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THOR on YouTubeThe Times newspaper (UK) feature on pain management gives LLLT a good mention.
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The Times newspaper (UK) feature on pain management gives LLLT a good mention
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on The Times newspaper (UK) feature on pain management gives LLLT a good mention
My Top Five LLLT wound healing papers
First an introduction to Low Level Light Therapy (LLLT) for wound healing.
Low Level Light Therapy (LLLT) improves tissue repair, reduces pain and inflammation wherever the beam is applied. Treatments take a few minutes and should be applied two or more times a week.
LLLT has been used for many years on sports injuries, arthritic joints, back and neck pain, and non-healing wounds such as venous ulcers diabetic foot ulcers and pressure sores as well as post chemotherapy and radiation ulcers (mucositis).
How LLLT works:
Mitochondria in stressed or ischemic tissues synthesise nitric oxide (NOmt) that binds to cytochrome c oxidase competitively displacing oxygen leading to oxidative stress and reduced ATP production.
Light of the correct wavelength when applied to wounds is absorbed by cytochrome c oxidase displacing NOmt thereby reducing oxidative stress and increasing ATP production.
A cascade of downstream metabolic effects have been shown to include increased Ca2+, secretion of growth factors, activation of enzymes & other secondary messengers.
Subsequent increases in cellular activity and mitosis has been shown in vitro and in vivo including neutrophils, macrophages, fibroblasts, mast cells, endothelial cells and keratinocytes.
Several small clinical trials have shown a significant reduction in healing time and pain in hard to heal wounds.
The use of low energy photon therapy (LEPT) in venous leg ulcers: a double-blind, placebo-controlled study.
Gupta AK, Filonenko N, Salansky N, Sauder DN
Department of Medicine, University of Toronto, Ontario, Canada
BACKGROUND: Venous ulcers are estimated to be present in 0.2 to 0.4% of the population. Although new therapies have significant promise, nonhealing ulcers still represent a significant problem. OBJECTIVE: To evaluate the efficacy of low energy photon therapy (LEPT) in the treatment of venous leg ulcers. METHODS: A placebo-controlled, double-blind study using low energy photon therapy was performed in nine patients with 12 venous ulcers. Treatment was given three times a week for 10 weeks, using two monochromatic optical sources. One source provided a wavelength (lambda) of 660 nm (red) while the second source delivered a wavelength of 880 nm (infrared). Two optical probes were used, one consisted of an array of 22 monochromatic sources, operating at a wavelength of 660 nm and covering an area 6 x 10 cm2. The second probe had seven infrared sources, operating at a wavelength of 880 nm and covering an area of 4 cm2. The above configuration of optical probes was selected to cover the majority of the ulcer area being treated. The patients who were randomized to placebo treatment received sham therapy from an identical-appearing light source from the same delivery system. RESULTS: Nine patients with 12 venous ulcers were randomized to receive LEPT or placebo therapy. At the conclusion of the study, the percentage of the initial ulcer area remaining unhealed in the LEPT and placebo groups was 24.4% and 84.7%, respectively (P = 0.0008). The decrease in ulcer area (compared to baseline) observed in the LEPT and placebo groups was 193.0 mm2 and 14.7 mm2, respectively (P = 0.0002). One patient dropped out of the study, complaining of lack of treatment efficacy; he was found to be randomized to the placebo group. There were no adverse effects. CONCLUSION: In this placebo-controlled, double-blind study LEPT was an effective modality for the treatment of venous leg ulcers.
Dermatol Surg. 1998 Dec 24(12) 1383-6
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9865208
Phototherapy Improves Healing of Chronic Venous Ulcers.
Caetano KS, Frade MA, Minatel DG, Santana LA, Enwemeka CS Department of Bioengineering, Faculty of Medicine, University of Sao Paulo, Ribeirao Preto, Brazil.
Abstract
Objective: We tested the hypothesis that LED phototherapy with combined 660-nm and 890-nm light will promote healing of venous ulcers that failed to respond to other forms of treatment. Background Data: A variety of dressings, growth factors, and adjunct therapies are used to treat venous ulcers, but none seems to yield satisfactory results. Materials and Methods: We used a randomized placebo-controlled double-blind study to compare a total of 20 patients divided with 32 chronic ulcers into three groups. In group 1 the ulcers were cleaned, dressed with 1% silver sulfadiazine (SDZ) cream, and treated with placebo phototherapy (< .03 J/cm(-3)) using a Dynatron Solaris 705((R)) phototherapy research device. In group 2 the ulcers were treated similarly but received real phototherapy (3 J/cm(-2)) instead of placebo. In group 3 (controls), the ulcers were simply cleaned and dressed with SDZ without phototherapy. The ulcers were evaluated with digital photography and computer image analysis over 90 d or until full healing was attained. Results: Ulcers treated with phototherapy healed significantly faster than controls when compared at day 30 (p < 0.01), day 60 (p < 0.05), and day 90 (p < 0.001), and similarly healed faster than the placebo-treated ulcers at days 30 and 90 (p < 0.01), but not at day 60. The beneficial effect of phototherapy was more pronounced when the confounding effect of small-sized ulcers was removed from the analysis. Medium- and large-sized ulcers healed significantly faster with treatment (>/=40% rate of healing per month) than placebo or control ulcers (p < 0.05). Conclusion: Phototherapy promotes healing of chronic venous ulcers, particularly large recalcitrant ulcers that do not respond to conventional treatment.
Photomed Laser Surg 2009 Jan 16
Phototherapy promotes healing of chronic diabetic leg ulcers that failed to respond to other therapies.
Minatel DG, Frade MA, Franca SC, Enwemeka CS Department of Biotechnology, University of Ribeirao Preto, Ribeirao Preto, Brazil.
OBJECTIVE: We tested the hypothesis that combined 660 and 890 nm LED phototherapy will promote healing of diabetic ulcers that failed to respond to other forms of treatment. RESEARCH DESIGN AND METHODS: A double-blind randomized placebo controlled design was used to study 23 diabetic leg ulcers in two groups of 14 patients. Group one ulcers were cleaned, dressed with 1% silver sulfadiazine cream and treated with “placebo” phototherapy (<1.0 J cm(-2)) twice per week, using a Dynatron Solaris 705(R) device. Group two ulcers were treated similarly but received 3 J cm(-2) dose. RESULTS: At each of 15, 30, 45, 60, 75, and 90 days of healing, mean ulcer granulation and healing rates were significantly higher for group two than the “placebo” group (P < 0.02). While “placebo” treated ulcers worsened during the initial 30 days, group two ulcers healed rapidly; achieving 56% more granulation and 79.2% faster healing by day 30, and maintaining similarly higher rates of granulation and healing over the “placebo” group all through. By day 90, 58.3% of group two ulcers had healed fully and 75% had achieved 90-100% healing. In contrast, only one “placebo” treated ulcer healed fully by day 90; no other ulcer attained > or =90% healing. CONCLUSION: Combined 660 and 890 nm light promotes rapid granulation and healing of diabetic ulcers that failed to respond to other forms of treatment.
Lasers Surg Med 2009 Aug 41(6) 433-41
Low-Level Laser Therapy Facilitates Superficial Wound Healing in Humans: A Triple-Blind, Sham-Controlled Study.
