THOR Literature watch for May 2013 Low Level Laser Therapy / Cold Laser / Photobiomodulation PBM

25 new LLLT papers for you this month including clinical trials on Bells palsy, orthodontic pain, herpes zoster ophthalmicus and orthognathic surgery. There are reviews on dentine hypersensitivity, muscle contractile function, postexercise recovery and infarct volume after stroke. Some interesting laboratory studies on bone marrow in mice, early vs delayed LLLT application on nerve regeneration, bone remodeling during induced tooth movement in rats and LED vs ultrasound for tendinitis.

Efficacy of high and low level laser therapy in the treatment of Bell’s palsy: A randomized double blind placebo-controlled trial.

Alayat MS, Elsodany AM, El Fiky AA

Department of Basic Science, Faculty of Physical Therapy, Cairo University, 7 Ahmed Elziat Street from Eltahrir Street, Cairo, Egypt, mohsalahpt@hotmail.com.

The aim of the present study was to investigate and compare the effects of high intensity laser therapy (HILT) and low level laser therapy (LLLT) on the treatment of patients with Bell’s palsy. Forty-eight patients participated in and completed this study. The mean age was 43 +/- 9.8 years. They were randomly assigned into three groups: HILT group, LLLT group, and exercise group. All patients were treated with facial massage and exercises, but the HILT and LLLT groups received the respective laser therapy. The grade of facial recovery was assessed by the facial disability scale (FDI) and the House-Brackmann scale (HBS). Evaluation was carried out 3 and 6 weeks after treatment for all patients. Laser treatments included eight points on the affected side of the face three times a week for 6 successive weeks. FDI and HBS were used to assess the grade of recovery. The scores of both FDI and HBS were taken before as well as 3 and 6 weeks after treatment. The Friedman test and Wilcoxon signed ranks test were used to compare the FDI and HBS scores within each group. The result showed that both HILT and LLLT significantly improved the recovery of patients with Bell’s palsy. Moreover, HILT was the most effective treatment modality compared to LLLT and massage with exercises. Thus, both HILT and LLLT are effective physical therapy modalities for the recovery of patients with Bell’s palsy, with HILT showing a slightly greater improvement than LLLT.

Lasers Med Sci 2013 May 26

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23709010

How does LLLT / cold laser therapy work? click here

How to calculate LLLT dose click here

Get yourself trained click here

The effect of diode superpulsed low-level laser therapy on experimental orthodontic pain caused by elastomeric separators: a randomized controlled clinical trial.

Marini I, Bartolucci ML, Bortolotti F, Innocenti G, Gatto MR, Alessandri Bonetti G

Department of Biomedical Sciences, Section of Orthodontics, University of Bologna, Italy, via san Vitale, 59 40125, Bologna, Italy.

The aim of this study was to evaluate the efficacy of diode superpulsed low-level laser therapy (SLLLT) in reducing experimentally induced orthodontic pain. Overall, 120 subjects (23.01 +/- 1.39 years) were enrolled for a clinical trial. Subjects were randomly assigned to upper (U, N = 60) or lower (L, N = 60) jaw groups. All subjects received 4 elastomeric separators mesial and distal to the upper (U group) or lower (L group) right first molar and bicuspids. Each subject of the U and L groups was randomly assigned to laser (Ul, N = 20 and Ll, N = 20), placebo (Up, N = 20 and Lp, N = 20) or control (Uc, N = 20 and Lc, N = 20) sub-groups. Subjects in laser groups received a single GaAs diode SLLLT application (910 nm, 160 mW, beam diameter of 8 mm, applied for 340 s) immediately after placing orthodontic separators. Placebo groups received a simulated SLLLT and controls did not receive any therapy. All participants compiled a survey on pain duration and a 100-mm visual analogue scale immediately after the separators placement and after 12, 24, 36, 48, 72, and 96 h. Pain intensity of laser groups was significantly lower compared to placebo and control groups (p = 0.0001). In the laser group, 70 % of subjects felt pain, while in the placebo and control groups all subjects felt pain (p = 0.0001). The end of pain occurred earlier in laser compared to placebo and control groups (p = 0.021). A single-diode SLLLT application appeared to be effective in reducing the intensity and duration of experimentally induced orthodontic pain and could be used in daily orthodontic practice.

