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THOR on YouTube30 more papers for your review including: two systematic reviews, one on tendionpathies the other on wound healing. A nice summary by Rochkind on nerve regeneration and several papers on LLLT dose response, dose rate response and dose interval response papers.
Low Level Laser Treatment of Tendinopathy: A Systematic Review with Meta-analysis.
Tumilty S, Munn J, McDonough S, Hurley DA, Basford JR, Baxter GD
1 Centre for Physiotherapy Research, School of Physiotherapy, University of Otago , Dunedin, New Zealand .
Abstract Objectives: To assess the clinical effectiveness of Low Level Laser Therapy (LLLT) in the treatment of tendinopathy. Secondary objectives were to determine the relevance of irradiation parameters to outcomes, and the validity of current dosage recommendations for the treatment of tendinopathy. Background: LLLT is proposed as a possible treatment for tendon injuries. However, the clinical effectiveness of this modality remains controversial, with limited agreement on the most efficacious dosage and parameter choices. Method: The following databases were searched from inception to 1(st) August 2008: MEDLINE, PubMed, CINAHL, AMED, EMBASE, All EBM reviews, PEDro (Physiotherapy Evidence Database), SCOPUS. Controlled clinical trials evaluating LLLT as a primary intervention for any tendinopathy were included in the review. Methodological quality was classified as: high (>/=6 out of 10 on the PEDro scale) or low (<6) to grade the strength of evidence. Accuracy and clinical appropriateness of treatment parameters were assessed using established recommendations and guidelines. Results: Twenty-five controlled clinical trials met the inclusion criteria. There were conflicting findings from multiple trials: 12 showed positive effects and 13 were inconclusive or showed no effect. Dosages used in the 12 positive studies would support the existence of an effective dosage window that closely resembled current recommended guidelines. In two instances where pooling of data was possible, LLLT showed a positive effect size; in studies of lateral epicondylitis that scored >/=6 on the PEDro scale, participants’ grip strength was 9.59 kg higher than that of the control group; for participants with Achilles tendinopathy, the effect was 13.6 mm less pain on a 100 mm visual analogue scale. Conclusion: LLLT can potentially be effective in treating tendinopathy when recommended dosages are used. The 12 positive studies provide strong evidence that positive outcomes are associated with the use of current dosage recommendations for the treatment of tendinopathy.
Photomed Laser Surg 2009 Aug 26
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A Meta-analysis of the Efficacy of Phototherapy in Tissue Repair.
Fulop AM, Dhimmer S, Deluca JR, Johanson DD, Lenz RV, Patel KB, Douris PC, Enwemeka CS
Department of Physical Therapy, School of Health Professions, New York Institute of Technology , Old Westbury, New York .
Abstract Objective: The effect of phototherapy on tissue repair was determined by aggregating the literature and using statistical meta-analysis to analyze pertinent studies published between 2000 and 2007. Background Data: Phototherapy has been used for more than 40 y; however, its efficacy on tissue repair remains contentious. Method: Related original studies were gathered from every available source. The papers were then screened and coded; those meeting pre-established inclusion criterion were subjected to meta-analysis, using Cohen’s d statistic to determine treatment effect size. Results: Seventy effect sizes were computed from the 23 papers that met the inclusion criteria. The overall mean effect obtained was highly significant, d = +1.94 (95% confidence interval = 0.58-2.50). Further analyses revealed a similarly positive effect of phototherapy on tissue repair in experimental animal studies, d = +2.60, and a small to moderately positive effect in human cases of tissue repair, d = +0.34. The fail-safe number associated with the overall effect was 869; i.e., the number of additional studies in which phototherapy has negative or no effect on wound healing needed to negate the overall large effect size of + 1.94. The corresponding fail-safe numbers for experimental animal and human tissue repair studies were 612 and 64, respectively. Conclusion: These findings indicate that phototherapy is a highly effective form of treatment for tissue repair, with stronger supporting evidence resulting from experimental animal studies than human studies.
Photomed Laser Surg 2009 Aug 21
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Chapter 25: Phototherapy in peripheral nerve injury: effects on muscle preservation and nerve regeneration.
Rochkind S, Geuna S, Shainberg A
Division of Peripheral Nerve Reconstruction, Department of Neurosurgery, Tel Aviv Sourasky Medical Center, Tel Aviv University, Israel.
Posttraumatic nerve repair and prevention of muscle atrophy represent a major challenge of restorative medicine. Considerable interest exists in the potential therapeutic value of laser phototherapy for restoring or temporarily preventing denervated muscle atrophy as well as enhancing regeneration of severely injured peripheral nerves. Low-power laser irradiation (laser phototherapy) was applied for treatment of rat denervated muscle in order to estimate biochemical transformation on cellular and tissue levels, as well as on rat sciatic nerve model after crush injury, direct or side-to-end anastomosis, and neurotube reconstruction. Nerve cells’ growth and axonal sprouting were investigated in embryonic rat brain cultures. The animal outcome allowed clinical double-blind, placebo-controlled randomized study that measured the effectiveness of 780-nm laser phototherapy on patients suffering from incomplete peripheral nerve injuries for 6 months up to several years. In denervated muscles, animal study suggests that the function of denervated muscles can be partially preserved by temporary prevention of denervation-induced biochemical changes. The function of denervated muscles can be restored, not completely but to a very substantial degree, by laser treatment initiated at the earliest possible stage post injury. In peripheral nerve injury, laser phototherapy has an immediate protective effect. It maintains functional activity of the injured nerve for a long period, decreases scar tissue formation at the injury site, decreases degeneration in corresponding motor neurons of the spinal cord, and significantly increases axonal growth and myelinization. In cell cultures, laser irradiation accelerates migration, nerve cell growth, and fiber sprouting. In a pilot, clinical, double-blind, placebo-controlled randomized study in patients with incomplete long-term peripheral nerve injury, 780-nm laser irradiation can progressively improve peripheral nerve function, which leads to significant functional recovery. A 780-nm laser phototherapy temporarily preserves the function of a denervated muscle, and accelerates and enhances axonal growth and regeneration after peripheral nerve injury or reconstructive procedures. Laser activation of nerve cells, their growth, and axonal sprouting can be considered as potential treatment for neural injury. Animal and clinical studies show the promoting action of phototherapy on peripheral nerve regeneration, which makes it possible to suggest that the time for broader clinical trials has come.