Hopkins JT, McLoda TA, Seegmiller JG, David Baxter G Brigham Young University, Provo, UT. OBJECTIVE:
Low-level laser therapy (LLLT) has been promoted for its beneficial effects on tissue healing and pain relief. However, according to the results of in vivo studies, the effectiveness of this modality varies. Our purpose was to assess the putative effects of LLLT on healing using an experimental wound model. DESIGN AND SETTING: We used a randomized, triple-blind, placebo-controlled design with 2 within-subjects factors (wound and time) and 1 between-subjects factor (group). Data were collected in the laboratory setting. SUBJECTS: Twenty-two healthy subjects (age = 21 +/- 1 years, height = 175.6 +/- 9.8 cm, mass = 76.2 +/- 14.2 kg). MEASUREMENTS: Two standardized 1.27-cm(2) abrasions were induced on the anterior forearm. After wound cleaning, standardized digital photos were recorded. Each subject then received LLLT (8 J/cm(2); treatment time = 2 minutes, 5 seconds; pulse rate = 700 Hz) to 1 of the 2 randomly chosen wounds from either a laser or a sham 46-diode cluster head. Subjects reported back to the laboratory on days 2 to 10 to be photographed and receive LLLT and on day 20 to be photographed. Data were analyzed for wound contraction (area), color changes (chromatic red), and luminance. RESULTS: A group x wound x time interaction was detected for area measurements. At days 6, 8, and 10, follow-up testing revealed that the laser group had smaller wounds than the sham group for both the treated and the untreated wounds (P < .05). No group x wound x time differences were detected for chromatic red or luminance. CONCLUSIONS: The LLLT resulted in enhanced healing as measured by wound contraction. The untreated wounds in subjects treated with LLLT contracted more than the wounds in the sham group, so LLLT may produce an indirect healing effect on surrounding tissues. These data indicate that LLLT is an effective modality to facilitate wound contraction of partial-thickness wounds.
J Athl Train 2004 Sep 39(3) 223-229
Posted in My top five research papers
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LLLT in the Lancet Top 20 Hit Parade
The paper by Roberta Chow, Mark Johnson, Rodrigo Lopes-Martins, Jan M Bjordal titled “Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials” (abstract here) reached number 17 in The Lancet top 20 most downloaded papers for 2010. The full top 20 list is here:
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Low Level Laser Therapy (LLLT) Literature Watch for July 2010
30 abstracts for you to review including: LLLT before eccentric exercise reduces muscle damage, LLLT reduces limb volume, increases shoulder mobility and grip strength in patients with postmastectomy lymphedema, and a case report on LLLT for ’extrusive luxation” (traumatic displaced teeth).
Low level laser therapy before eccentric exercise reduces muscle damage markers in humans.
Baroni BM, Leal Junior EC, De Marchi T, Lopes AL, Salvador M, Vaz MA
Exercise Research Laboratory (LAPEX), Federal University of Rio Grande do Sul (UFRGS), Rua Felizardo, 750-Bairro Jardim Botanico, Porto Alegre, RS, 90690-200, Brazil, bmbaroni@yahoo.com.br.
The purpose of the present study was to determine the effect of low level laser therapy (LLLT) treatment before knee extensor eccentric exercise on indirect markers of muscle damage. Thirty-six healthy men were randomized in LLLT group (n = 18) and placebo group (n = 18). After LLLT or placebo treatment, subjects performed 75 maximal knee extensors eccentric contractions (five sets of 15 repetitions; velocity = 60 degrees seg(-1); range of motion = 60 degrees ). Muscle soreness (visual analogue scale-VAS), lactate dehydrogenase (LDH) and creatine kinase (CK) levels were measured prior to exercise, and 24 and 48 h after exercise. Muscle function (maximal voluntary contraction-MVC) was measured before exercise, immediately after, and 24 and 48 h post-exercise. Groups had no difference on kineanthropometric characteristics and on eccentric exercise performance. They also presented similar baseline values of VAS (0.00 mm for LLLT and placebo groups), LDH (LLLT = 186 IU/l; placebo = 183 IU/l), CK (LLLT = 145 IU/l; placebo = 155 IU/l) and MVC (LLLT = 293 Nm; placebo = 284 Nm). VAS data did not show group by time interaction (P = 0.066). In the other outcomes, LLLT group presented (1) smaller increase on LDH values 48 h post-exercise (LLLT = 366 IU/l; placebo = 484 IU/l; P = 0.017); (2) smaller increase on CK values 24 h (LLLT = 272 IU/l; placebo = 498 IU/l; P = 0.020) and 48 h (LLLT = 436 IU/l; placebo = 1328 IU/l; P < 0.001) post-exercise; (3) smaller decrease on MVC immediately after exercise (LLLT = 189 Nm; placebo = 154 Nm; P = 0.011), and 24 h (LLLT = 249 Nm; placebo = 205 Nm; P = 0.004) and 48 h (LLLT = 267 Nm; placebo = 216 Nm; P = 0.001) post-exercise compared with the placebo group. In conclusion, LLLT treatment before eccentric exercise was effective in terms of attenuating the increase of muscle proteins in the blood serum and the decrease in muscle force.
Eur J Appl Physiol 2010 Jul 3
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Treatment of Post-Mastectomy Lymphedema with Laser Therapy: Double Blind Placebo Control Randomized Study.
Ahmed Omar MT, El Morsy AM, Abd-El-Gayed Ebid A
Faculty of Physical Therapy, Cairo, Egypt. Member of International Panel of Advisory Board for Indian Journal of Physiotherapy and Occupational Therapy.
BACKGROUND: In post-mastectomy patients, lymphedema has the potential to become a permanent progressive condition and become extremely resistant to treatment. Thus, it can results in function impairment and decrease quality of life. The aim of this study was to evaluate the effect of low level laser therapy (LLLT) on limb volume, shoulder mobility, and hand grip strength. MATERIAL AND METHODS: Fifty women with breast cancer-related lymphedema were enrolled in a double-blind, placebo controlled trial. Patients were randomly assigned to active laser (n = 25) and placebo (n = 25) groups and received irradiation with Ga-As laser device that had wavelength of 904 nm, power of 5 mW, and spot size of 0.2 cm(2) over the axillary and arm areas, three times a week for 12 wk. The total energy applied at each point was 300 mjoules over seven points, giving a dosage of 1.5 joules/cm(2) in the active group. The placebo group received placebo therapy in which the laser had been disabled without affecting its apparent function. Limb circumference, shoulder mobility, and grip strength were measured before treatment and at 4, 8, and 12 wk. RESULTS: The two groups had similar parameters at baseline. The reduction of limb volume tended to decline in both groups. The trend being more significantly pronounced in active LLLT group than placebo at 8 and 12 wk, respectively (P < 0.05). Goniometric data for shoulder mobility and hand grip strength were statistically significance for LLLT group than for placebo. CONCLUSION: Laser treatment was found to be effective in reducing the limb volume, increase shoulder mobility, and hand grip strength in approximately 93% of patients with postmastectomy lymphedema.
J Surg Res 2010 Apr 18
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Low-level laser therapy effects in traumatized permanent teeth with extrusive luxation in an orthodontic patient.
Gorur I, Orhan K, Can-Karabulut DC, Orhan AI, Ozturk A
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Ankara, Ankara, Turkey.
The aim of this case report was to present and evaluate the effect of low-level laser therapy on traumatized permanent teeth with extrusive luxation in an orthodontic patient. The treatment and follow-up evaluation of two orally luxated maxillary permanent central incisors in a 19-year-old man is described. Detailed anamnesis was taken, and extraoral, intraoral, radiographic examinations and electrical and thermal pulpal tests were performed to determine the type of the luxation and the further treatment protocol. Teeth were splinted with composite resin, and antibiotic therapy was prescribed. Low-level laser therapy was applied for 25 sessions. No root canal treatment was applied to the teeth. Continuation of the orthodontic treatment was restarted after 6 months. No sign of clinical or radiographic pathology was detected after 2 years from the end of the treatment. Teeth were identified healthy and sound without any root canal intervention. Treatments with low-level laser applications may be evaluated as noninvasive alternative treatment options in comparison with endodontic treatment for teeth with extrusive luxation more than 2 mm, especially for those who have orthodontic treatment needs.
