Author Archives: James Carroll

At the NZ2008 laser meeting  we debated  LLLT nomenclature, many scientists prefer to call it Photobiomodulation (and I agree this is the best name). Laser Biostimulation was used for some time by the American Society for Lasers in Surgery and Medicine, who recently 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 have used that label for almost every form of medical laser treatment (low level or otherwise). Low Level Laser Therapy was a term coined by Oshiro and Calderhead back on the 1980’s.

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

Bioregulating Laser
Biostimulating Laser
Broad Band Radiation Therapy
Class IV laser Therapy
Cold Laser Therapy
Diode Laser Therapy
He-Ne Laser therapy
Helium-neon laser irradiation
HILT (High Intensity Laser Therapy)
… Continue reading →

oh dear, I hope that none of this audience (you) are attempting to treat through clothing. Light does not go through clothing very well (if at all). You must treat the skin directly, preferably in contact (or very close).

These examples will not work

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

LLLT Systematic reviews with meta-analysis are hard to do for all sorts of reasons:

1) LLLT has had a lot of different names (cold laser, laser biostimulation, photobiomodulation, low intensity laser laser therapy, LEDT,  etc) so the literature search is hard (see my post on this from 2008, recently updated)

2) The authors need to have an advanced knowledge of the pathology in question.

3) The authors need to have an advanced knowledge of LLLT too, particularly the matter of irradiation parameters and dose*

4) Then the meta-analysis requires a high degree of competence with medical statistics (see how to write a systematic review with meta-analysis)

* So we should not be surprised when someone who looks at a broad range of interventions for a pathology with lmited knowledge of LLLT struggles (and often fails)  to stratify the data by effective irradiation parameters (wavelength, power, beam area, irradiance, pulses), dose (time, energy, fluence), treatment location, number of treatments and interval between treatments.

It may be that LLLT is not a suitable intervention for the pathology in question … Continue reading →