NICE to see you

The good news is I received an invite from NICE to go see them.

NICE are the UK’s National Institute for Health and Clinical Excellence. Their guidance helps British health professionals deliver the optimal care based on the best available evidence. It seems they like what we do and want me go show them LLLT. Watch this space.  8-)

Posted in Industry | 7 Comments

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.

Posted in Rants, Research | on Class IV laser treatments take longer than 3B lasers

Protected: Class IV laser misinformation

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LLLT Q&A : “how it is possible to have higher power density than the applicator’s total power”

QUESTION FROM KOREA
Dear James

The THOR 810nm 1W laser cluster (5 × 200mW) has a 1/e2 power density of 5.96W/cm2. Just wondering how it is possible to have higher power density than the applicator’s total power

The formula is power/beam area

ILLUSTRATION
When you drive your car at 60 kph that is 60 kilometres per hour you don’t have to drive for one hour and you don’t have to drive for 60 kilometres.
e.g. You can drive at 60kph for one minute* and you will have travelled only 1 kilometre
*(1/60th of an hour)(or to put it another 1 minute = 0.01666 of an hour)

Math: 1 kilometre / 0.01666 hours = 60kph

LASER
Same for laser irradiance (power density)

If the laser was 5 Watts and if the beam area was 1cm2 then you would have 5W /cm2
but 5W/cm2 does not need a 5W laser (same as you don’t need to drive 60 kilometres or drive for one hour)

e.g. a 1W laser with a beam that is 0.2cm2 is also 5W/cm2
Maths: 1W / 0.2cm2 = 5W/cm2

ALSO

If a 200mW laser (0.2W) has a beam area of 0.4cm2 then that is also 5W/cm2

so on the THOR 1W laser cluster we have five beams of 200mW
each beam is approx 0.04cm2
so each beam is approx 5W/cm2

Posted in PBM/LLLT | on LLLT Q&A : “how it is possible to have higher power density than the applicator’s total power”

Protected: Class IV laser vs Class 3B laser vs LEDs

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LLLT for Multiple sclerosis (MS) : Nice work Jeri-Anne, Janis and Chukuka

Original article  from http://www.sciencecodex.com/light_as_medicine-121445

Multiple sclerosis (MS) causes progressive paralysis by destroying nerve cells and the spinal cord. It interrupts vision, balance and even thinking.

On a suggestion from a colleague, Jeri-Anne Lyons decided to test how the disease responded to a radical therapy – exposure to a certain wavelength of light called near-infrared (NIR). Continue reading

Posted in Special Feature | 1 Comment

THOR LLLT research, training and conference news September 2013

26 papers for you this month starting with a phase III trial of LLLT to prevent oral mucositis in 94 head and neck cancer patients receiving chemoradiation therapy, a controlled clinical trial on 64 diabetic leg ulcers with THOR LED cluster, a clinical trial on 60 patients with diabetic polyneuropathy, a muscle fatigue study, a rat study on acute joint inflammation which confirms that low irradiance (power density) is better than high (as usual) and that the target is the synovia (not the joint) and, finally, a pointless study on hearing loss with a 635nm laser. They used a green 532nm and a red 635nm laser each 7.5mW, applied to the ear, head, and neck for a total of 5 mins. I’m not sure why anyone would think that was going to work!
Continue reading

Posted in Research | on THOR LLLT research, training and conference news September 2013