Int Rev Neurobiol 2009 87 445-64
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Effect of Polarized Light Emitting Diode Irradiation on Wound Healing.
Tada K, Ikeda K, Tomita K
From the Department of Orthopaedics Surgery, School of Medicine, Kanazawa University, Takaramachi, Kanazawa, Japan.
BACKGROUND:: We propose a new phototherapy using polarized light from light emitting diode (LED). The purpose of this study is to clarify the effect of polarized LED irradiation on wound healing. METHODS:: Five groups were classified: control (C), unpolarized (U), linearly polarized (L), right circularly polarized (RC), and left circularly polarized (LC) LED irradiation. In vitro study, fibroblast cell cultures were irradiated, and cellular proliferation was evaluated with a WST-8 assay. In vivo study, full-thickness skin defect of 20 mm diameter was created on the dorsal side of rats. The ratio of the residual wound area was measured, and expression of type 1 and type 3 procollagen mRNA in granulation tissue was determined by real-time reverse transcription polymerase chain reaction method. RESULTS:: The cellular proliferation rates of group RC and L were significantly higher than other groups. The ratio of the residual wound area of group RC and L was significantly reduced than group C and U. Expression of type 1 procollagen mRNA in group RC was found to be significantly increased about 1.5-fold in comparison with the group C. There were no significant differences for type 3 procollagen. CONCLUSIONS:: The right circularly polarized light and linearly polarized light promoted the process of wound healing by increasing the proliferation of fibroblasts, and the right circularly polarized light increased the expression of type 1 procollagen mRNA. The effectiveness of right circularly polarized light suggests that some optical active material, which has a circular dichroic spectrum, takes part in a biochemical reaction.
J Trauma 2009 Aug 12
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Effects of Low-Level Laser Irradiation on Rat Skeletal Muscle Injury after Eccentric Exercise.
Liu XG, Zhou YJ, Liu TC, Yuan JQ
1 Britton Chance Center for Biomedical Photonics, Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology , Wuhan, China .
Abstract Background and Objective: The effect of photobiomodulation on delayed onset muscle soreness remains unknown. This study represents the first investigation of this treatment using an animal model. Methods: Seventy-two Sprague-Dawley rats were randomly divided into five groups: sedentary control group, exercise control group and three exercise-plus-laser groups. Downhill running was used to induce muscle injury in the gastrocnemius muscle. He-Ne laser irradiations were administered to the injured muscles immediately and at 18 and 42 h after exercise in the three exercise-plus-laser groups at 12, 28, and 43 J/cm(2), respectively. Histological examination and serum creatine kinase (CK), muscle superoxide dismutase (SOD) and malondialdehyde (MDA) analyses were done at 24 and 48 h after exercise. Results: The exercise control group exhibited a marked inflammation in the gastrocnemius muscle and significant elevations in serum CK activity and muscle MDA level after downhill running. He-Ne laser irradiation at 43 J/cm(2) inhibited muscle inflammation, significantly enhanced muscle SOD activity and significantly reduced serum CK activity and muscle MDA level at both 24 and 48 h after exercise, whereas the irradiation at 12 or 28 J/cm(2) slightly inhibited muscle inflammation and significantly reduced serum CK activity at 48 h after exercise only (P < 0.05). Conclusions: Low-level He-Ne laser therapy could exert therapeutic effects on eccentric exercise-induced rat muscle injury through enhancing muscle anti-oxidative capacity and reducing the inflammatory reaction. The photobiomodulation was dose-dependent, and the 43 J/cm(2) dose was the most efficient among the doses used.
Photomed Laser Surg 2009 Aug 21
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A role for photoreceptors in retinal oedema and angiogenesis: an additional explanation for laser treatment?
Foulds WS, Kaur C, Luu CD, Kek WK
[1] Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore [2] Department of Ophthalmology, Yong Loo Lim School of Medicine, National University Hospital, Singapore, Singapore [3] University of Glasgow, Glasgow, Scotland, UK.
PurposeTo investigate the possible roles of retinal photoreceptors in macular oedema and retinal angiogenesis with particular reference to the mode of action of laser therapy.Methods(i) Studies in rats made hypoxic for 2 h by administering an oxygen/nitrogen mixture of reduced oxygen content, and growth factors determined by RT-PCR, western blotting, and immunohistochemistry. Assessment of blood-retinal barrier integrity using fluorescent and electron-dense tracers. (ii) Studies in pigs with one retina made hypoxic by selective embolisation of the retinal capillary circulation with fluorescent microspheres. (iii) Assessment of laser therapy in selected cases of retinal neovascularisation indicating a role for photoreceptors.ResultsIn the hypoxic retina, angiogenic and vascular permeability factors such as vascular endothelial growth factor (VEGF), nitric oxide synthases (NOSs), and insulin-like growth factor-1 are upregulated in retinal astrocytes and Muller cells but are also present in large amount in the photoreceptors. Hypoxia-inducible factor-1 (HIF-1) is upregulated in retinal glial cells but not in the photoreceptors, suggesting that growth factors in the photoreceptors may not have been generated there. The tracer dye, rhodium isothiocyanate, leaking from an abnormally permeable inner blood-retinal barrier in the hypoxic retina accumulates in the photoreceptors.ConclusionsThe results indicate that laser treatment of macular oedema or retinal neovascularisation may obtain its effect not only by improving oxygen availability in the inner retina, but also by reducing the load of angiogenic/permeability factors that accumulate in the photoreceptors in hypoxic/ischaemic conditions.Eye advance online publication, 11 September 2009; doi:10.1038/eye.2009.173.
Eye 2009 Sep 11
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The Effect of Equal Daily Dose Achieved by Different Power Densities of Low-Level Laser Therapy at 635 and 670 nm on Wound Tensile Strength in Rats: A Short Report.