Angle Orthod 2010 Sep 80(5) 968-74
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[Application of low-intensive laser irradiation in the treatment of perforative gastroduodenal ulcers]
Comparative analysis of results of surgical treatment, performed for perforative gastroduodenal ulcers in the patients, lacking H. pylori (control group) and owing this etiologic factor (main group), was conducted. Together with other conventional schemes of medicinal treatment in the early postoperative period a low-intensive irradiation of He-Ne laser was applied. Complete eradication of H. pylori was noted in 95.8% patients of the main group. In a late follow-up period (in 1-5 yrs observation terms) the frequency of recurrence, hemorrhage, pyloroduodenal stenosis and other surgical complications, occurring in the main group, was lesser than in a control one.
Klin Khir 2010 May (5) 15-7
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Lung tissue regeneration after induced injury in Runx3 KO mice.
Lee JM, Kwon HJ, Bae SC, Jung HS
Division in Anatomy and Developmental Biology, Department of Oral Biology, Research Center for Orofacial Hard Tissue Regeneration, Brain Korea 21 project, Oral Science Research Center, College of Dentistry, Yonsei Center of Biotechnology, Yonsei University, 250 Seongsanno, Seodaemoon-Gu, Seoul, 120-752, South Korea.
Runx3 is essential for normal murine lung development, and Runx3 knockout (KO) mice, which die soon after birth, exhibit alveolar hyperplasia. Wound healing, tissue repair, and regeneration mechanisms are necessary in humans for proper early lung development. Previous studies have reported that various signaling molecules, such as pErk, Tgf-ss1, CCSP, pJnk, Smad3, and HSP70 are closely related to wound healing. In order to confirm the relationship between lung defects caused by the loss of function of Runx3 and wound healing, we have localized various wound-healing markers after laser irradiation in wild-type and in Runx3 KO mouse lungs at post-natal day 1. Our results indicate that pERK, Tgf-beta1, CCSP, pJnk, and HSP70 are dramatically down-regulated by loss of Runx3 during lung wound healing. However, Smad3 is up-regulated in the Runx3 KO laser-irradiated lung region. Therefore, the lung wound-healing mechanism is inhibited in the Runx3 KO mouse, which shows abnormal lung architecture, by reduced pErk, Tgf-beta1, CCSP, pJnk, and HSP70 and by induced Smad3.
Cell Tissue Res 2010 Jul 11
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Photostimulation of Phox2b Medullary Neurons Activates Cardiorespiratory Function in Conscious Rats.
Kanbar R, Stornetta RL, Cash DR, Lewis SJ, Guyenet PG
Pharmacology, University of Virginia School of Medicine, Charlottesville, Virginia, United States.
RATIONALE: Hypoventilation is typically treated with positive pressure ventilation or, in extreme cases, by phrenic nerve stimulation. This preclinical study explores whether direct stimulation of central chemoreceptors could be used as an alternative method to stimulate breathing. OBJECTIVES: To determine whether activation of the retrotrapezoid nucleus (RTN) which is located in the rostral ventrolateral medulla (RVLM) stimulates breathing with appropriate selectivity. METHODS: A lentivirus was used to induce expression of the photoactivatable cationic channel channelrhodopsin-2 (ChR2) by RVLM Phox2b-containing neurons, a population that consists of central chemoreceptors (the ccRTN neurons) and blood-pressure regulating neurons (the C1 cells). The transfected neurons were activated with pulses of laser light. Respiratory effects were measured by plethysmography or diaphragmatic EMG recording and cardiovascular effects by monitoring blood pressure (BP), renal sympathetic nerve discharge (rSND) and the baroreflex. MEASUREMENTS AND MAIN RESULTS: The RVLM contained 600-900 ChR2-transfected neurons (63% C1, 37% ccRTN). RVLM photostimulation significantly increased breathing rate (+42 %), tidal volume (21%), minute volume (68%) and peak expiratory flow (48%). Photostimulation increased diaphragm EMG amplitude (19%) and frequency (21%). Photostimulation increased BP (4 mmHg) and rSND (43%) while decreasing heart rate (15 bpm). CONCLUSIONS: Photostimulation of ChR2-transfected RVLM Phox2b neurons produces a vigorous stimulation of breathing accompanied by a small sympathetically-mediated increase in BP. These results demonstrate that breathing can be relatively selectively activated in resting unanesthetized mammals via optogenetic manipulation of RVLM neurons presumed to be central chemoreceptors. This methodology could perhaps be used in the future to enhance respiration in man.
Am J Respir Crit Care Med 2010 Jul 9
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Emg analysis after laser acupuncture in patients with temporomandibular dysfunction (TMD). Implications for practice.
Hotta PT, Hotta TH, Bataglion C, Bataglion SA, de Souza Coronatto EA, Siessere S, Regalo SC
Ribeirao Preto Dental School/ Sao Paulo University, Ribeirao Preto, SP, Brazil.
The aim of this study was to analyze the effect of low level laser applied to acupuncture points of patients diagnosed with temporomandibular dysfunction (TMD). Ten patients aged between 20 and 50 years were clinically examined with regard to pain and dysfunction of the masticatory system. They received laser applications (GaAlAs diode laser, 780 nm wavelength; 70 mW power output, 35 j/cm(2)) in acupuncture specific points (Ig4, C3, E6, E7) once a week, for ten sessions. The range of jaw movement was registered after each session and visual analogue scale (VAS) was applied. Results were analyzed (SPSS-15.0-Chicago) during the comparison, before and after treatment. Statistical tests showed significant improvements (p < 0.01) in painful symptoms and electromyographic activities of masseter muscles in maximal habitual occlusion after laser applications but no significant improvements (p = 0.05) in measurements of mandibular movements. The laser therapy in specific acupuncture points promoted improvement of symptoms and it may be used as complementary therapy for TMD.
Complement Ther Clin Pract 2010 Aug 16(3) 158-160
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Characteristics of calcium signaling in astrocytes induced by photostimulation with femtosecond laser.
Zhao Y, Zhang Y, Zhou W, Liu X, Zeng S, Luo Q
Huazhong University of Science and Technology, Wuhan National Laboratory for Optoelectronics, Britton Chance Center for Biomedical Photonics, Wuhan 430074, China.
Astrocytes have been identified to actively contribute to brain functions through Ca(2+) signaling, serving as a bridge to communicate with neurons and other brain cells. However, conventional stimulation techniques are hard to apply to delicate investigations on astrocytes. Our group previously reported photostimulation with a femtosecond laser to evoke astrocytic calcium (Ca(2+)) waves, providing a noninvasive and efficient approach with highly precise targeting. In this work, detailed characteristics of astrocytic Ca(2+) signaling induced by photostimulation are presented. In a purified astrocytic culture, after the illumination of a femtosecond laser onto one cell, a Ca(2+) wave throughout the network with reduced speed is induced, and intracellular Ca(2+) oscillations are observed. The intercellular propagation is pharmacologically confirmed to be mainly mediated by ATP through P(2)Y receptors. Different patterns of Ca(2+) elevations with increased amplitude in the stimulated astrocyte are discovered by varying the femtosecond laser power, which is correspondingly followed by broader intercellular waves. These indicate that the strength of photogenerated Ca(2+) signaling in astrocytes has a positive relationship with the stimulating laser power. Therefore, distinct Ca(2+) signaling is feasibly available for specific studies on astrocytes by employing precisely controlled photostimulation.
