Literature Watch

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

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“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

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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)

PMLS - free edition for download

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ECI meeting in Tomar, Portugal papers published

If you missed the ECI meeting last year (2007) then you can buy related articles here:
Proceedings of Light-Activated Tissue Regeneration and Therapy

I have attended two ECI meetings now and will declare them my favourite on the conference calender. They are only every 2 - 3 years, they are one week long and in a remote location. Watch this space for the announcement of the next event.

Task Force on Neck Pain supports use of laser

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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LESS IS MORE

Effects of Low-Level Laser Therapy and Eccentric Exercises in the Treatment of Recreational Athletes With Chronic Achilles Tendinopathy.
Stergioulas et al Am J Sports Med. 2008.

This study demonstrates that a 30mW 830nm laser with a 0.5cm2 beam (= only 60mW/cm2 intensity) applied over 6 points along the Achilles tendon for 180 seconds per point accelerates recovery from chronic Achilles tendonitis.

Note the relatively large spot size of this 30mW laser (hence rather low intensity), and long treatment times used.

All the dose rate studies that I have read indicate that intensities in the tens of mW/cm2 range work best for anti inflammatory and healing effects in superficial tendon injuries, whereas the higher intensities (1,000 mW/cm2) are probably only suitable for analgesic effects.

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REMEMBER TO READ THIS

Infrared light may reverse dementia and memory loss

That was the big claim British researchers made last month in what appears to be a global PR / news story that was covered substantially by the popular press.The news / PR reports claim that regular exposure to low-level infra-red light can improve learning performance and trigger regeneration of the cognitive function of the brain.

Our attempts to find the related published research produced by this group led us to just one paper showing that IR light improves “acquisition of working memory spatial navigation” in CD1 mice. The headlines that have been generated are quite bold given the limited published material but we cautious welcome this news.

Human testing is due to start summer 2008 they say. Read More here>>

Read research here

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TIME IS OF THE ESSENCE

Low-level laser therapy for zymosan-induced arthritis in rats: Importance of illumination time
Lasers Surg Med. 2007 Jul;39(6):543-50
Castano AP et al

This fluence rate study demonstrates good results from surprisingly low radiances with best results found at 5mW/cm2 in this animal model .

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