupuncture (click here to see) but zero return when the terms dose rate, dose range or fluence rate are added to the search.

We need dose rate studies and even more research with ineffective outcomes to help identify what actually works.

*(typically 632.8 and 660nm for red and 810nm - 830nm + 904nm)