Vasilenko T,Slezak M,Kovac I,Bottkova Z,Jakubco J,Kostelnikova M,Tomori Z,Gal P
1 Department of Medical Biophysics, Pavol Jozef Safarik University , Kosice, Slovak Republic.
Abstract Objective: The aim of our study was to compare the effects of different power densities of LLLT at 635 and 670 nm achieving a daily dose of 5 J/cm(2) on wound tensile strength (TS) in rats. Background Data: Optimal parameters of low-level laser therapy (LLLT) are still unknown. Materials and Methods: Under general anesthesia, one full-thickness skin incision was performed on the back of each rat (n = 40) and immediately closed using an intradermal running suture. Rats were separated into five groups depending on treatment parameters: (1) sham irradiated control group (SIC); (2) 635 nm laser-treated group at 4 mW/cm(2) (L-635/4); (3) 635 nm laser-treated group at 15 mW/cm(2) (L-635/15); (4) 670 nm laser-treated group at 4 mW/cm(2) (L-670/4); and (5) 670 nm laser-treated group at 15 mW/cm(2) (L-670/15). The total daily dose was 5 J/cm(2). Seven days after surgery each wound was removed for wound TS measurement. Results: The lowest wound TS results were measured in the SIC rats (10.5 +/- 2.8 g/mm(2)). Higher wound TS results were measured in group L-670/15 (11.5 +/- 2.5 g/mm(2)) and group L-635/4 (11.7 +/- 4.3 g/mm(2)) rats, while significantly higher results were found in group L-670/4 (15.8 +/- 4.4 g/mm(2)) and group L-635/15 (15.9 +/- 4.8 g/mm(2)). The differences were significant between certain groups (p < 0.01: SIC vs. L-635/15, SIC vs. L-670/4; p < 0.05: L-635/4 vs. L-635/15, L-635/4 vs. L-670/4, L-635/15 vs. L-670/15, L-670/4 vs. L-670/15). Conclusion: Both red lasers significantly increased wound TS at selected parameters. Whereas the 635 nm laser significantly improved wound healing, the 670 nm laser improved healing using a lower power density.
Photomed Laser Surg 2009 Sep 11
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In Vivo Comparison of Simple and Double-Fractionated Low-Level Laser Irradiation Schemes on the Healing of Rat Skin Lesions.
Calin MA, Botea S
1 National Institute of Research and Development for Optoelectronics , Magurele, Romania .
Abstract Objective: To compare the efficacy of a simple irradiation scheme with that of a double-fractionated irradiation scheme on the healing of rat skin lesions using in vivo monitoring of tissue diffuse reflectance. Background Data: Low-level laser therapy (LLLT) is used in medicine for treating a wide range of pathological conditions. The practical benefits of laser treatment of acute and chronic conditions were obtained, using a single session of irradiation per day. Materials and Methods: Thirty Wistar rats were divided into three experimental groups (controls, simple laser irradiation scheme, and double-fractionated laser irradiation scheme). A skin lesion was created on the calf of the right hind leg of all rats. The laser irradiation parameters were lambda = 635 nm and power = 15 mW. The exposure time was 600 s for the simple laser irradiation scheme and 300 s x 2 for the double-fractionated laser irradiation scheme on 3 consecutive days. The optical properties of tissue were studied by processing and analyzing the diffuse reflectance spectra of injured skin, acquired before and after each laser irradiation. Results: The results demonstrate that, using a simple laser irradiation scheme (single daily irradiation session: t(exp(1)) = 600 s, power = 15 mW, lambda = 635 nm), healing of the skin lesion began after 3 consecutive treatment days. The application of the double-fractionated laser irradiation scheme (2 daily irradiation sessions : t(exp(2)) = t(exp(1))/2 = 300 s, power = 15 mW and lambda = 635 nm) led to a reduction in treatment time to 2 days. Conclusion: In conclusion, a double-fractionated irradiation scheme is more efficient than simple irradiation scheme for LLLT in rat skin lesions.
Photomed Laser Surg 2009 Sep 11
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Laser acupuncture for chronic non-specific low back pain: a controlled clinical trial.
Glazov G, Schattner P, Lopez D, Shandley K
School of Primary, Aboriginal and Rural Health Care, University of Western Australia, 328 Stirling Hwy Claremont WA 6010; glazog01@student.uwa.edu.au.
OBJECTIVE: The primary aim was to determine if laser acupuncture (LA) is more effective than sham laser in reducing pain and disability in adults with chronic non-specific low back pain. METHODS: The design was a double blind, two-group parallel randomised controlled trial. The active intervention was an 830 nm (infrared), 10 mW, Ga-Al-As laser diode laser for acupuncture and a sham control. The primary outcome measures were changes in pain (visual analogue scale) and disability (Oswestry Disability Index) at the end of 5-10 treatment sessions. Secondary outcomes were patient global assessment, psychological distress (Depression Anxiety Stress Scale) and subjective wellbeing (Personal Wellbeing Index). Follow up was performed at 6 weeks and 6 months after completion of treatment. RESULTS: 100 participants were enrolled and treated in a general practice setting. Per protocol analysis of the primary outcome measures using ANOVA suggested that although there was a significant overall improvement in pain and disability after the course of treatments (p<0.01), there was no significant difference between the intervention and control group in both the primary and most secondary outcome measures. CONCLUSION: This study did not show a specific effect for LA using infrared laser at 0.2 Joules per point for chronic low back pain. The overall intervention appeared effective because of placebo and other factors. As there was some concern about baseline inequality between the groups further research using tighter inclusion criteria should attempt to replicate the result and examine if a dose response may exist.
Acupunct Med 2009 Sep 27(3) 94-100
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Laser acupuncture: effectiveness depends upon dosage.
David Baxter G
Centre for Physiotherapy Research, University of Otago, PO Box 56, Dunedin 9054, New Zealand; david.baxter@otago.ac.nz.
Acupunct Med 2009 Sep 27(3) 92
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Effect of cluster multi-diode light emitting diode therapy (LEDT) on exercise-induced skeletal muscle fatigue and skeletal muscle recovery in humans.
Leal Junior EC, Lopes-Martins RA, Rossi RP, De Marchi T, Baroni BM, de Godoi V, Marcos RL, Ramos L, Bjordal JM
Laboratory of Human Movement (LMH), University of Caxias do Sul (UCS), Caxias do Sul, RS, Brazil.
