THOR Literature watch for April 2013 Low Level Laser Therapy / Cold Laser / Photobiomodulation PBM -

33 new LLLT papers for you this month including: a review of 21 papers on muscle performance, fatigue and repair, a controlled multicenter trial on male pattern baldness, another trial on oral mucositis and how about this, 810nm laser ameliorates diabetes!

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Mike Hamblin Harvard LLLT TBI video interview

LLLT for Traumatic Brain Injury (TBI) by Prof. Michael Hamblin, Wellman Centre for Photomedicine, Harvard Medical School.

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BMJ says Death from opioid pain relievers is an epidemic in the USA

The BMJ reported that the US Centers for Disease Control and Prevention had declared there was a national epidemic of prescription drug overdoses which led to 14,800 deaths in 2008. This is more than cocaine and heroin combined for the same period. If you think this an exaggeration click here to see the full government report.

They highlight the following key points :

  • Death from opioid pain relievers (OPR) is an epidemic in the United States.
  • Sales of OPR quadrupled between 1999 and 2010.
  • Enough OPRs were prescribed last year to medicate every American adult for a month
  • Abuse of OPRs costs health insurers approximately $72.5 billion annually in health-care costs.

And just in case you were not astonished already, I will remind those of you that have not heard me say it before that NSAIDs were the 15th biggest cause of death in the USA according to the New England Journal of Medicine 1999. Unfortunately there is no abstract so I am going to show you a little snip from the full paper

NEJM NSAID Deaths

If only there was an alternative ;-)

Send me your comments below

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Two tigers and a bear get THOR LLLT / Low Level laser Therapy

As you probably know, LLLT / Low Level laser Therapy can be used on horses, dogs and cats. What about big cats and grizzly bears?
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The THOR LLLT treatment Library

Available only to people who have attended a THOR training course in the last 3 years. All treatments are based on our four step method which includes treatment of the injury, trigger points, lymphatics and nerve roots.

Take a look to see how it works and let us know what you think.

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LLLT progress and dose. An update from Prof. Jan Bjordal. World Association for Laser Therapy (WALT)

The title of last months PMLS editorial was Low Level Laser Therapy (LLLT) and World Association for Laser Therapy (WALT) Dosage Recommendations. Written by the Scientific Secretary Prof. Jan Bjordal. He describes how far we have come and the importance of the WALT dosage recommendations. No abstract is available for editorials so I have prepared one for you below. Continue reading

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LLLT in the Lancet Top 20 Hit Parade

The paper by Roberta Chow, Mark Johnson, Rodrigo Lopes-Martins, Jan M Bjordal titled “Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials” (abstract here) reached number 17 in The Lancet top 20 most downloaded papers for 2010. The full top 20 list is here:

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International Association for Study of Pain finds “strong evidence” for LLLT

A guidance document on myofascial pain syndrome (MPS) published on the International Association for Study of Pain web site finds “strong evidence” for Low Level Laser Therapy (LLLT). We have archived a copy here and you can find the original source here . Myofascial pain syndrome is often confused with fibromyalgia so it may be worth reading this blog to help understand the difference.

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BMJ systematic review finds “strong evidence” for LLLT on Frozen Shoulder

The BMJ sports medicine journal (BJSM) published a systematic review of conservative and surgical interventions and found “strong evidence for the effectiveness of laser therapy” adding to the rapidly expanding list of authoritative journals endorsing LLLT.

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APTA recommends LLLT for Achilles Tendinopathies

American Physical Therapy Association (APTA) Clinical Guidelines recommend Low Level Laser Therapy (LLLT) for Achilles tendinopathies. The report says “Clinicians should consider the use of low level laser therapy to decrease pain and stiffness in patients with Achilles tendinopathy.” Hooray, it’s only been 20 years since Chukuka Enwemeka first published his tendinopathy research. It is unfortunate that the guidelines neglected to comment on the importance of treatment parameters, they incorrectly describe energy as “intensity” and failed to mention Tumilty’s systematic review which found that 55% of LLLT tendinopathy studies failed due to incorrect power density and / or energy delivered.

You can download the APTA paper here APTA-Achilles-Tendinopathy-Guideline-USA-2010.pdf

GET TRAINED

Understanding power density and energy is important for effective treatment. To get yourself trained click here http://www.thorlaser.com/courses

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The Lancet systematic review and meta-analysis of LLLT for Neck Pain

This landmark study establishes that there is now more evidence for the use of laser for neck pain than any other medical procedure. For comment and to hear an interview with the lead author click here: The Lancet publishes that laser therapy helps neck pain

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World Health Organisation Bone and Joint Task Force Task Force support LLLT for neck pain

Results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders.