J Biomed Opt 2010 May-Jun 15(3) 035001
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Biological effects of a semiconductor diode laser on human periodontal ligament fibroblasts.
Choi EJ, Yim JY, Koo KT, Seol YJ, Lee YM, Ku Y, Rhyu IC, Chung CP, Kim TI
Department of Periodontology and Dental Research Institute, Seoul National University College of Dentistry, Seoul, Korea.
PURPOSE: It has been reported that low-level semiconductor diode lasers could enhance the wound healing process. The periodontal ligament is crucial for maintaining the tooth and surrounding tissues in periodontal wound healing. While low-level semiconductor diode lasers have been used in low-level laser therapy, there have been few reports on their effects on periodontal ligament fibroblasts (PDLFs). We performed this study to investigate the biological effects of semiconductor diode lasers on human PDLFs. METHODS: Human PDLFs were cultured and irradiated with a gallium-aluminum-arsenate (GaAlAs) semiconductor diode laser of which the wavelength was 810 nm. The power output was fixed at 500 mW in the continuous wave mode with various energy fluencies, which were 1.97, 3.94, and 5.91 J/cm(2). A culture of PDLFs without laser irradiation was regarded as a control. Then, cells were additionally incubated in 72 hours for MTS assay and an alkaline phosphatase (ALPase) activity test. At 48 hours post-laser irradiation, western blot analysis was performed to determine extracellular signal-regulated kinase (ERK) activity. ANOVA was used to assess the significance level of the differences among groups (P<0.05). RESULTS: At all energy fluencies of laser irradiation, PDLFs proliferation gradually increased for 72 hours without any significant differences compared with the control over the entire period taken together. However, an increment of cell proliferation significantly greater than in the control occurred between 24 and 48 hours at laser irradiation settings of 1.97 and 3.94 J/cm(2) (P<0.05). The highest ALPase activity was found at 48 and 72 hours post-laser irradiation with 3.94 J/cm(2) energy fluency (P<0.05). The phosphorylated ERK level was more prominent at 3.94 J/cm(2) energy fluency than in the control. CONCLUSIONS: The present study demonstrated that the GaAlAs semiconductor diode laser promoted proliferation and differentiation of human PDLFs.
J Periodontal Implant Sci 2010 Jun 40(3) 105-10
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Review conclusion for low-level laser therapy in shoulder impingement syndrome appears to be sensitive to alternative interpretations of trial results.
Bjordal JM
J Rehabil Med 2010 Jul 42(7) 700-1; author reply 701-2
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Platelet Derived Growth Factor (PDGF) secretion and bone healing after Er: YAG laser bone irradiation.
Romanos G, Kesler G, Siman Tov Y, Romanos G, Kesler G, Kesler S, Kasler G, Kesler-Shrevo D, Siman Tov Y
a Eastman Institute for Oral Health, Rochester, NY, United States.
Abstract Background: Er:YAG laser irradiation has been reported to enhance wound healing. However, no studies have evaluated the synthesis of growth factors after laser irradiation. The present study investigated the effects of laser irradiation on the amount of secretion of PDGF in the wound, clarifying the effects of the Er:YAG laser on the bone healing.Methods: Osteotomies were prepared in the tibiae of 28 rats using an Er:YAG laser (test group). Maximum power of 8 watts, energy per pulse of 700 mJ, and frequency up to 50 Hz were used. The laser used with external water irrigation, a spot size of 2 mm, energy per pulse of 500 to 1,000 mJ/pulse and energy density of 32J/cm2. Twenty eight additional rats served as a control group and their osteotomies were prepared with a drill 1.3 mm in diameter at 1000 rpm, with simultaneous saline irrigation. Two rats from the tested group and 2 from the control group were sacrificed on each day following surgery (1-14 days) and the tissue specimens were prepared for histological evaluation. Immunohistochemical staining with anti-PDGF was performed after histological examination. The difference between the PDGF staining intensities of the two treatments groups was analyzed using a multivariate logistic regression test.Results: A significant rise in PDGF staining occurred in both groups 2-3 days following surgery. However, while high PDGF counts remained for the 2 weeks experimental period in the laser group, PDGF levels in the control group return to baseline levels 8 days post-surgery. The two groups (laser and control) were found to be different throughout the experiment, and the rat type was found to be significant predictor (p=0.000011).Conclusions: The present study demonstrated that Er:YAG laser irradiation seems to stimulate the secretion of PDGF in osteotomies sites in a rat model. It is possible that the high levels of PDGF are part of the mechanism that Er:YAG irradiation enhances and improves the healing of osteotomy sites.
J Oral Implantol 2010 Jun 16
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Low-level laser therapy of dentin hypersensitivity: a short-term clinical trial.
Orhan K, Aksoy U, Can-Karabulut DC, Kalender A
Department of Oral Diagnosis and Radiology, Faculty of Dentistry, University of Ankara, Ankara, Turkey, call53@yahoo.com.
The aim of this study was to evaluate low-level laser therapy in cervical dentin hypersensitivity. A randomized controlled clinical trial was conducted with a total of 64 teeth. Dentin desensitizer and diode laser were applied on the cervical dentin surfaces. Distilled water and placebo laser was used as the placebo groups. The irradiance used was 4 J/cm(2) per treatment site. The baseline measurement of hypersensitivity was made by using visual analog scale (VAS). Twenty-four hours and 7 days after the application of desensitizer, diode laser and placebo groups, a new VAS analysis was conducted for the patients’ sensitivity level. The mean pain scores of placebo groups were significantly higher than the desensitizer’s and diode laser’s mean scores (ANOVA, p < 0.05). The VAS analysis revealed a significant decrease in dentin hypersensitivity in 7 days with the use of the desensitizer and low-level laser therapy and no statistically significant difference was observed between these two treatments (p > 0.05). Although low-level laser and glutaraldehyde containing desensitizer present distinct modes of action, experimental agents caused a significant reduction of dentin hypersensitivity without showing secondary effects, not irritating the pulp or causing pain, not discoloring or staining the teeth, and not irritating the soft tissues at least for a period of 1 week with no drawbacks regarding handling and/or ease of application. Low-level laser therapy and desensitizer application had displayed similar effectiveness in reducing moderate dentin hypersensitivity.
Lasers Med Sci 2010 Jun 30
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Phototherapy for allergic rhinitis: a prospective, randomized, single-blind, placebo-controlled study.
Cingi C, Cakli H, Yaz A, Songu M, Bal C
Department of Otorhinolaryngology, Osmangazi University Medical Faculty, Eskisehir, Turkey.
BACKGROUND: Phototherapy has a profound immunosuppressive effect, and phototherapeutic methods using both ultraviolet (UV) and visible light are therefore widely used for the therapy of various inflammatory skin diseases. It is also proposed that phototherapy, using a combination of UV-A (25%), UV-B (5%) and visible light (70%), may represent a therapeutic alternative in patients with allergic rhinitis. METHOD: Seventy-nine patients were randomly assigned to receive either a combination of UV-A (25%), UV-B (5%) and visible light (70%), in the phototherapy group, or low-intensity visible light, in the control group. The efficacy of treatment was assessed by means of total nasal symptom score before treatment and 1 month after the end of treatment. RESULTS: Total nasal scores decreased in both groups but the decrease was highly significant in the active treatment group when compared with the placebo (p < 0.001). CONCLUSIONS: This study demonstrates that phototherapy may be an effective modality in the treatment of allergic rhinitis especially in cases of which commonly used drugs either are contraindicated and/or have insufficient efficacy.