BACKGROUND AND OBJECTIVES: There are some indications that low-level laser therapy (LLLT) may delay the development of skeletal muscle fatigue during high-intensity exercise. There have also been claims that LED cluster probes may be effective for this application however there are differences between LED and laser sources like spot size, spectral width, power output, etc. In this study we wanted to test if light emitting diode therapy (LEDT) can alter muscle performance, fatigue development and biochemical markers for skeletal muscle recovery in an experimental model of biceps humeri muscle contractions. STUDY DESIGN/MATERIALS AND METHODS: Ten male professional volleyball players (23.6 [SD +/-5.6] years old) entered a randomized double-blinded placebo-controlled crossover trial. Active cluster LEDT (69 LEDs with wavelengths 660/850 nm, 10/30 mW, 30 seconds total irradiation time, 41.7 J of total energy irradiated) or an identical placebo LEDT was delivered under double-blinded conditions to the middle of biceps humeri muscle immediately before exercise. All subjects performed voluntary biceps humeri contractions with a workload of 75% of their maximal voluntary contraction force (MVC) until exhaustion. RESULTS: Active LEDT increased the number of biceps humeri contractions by 12.9% (38.60 [SD +/-9.03] vs. 34.20 [SD +/-8.68], P = 0.021) and extended the elapsed time to perform contractions by 11.6% (P = 0.036) versus placebo. In addition, post-exercise levels of biochemical markers decreased significantly with active LEDT: Blood Lactate (P = 0.042), Creatine Kinase (P = 0.035), and C-Reative Protein levels (P = 0.030), when compared to placebo LEDT. CONCLUSION: We conclude that this particular procedure and dose of LEDT immediately before exhaustive biceps humeri contractions, causes a slight delay in the development of skeletal muscle fatigue, decreases post-exercise blood lactate levels and inhibits the release of Creatine Kinase and C-Reative Protein. Lasers Surg. Med. (c) 2009 Wiley-Liss, Inc.
Lasers Surg Med 2009 Sep 3
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Current studies on myofascial pain syndrome.
Kuan TS
Department of Physical Medicine and Rehabilitation, College of Medicine, National Cheng-Kung University, 138 Sheng-Li Road, Tainan, 704, Taiwan. kuan@mail.ncku.edu.tw.
Recent studies have clarified the nature of myofascial trigger points (MTrPs). In an MTrP region, multiple hyperirritable loci can be found. The sensory components of the MTrP locus are sensitized nociceptors that are responsible for pain, referred pain, and local twitch responses. The motor components are dysfunctional endplates that are responsible for taut band formation as a result of excessive acetylcholine (ACh) leakage. The concentrations of pain- and inflammation-related substances are increased in the MTrP region. It has been hypothesized that excessive ACh release, sarcomere shortening, and release of sensitizing substances are three essential features that relate to one another in a positive feedback cycle. This MTrP circuit is the connection among spinal sensory (dorsal horn) neurons responsible for the MTrP phenomena. Recent studies suggest that measurement of biochemicals associated with pain and inflammation in the MTrP region, the sonographic study of MTrPs, and the magnetic resonance elastography for taut band image are potential tools for the diagnosis of MTrPs. Many methods have been used to treat myofascial pain, including laser therapy, shockwave therapy, and botulinum toxin type A injection.
Curr Pain Headache Rep 2009 Oct 13(5) 365-9
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The Effects of Light-Emitting Diode Irradiation at 610 nm and 710 nm on Murine T-Cell Subset Populations.
Lim JH, Lee J, Choi J, Hong J, Jhun H, Han J, Kim S
1 Department of Rehabilitation Medicine, Konkuk University Medical Center , Seoul, South Korea .
Abstract Objective: The aim of this study was to investigate the effects of light-emitting diode (LED) irradiation (radiant power, 0.047 mW; irradiation area, 1.13 cm(2)) at 610 nm and 710 nm on T-lymphocyte subset populations and cytokine expression using an in vivo rat model. Background Data: The proliferation of CD4+ T lymphocytes was induced by polychromatic visible polarized light at the range of 540-780 nm in a previous study, but the specific target wavelength for this effect has not yet been identified. Methods: Before and after 4 weeks of LED phototherapy, whole blood samples were collected from 610 nm, 710 nm, and control groups. The percentages of CD4+ and CD8+ T lymphocyte populations were determined by flow cytometry. The transcript levels of representative cytokines of CD4+ T-cell (interleukin [IL]-4, interferon [IFN]gamma) and proinflammatory cytokines (IL-1beta, IL-6) were assessed with the reverse transcriptase-polymerase chain reaction. Results: The population of CD4+ T cells increased significantly in 710 nm group on day 28 (p < 0.05), but it did not increase in the 610 nm or control group. The population of CD8+ T cells did not show any significant change after irradiation in all groups. The mRNA expression of IL-4 increased in both the 610 nm and 710 nm groups compared to the control group, but IFNgamma was not detected in any group. The transcripts of IL-1beta and IL-6 were slightly induced in the 710 nm group. Conclusion: The in vivo irradiation of 710 nm wavelength LED significantly increases the population of murine CD4+ T cells, which suggests that this new phototherapeutic regimen might be promising for CD4+ T lymphocyte-mediated immune modulation therapy.
Photomed Laser Surg 2009 Aug 29
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Evaluation of Neodymium-Doped Yttrium Aluminium Garnet Laser, Scalpel Incision Wounds, and Low-Level Laser Therapy for Wound Healing in Rabbit Oral Mucosa: A Pilot Study.
Demir T, Kara C, Ozbek E, Kalkan Y
1 Department of Periodontology, Faculty of Dentistry, Ataturk University , Erzurum, Turkey .
Abstract Objective: The aim of the present randomized controlled clinical trial was to assess the clinical and histopathological effects of laser and low-level laser therapy (LLLT) on healing of the oral mucosa after vestibuloplasty surgery. Methods: The alterations at the end of healing in scalpel- and laser-incised and LLLT-applied oral mucosa were studied in eight healthy adult New Zealand white rabbits by taking specimens for light microscopic inspection. For the evaluation of wound healing, the surgical areas were stained using a solution (Mira-2-tones), and the stained surfaces were measured horizontally immediately after the surgery and on postoperative days 4, 7, and 10. Results: Although the stained surface areas of the groups were similar immediately after the surgical procedures, the LLLT-applied sites had significantly fewer stained surface areas than the other groups on postoperative days 4, 7, and 10. Areas of hyperkeratosis and parakeratinization were observed in the epithelia of the laser surgery groups. A significant increase in epithelial thickness was found, suggesting increased scar tissue after wound repair; long and irregular connective tissue protrusions projecting into the undersurface of the epithelium were noted in these groups. Conclusion: LLLT used for soft tissue operations provides better and faster wound healing, and LLLT enhances epithelization.
Photomed Laser Surg 2009 Aug 27
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Effect of Low-Level Laser Therapy and Calcitonin on Bone Repair in Castrated Rats: A Densitometric Study.
