THOR Photobiomodulation Therapy Products & Training

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)
Infrared laser light
Laser Acupuncture
Laser Biostimulation
Laser Irradiation
Laser Phototherapy
Laser Therapy
LED phototherapy
LED therapy
LELT (Low Energy Laser Therapy)
LEPT (Low Energy Photon Therapy)
Light Therapy
light-emitting diode phototherapy
LILT (Low Intensity Laser Therapy)
LLLT (Low level Laser Therapy)
low fluence diode laser irradiation
low level light treatment
Low Light Laser Therapy
Low Power Laser Irradiation
Low Power Laser Therapy
Low Reactive Level Laser Therapy
lower-level laser therapy
Mid Laser Therapy
Moderate intensity light ( MIL)
Monochromatic Infra Red Energy
Monochromatic Infrared Photo Energy
Monochromatic Light Therapy
Monochromatic phototherapy
near-infrared light therapy
NIR laser therapy
nonablative laser therapy
PBM (Photobiomodulation)
Photo Irradiation
Photobioactivation
Photobiomodulation
Photobiostimulation
Photomedicine
Photon Therapy
Photoradiation
Photostimulation
Phototherapy
Physiotherapy Laser
Polarised Polychromatic Light
Polarised Radiation
Red light phototherapy
Soft Laser Therapy
Therapeutic Laser
Medium-level laser therapy

It is also common for laser wavelength and / or lasing medium to be added to the title . common examples are 810nm laser diode therapy for xyz. In case you are not familiar with the common wavelengths and materials used they are: 660nm 810nm 830nm 904nm

Full list as follows: 590nm 632.8 650nm 635nm 660nm 670nm 680nm 750nm 780nm 705nm 908nm 810nm 820nm 830nm 850nm 870nm 880nm 890nm 904nm 905nm 950nm 940nm 970nm 980nm 1064nm

Materials: GaAlAs, Gallium Aluminium Arsenide, GaAs, Gallium Arsenide, HeNe, Helium Neon, AlGaInP, Aluminium Gallium Indium Phosphide,

Some class IV surgical lasers are being detuned down to LLLT intensities (defused beam) so you will find other materials and wavelengths appearing CO2 and NdYag 940nm 970nm 980nm 1064nm

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

Continue reading →

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 but if LLLT appears to be effective sometimes and not others then you have to stratify the data in the way that others have done to discover that there may dose, dose rate (irradiance/power density) or other irradiation dependent effects.

The WALT guidelines go some way towards helping the reviewers in this regard though there are gaps due to lack of data, and even then there are mistakes in the original papers which makes writing those guidelines hard too.

I will get around to preparing a blog post on my extended version of the WALT guidelines which attempt to fill in the gaps based on extrapolation and first principles.