Lasers Med Sci 2013 May 11

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23666533

How does LLLT / cold laser therapy work? click here

How to calculate LLLT dose click here

Get yourself trained click here

Does phototherapy enhance skeletal muscle contractile function and postexercise recovery? A systematic review.

Borsa PA, Larkin KA, True JM

Department of Applied Physiology and Kinesiology, University of Florida, Gainesville;

Context : Recently, researchers have shown that phototherapy administered to skeletal muscle immediately before resistance exercise can enhance contractile function, prevent exercise-induced cell damage, and improve postexercise recovery of strength and function. Objective : To critically evaluate original research addressing the ability of phototherapeutic devices, such as lasers and light-emitting diodes (LEDs), to enhance skeletal muscle contractile function, reduce exercise-induced muscle fatigue, and facilitate postexercise recovery. Data Sources : We searched the electronic databases PubMed, SPORTDiscus, Web of Science, Scopus, and Rehabilitation & Physical Medicine without date limitations for the following key words: laser therapy, phototherapy, fatigue, exercise, circulation, microcirculation, and photobiomodulation. Study Selection : Eligible studies had to be original research published in English as full papers, involve human participants, and receive a minimum score of 7 out of 10 on the Physiotherapy Evidence Database (PEDro) scale. Data Extraction : Data of interest included elapsed time to fatigue, total number of repetitions to fatigue, total work performed, maximal voluntary isometric contraction (strength), electromyographic activity, and postexercise biomarker levels. We recorded the PEDro scores, beam characteristics, and treatment variables and calculated the therapeutic outcomes and effect sizes for the data sets. Data Synthesis : In total, 12 randomized controlled trials met the inclusion criteria. However, we excluded data from 2 studies, leaving 32 data sets from 10 studies. Twenty-four of the 32 data sets contained differences between active phototherapy and sham (placebo-control) treatment conditions for the various outcome measures. Exposing skeletal muscle to single-diode and multidiode laser or multidiode LED therapy was shown to positively affect physical performance by delaying the onset of fatigue, reducing the fatigue response, improving postexercise recovery, and protecting cells from exercise-induced damage. Conclusions : Phototherapy administered before resistance exercise consistently has been found to provide ergogenic and prophylactic benefits to skeletal muscle.

J Athl Train 2013 Jan-Feb 48(1) 57-67

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23672326

How does LLLT / cold laser therapy work? click here

How to calculate LLLT dose click here

Get yourself trained click here

Lasers for the Treatment of Dentin Hypersensitivity: A Meta-analysis.

Sgolastra F, Petrucci A, Severino M, Gatto R, Monaco A

Department of Life, Health, and Environmental Sciences, School of Dentistry, University of L’Aquila, Italy.

This systematic review and meta-analysis assessed the efficacy of lasers in reducing dentin hypersensitivity (DH) as compared with placebo or no treatment. Seven electronic databases and a manual search resulted in 2,538 unique publications. After selection, 13 studies were included in the meta-analysis. A CONSORT-based quality assessment revealed that 3 and 10 studies were at low and high risk of bias, respectively. A random-effects model with the generic inverse variance standardized mean difference (SMD) was used because of expected heterogeneity. Meta-analyses of the baseline-end of follow-up changes in pain revealed no differences for Er,Cr:YSSG vs. placebo (SMD = 2.49; 95% CI, -0.25 to 5.22; p = .07) but did reveal differences in favor of lasers for Er:YAG vs. placebo (SMD, 2.65; 95% CI, 1.25 to 4.05; p = .0002), Nd:YAG vs. placebo (SMD, 3.59; 95% CI, 0.49 to 6.69; p = .02), and GaAlAs vs. placebo (SMD, 3.40; 95% CI, 1.93 to 4.87; p < .00001). High and significant heterogeneity was found for all comparisons. In conclusion, Er:YAG, Nd:YAG, and GaAlAs lasers appear to be efficacious in reducing DH. However, given the high heterogeneity of the included studies, future randomized controlled clinical trials are needed to confirm these results.