Nascimento SB, Cardoso CA, Ribeiro TP, Almeida JD, Albertini R, Munin E, Arisawa EA
1 Biomedical Vibrational Spectroscopy Laboratory, Research and Development Institute, Universidade do Vale do Paraiba , Sao Jose dos Campos, Sao Paulo, Brazil .
Abstract Objective: To investigate the healing of bone defects in male rats treated with salmon calcitonin, low-level laser therapy (LLLT), or both. Background: Healing of bone defects still represents a challenge to health professionals in several areas. In this article, the effect of calcitonin in combination with LLLT on bone repair was studied. Densitometry was used as a valuable tool for the measurement of bone regeneration. Methods: Sixty male Wistar rats underwent bilateral castration surgery before the creation of a surgical bone defect. The animals were randomly divided into four groups: control, treated with calcitonin (Ca), treated with LLLT (La), and treated with calcitonin and LLLT (CaLa). Groups Ca and CaLa received 2 IU/kg of synthetic salmon calcitonin intramuscularly three times a week. Groups La and CaLa received laser therapy using a gallium-aluminum-arsenide laser (10 mW, 20 J/cm(2), wavelength 830 nm). Control animals were submitted to sham irradiation. The animals were sacrificed 7, 14, and 21 days after surgery, and bone defects were analyzed using densitometry. Results: The CaLa group had a higher degree of bone regeneration 14 and 21 days after surgery. Conclusions: The La and CaLa had significantly higher bone mineral density than the control and Ca groups.
Photomed Laser Surg 2009 Aug 27
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Analysis of the Systemic Effect of Red and Infrared Laser Therapy on Wound Repair.
Rodrigo SM, Cunha A, Pozza DH, Blaya DS, Moraes JF, Weber JB, de Oliveira MG
1 School of Dentistry, Pontificia Universidade Catolica do Rio Grande do Sul , Porto Alegre, Brazil .
Abstract Objective: To evaluate, using histological analysis, the systemic action and repair process of wounds produced on the back of rats and treated with red, infrared, or both lasers applied directly or indirectly to the wounds. Background Data: Skin tissue repair and wound healing are complex processes that involve a series of dynamic events. Many benefits are associated with biomodulation uisng laser therapy. Methods: Thirty-six male Wistar rats were divided into four groups: control (without laser), red laser (aluminium gallium indium phosphide (InGaAlP); lambda = 685 nm; phi = 0.2 mm(2); CW; P = 30 mW; D = 20 J/cm(2), time of irradiation = 11.07 min), infrared laser (gallium-aluminum-arsenide (AsGaAl): lambda = 830 nm; phi = 0.2 mm(2); CW; P = 50 mW; D = 20 J/cm(2), time of irradiation = 6.41 min), and both lasers (infrared laser: AsGaAl; lambda = 830 nm; phi = 0.2 mm(2); CW; P = 50 mW; D = 10 J/cm(2), time of irradiation = 3.21 min + red laser: InGaAlP; lambda = 685 nm; phi = 0.2 mm(2); CW; P = 30 mW; D = 10 J/cm(2), time of irradiation = 5.34 min; total dose = 20 J/cm(2)). Three subgroups were formed according to observation time points. Three wounds were produced on the back of each animal. Only the wound closest to the head was irradiated in the experimental groups. For the evaluation of skin reaction and wound healing, three animals of each group were killed at 3, 5, and 7 days postoperatively. The irradiation protocol established 48-hour intervals between applications, with the first application immediately after the surgical procedure. Results: In the red and infrared laser group, healing was more advanced in the wound located furthest from the point of laser application. The most effective healing of a proximal wound was verified in the control group on the 7th postoperative day. Conclusion: The combined application of red and infrared lasers resulted in the most evident systemic effect on the repair of skin wounds produced in rats.
Photomed Laser Surg 2009 Aug 26
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101 Hz frequency-modulated infrared light induces cytogenetic adaptive response in mouse bone marrow in vivo.
Zaichkina SI, Rozanova OM, Dyukina AR, Akhmadieva AKh, Aptikaeva GF, Romanchenko SP, Muller X
Institute of Theoretical and Experimental Biophysics Russian Academy of Sciences, Puschino, Russia. szaichkina@yandex.ru.
The micronucleus test was used tu study the possibility of inducing cross-adaptive response in mouse bone marrow cells in vivo with an 850 nm infrared light modulated by a 101 Hz frequency, emitted by a light therapy device “Kurator”. We demonstrated that this exposure led to a substantial reduction of cytogenetic cell damage produced by further exposure of animals to X-radiation in the dose of 1.5 Gy, i.e. it induced an adaptive response which did not differ by the magnitude and time course from the adaptive response to radiation.
Bull Exp Biol Med 2009 Apr 147(4) 427-30
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The Effects of Low-Level Laser Therapy on Bone in Diabetic and Nondiabetic Rats.
Bayat M, Abdi S, Javadieh F, Mohsenifar Z, Rashid MR
1 Cellular and Molecular Biology Research Center, Shahid Beheshti University , M.C., Tehran, Iran .
Abstract Objective: The aim of the present study was to examine the effects of low-level laser therapy (LLLT) on the tibia of streptozotocin-induced diabetic (STZ-D) rats. Background Data: LLLT has been found to accelerate fracture healing in animals. Diabetes mellitus decreases bone volume and its biomechanical parameters. Materials and Methods: Twenty rats were divided randomly into four groups. Rats in the first two groups were administrated a single injection of STZ to induce diabetes, while animals in groups 3 and 4 were given a sham injection of distilled water. The right tibia in groups 1 and 2 was treated with a He-Ne laser (632.8 nm, 10 mW) of 28.6 and 382.2 J/cm(2), respectively. LLLT was performed daily for 14 consecutive days. The right tibia of rats in group 3 was treated with LLLT the same as group 2. The right tibia of rats in group 4 was used for based line studies. After 14 d, right tibiae and left tibiae (control bone) were extracted and subjected to the three-point bending test and histological study. Results: Maximum force (N) was significantly greater in laser-treated bones of groups 2 and 3 compared with their relevant control groups (paired Student t test, p = 0.05 and p = 0.007, respectively). Density of the bone lamella meshwork of compact bone in group 2 was significantly greater in comparison with its control group (paired Student t test, p = 0.005). Conclusion: LLLT on tibia of STZ-D rats increased the bone lamella meshwork density of compact bone and also increased its strength.
