Course Testimonial: Dr. Eric Bugna

Dr. Eric Bugna, MDLLLT Training Course Testimonial: Dr. Eric Bugna, MD
Orthopaedic Surgeon, Portola, CA, USA

“As usual, another great meeting/course. Latest info on LLLT provided. It reinforces my data base/use of the LED/Laser.

More uses for LLLT explored. I am using the Thor device for more problems.

Am having great results treating peripheral neuropathy and postherpetic pain. Spine and knees doing well too. Thanks THOR!”

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Course Testimonial: Kimberly Juhlin

DVM Kimberly Juhlin, DVMLLLT Training Course Testimonial: Kimberly Juhlin, DVM
Vale Park Animal Hospital, Valparaiso, IN, USA

“After attending the Orlando CE meeting and all the learning that has followed I have come to the conclusion that Thor beats them all, on several levels.

The Orlando CE meeting was one of the best that I have ever attended. I learned a lot about a complex topic in an easier to understand and clinically relevant way. James Carroll is a fabulous, fun teacher and a humble genius in the area of LLLT. After the meeting, I had a lot more questions.

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Literature watch update: End 2014

130 new LLLT papers for you including a systematic review on shoulder tendinopathies, a lovely article review in an orthopaedics journal by Howard Cotler, four systematic reviews on orthodontic tooth movement, a trial showing LEDs improve sperm motility, another systematic review on oral mucositis and much more.

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BMJ snubs LLLT for neck pain again, but gives drugs with no evidence a pass

As reported here in 2013 there are no licensed drugs for non-specific neck pain because “there isn’t much specific research that shows drugs help neck pain”. For LLLT/PBM however, there are at least 16 (mostly positive) RCTs and a positive systematic review  published in The Lancet. Despite this unequivocal evidence, the 2014 revised patient advice leaflet from the BMJ fails to mention LLLT/PBM but states “your doctor may recommend one or more of the following” and goes on to list pain killers, NSAIDs, antidepressants and muscle relaxants”.

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Pubmed to adopt “Photobiomodulation Therapy” as a MeSH term

The US National Library of Medicine (NLM) plans to adopt “Photobiomodulation Therapy” as an official MeSH term in November 2015.

Why this is important?

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THOR LLLT presentation at United Nations – Global Health Impact Forum

This 15 minute video starts with an overview of Photobiomodulation and low level light therapy. Later in the presentation James introduces the Lumithera treatment for Dry Age related Macular Degeneration (AMD).

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Transcranial LLLT for Chronic mild Traumatic Brain Injury

The VA, Boston University and Harvard Medical School published the results of a Transcranial LLLT (LED) pilot study on mild Traumatic Brain Injury (TBI). Incredibly; TBI is a leading cause of death and disability among children and young adults in the United States. Each year an estimated 1.5 million Americans sustain a TBI, 50,000 people die as a consequence, 230,000 are hospitalized and an estimated 5.3 million currently live with a permanent TBI-related disability (because there is no cure). This study showed significant improvement in Executive Function, Verbal Learning, Long Delay Free Recall and fewer post-traumatic stress disorder (PTSD) symptoms. Participants and family reported better ability to perform social, interpersonal, and occupational functions. This was a small pilot study on just eleven patients with chronic mTBI, there was no placebo control group so further studies are necessary to truly establish the effect size.

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More Class IV laser therapy misinformation

More Class IV laser therapy misinformationThe paper “High-intensity versus low-level laser therapy in the treatment of patients with knee osteoarthritis: a randomized controlled trial” Kheshie et al 2014 pitches the 3B BTL laser against the HIRO class IV “High intensity” laser. The results appear to show that the HIRO class IV “High intensity laser” was more effective than the “Low Level Laser”. HOWEVER, the HIRO class IV “High intensity” laser was delivered over a large area (not adequately defined but approx 100cm2 by my estimation) so the intensity was actually very low (about 13mW/cm2 which is less than most LED systems), and the 3B BTL “Low Level Laser” was actually very high (4 x 200mW small, high intensity beams) and were held stationary on the patella for over half an hour, YES, HALF AN HOUR IN ONE SPOT! This is insane.