J Dent Res 2013 Jun 92(6) 492-9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23609160

How does LLLT / cold laser therapy work? click here

How to calculate LLLT dose click here

Get yourself trained click here

Effect of infrared laser in the prevention and treatment of paresthesia in orthognathic surgery.

Prazeres LD, Muniz YV, Barros KM, Gerbi ME, Laureano Filho JR

From the Faculty of Dentistry of Pernambuco, University of Pernambuco (FOP-UPE), Recife, Brazil.

Orthognathic surgery is the surgical procedure that makes correcting deformities of the bones in the region of the maxilla and mandible a reality in the Brazilian dentistry. However, this type of surgery usually involves paresthesia in the postoperative period, concerning the surgeons who perform them and generating discomfort to patients. This study aimed at evaluating the effect of infrared laser (830 nm) in the prevention and treatment of paresthesias after orthognathic surgery. Six patients underwent orthognathic surgery: the experimental group composed of 4 patients and the control group that did not receive laser therapy composed of 2 patients. The experimental group received laser applications during the transoperative and 12 postoperative sessions. Tests for mechanical (deep and shallow) and thermal (cold) sensitivity were performed in the preoperative and postoperative period (during 12 sessions) in the lip and chin areas by the same operator. The paresthesia was classified into 1, strong; 2, moderate; 3, mild; and 4, absent, through the patient’s response to stimuli. The results showed that all patients had no disturbance of sensitivity in the preoperative period, but paresthesia was presented at various levels in the postoperative period. Both groups showed recovery of deep mechanical sensitivity within a shorter time interval compared with the superficial mechanical and thermal sensitivity. However, at the 12th assessment, patients who underwent the laser therapy showed better reduction in the level of paresthesia or even complete regression of this. The laser, therefore, brought benefits to the treatment of paresthesia, accelerating the return of neurosensorial sensitivity.

J Craniofac Surg 2013 May 24(3) 708-11

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23714864

How does LLLT / cold laser therapy work? click here

How to calculate LLLT dose click here

Get yourself trained click here

The Effects of 830 nm Light-Emitting Diode Therapy on Acute Herpes Zoster Ophthalmicus: A Pilot Study.

Park KY, Han TY, Kim IS, Yeo IK, Kim BJ, Kim MN

Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea.

BACKGROUND: Skin lesions and pain are the most distinctive features of herpes zoster. Light-emitting diode (LED) therapy is an effective treatment known for its wound-healing effects. OBJECTIVE: To determine whether the LED treatment affects wound healing and acute pain in acute herpes zoster ophthalmicus. METHODS: We recruited 28 consecutive Korean patients with acute herpes zoster ophthalmicus for the study. In the control group (group A), 14 subjects received oral famcyclovir. In the experimental group (group B), 14 subjects received oral famcyclovir and 830 nm LED phototherapy on days 0, 4, 7, and 10. In order to estimate the time for wound healing, we measured the duration from the vesicle formation to when the lesion crust fell off. The visual analogue scale (VAS) was used for the estimation of pain on days 4, 7, 10, and 14. RESULTS: The mean time required for wound healing was 13.14+/-2.34 days in group B and 15.92+/-2.55 days in group A (p=0.006). From day 4, the mean VAS score showed a greater improvement in group B, compared with group A. A marginal but not statistically significant difference in the VAS scores was observed between the two groups (p=0.095). CONCLUSION: LED treatment for acute herpes zoster ophthalmicus leads to faster wound healing and a lower pain score.

Ann Dermatol 2013 May 25(2) 163-7

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23717006

How does LLLT / cold laser therapy work? click here

How to calculate LLLT dose click here

Get yourself trained click here

Photobiomodulation: An Enlightened Path Emerges.

Lanzafame RJ

Raymond J Lanzafame, MD, PLLC , Rochester, New York.