Photomed Laser Surg 2009 Aug 21
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Low-Level Laser Therapy Using 80-Hz Pulsed Infrared Diode Laser Accelerates Third-Degree Burn Healing in Rat.
Vasheghani MM, Bayat M, Dadpay M, Habibie M, Rezaei F
1 Basic Sciences Department, Paramedical Faculty, Shahid Beheshti University , M.C., Tehran, Iran .
Abstract Objective: To evaluate 80-Hz pulsed infrared diode low-level laser therapy (LLLT) for third-degree burn healing in rats. Background Data: Review of the literature indicates that LLLT has a biostimulatory effect on wound healing, although no clear recommendation can be made yet. Methods: Forty-eight male rats were divided into groups 1 and 2. On day 0, three third-degree burns were made on the dorsum of each rat using steam. In group 1, the first burn was exposed to an 80-Hz pulsed 890-nm infrared diode laser at 0.396 J/cm(2) three times a week. In group 2, the first burn was exposed to the inactivated laser. In both groups, the second burns were treated with topical application of nitrofurazone 0.2%, and third burns did not receive any treatment and were considered as control burns. Burns were clinically examined. The rats were treated for 8, 12, and 20 days in both groups. On days 8, 2, and 20, microbiological samples of burns were collected and analyzed. Data were analyzed using the chi-square method. Results: The paired Student t-test showed that the wound closure rate of laser-treated burns (17.6 +/- 1.86 days) was significantly longer than that of the control burns (19.6 +/- 0.81days) (p = 0.007).The number of laser-treated burns that closed was significantly higher than controls. Chi-square tests showed that there was not significant difference between each microorganism (Staphylococcus epidermis, S. aureus and Pseudomonas aeruginosa). Conclusion: LLLT using an 80-Hz pulsed infrared diode laser accelerated third-degree burn healing in rat.
Photomed Laser Surg 2009 Aug 21
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Effect of Low-Energy Gallium-Aluminum-Arsenide and Aluminium Gallium Indium Phosphide Laser Irradiation on the Viability of C2C12 Myoblasts in a Muscle Injury Model.
Ferreira MP, Ferrari RA, Gravalos ED, Martins MD, Bussadori SK, Gonzalez DA, Fernandes KP
1 Rehabilitation Sciences Department, Nove de Julho University , Sao Paulo, SP, Brazil .
Abstract Objective: To evaluate the effect of phototherapy on the viability of cultured C2C12 myoblasts under different nutritional conditions (muscle injury model) using low-energy gallium-aluminum-arsenide (GaAlAs) and aluminium-gallium-indium-phosphide (InGaAlP) lasers with different wavelengths and powers. Background Data: The beneficial effects of phototherapy using low-energy lasers depend on irradiation parameters and type of laser used, but there are no data in the literature on C2C12 myoblasts proliferation after phototherapy with GaAlAs and InGaAlP lasers. Methods: A C2C12 cell line cultured in regular (10% fetal bovine serum, FBS) and nutrient-deficient (5% FBS) media were irradiated with low-energy GaAlAs (660 nm) and InGaAlP (780 nm) lasers with energy densities of 3.8, 6.3, and 10 J/cm(2), and 3.8, 10, and 17.5 J/cm(2), respectively. Cell proliferation was assessed indirectly 24 h after irradiation by measuring the mitochondrial activity and using the crystal violet assay. Results: There were no significant differences in cell viability between laser-treated myoblasts and control cultures for all tested parameters after 24 h of cell culture, although cell cultures grown in regular nutrient medium supplemented with 10% FBS exhibited higher growth rates than cultures, irradiated or not, grown in nutrient-deficient medium. Conclusion: Laser phototherapy did not improve C2C12 viability under regular or nutrient-deficient (muscle injury model) conditions using the above parameters.
Photomed Laser Surg 2009 Aug 21
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The Effect of Gallium-Aluminum-Arsenide 808-nm Low-Level Laser Therapy on Healing of Skin Incisions Made Using a Diode Laser.
Gungormus M, Akyol U
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ataturk University , Erzurum, Turkey .
Abstract Background and Objective: To investigate the effect of low-level laser therapy (LLLT) on healing of skin incisions made using a diode laser in rats. Material and Methods: Eighteen Wistar rats were used for this study. Two parallel incisions (approximately 15 mm in length) were performed on the left and right side of the dorsum of each rat using a diode laser (4-W output powers with a tip 300 mum in diameter, 6 mm long, and 635-nm aiming beam). The wound on the left side of each rat received laser stimulation (10 J/cm(2)) from an 808-nm-wavelength gallium-aluminum-arsenide laser (Laser Source Power 20W, Laser Class IV, Medical Class IIB, Input Power Supply 230 +/- 10% VAC). They were assigned to two experimental groups: Group 1, diode laser (control); Group 2, diode laser + LLLT. Results: It was determined that there was a significant difference between the diode laser and diode laser + LLLT groups in inflammation at day 10 and a difference in reepithelization at day 20 but no significant difference in inflammation at day 20. Conclusions: Diode laser incision (4 W) with 10 J/cm(2) LLLT seems to have a beneficial effect on skin incisions in rats. As a result, it can be concluded that wound closure was significantly enhanced with lllt on diode laser incisions in rats.
Photomed Laser Surg 2009 Aug 21
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The effects of infrared low-level laser therapy on healing of partial osteotomy of tibia in streptozotocin-induced diabetic rats.
Javadieh F, Bayat M, Abdi S, Mohsenifar Z, Razi S
Anatomy Department, Medical Faculty, Shahid Beheshti University, MC, Tehran, Iran.
OBJECTIVE: The effects of low-level laser therapy (LLLT) on a bone defect model in streptozotocin-induced diabetic (STZ-D) rats was examined. BACKGROUND DATA: LLLT accelerates bone fracture repair in healthy animals, but its effect in diabetic animals is unclear. METHODS: Twenty-eight rats were divided into five groups: 1 (diabetes, no LLLT), 2 (diabetes, LLLT high dose), 3 (diabetes, LLLT low dose), 4 (no diabetes, no LLLT), and 5 (no diabetes, LLLT low dose) Diabetes was induced by a single injection of STZ in rats of groups 1, 2, and 3. A bone defect was made in the right tibia of rats in all groups. The defect in groups 2, 3, and 5 was treated with LLLT (890 nm, 70 W, 3000 Hz, circular beam shape, and 1 cm(2) spot size). Doses of 23.3 J/cm(2) (530 s) for group 2 and 11.6 J/cm(2) (265 s) for groups 3 and 5 were applied three times a week. The right tibias were collected 42 days after surgery and subjected to three-point bending test on a material testing machine (MTM) until fracture occurred. Data was automatically recorded on the MTM formed the load-deformation curve. RESULTS: Mann-Whitney test showed that LLLT with 11.6 J/cm(2) significantly increased bending stiffness and maximum force in diabetic rats compared with group 1 (both p = 0.041). CONCLUSION: LLLT in an experimental diabetic model enhanced bone repair with a higher bending stiffness and maximum force compared to the control group.