This paper leads people to think that the class IV Hiro laser was more effective because it was higher intensity when in fact the beam distribution meant the average intensity distribution was low (13mW/cm2). The 3B laser was not so effective because it was held stationary such that it would cause an overdose. If the 3B laser treatment had been delivered in using same scanning technique as the class IV then they would likely have achieved the same result. (I am not a fan of scanning because you can never be sure how much energy you have delivered to an area, better to use a low intensity device and hold it still in my view).

This paper misdirects the reader towards favouring class IV lasers rather than 3b or LED by misinforming the reader.

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Low Level Laser (LLLT) “regenerates teeth”

Low level laser regenerates teeth TV, radio and newspapers all over the world got very excited last week reporting that “laser regenerates teeth” following a Harvard study. The study showed that LLLT stimulates the stem cells resident in the tooth pulp to form dentin (for details click below). This is the highest profile announcement for any LLLT paper ever and will add significant awareness and credibility for everyone in the field. Congratulations and huge thanks to the author Dr Praveen Arany B.D.S., M.D.S., M.M.Sc., Ph.D. who is now a Clinical Investigator at NIH.

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Kadhim-Saleh laser neck pain review conclusion incorrect. LLLT is clinically effective

Last October a systematic review on LLLT for neck pain was written by Kadhim-Saleh et al and published in the British Journal of Sports Medicine. They report that the evidence for LLLT in neck pain is inconclusive. The paper criticises the 2009 Lancet review by Roberta Chow & Bjordal et al on LLLT for non-specific neck pain claiming their review was more stringent. Well you have to read the rebuttal Bjordal shot back to the journal editor revealing the weakness, errors and fundamental flaws in the work of Kadhim-Saleh et al

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Class IV laser dose concern. 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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Class IV laser treatments take longer than 3B lasers

A paper titled ”The Effectiveness of Therapeutic Class IV (10 W) Laser Treatment for Epicondylitis” [ref] showed that 10 Watt Class IV laser (mixed 8W 970nm, 2W 810) was successful in reducing pain and improving function in an RCT with 15 patients, and that there was good statistical significance at 6 months following a course of 6 treatments.

The claim by class IV laser manufacturers is that class IV lasers are better (faster, deeper and more effective) than Class 3b and LED systems. Conversely the 3B laser and LED manufacturers argue that less power density is more effective because delivering energy too quickly can overdose tissues and class IV lasers might burn the skin.

Throughout this paper there are marketing messages claiming the advantages  of shorter treatment times than low power LLLT systems and of course the title shouts “10 Watt Class IV laser” just in case the reader is in any doubt that more power is what you need.

Regular readers of this column know my obsession with irradiation parameters, particularly dose rate effects (W/cm2) and will not be surprised to learn that I deconstruced the irradiation parameters used in this trial . Surprise, surprise they were the same low irradiance levels typically used by 3B lasers and LED systems, if not less and the treatment time was longer too.

Yes, it was a 10 Watt laser and yes, 3,000 joules was delivered, however it had a  large beam area and treatment was delivered over (45cm2) in a “painting fashion”. The fluence (dose) was 6.6 Joules/cm2 and the power density was a tiny 22mW/cm2, consequently  treatment time was a hefty 5 mins.

The average irradiance was not disclosed in the paper and the reader is directed to think that more power is quicker.

P.S.  research trials with 3B lasers are typically 30 seconds to 3 mins and our recommended treatment is 1 min with a large LED cluster to the lateral epicondyle and 30 seconds for any related trigger points.

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The Bottom Line – lazy or ignorant professors?

Irradiation parameters and dose are critical aspects of LLLT and if you are a doctor or therapist you probably trust the research you read. Prepare to be disappointed.