Photomed Laser Surg 2013 May 24

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23705907

How does LLLT / cold laser therapy work? click here

How to calculate LLLT dose click here

Get yourself trained click here

Noninvasive laser therapy for outpatients with chronic inflammatory disorders of cervix.

Botez M, Anton C, Mircea R, Anton E

Medical-Center Themis Art, Iasi., University of Medicine and Pharmacy Grigore T Popa Iasi, Faculty of Medicne.

Chronic inflammation of the cervix can develop cervical stenosis with infertility and cervical congestion is related with the cervical cancer. We create a review of main etiological agents and methods of screening and diagnose. We also make a short brief review of modern therapeutic approach. CONCLUSIONS: We follow the utility of LLLT through the following aspects: evolution, indications, results of Babes-Papanicolau screening, cytology, clinical aspects. The results of the study will allow the complex system of treatment to be used in a large category of women. We appreciate that the procedure (used in our center also) will decrease the cervical pathology, the morbidity inside the treatment, the mortality through the evolution of cervical cancer. We propose the applicability for outpatients first and then as an integrated treatment method inside hospitals for a wide access.

Rev Med Chir Soc Med Nat Iasi 2012 Oct-Dec 116(4) 1131-5

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23700901

How does LLLT / cold laser therapy work? click here

How to calculate LLLT dose click here

Get yourself trained click here

Transcranial Laser Therapy and Infarct Volume.

Kasner SE, Rose DZ, Skokan A, Walker MG, Shi J, Streeter J

Department of Neurology, University of Pennsylvania, Philadelphia, PA.

BACKGROUND AND PURPOSE: Two randomized trials suggested that transcranial laser therapy (TLT) may benefit patients with acute ischemic stroke, although efficacy has not been confirmed. Supportive proof of concept could be demonstrated if TLT reduces the volume of cortical infarction. METHODS: The NeuroThera Efficacy and Safety Trial-2 (NEST-2) was a randomized trial of TLT versus sham in patients with acute ischemic stroke treated within 24 hours of onset. Infarct volumes were measured quantitatively and semiquantitatively on all protocol-required computed tomography (or MRI, if clinically indicated) scans performed on day 5 (+/-2). Two approaches assessed treatment effects on cortex: (1) indirectly, by analyzing total infarct volume among patients with clinical presentations suggesting cortical involvement; and (2) directly, by assessing the cortical Alberta Stroke Program Early CT Score (cASPECTS) components (M1-M6, anterior, posterior) on a 0- to 8-point modified scale. RESULTS: A total of 640 subjects had scans (576 computed tomography, 64 MRI) on day 5. The reliability of ASPECTS (intraclass correlation coefficient=0.85) and cASPECTS (intraclass correlation coefficient=0.82) was excellent, and total ASPECTS was correlated with total infarct volume (r=0.71). In the overall study population, there was no impact of TLT on total infarct volume (P=0.30), total ASPECTS (P=0.85), or cASPECTS (P=0.89). Similarly, no effect was seen in any of the following prespecified subgroups selected to indicate cortical involvement: baseline National Institutes of Health Stroke Scale score >10, Oxfordshire Total Anterior Circulation Syndrome, subjects with aphasia or extinction at baseline, or subjects with radiographic involvement of cortex. CONCLUSIONS: TLT was not associated with a reduction in overall or cortical infarct volume as measured on computed tomography in the subacute phase.

Stroke 2013 May 9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23660846

How does LLLT / cold laser therapy work? click here

How to calculate LLLT dose click here

Get yourself trained click here

Intense pulsed light treatment of chronic mid-body Achilles tendinopathy: A double blind randomised placebo-controlled trial.