It is nice to see LLLT making it into mainstream medical recommendations.

Published in the journal Spine; a systematic review of the literature 1980 – 2006 on the use, effectiveness and safety of noninvasive interventions for neck pain and associated disorders. 139 papers admitted into this review.

CONCLUSIONS: For whiplash-associated disorders, evidence suggests that educational videos, mobilization, and exercises appear more beneficial than usual care or physical modalities. For other neck pain, the evidence suggests that manual and supervised exercise interventions, low-level laser therapy, and perhaps acupuncture are more effective than no treatment, sham, or alternative interventions.

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Convince if possible, confuse if necessary, and corrupt if nothing else works, is THOR complicit?

In the BMJ Last Saturday Anita Jain wrote “Gold jewellery, cars or an exotic foreign holiday, these are among the luxury gifts listed in a parliamentary committee report as being used by pharmaceutical companies to coax doctors into prescribing their drugs”. She goes on to describe the “3C strategy” employed by drug companies. “convince if possible, confuse if necessary, and corrupt if nothing else works”. Many (she says) will say an emphatic no to luxury gifts, but what about discounts, conference fees, hotels and flights?

Since we have been working with more doctors these days (rather than therapists) I am being approached with requests for hotel and flight costs and I confess I have conceded.

Why does this happen?
a) Because this is the world they live in (i.e. it is normal to have industry pay)
b) Academic and educational budgets are tight and industry has more money than it knows what to do with (they think).

So what should I do ?

I have conceded and paid out a few times, but not with any enthusiasm as we are not yet making $ billions in profits, but my conscience wrestles with it. I do not want to be guilty of behaving like bad pharma but then again I want our product to be accepted by mainstream medicine, so what should I do?

Comment below

 

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How THOR pulses affect dose (they dont)

THOR laser and LED treatment probes always give the same average power regardless if pulsed or continuous.

THOR pulses are not a fixed pulse width, the pulses are always 88% on 12% off so no matter what pulse frequency is used the the average power remains the same, even when compared with continuous.

This is because we increase the peak power in pulsed mode to compensate for the period when the beam is off.

At say 2.5Hz the THOR pulse width is calculated  0.88 / 2.5  = 0.352 seconds (352ms)

At say 10Hz the THOR pulse width is calculated 0.88 / 10 = 0.088 seconds (88ms)

At say 100Hz the THOR pulse width is calculated 0.88 / 100 = 0.0088 seconds (8.8ms)

How THOR pulses affect dose (they dont)

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THOR Literature watch for March 2013 Low Level Laser Therapy / Cold Laser / Photobiomodulation PBM

28 new papers for you this month, starting with the most entertaining: “successful management of acute-onset torticollis in a giraffe” which included a laser to reduce “cervical muscle hypertonicity”, an RCT on cellulite (see commentary), an analysis of 589 tooth extractions in patients under bisphosphonate therapy following LLLT, chronic rhinosinusitis, oral lichen planus, combined bone marrow aspirate and LLLT on bone healing, mesenchymal stem cells and LLLT on peripheral nerve regeneration and more …..

How does LLLT / cold laser therapy work? click here

How to calculate LLLT dose click here

Get yourself trained click here

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Unbelievable results

At first glance this cellulite paper looks like a well designed study, but if you are familiar with LLLT parameters then you may notice something odd about them:
6 treatments (3 x week for 2 weeks) this is probably a good treatment interval
8 x 10 inches (516 cm2) that is a very large area
5 x 17mW Green 532nm this is a poor penetrating wavelength
Combined power of 102mW that is a tiny amount of power for such a large area
Irradiance 0.2mW/cm2 that is less than sunshine on a clear day
15 mins twice (two side of the body) that is a long treatment time
Fluence (dose) 0.18J/cm2 per side that is not enough to do anything

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Blue Cross and Blue Shield (Kansas) LLLT coding update

Blue Cross and Blue Shield Kansas (BCBS) have updated their assessment of LLLT and it is still considered “experimental” despite referencing the “strong evidence” conclusions in systematic reviews published by the British Medical Journal (BMJ) and International Society for the Study of Pain (IASP). Then there is The Lancet Systematic Review on Neck pain and the MASCC “recommendation” statements, also brushed aside by BCBS.

How can this be when: Continue reading

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