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New video interview. Very good I think. Ron is articulate and a straight down the middle guy.

It would be nice if human hospitals could give the LLLT attention Ron gives his animal patients.

For more on THOR pet treatments click here

For more on LLLT training click here

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THOR at Harvard MIT

David Sengeh has been developing powered limbs at MIT for amputees (like the bionic man). Where the powered limb attaches to the body (the stump of the original leg) it gets very sore. David has been using our standard THOR products to heal the stump and reduce pain. It works very well, though it takes a lot of time to treat the whole area. I am in Boston now to help David start clinical trials with a new device we designed that will treat the whole stump. The amputee puts the the leg stump into the LED treatment cylinder and gets a complete treatment in just one minute :-)

MIT

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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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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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Course Testimonial: Dr. John Hendy

Dr. John HendyLLLT Training Course Testimonial, Palm Springs CA, USA:
Dr. John Hendy DDS MS
Aesthetic Laser Dentistry
Oregon, USA

“I was very impressed with James’ lecture as always. I always come away with many new ideas and uses of LLLT.”

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Course Testimonial: Liz deGroot

Liz deGroot, Massage Therapist BTSM CDT MLD, Wyndham, New ZealandLLLT Training Course Testimonial, Auckland, New Zealand: Liz deGroot, Massage Therapist BTSM CDT MLD, Wyndham, New Zealand

“Excellent course! Information backed by peer review research. James is an amazing speaker and his assistant Mark is extremely well organized and accommodating. Most of my questions were answered well and the ones that weren’t due to time constrictions I have sent to Mark who assures me he will answer. Trial of product at the site was fabulous. Well worth the time and money.”

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Low-Level Laser Therapy Reduces the Incidence and Severity of Oral Mucositis | PracticeUpdate

Nurse personal experience + 32 trials (1505 patients) treated with LLLT for Oral mucositis presented at Oncology Nursing conference, read full article on PracticeUpdate.

April 23, 2015–Orlando, Florida–Low-level laser therapy has been shown to reduce the incidence and severity of oral mucositis significantly in patients undergoing chemoradiotherapy for head and neck cancer or stem cell transplantation. This result of an analysis of 32 prospective trials including 1505 patients was presented at the 40th Annual Oncology Nursing Symposium from April 23 – 26 in Orlando, Florida.

Annette Quinn, RN, MSN, of the University of Pittsburgh Cancer Institute, explained that oral mucositis is one of the most debilitating toxicities of cancer therapy. Nearly all patients with head and neck tumors treated with chemoradiotherapy, and 75% of those undergoing stem cell transplantation with total body irradiation experience some degree of oral mucositis. “Over the last decade,” said Ms. Quinn, “the prevalence of oral mucositis has risen due to new chemotherapy, the introduction of targeted agents, and the delivery of higher doses of radiation.”

Source: Low-Level Laser Therapy Reduces the Incidence and Severity of Oral Mucositis | PracticeUpdate

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Course Testimonial: Grace Santos

Grace Santos, Reg. Vet Tech, Chabot Veterinary ClinicLLLT Training Course Testimonial, San Francisco, USA: Grace Santos, Reg. Vet Tech, Chabot Veterinary Clinic.

What did you like about the training? Small class size with more one on one. Great speaker and video presentation. Hands on with equipment and treatment protocols.

Was the course material useful? :)

Overall percentage for the day: 100%

5 Stars for Speaker, Venue and Location.

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Course Testimonial: Janis Eells

Janis Eells, Professor & Graduate Program DirectorLLLT Training Course Testimonial: Janis Eells, Professor & Graduate Program Director, LLLT researcher for NASA

“The training course that I took last year in Chicago was outstanding. James Carroll does an excellent job of presenting the key elements of photobiomodulation in an entertaining and informative manner. I’ve been working in this area of research for 15 years and I learned much in this course. I would take it again.”

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