Hutchison AM, Pallister I, Evans RM, Bodger O, Topliss CJ, Williams P, Beard DJ

Abertawe Bro Morgannwg University Health Board and College of Medicine, Swansea University, Physiotherapy Department, Morriston Hospital, Swansea SA6 6NL, UK. annemarie.hutchison@wales.nhs.uk

We conducted a randomised controlled trial to determine whether active intense pulsed light (IPL) is an effective treatment for patients with chronic mid-body Achilles tendinopathy. A total of 47 patients were randomly assigned to three weekly therapeutic or placebo IPL treatments. The primary outcome measure was the Victorian Institute of Sport Assessment – Achilles (VISA-A) score. Secondary outcomes were a visual analogue scale for pain (VAS) and the Lower Extremity Functional Scale (LEFS). Outcomes were recorded at baseline, six weeks and 12 weeks following treatment. Ultrasound assessment of the thickness of the tendon and neovascularisation were also recorded before and after treatment. There was no significant difference between the groups for any of the outcome scores or ultrasound measurements by 12 weeks, showing no measurable benefit from treatment with IPL in patients with Achilles tendinopathy.

Bone Joint J 2013 Apr 95-B(4) 504-9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23539702

How does LLLT / cold laser therapy work? click here

How to calculate LLLT dose click here

Get yourself trained click here

Effects of light-emitting diodes on muscle fatigue and exercise tolerance in patients with COPD: study protocol for a randomized controlled trial.

Miranda EF, Leal-Junior EC, Marchetti PH, Dal Corso S

Post Graduate Program in Rehabilitation Sciences, Nove de Julho University, Sao Paulo, Brazil. simonedc@uninove.br.

BACKGROUND: Light-emitting diodes (LED) have been used to minimize muscle fatigue in athletes and healthy subjects. Patients with chronic obstructive pulmonary disease (COPD) are susceptible to early muscle fatigue. OBJECTIVE: The objective of this study is to investigate the acute effects of LED on muscle function, exercise capacity and cardiorespiratory responses during isometric and dynamic exercise in patients with COPD. METHODS: This study will assess 30 patients with moderate to severe obstruction (forced expiratory volume-one second,FEV1
Trials 2013 14 134

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23663518

How does LLLT / cold laser therapy work? click here

How to calculate LLLT dose click here

Get yourself trained click here

Comments on: “Efficacy of low-level laser therapy in the management of orthodontic pain: a systematic review and meta-analysis”

Yan B

State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China, docbxyan@gmail.com.

Dear Editor, I read with great interest the online first article by He et al. [1] entitled “Efficacy of low-level laser therapy in the management of orthodontic pain: a systematic review and meta-analysis.” The authors concluded that laser therapy had favorable effect in dealing with orthodontic pain. I wonder why one article [2] published in 2011 was not included, since this study was also a randomized controlled trial about laser therapy in the management of orthodontic pain. Previous systematic reviews concerning orthodontic pain management [3, 4] measured the outcomes between the intervention group and placebo group by the intensity of pain at each point of follow-up using Visual Analog Scale (VAS), which should be considered as the primary outcome. Yet in this review, the authors did not define the primary outcome and measured many alternative indicators and did not separate the placebo and control groups. Also, the methods of pain evaluation by most trials included in this review were self-designed questionnaires which differed from each other. Though some of these outcomes showed favorable effect, it was not convincible that laser therapy for relieving the pain was beyond a placebo effect. The authors mentioned low risk of selective reporting bias for all the included studies in the “assessment of risk of bias”; however, none of the trial’s protocol was available online and most trials did not report any data of the intensity of pain at each point of follow-up, which could be due to lacked of statistical significance in this outcome. Furthermore, some included studies [5, 6] were short of detailed outcome data, so the risk of bias for most trials in this domain of assessment should be unclear or even high risk. Thus, the efficacy of laser therapy for managing orthodontic pain needs to be interpreted with more caution.