Photomed Laser Surg 2009 Aug 27(4) 641-6
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Effect of biostimulation on wound healing in diabetic rats.
Gungormus M, Akyol UK
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ataturk University, Erzurum, Turkey. gungormusm@yahoo.com
BACKGROUND AND OBJECTIVE: Impaired wound healing is a complication of diabetes and is a serious problem in clinical practice. The purpose of this study was to evaluate the effect of biostimulation on wound healing in diabetic rats. MATERIAL AND METHODS: Thirty-six female Wistar rats weighting 250 to 300 g were used for this study. Diabetes was chemically induced with streptozotocin. Eighteen nondiabetic and 18 diabetic rats were included in the analysis. One incision was performed on the dorsum of each nondiabetic rat and the wound served as a control. Two parallel incisions were performed on the dorsum of each diabetic rat. The laser treatments were started immediately after surgery and were repeated on the second, fourth, sixth, and eighth days. A GaAlAs laser was used with an 808 nm wavelength. One wound of each diabetic rat received 10 J/cm(2) laser stimulation. RESULTS: Inflammation and re-epithelialization were evaluated in all groups, and there was a significant difference between the nondiabetic scalpel, diabetic scalpel, and diabetic scalpel + biostimulation groups. CONCLUSIONS: Treatment with laser biostimulation showed a beneficial effect on wound healing in diabetic rats. It can be concluded that low-level laser therapy (808 nm laser at 10 J/cm(2)) can have a beneficial effect on diabetic wound healing, when used at 2 d intervals over 5 d.
Photomed Laser Surg 2009 Aug 27(4) 607-10
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Laser phototherapy in dentistry.
Junior AB
Photomed Laser Surg 2009 Aug 27(4) 533-4
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A single point acupuncture treatment at large intestine meridian: a randomized controlled trial in acute tonsillitis and pharyngitis.
Fleckenstein J, Lill C, Ludtke R, Gleditsch J, Rasp G, Irnich D
Multidisciplinary Pain Center, Department of Anesthesiology, University of Munich, Pettenkoferstr 8A, 80336 Munchen, Germany.
OBJECTIVES: One out of 4 patients visiting a general practitioner reports of a sore throat associated with pain on swallowing. This study was established to examine the immediate pain alleviating effect of a single point acupuncture treatment applied to the large intestine meridian of patients with sore throat. PATIENTS AND METHODS: Sixty patients with acute tonsillitis and pharyngitis were enrolled in this randomized placebo-controlled trial. They either received acupuncture, or sham laser acupuncture, directed to the large intestine meridian section between acupuncture points LI 8 and LI 10. The main outcome measure was the change of pain intensity on swallowing a sip of water evaluated by a visual analog scale 15 minutes after treatment. A credibility assessment regarding the respective treatment was performed. RESULTS: The pain intensity for the acupuncture group before and immediately after therapy was 5.6+/-2.8 and 3.0+/-3.0, and for the sham group 5.6+/-2.5 and 3.8+/-2.5, respectively. Despite the articulation of a more pronounced improvement among the acupuncture group, there was no significant difference between groups (Delta=0.9, confidence interval: -0.2-2.0; P=0.12; analysis of covariance). Patients’ satisfaction was high in both treatment groups. The study was prematurely terminated due to a subsequent lack of suitable patients. DISCUSSION: A single acupuncture treatment applied to a selected area of the large intestine meridian was no more effective in the alleviation of pain associated with clinical sore throat than sham laser acupuncture applied to the same area. Hence, clinically relevant improvement could be achieved. Pain alleviation might partly be due to the intense palpation of the large intestine meridian. The benefit of a comprehensive acupuncture treatment protocol in this condition should be subject to further trials.
Clin J Pain 2009 Sep 25(7) 624-31
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Acupuncture in acute herpes zoster pain therapy (ACUZoster) – design and protocol of a randomised controlled trial.
Fleckenstein J, Kramer S, Hoffrogge P, Thoma S, Lang PM, Lehmeyer L, Schober GM, Pfab F, Ring J, Weisenseel P, Schotten KJ, Mansmann U, Irnich D
Multidisciplinary Pain Centre, Department of Anaesthesiology, University of Munich, Munich, Germany. johannes.fleckenstein@med.uni-muenchen.de
BACKGROUND: Acute herpes zoster is a prevalent condition. One of its major symptoms is pain, which can highly influence patient’s quality of life. Pain therapy is limited. Acupuncture is supposed to soften neuropathic pain conditions and might therefore act as a therapeutic alternative. Objective of the present study is to investigate whether a 4 week semi-standardised acupuncture is non-inferior to sham laser acupuncture and the anticonvulsive drug gabapentine in the treatment of pain associated with herpes zoster. METHODS/DESIGN: Three-armed, randomised, placebo-controlled trial with a total follow-up time of 6 months. Up to estimated 336 patients (interim analyses) with acute herpes zoster pain (VAS > 30 mm) will be randomised to one of three groups (a) semi-standardised acupuncture (168 patients); (b) gabapentine with individualised dosage between 900-3600 mg/d (84 patients); (c) sham laser acupuncture. Intervention takes place over 4 weeks, all patients will receive analgesic therapy (non-opioid analgesics: metamizol or paracetamol and opioids: tramadol or morphine). Therapy phase includes 4 weeks in which group (a) and (c) consist of 12 sessions per patient, (b) visits depend on patients needs. Main outcome measure is to assess the alteration of pain intensity before and 1 week after treatment sessions (visual analogue scale VAS 0-100 mm). Secondary outcome measure are: alteration of pain intensity and frequency of pain attacks; alteration of different aspects of pain evaluated by standardised pain questionnaires (NPI, PDI, SES); effects on quality of life (SF 36); analgesic demand; alteration of sensoric perception by systematic quantitative sensory testing (QST); incidence of postherpetic neuralgia; side effects and cost effectiveness. Credibility of treatments will be assessed. DISCUSSION: This study is the first large-scale randomised placebo controlled trial to evaluate the efficacy of acupuncture compared to gabapentine and sham treatment and will provide valuable new information about the clinical and physiological effects of acupuncture and gabapentine in the treatment of acute herpes zoster pain. The study has been pragmatically designed to ensure that the study findings can be implemented into clinical practice if acupuncture can be shown to be an effective treatment strategy in acute herpes zoster pain. TRIAL REGISTRATION: NCT00885586.