Ther Adv Respir Dis 2010 Jun 29
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[The role of endogenous porphyrins in laser therapy of experimental skin wounds]
The role of endogenous porphyrins in the effect of laser irradiation on the superoxide dismutase (SOD) activity of wound exudate and rat leukocyte activity has been studied on models of aceptic incised skin wounds. Wounds were irradiated by a He-Ne laser (632.8 nm, 1.5 J/cm2) on the 2nd, 3rd, and 4th days after the beginning of the experiment. Irradiation effects were evaluated by the SOD activity (NBT test) and the activity of leukocytes of wound exudate (as a chemiluminescent response to opsonized zymosan). It was found that in animals subjected to laser irradiation, the SOD activity sharply increased. This effect depended on endogenous porphyrin concentration and was retained throughout the experiment. The SOD activity in unirradiated animals decreased from the 2nd to the 5th day of experiment. The evaluation of the activity of wound exudate leukocytes did not reveal any distrinct dependence of the effect on the concentration of endogenous porphyrins.
Biofizika 2010 May-Jun 55(3) 532-8
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Survivin mediates self-protection through ROS/cdc25c/CDK1 signaling pathway during tumor cell apoptosis induced by high fluence low-power laser irradiation.
Chu J, Wu S, Xing D
MOE Key Laboratory of Laser Life Science & Institute of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou 510631, China.
Survivin, an important member of inhibitor-of-apoptosis (IAP) family, can be up-regulated by various pro-apoptotic stimuli, such as UV, photodynamic therapy (PDT) and cisplatin. High fluence low-power laser irradiation (HF-LPLI) is a newly discovered pro-apoptotic stimulator. The anti-apoptotic mechanism of survivin during HF-LPLI-induced apoptosis is still not investigated. Here, we report that HF-LPLI up-regulates survivin activity through reactive oxygen species (ROS)/cdc25c protein phosphatase (cdc25c)/cyclin-dependent kinase (CDK1) signaling pathway in human lung adenocarcinoma cells (ASTC-a-1). The up-regulation of survivin activity can reduce HF-LPLI-induced apoptosis, while down-regulation of the activity can promote the apoptosis. In addition, activated survivin delays mitochondrial depolarization, cytochrome c release, caspase-9 and Bax activation, all of which are typical pro-apoptotic events of cell apoptosis induced by HF-LPLI. On the basis of the present studies, we conclude that survivin can mediate self-protection during tumor cell apoptosis caused by HF-LPLI.
Cancer Lett 2010 Jun 23
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Low-level laser therapy effects in traumatized permanent teeth with extrusive luxation in an orthodontic patient.
Gorur I, Orhan K, Can-Karabulut DC, Orhan AI, Ozturk A
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Ankara, Ankara, Turkey.
The aim of this case report was to present and evaluate the effect of low-level laser therapy on traumatized permanent teeth with extrusive luxation in an orthodontic patient. The treatment and follow-up evaluation of two orally luxated maxillary permanent central incisors in a 19-year-old man is described. Detailed anamnesis was taken, and extraoral, intraoral, radiographic examinations and electrical and thermal pulpal tests were performed to determine the type of the luxation and the further treatment protocol. Teeth were splinted with composite resin, and antibiotic therapy was prescribed. Low-level laser therapy was applied for 25 sessions. No root canal treatment was applied to the teeth. Continuation of the orthodontic treatment was restarted after 6 months. No sign of clinical or radiographic pathology was detected after 2 years from the end of the treatment. Teeth were identified healthy and sound without any root canal intervention. Treatments with low-level laser applications may be evaluated as noninvasive alternative treatment options in comparison with endodontic treatment for teeth with extrusive luxation more than 2 mm, especially for those who have orthodontic treatment needs.
Angle Orthod 2010 Sep 80(5) 968-74
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Interventions for pain during fixed orthodontic appliance therapy. A systematic review.
Xiaoting L, Yin T, Yangxi C
State Key Laboratory of Oral Disease and Department of Orthodontics, West China School of Dentistry, Sichuan University, Chengdu, China.
OBJECTIVE: To compare the different methods of pain control intervention during fixed orthodontic appliance therapy. MATERIALS AND METHODS: A computerized literature search was performed in MEDLINE (1966-2009), The Cochrane Library (Issue 4, 2009), EMBASE (1984-2009), and CNKI (1994-2009) to collect randomized controlled trials (RCTs) for pain reduction during orthodontic treatment. Data were independently extracted by two reviewers and a quality assessment was carried out. The Cochrane Collaboration’s RevMan5 software was used for data analysis. The Cochrane Oral Health Group’s statistical guidelines were followed. RESULTS: Twenty-six RCTs were identified and six trials including 388 subjects were included. Meta-analysis showed that ibuprofen had a pain control effect at 6 hours and at 24 hours after archwire placement compared with the placebo group. The standard mean difference was -0.47 and -0.48, respectively. There was no difference in pain control between ibuprofen, acetaminophen, and aspirin. Other analgesics such as tenoxicam and valdecoxib had relatively lower visual analog scale (VAS) scores in pain perception. Low-level laser therapy (LLLT) was also an effective approach for pain relief with VAS scores of 3.30 in the LLLT group and 7.25 in the control group. CONCLUSIONS: Analgesics are still the main treatment modality to reduce orthodontic pain despite their side effects. Some long-acting nonsteroidal anti-inflammatory drugs (NSAIDs) and cyclo-oxygenase enzyme (COX-2) inhibitors are recommended for their comparatively lesser side effects. Their preemptive use is promising. Other approaches such as LLLT have aroused researchers’ attention.
Angle Orthod 2010 Sep 80(5) 925-32
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Histological examination of experimentally infected root canals after preparation by Er:YAG laser irradiation.
Kimura Y, Tanabe M, Imai H, Amano Y, Masuda Y, Yamada Y
Division of Endodontics, Department of Conservative Dentistry, Ohu University School of Dentistry, 31-1 Misumido, Tomita-machi, Koriyama City, Fukushima, 963-8611, Japan, y-kimura@den.ohu-u.ac.jp.
The influence of Er:YAG laser irradiation on periodontal tissues along the root surface and apical region during root canal preparation was histologically evaluated using experimentally infected root canals of rats. Eighty experimentally mesial infected root canals of mandibular first molars in rats were divided into four groups. In three groups, root canals were irradiated using an Er:YAG laser at 2 Hz with 34, 68, or 102 mJ/pulse for 30 s. Non-irradiated canals served as controls. The influence of laser irradiation on periodontal tissues along the root surface and apical area was evaluated histologically under light microscopy at 0 (immediately after), 1, 2, 4, and 8 weeks after irradiation. At all periods, no inflammation or resorption on the root surfaces caused by laser irradiation was observed in any cases in the control or 34 mJ/pulse-irradiated groups. However, mild to severe inflammation with resorption of root surfaces was observed in some cases in the 68- and 102-mJ/pulse-irradiated groups. No significant difference was apparent between control and laser-irradiated groups at the apical area for all experimental periods (p > 0.05). These results suggest that thermal influences on periodontal tissues of experimentally infected root canals during root canal preparation by Er:YAG laser irradiation are minimal if appropriate parameters are selected. Er:YAG laser irradiation is thus a potential therapy for human infected root canals.
Lasers Med Sci 2010 Jun 24
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[Preventive measures with low-intensity laser for workers exposed to physical exertion]
Studies covered 168 personal computer users, 98 jewelry female polishers, 64 assemblers of metallic ship frameworks. Various doses of laser rays in accordance with work conditions appeared effective for improving upper limbs microcirculation. The suggested method is based on effects of low-intensity laser irradiation.