1. He WL, Li CJ, Liu ZP, Sun JF, Hu ZA, Yin X, Zou SJ (2012) Efficacy of low-level laser therapy in the management of orthodontic pain: a systematic review and meta-analysis. Lasers Med Sci. doi:10.1007/s10103-012-1196-y

2. Esper MA, Nicolau RA, Arisawa EA (2011) The effect of two phototherapy protocols on pain control in orthodontic procedure—a preliminary clinical study. Lasers Med Sci 26(5):657–663 PubMedCrossRef

3. Xiaoting L, Yin T, Yangxi C (2010) Interventions for pain during fixed orthodontic appliance therapy. A systematic review. Angle Orthod 80(5):925–932 PubMedCrossRef

4. Angelopoulou MV, Vlachou V, Halazonetis DJ (2012) Pharmacological management of pain during orthodontic treatment: a meta-analysis. Orthod Craniofac Res 15(2):71–83 PubMedCrossRef

5. Lim HM, Lew KK, Tay DK (1995) A clinical investigation of the efficacy of low level laser therapy in reducing orthodontic postadjustment pain. Am J Orthod Dentofacial Orthop 108(6):614–622 PubMedCrossRef

6. Youssef M, Ashkar S, Hamade E, Gutknecht N, Lampert F, Mir M (2008) The effect of low-level laser therapy during orthodontic movement: a preliminary study. Lasers Med Sci 23(1):27–33 PubMedCrossRef

Lasers Med Sci 2013 May 1

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23636298

How does LLLT / cold laser therapy work? click here

How to calculate LLLT dose click here

Get yourself trained click here

Laser treatment of onychomycosis.

Fungal infections of the fingernails or toenails can persist for months or years despite topical and systemic antimicrobial therapy. The FDA has cleared several short-pulse laser systems for treatment of this mainly cosmetic disorder.

Med Lett Drugs Ther 2013 Feb 18 55(1410) 15

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23589900

How does LLLT / cold laser therapy work? click here

How to calculate LLLT dose click here

Get yourself trained click here

A knowledge translation initiative to enhance evidence-informed clinical management of achilles tendinopathy: the purpose, process and outcomes of the bc tendinopathy toolkit.

Hoens AM, Ezzat A, Anthony J, Scott A, Yates M, Justesen JR, Hughes D

Department of Physical Therapy, University of British Columbia, Vancouver, Canada.

INTRODUCTION: Translation of knowledge to practice in health care is a significant challenge.1(-)3 This presentation describes the purpose, process and preliminary outcomes of a knowledge translation (KT) initiative undertaken by a unique partnership of physical therapy researchers, educators and expert clinicians to address the gap between evidence and practice in the management of Achilles tendinopathy. METHODS: Physiotherapy clinicians in British Columbia requested evidence-informed guidance on the management of tendinopathy. To address this need, the provincial Physical Therapy Knowledge Broker assembled a team of researchers, educators and expert clinicians with the mandate to develop, disseminate and implement a toolkit of decision aids to guide clinical decision-making for Achilles Tendinopathy. The process to develop the toolkit involved the following components: (1) identification of the purpose and scope of the project (2) agreement on the processes for selection of content and format (3) creation of a mechanism for resolution of conflicting opinion (4) an iterative feedback process with stakeholders and (4) the incorporation of concepts and strategies from the knowledge translation and implementation science literature to support the stages of knowledge synthesis, dissemination and implementation.1(-)4 RESULTS: The ‘Tendinopathy Toolkit’ included: (1) a tabulated summary of the evidence for manual therapy, exercise, low level laser therapy, ultrasound, extracorporeal shock wave therapy, iontophoresis using dexamethasone, taping, orthotics, night splints and braces, heel raise inserts, needling techniques, and the appropriate outcome measures for this population (targeted ‘take home messages’ and clinical implications for each were also included); (2) an algorithm to guide the sequence of interventions; (3) and appendices including (a) exercise programmes (b) low level laser dosage calculation (c) tabulated details for each article reviewed and (d) a review of common medical interventions. The second phase of the initiative-utilization of strategies to enhance implementation and uptake of the toolkit-is currently being undertaken. DISCUSSION: Clinicians want to provide evidence-informed management of tendinopathy but many struggle with accessing, appraising and synthesising the vast array of literature available on this topic. This KT initiative highlights the need for, challenges associated with, evidence-informed process for and positive response to the development of decision aids synthesising the current evidence to guide clinical management of this patient population.