BMC Complement Altern Med 2009 9 31
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[Effect of intravenous laser blood irradiation on endothelial dysfunction in patients with hypertensive disease]
The aim of this work was to study effect of intravenous laser blood irradiation (ILBI) on endothelial dysfunction in 120 patients (mean age 53.4 +/- 1.3 yr) with grade I-II hypertensive disease (HD) allocated to 2 groups. Traditional drug therapy given to patients of control group was supplemented by ILBI using a Mulat laser therapy device in the study group. Endothelial function was evaluated from the total plasma concentration of stable NOx metabolites, nitrates (NO3-), nitrites (NO2-), and Willebrand’s factor. HD patients were found to have elevated activity of the Willebrand factor and show 3 types of response of the NO generating system: (1) decreased NO synthesis, (2) lack of its changes, and (3) increased NO synthesis. NO production in HD patients negatively correlated with systolic (r = -0.59) and diastolic (r = – 0.64) arterial pressure (AP) which suggests the relationship between decreased NO production and elevated AP. Inclusion of ILBl in the therapy of HD resulted in a significant decrease of Willebrand’s factor activity and normalization of the NO level regardless of its initial value.
Klin Med (Mosk) 2009 87(6) 22-5
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Effect of laser phototherapy on recurring herpes labialis prevention: an in vivo study.
de Carvalho RR, de Paula Eduardo F, Ramalho KM, Antunes JL, Bezinelli LM, de Magalhaes MH, Pegoretti T, de Freitas PM, de Paula Eduardo C
Special Laboratory of Lasers in Dentistry, Department of Restorative Dentistry, School of Dentistry, University of Sao Paulo, Sao Paulo, SP, Brazil.
Alternative treatment for recurrent labial infection by herpes simplex virus (HSV) have been considered. The aim of this study was to evaluate the effectiveness of laser phototherapy in prevention and reduction of severity of labial manifestations of herpes labialis virus. Seventy-one patients, divided into experimental (n = 41) and control (n = 30) groups were followed up for 16 months. Patients in the control group were treated topically with aciclovir and patients in the experimental group were subjected to laser phototherapy (one session per week, 10 weeks): 780 nm, 60 mW, 3.0 J/cm(2) or 4.5 J/cm(2) on healthy (no HSV-1 infection) and affected (with HSV-1 infection) tissues. Patients in the experimental group presented a significant decrease in dimension of herpes labialis lesions (P = 0.013) and inflammatory edema (P = 0.031). The reduction in pain level (P = 0.051) and monthly recurrences (P = 0.076) did not reach statistical significance. This study represents an in vivo indication that this treatment should be further considered as an effective alternative to therapeutic regimens for herpes labialis lesions.
Lasers Med Sci 2009 Aug 11
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[Phototherapy (LEDs 660/890nm) in the treatment of leg ulcers in diabetic patients: case study]
Minatel DG, Enwemeka CS, Franca SC, Frade MA
Fisioterapeuta, Doutora em Biotecnologia pela Universidade Federal do Amazonas (UFAM), Manaus (AM), Brazil.
This study evaluated the use of phototherapy in the healing of mixed leg ulcers in two diabetic patients (type 2) with arterial hypertension. The device had probe 1 (one 660 nm LED, 5 mW) applied in 3 ulcers and probe 2 (32 890 nm LEDs associated with 4 660 nm LEDs, 500 mW) in 6 ulcers. After asepsis, ulcers were treated with probes to 3 J/cm2, 30 sec per point, twice a week, followed by topical daily dressing with 1% silver sulphadiazine during 12 weeks. The following analyses of ulcers with software Image J showed that probe 2 presented mean healing rates of 0.6; 0.7 and 0.9, whereas probe 1 had 0.2; 0.4 and 0.6 at 30, 60 and 90 days, respectively. Phototherapy accelerated wound healing of leg ulcers in diabetic patients.
An Bras Dermatol 2009 Jul 84(3) 279-83
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Effect of laser acupoint treatment on blood pressure and body weight-a pilot study.
Zhang J, Marquina N, Oxinos G, Sau A, Ng D
Associate Director of Research, Research Department, Logan College of Chiropractic, Chesterfield, MO.
OBJECTIVE: This study reports on the effects of laser acupuncture on blood pressure, body weight, and heart rate variability by stimulating acupuncture points and meridians on college students and faculty members. METHODS: Forty-five students and faculty members from a chiropractic college were recruited in the study. All subjects signed a written informed consent before their participation in the study. This study was a randomized controlled pilot study with subjects divided into control and experimental groups. The control group received a sham low-level laser therapy treatment with no power output to the laser during their “treatment.” The experimental group was treated with an activated laser. The acupuncture points used in this study were LI 4 and LI 11 for body weight and blood pressure. The treatment groups received 16 J of laser energy output for a total treatment time of 8 minutes (4 minutes for each of the 2 points). RESULTS: After using the laser treatment for 90 days (at least 12 treatments per subject), both the systolic and diastolic blood pressures decreased significantly (P < .01). The mean systolic blood pressure was 129.6 +/- 14.7 mm Hg before the treatment and was reduced to 122.5 +/- 17.2 mm Hg (P < .001). The mean diastolic blood pressure was 85.6 +/- 8.0 mm Hg before treatment and was reduced to 77.2 +/- 8.7 mm Hg (P < .001). Subject’s body weight was reduced in the active acupoint group, but the weight reduction did not reach a significant level. There were no significant changes in the heart rate variability. CONCLUSION: It was concluded that low-level laser treatment of acupoint resulted in lower blood pressure by stimulating the LI 11 and LI 4. No significant difference was observed in both the body weight and heart rate variability after the laser acupoint treatment.
J Chiropr Med 2008 Dec 7(4) 134-9
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