Med Tr Prom Ekol 2010 (4) 33-6
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Quantification of fibrosis and mast cells in the tissue response of endodontic sealer irradiated by low-level laser therapy.
Berbert FL, Sivieri-Araujo G, Ramalho LT, Pereira SA, Rodrigues DB, de Araujo MS
Department of Restorative Dentistry, Discipline of Endodontics, Dental School of Araraquara, Sao Paulo State University-UNESP, Rua Humaita, 1680, PO 331, CEP 14.801-903, Araraquara, SP, Brazil.
Low-level laser therapy (LLLT) accelerates tissue repair. Mast cells induce the proliferation of fibroblasts and the development of local fibrosis. The objective of this study was to quantify fibrosis rate and mast cells in connective tissue after endodontic sealer zinc oxide and eugenol (ZOE) was implanted and submitted to LLLT, immediately after implant and again 24 h later. Sixty mice were distributed into three groups: GI, GII, and GIII (n = 20). In GI, the tubes filled with Endofill were implanted in the animals and were not irradiated with LLLT. In GII, the tubes containing Endofill were implanted in the animals and then irradiated with red LLLT (InGaAIP) 685-nm wavelength, D = 72 J/Cm(2), E = 2 J, T = 58 s, P = 35 mW, and in GIII, the tubes with Endofill were implanted and irradiated with infrared LLLT (AsGaAl) 830-nm wavelength, D = 70 J/Cm(2), E = 2 J, T = 40 s, P = 50 mW. After 7 days and 30 days, the animals were killed. A series of 6-microm-thick sections were obtained and stained with Toluidine Blue and Picrosirius and analyzed under a standard light microscope using a polarized light filter for the quantification of fibrosis. The statistics were qualitative and quantitative with a significance of 5%. The irradiation with LLLT did not offer improvement in the fibrosis rate, however, it provided a significant decrease in the concentration of independent mast cells for the period studied.
Lasers Med Sci 2010 Jun 12
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Photomedicine and LLLT literature watch.
Carroll JD
Photomed Laser Surg 2010 Jun 28(3) 445-6
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Activity-dependent relocation of the axon initial segment fine-tunes neuronal excitability.
Grubb MS, Burrone J
MRC Centre for Developmental Neurobiology, King’s College London, 4th Floor, New Hunt’s House, Guy’s Campus, London SE1 1UL, UK. matthew.grubb@kcl.ac.uk
In neurons, the axon initial segment (AIS) is a specialized region near the start of the axon that is the site of action potential initiation. The precise location of the AIS varies across and within different neuronal types, and has been linked to cells’ information-processing capabilities; however, the factors determining AIS position in individual neurons remain unknown. Here we show that changes in electrical activity can alter the location of the AIS. In dissociated hippocampal cultures, chronic depolarization with high extracellular potassium moves multiple components of the AIS, including voltage-gated sodium channels, up to 17 mum away from the soma of excitatory neurons. This movement reverses when neurons are returned to non-depolarized conditions, and depends on the activation of T- and/or L-type voltage-gated calcium channels. The AIS also moved distally when we combined long-term LED (light-emitting diode) photostimulation with sparse neuronal expression of the light-activated cation channel channelrhodopsin-2; here, burst patterning of activity was successful where regular stimulation at the same frequency failed. Furthermore, changes in AIS position correlate with alterations in current thresholds for action potential spiking. Our results show that neurons can regulate the position of an entire subcellular structure according to their ongoing levels and patterns of electrical activity. This novel form of activity-dependent plasticity may fine-tune neuronal excitability during development.
Nature 2010 Jun 24 465(7301) 1070-4
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Adjunctive Nd:YAG laser application in chronic periodontitis: clinical, immunological, and microbiological aspects.
Gomez C, Dominguez A, Garcia-Kass AI, Garcia-Nunez JA
Departamento de Quimica Laser. Instituto de Quimica Fisica “Rocasolano”, Consejo Superior de Investigaciones Cientificas, CSiC C/ Serrano 119, 2806, Madrid, Spain, c.gomez@iqfr.csic.es.
In recent years, the use of laser radiation has been investigated as an alternative or adjunctive tool to conventional procedures employed in the treatment of periodontal disease. Various beneficial characteristics of Nd:YAG laser radiation, such as hemostatic and bactericidal effects, might lead to improved treatment outcomes. The objective of the present study was to examine the clinical, microbiological, and anti-inflammatory efficacy of Nd:YAG laser periodontal pocket irradiation as an adjunct to scaling and root planing (SRP). Thirty patients with chronic periodontitis (CP) were randomly assigned in parallel groups to receive SRP alone or SRP followed by Nd:YAG laser (lambda = 1,064 nm) (SRP+NDL). Probing pocket depth (PPD), bleeding on probing (BOP), and plaque index (PI) were recorded, and samples of gingival crevicular fluid (GCF) and subgingival microbiota were taken at baseline and post-therapy (4 and 8 weeks after treatment). The laser therapy was performed 1 day after the SRP procedure. The GCF samples were analyzed for interleukin-1beta (IL-1beta), tumor necrosis factor alpha (TNF-alpha), and total antioxidative status (TAS). Microbiological samples were cultured and analyzed for ten bacteria. No statistically significant differences were detected for clinical or microbiological variables between SRP and SRP+NDL treatments. However, levels of IL-1 beta in GCF were significantly lower after SRP+NDL treatment when compared to IL-1 beta levels obtained by SRP alone after 4 weeks of treatment. Levels of TNF-alpha were significantly lower after the SRP+NDL treatment during post-therapy. TAS of GCF increased during post-therapy after the SRP+NDL treatment. However, after SRP alone, it remained constant. In this short-term clinical study Nd:YAG laser radiation in the treatment of CP is showed to be a potential adjunct to conventional SRP.
Lasers Med Sci 2010 Jun 10
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Low-level laser therapy for hand arthritis-fact or fiction?
Tuner J, Hode L
Swedish Laser Medical Society, Spjutvagen 9, 77232, Grangesberg, Sweden, jan.tuner@swipnet.se.
Clin Rheumatol 2010 Jun 8
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Comparative study of the effects of low-intensity pulsed ultrasound and low-level laser therapy on bone defects in tibias of rats.
Favaro-Pipi E, Feitosa SM, Ribeiro DA, Bossini P, Oliveira P, Parizotto NA, Renno AC
Department of Physiotherapy, Federal University of Sao Carlos, Rodovia Washington Luis (SP-310), Km 235, Sao Carlos, SP, Brazil.
The aim of this study was to investigate and to compare the effects of low intensity ultra-sound (LIPUS) and low-level laser therapy (LLLT) during the process of bone healing by means of histopathological and morphometric analysis. The animals were randomly distributed into three groups of 30 animals each: the control group (bone defect without treatment); the laser-treated group: (bone defect treated with laser), and the LIPUS-treated (bone defect treated with ultrasound). Each group was further divided into three different subgroups (n = 10) and on days 7, 13, and 25 post-injury, rats were killed with an intra-peritoneal injection of general anesthetic. The rats were treated with a 30-mW/cm(2) low-intensity pulsed ultrasound and a 830-nm laser at 50 J/cm(2). The results showed intense new bone formation surrounded by highly vascularized connective tissue presenting a slight osteogenic activity, with primary bone deposition being observed in the group exposed to laser in the intermediary (13 days) and late stages of repair (25 days). This was confirmed by morphometric analysis in which significant statistical differences (p < 0.05) were noticed when compared to the control. No remarkable differences were noticed in the specimens treated with ultrasound with regard to the amount of newly formed bone in comparison to the control group. Taken together, our results indicate that laser therapy improves bone repair in rats as depicted by histopathological and morphometric analysis, mainly at the late stages of recovery. Moreover, it seems that this therapy was more effective than US to accelerate bone healing.