Br J Sports Med 2013 Jun 47(9) e2

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23666995

How does LLLT / cold laser therapy work? click here

How to calculate LLLT dose click here

Get yourself trained click here

Treatment of Acne Vulgaris During Pregnancy and Lactation.

Kong YL, Tey HL

National Skin Centre, 1 Mandalay Road, Singapore, 308205, Singapore.

Acne vulgaris is a common problem encountered by pregnant and lactating women. Unfortunately, in clinical practice, treatment is often not optimized as a result of the lack of safety data and unified recommendations on the use of the various anti-acne therapies. In this narrative review, current data on their safety is summarized. We recommend the use of topical medications as first-line treatment for acne vulgaris in pregnant and lactating women. These include antibiotics (erythromycin, clindamycin, metronidazole and dapsone), benzoyl peroxide, azelaic acid and salicylic acid. Oral agents and/or light-based therapy may be considered as second-line treatment. The former consists of oral macrolides (erythromycin and azithromycin), cephalexin or zinc compounds. Blue-violet or red light phototherapy may be used as monotherapy or in addition to topical and/or oral therapies. Hormonal therapy, antibiotics consisting of tetracyclines, co-trimoxazole and fluoroquinolones, and both oral and topical retinoids should be avoided.

Drugs 2013 May 9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23657872

How does LLLT / cold laser therapy work? click here

How to calculate LLLT dose click here

Get yourself trained click here

Long-Term Safety of Low-Level Laser Therapy at Different Power Densities and Single or Multiple Applications to the Bone Marrow in Mice.

Tuby H, Hertzberg E, Maltz L, Oron U

Department of Zoology, The George S. Wise Faculty of Life Sciences, Tel-Aviv University Tel-Aviv , Israel .

Abstract Objective: The purpose of this study was to determine the long-term safety effect of low-level laser therapy (LLLT) to the bone marrow (BM) in mice. Background data: LLLT has been shown to have a photobiostimulatory effect on various cellular processes and on stem cells. It was recently shown that applying LLLT to BM in rats post-myocardial infarction caused a marked reduction of scar tissue formation in the heart. Methods: Eighty-three mice were divided into five groups: control sham-treated and laser-treated at measured density of either 4, 10, 18, or 40 mW/cm2 at the BM level. The laser was applied to the exposed flat medial part of the tibia 8 mm from the knee joint for 100 sec. Mice were monitored for 8 months and then killed, and histopathology was performed on various organs. Results: No histological differences were observed in the liver, kidneys, brain or BM of the laser-treated mice as compared with the sham-treated, control mice. Moreover, no neoplasmic response in the tissues was observed in the laser-treated groups as compared with the control, sham-treated mice. There were no significant histopathological differences among the same organs under different laser treatment regimes in response to the BM-derived mesenchymal stem cell proliferation following LLLT to the BM. Conclusions: LLLT applied multiple times either at the optimal dose (which induces photobiostimulation of stem cells in the BM), or at a higher dose (such as five times the optimal dose), does not cause histopathological changes or neoplasmic response in various organs in mice, as examined over a period of 8 months.

Photomed Laser Surg 2013 May 15

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23675984

How does LLLT / cold laser therapy work? click here

How to calculate LLLT dose click here

Get yourself trained click here

Effects of early and delayed laser application on nerve regeneration.

Akgul T, Gulsoy M, Gulcur HO

Institute of Biomedical Engineering, Bogazici University, Kandilli Kampus, Cengelkoy, 34684, Istanbul, Turkey.

