THOR Low Level Laser Therapy LLLT Products and Training

Just 9 papers for you this month including LLLT for orthodontic tooth movement, diabetic periodontitis, ischemic stroke and a laboratory study on chronic mild stress to add to the clinical reports we have seen in recent months.

A plug for the 2012 World Association for Laser Therapy conference in Gold Coast Australia in September. You know you have to go to Australia at some time in your life, well this is that time. Not only does Australia have the most extraordinary wilderness, wildlife and waves of anywhere in the world, it is also the host of this year’s WALT conference. I anticipate that most of the researchers you have read about on this newsletter / blog over recent years will be there . At the WALT 2012 conference in September you can see their latest work and hear their latest thoughts first hand. This land of sun, sea and and so many lasers is probably the most welcoming country i have ever visited, so I suggest you click here to register and click here to book your flights.

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I love introducing LLLT to an audience of doctors oblivious and innocent of its effects on tissue regeneration, inflammation and pain. At first, the response is that no therapy can do all of this (heal diabetic wounds, improve recovery from sports injuries, neck pain, osteoarthritis and neuropathic pain etc), then I explain the mechanism by which LLLT increases ATP and reduces oxidative stress. By the time I have finished, the final question is not “what is LLLT?” or “how does it work?” or “is there clinical evidence?” but “why is this not used everywhere throughout medicine?”.

The truth is that evidence is not enough. I am involved in the early stages of putting together an international multicentre clinical trial for a pathology that already has 14 RCTs behind it. What difference will one more trial make? The difference may not be the trial itself, but the eminence of the doctors / scientists and their institutions doing it. I am also involved in the early stages of fund raising for another trial that has considerably less clinical data behind it and will be far less ambitious in its scale but, I suspect, will make greater progress. Why ? The focus on political influence. It is not enough to do good science, not enough to address a big unmet need, not enough to influence key opinion leaders, you have got to get the political bulldozers in.

Watch this space…..

Having just posted a feature on Prof. Jan Bjordal and the WALT dosage recommendations (read here), I am thinking about dose and cluster probes.

The advice from them is that the correct energy should be applied, that the whole pathology should be treated and, in some cases, there is a power density limit.

At our training course last weekend, someone asked how our LED cluster probe treatment dosage can be compared with the WALT guidelines which are based on single probe treatments. For example, the guidelines for treating a tennis elbow is one or two points, 4 joules per point, max 100mW/cm2.

With our 69 LED cluster probe, for example, the total power applied seems very high (1390 mW). It delivers 4 joules in less than 3 seconds. But this energy is delivered over a very wide area (28 cm2), not over a single point as in the WALT guidelines.

If we divide the 1390 mW power delivered by the area covered of 28 cm2, we get 50mW/cm2. So each cm2 gets 50mW, in which case 4 Joules is achieved at every square cm in 1min 10 seconds. That seems reasonable at first.

We conducted studies on a pig and on a cadaver and found that at 3 cm and 5 cm deep. our 69 LED cluster has the same power density at depth as our 200mW laser which has a surface power density of 5,000mW/cm2. The study showed that light at 50mW/cm2 from the LEDs on the surface scatters and then accumulates at depth to achieve the same density as our single 200mW laser. A 200mW laser delivers 4 joules in 20 seconds but with its surface power density of 5,000mW/cm2, it is considered too strong for treating a tennis elbow (as it exceeds the recommended power density maximum of 100mW/cm2). However, the LED cluster probe has a lower surface power density (so doesn’t exceed the WALT guidelines) but maintains a suitable power density several cm down, to deeper the target tissues.

I think that cluster probes achieve the best of both worlds, they have a lower surface density light than most lasers and yet the same subcutaneous density at depth and over a larger area too, so the whole pathology gets a more even treatment.

I would love you to leave me some feedback. If you use our LED clusters what is your clinical experience? and if you are a physicist what formulas might explain this?

I’m thinking that many diodes make light work, better.

Please leave a comment

17 papers published this month including LLLT for amblyopia, chronic periodontitis, knee osteoarthritis, cracked nipples in breastfeeding mothers, chronic gingivitis, allergic rhinitis and an editorial written by Prof. Jan Bjordal regarding WALT dosage recommendations. 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 along with a short feature on Prof. Jan Bjordal and a summary of his published work.

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