Lasers Med Sci 2010 Jun 3
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Evaluation of a noninvasive, dual-wavelength laser-suction and massage device for the regional treatment of cellulite.
Kulick MI
kulickmd@pacbell.net
BACKGROUND: Cellulite is a condition usually limited to women. The most common location for this surface irregularity is the thigh. Evaluation of treatment efficacy is difficult because of the reliance on patient satisfaction surveys and flash photography, which can “flatten” surface texture. Reproducibility of photographs is also difficult, as subtle changes in body position can affect appearance. METHODS: Twenty women with mild to moderate cellulite of their lateral thighs were enrolled. Pretreatment and posttreatment assessment included patient weight, body mass index, percentage body fat, standard digital photographs, VECTRA three-dimensional images, and patient questionnaire. Patients received two treatments per week for 4 weeks. Treatment time was 15 minutes per thigh using the SmoothShapes device. Patients were evaluated 1, 3, and 6 months after their last treatment. To be considered improved after treatment, both thighs needed clear improvement in contour as determined by the “untextured” images obtained with the VECTRA camera system. This device depicts skin contour independent of incident lighting. RESULTS: There were no complications. Seventeen patients had complete data for analysis. Ninety-four percent of the patients felt their cellulite was improved. VECTRA analysis showed 82 percent improvement at 1 month, 76 percent improvement at 3 months, and 76 percent improvement at 6 months. Initial cellulite irregularities and improvement were more difficult to discern using standard digital photographs. There was an average increase in patient weight, body mass index, and percentage body fat at 6 months. CONCLUSION: The SmoothShapes device provided improvement in surface contour (cellulite) 6 months after the last treatment in the majority of the patients based on patient survey and VECTRA analysis.
Plast Reconstr Surg 2010 Jun 125(6) 1788-96
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Immediate effects of acupuncture on strength performance: a randomized, controlled crossover trial.
Hubscher M, Vogt L, Ziebart T, Banzer W
Department of Sports Medicine, Goethe-University Frankfurt, Ginnheimer Landstrasse 39, 60487, Frankfurt, Germany, m.huebscher@sport.uni-frankfurt.de.
The present study investigated the immediate efficacy of acupuncture compared to sham acupuncture and placebo laser acupuncture on strength performance. A total of 33 recreational athletes (25.2 +/- 2.8 years; 13 women) were randomized to receive acupuncture, sham acupuncture (needling at non-acupuncture points) and placebo laser acupuncture (deactivated laser device) in a double-blind crossover fashion with 1 week between trials. Assessment included bipedal drop jumps for maximum rebound height and quadriceps maximum isometric voluntary force (MIVF). Furthermore, surface electromyography (EMG) was used to measure the EMG activity of the rectus femoris muscle during a 30-s sustained MIVF of the knee extensors. Mean power frequency (MPF) analysis was applied to characterize muscular endurance. Measurements were performed at baseline and immediately after treatment by a blinded investigator. Repeated measures ANOVA and post hoc paired-sample t test with Bonferroni-Holm correction were used for statistical analysis. The difference in the mean change in MIVF from baseline between acupuncture (46.6 N) and sham laser acupuncture (19.6 N) was statistically significant (p < 0.05), but no significant difference was found between acupuncture (46.6 N) and sham acupuncture (28.8 N). ANOVA did not show statistically significant treatment effects for drop jump height or MPF. The present study shows that a single acupuncture treatment was efficacious for improving isometric quadriceps strength in recreational athletes. These results might have implications not only for athletic performance enhancement, but also for rehabilitation programs aimed at restoring neuromuscular function.
Eur J Appl Physiol 2010 May 25
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[The laser chromoendoscopy eradication of Helicobacter pylori]
Pavlov ON, Aleksandrov IuK
35 patients with absence of positive dynamics after course of treatment of diseases associated with Helicobacter pylori infection and without achievement of eradication are surveyed. The original technique of Helicobacter pylori endoscopy eradication with use of the therapeutic laser in length of a wave of 660 nanometers is offered. Carrying out of rate laser chromoendoscopy eradication considerably reduces terms of healing of inflammatory-destructive changes of stomach and duodenum mucous membrane allows achieving of Helicobacter pylori eradication.
Eksp Klin Gastroenterol 2010 (2) 32-6
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Effects of equal daily doses delivered by different power densities of low-level laser therapy at 670 nm on open skin wound healing in normal and corticosteroid-treated rats: a brief report.
Lacjakova K, Bobrov N, Polakova M, Slezak M, Vidova M, Vasilenko T, Novotny M, Longauer F, Lenhardt L, Bober J, Levkut M, Sabol F, Gal P
Department of Medical Biophysics, Pavol Jozef Safarik University, 040 11, Kosice, Slovak Republic.
The optimal parameters for low-level laser therapy (LLLT) for wound healing are still open to discussion. Hence, our study was aimed at comparing the effects of different power densities of LLLT at 670 nm in rats. Four round full-thickness skin wounds were placed on the backs of 16 rats which were divided into two groups (non-steroid and steroid-treated). Three wounds were stimulated daily with a diode laser (daily dose 5 J/cm(2)) at different power densities (5, 15 and 40 mW/cm(2), respectively), and the fourth wound served as a control. Six days after surgery all animals were killed and samples removed for histological evaluation. Significant acceleration of fibroblast proliferation and new vessel formation was observed in wounds treated at the selected power densities. No significant differences were found in corticosteroid-treated rats. In conclusion, LLLT with the methodology used improved wound healing in non-steroid rats, but was not effective after corticosteroid-treatment.
Lasers Med Sci 2010 May 23
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Excitation of primary afferent neurons by near-infrared light in vitro.
Katz EJ, Ilev IK, Krauthamer V, Kim do H, Weinreich D
Food and Drug Administration, Center for Devices and Radiological Health, Silver Spring, Maryland 20993, USA. elizabeth.katz@fda.hhs.gov
Near-infrared light therapy is an emerging neurostimulation technology, but its cellular mechanism of action remains unresolved. Using standard intracellular recording techniques, we observed that 5-10 ms pulses of 1889 nm light depolarized the membrane potential for hundreds of milliseconds in more than 85% of dorsal root ganglion and nodose ganglion neurons tested. The laser-evoked depolarizations (LEDs) exhibited complex, multiphasic kinetics comprising fast and slow components. There was no discernable difference in the LEDs in intact ganglion neurons and in acutely isolated neurons. Thus, the LED sensor seems to reside within the neuronal membrane. The near-uniform distribution of responsive neurons increased membrane conductance, and the negative reversal potential value (-41+/-2.9 mV) suggests that LED is unrelated to the activation of heat-sensitive transient receptor potential cation channel subfamily V member 1 channels. The long duration of LEDs favors an involvement of second messengers.
Neuroreport 2010 Jun 23 21(9) 662-6
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Low level laser effects on pain to palpation and electromyographic activity in TMD patients: a double-blind, randomized, placebo-controlled study.
Venezian GC, da Silva MA, Mazzetto RG, Mazzetto MO
Department of Restorative Dentistry, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Brazil.
The purpose of this study was to evaluate the effect of diode laser (GaAIAs – 780 nm) on pain to palpation and electromyographic (EMG) activity of the masseter and anterior temporalis muscles. The laser was applied on the temporalis and masseter muscles twice a week (four weeks). Forty-eight (48) patients with myofascial pain were randomly assigned between actual and placebo treatments and between the energetic doses of 25 J/cm2 and 60 J/cm2, and were evaluated using VAS before, immediately after the final application, and 30 days after the laser treatment. Surface electromyography was performed with maximum dental clenching before and after laser therapy. The results show there were no significant statistical differences in the EMG activity between the groups before and after laser treatment. With regard to the pain at palpation, although both groups presented a significant difference in the symptoms before and after the treatment, only the active doses showed statistically significant reductions in pain level in all the regions of the palpated muscles. However, there was no significant statistical difference between groups (experimental and placebo). In conclusion, low level laser did not promote any changes in EMG activity. The treatment did, however, lessen the pain symptoms in the experimental groups.
Cranio 2010 Apr 28(2) 84-91
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Conservative interventions provide short-term relief for non-specific neck pain: a systematic review.
Leaver AM, Refshauge KM, Maher CG, McAuley JH
Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia. andrew.leaver@sydney.edu.au
QUESTION: Which interventions for non-specific neck pain are effective in reducing pain or disability? DESIGN: Systematic review with meta-analysis of randomised controlled trials. PARTICIPANTS: Adults with non-specific neck pain. INTERVENTION: All interventions for neck pain that were evaluated in trials with a placebo, minimal- or no-intervention control. OUTCOME MEASURES: Pain and disability outcomes (0-100 scale) at the conclusion of a course of treatment (short term), and in the medium (3 to 9 months) and long (> 9 months) term. RESULTS: 33 trials were identified. The interventions with significant short-term effects on pain were manipulation (MD -22, 95% CI -32 to -11), multimodal intervention (MD -21, 95% CI -34 to -7), specific exercise (MD -12, 95% CI -22 to -2), combination orphenadrine/paracetamol (MD -17, 95% CI -32 to -2), and manual therapy (MD -12, 95% CI -16 to -7). There was a significant short-term effect on disability for acupuncture (MD -8, 95% CI -13 to -2) and manual therapy (MD -6, 95% CI -11 to -2). Treatment with laser therapy resulted in better pain outcomes at medium-term follow-up but not at short-term follow-up. No other intervention demonstrated medium- or long-term effects. CONCLUSION: Some conservative interventions for neck pain are effective in the short term. Few interventions that have been investigated have shown longer term effects that are better than placebo or minimal intervention.
J Physiother 2010 56(2) 73-85
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Acne rosacea: effectiveness of 532 nm laser on the cosmetic appearance of the skin.
Maxwell EL, Ellis DA, Manis H
Art of Facial Surgery, Facial Plastic Reconstructive Surgery, Toronto, ON. lindamaxwell22@hotmail.com
OBJECTIVE: The aim of the study was to perform a prospective blinded trial to compare the improvement of midface acne rosacea using 532 nm laser therapy with and without a retinaldehyde-based topical application. SETTING: A private clinic and surgicentre specializing in facial plastic surgery. DESIGN: A prospective randomized blinded clinical trial. METHODS: Fourteen patients with type 1 erythematotelangiectatic acne rosacea were enrolled in the study. The side of the face to be treated was chosen randomly. The opposite side of the face served as the control. Patients underwent six treatments with the 532 nm laser, with four sets of photodocumentation over a period of 3 months. Following each treatment, patients were asked to rate their degree of improvement based on a 5-point improvement scale. A final assessment was performed by five separate blinded evaluators. MAIN OUTCOME MEASURES: Final photographic evaluation to assess (1) reduction in overall redness, (2) reduction in visible telangiectasia, (3) difference between left and right sides of the face, and (4) degree of overall skin texture improvement. RESULTS: Three men and eight women completed the study. Six right hemifaces and five left hemifaces were treated. One hundred percent of patients noted a mild to moderate improvement in all signs of type 1 acne rosacea, including overall redness of the face, telangiectasia, and skin texture. The blinded evaluators were able to note a difference between the treated and untreated sides 47% of the time. CONCLUSION: The 532 nm laser combined with the topical retinaldehyde improved overall redness, telangiectasia, and skin texture in acne rosacea patients. The degree of improvement was greater when compared to using the laser alone as the sole treatment modality.
J Otolaryngol Head Neck Surg 2010 Jun 39(3) 292-6
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Posted in Research
on Low Level Laser Therapy (LLLT) Literature Watch for July 2010
International Association for Study of Pain finds “strong evidence” for LLLT
A guidance document on myofascial pain syndrome (MPS) published on the International Association for Study of Pain web site finds “strong evidence” for Low Level Laser Therapy (LLLT). We have archived a copy here and you can find the original source here . Myofascial pain syndrome is often confused with fibromyalgia so it may be worth reading this blog to help understand the difference.
Posted in Research
on International Association for Study of Pain finds “strong evidence” for LLLT
BMJ systematic review finds “strong evidence” for LLLT on Frozen Shoulder
The BMJ sports medicine journal (BJSM) published a systematic review of conservative and surgical interventions and found “strong evidence for the effectiveness of laser therapy” adding to the rapidly expanding list of authoritative journals endorsing LLLT.
Br J Sports Med. 2010 Jul 20
Frozen shoulder: the effectiveness of conservative and surgical interventions–systematic review.
Favejee MM, Huisstede BM, Koes BW.
Department of Rehabilitation Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
Background A variety of therapeutic interventions is available for restoring motion and diminishing pain in patients with frozen shoulder. An overview article concerning the evidence for the effectiveness of these interventions is lacking. Objective To provide an evidence-based overview regarding the effectiveness of conservative and surgical interventions to treat the frozen shoulder. Methods The Cochrane Library, PubMed, Embase, Cinahl and Pedro were searched for relevant systematic reviews and randomised clinical trials (RCTs). Two reviewers independently selected relevant studies, assessed the methodological quality and extracted data. A best-evidence synthesis was used to summarise the results. Results Five Cochrane reviews and 18 RCTs were included studying the effectiveness of oral medication, injection therapy, physiotherapy, acupuncture, arthrographic distension and suprascapular nerve block (SSNB). Conclusions We found strong evidence for the effectiveness of steroid injections and laser therapy in short-term and moderate evidence for steroid injections in mid-term follow-up. Moderate evidence was found in favour of mobilisation techniques in the short and long term, for the effectiveness of arthrographic distension alone and as an addition to active physiotherapy in the short term, for the effectiveness of oral steroids compared with no treatment or placebo in the short term, and for the effectiveness of SSNB compared with acupuncture, placebo or steroid injections. For other commonly used interventions no or only limited evidence of effectiveness was found. Most of the included studies reported short-term results, whereas symptoms of frozen shoulder may last up to 4 years. High quality RCTs studying long-term results are clearly needed in this field.
Br J Sports Med. 2010 Jul 20. [Epub ahead of print]
APTA recommends LLLT for Achilles Tendinopathies
American Physical Therapy Association (APTA) Clinical Guidelines recommend Low Level Laser Therapy (LLLT) for Achilles tendinopathies. The report says “Clinicians should consider the use of low level laser therapy to decrease pain and stiffness in patients with Achilles tendinopathy.” Hooray, it’s only been 20 years since Chukuka Enwemeka first published his tendinopathy research. It is unfortunate that the guidelines neglected to comment on the importance of treatment parameters, they incorrectly describe energy as “intensity” and failed to mention Tumilty’s systematic review which found that 55% of LLLT tendinopathy studies failed due to incorrect power density and / or energy delivered.
You can download the APTA paper here APTA-Achilles-Tendinopathy-Guideline-USA-2010.pdf
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