The aim of this study is to analyze the differences between early and delayed use of low-level laser therapy (LLLT) in functional and morphological recovery of the peripheral nerve. Thirty male Wistar rats were divided into three groups after the sciatic nerve was crushed: (1) control group without laser treatment, (2) early group with laser treatment started immediately after surgery and lasted 14 days, and (3) delayed group with laser treatment starting on the postoperative day 7 and lasted until day 21. A 650-nm diode laser (model: DH650-24-3(5), Huanic, China) with an output power of 25 mW exposed transcutaneously at three equidistant points on the surgical mark corresponding to the crushed nerve. The length of the laser application was calculated as 57 s to satisfy approximately 10 J/cm2. A Sciatic Functional Index (SFI) was used to evaluate functional improvement in groups at pre- and post-surgery (on days 7, 14, and 21). Compound action potential (CAP) was measured after the sacrifice and histological examination was performed for all groups. SFI results showed that there was no significant difference between groups at different days (p > 0.05). On the other hand, the latency of CAP decreased significantly (p < 0.05) in the delayed group. Histological examination confirmed that the number of mononuclear cells was lower (p < 0.05) in both early and delayed groups. In conclusion, results supported the hypothesis that LLLT could accelerate the rate of recovery of injured peripheral nerves in this animal model. Though both laser groups had positive outcomes, delayed group showed better recovery.

Lasers Med Sci 2013 May 29

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23715785

How does LLLT / cold laser therapy work? click here

How to calculate LLLT dose click here

Get yourself trained click here

Far red/near infrared light treatment promotes femoral artery collateralization in the ischemic hindlimb.

Lohr NL, Ninomiya JT, Warltier DC, Weihrauch D

Department of Medicine, Division of Cardiovascular Medicine, Medical College of Wisconsin, USA; Department of Cardiovascular Center, Medical College of Wisconsin, USA; Clement J Zablocki VA Medical Center, USA. Electronic address: ntonn@mcw.edu.

Nitric oxide (NO) is a crucial mediator of hindlimb collateralization and angiogenesis. Within tissues there are nitrosyl-heme proteins which have the potential to generate NO under conditions of hypoxia or low pH. Low level irradiation of blood and muscle with light in the far red/near infrared spectrum (670nm, R/NIR) facilitates NO release. Therefore, we assessed the impact of red light exposure on the stimulation of femoral artery collateralization. Rabbits and mice underwent unilateral resection of the femoral artery and chronic R/NIR treatment. The direct NO scavenger carboxy-PTIO and the nitric oxide synthase (NOS) inhibitor L-NAME were also administered in the presence of R/NIR. DAF fluorescence assessed R/NIR changes in NO levels within endothelial cells. In vitro measures of R/NIR induced angiogenesis were assessed by endothelial cell proliferation and migration. R/NIR significantly increased collateral vessel number which could not be attenuated with L-NAME. R/NIR induced collateralization was abolished with c-PTIO. In vitro, NO production increased in endothelial cells with R/NIR exposure, and this finding was independent of NOS inhibition. Similarly R/NIR induced proliferation and tube formation in a NO dependent manner. Finally, nitrite supplementation accelerated R/NIR collateralization in wild type C57Bl/6 mice. In an eNOS deficient transgenic mouse model, R/NIR restores collateral development. In conclusion, R/NIR increases NO levels independent of NOS activity, and leads to the observed enhancement of hindlimb collateralization.

J Mol Cell Cardiol 2013 May 20

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23702287

How does LLLT / cold laser therapy work? click here

How to calculate LLLT dose click here

Get yourself trained click here

Influence of low-level laser on bone remodeling during induced tooth movement in rats.

Cossetin E, Janson G, de Carvalho MG, de Carvalho RA, Henriques JF, Garib D

a Graduate student, Department of Orthodontics, Bauru Dental School, University of Sao Paulo, Bauru, Sao Paulo, Brazil.

Abstract Objective: To analyze the effect of low-level laser on bone remodeling during induced tooth movement in rats. Materials and Methods: A diode laser (808 nm, 100 mW, 54 J on an area of 0.0028 cm2) was used. The application was continuous, punctual, and with contact. Forty-two 70-day-old Wistar rats had the maxillary left first molar moved using a force level of 25 g. In two experimental subgroups the movement was performed over 7 days and in three subgroups the movement occurred over 14 days. In the 7-day movement subgroups, one subgroup received laser irradiation on day 1 only; the other subgroup received laser irradiation on days 1, 3, and 5. In the 14-day movement subgroups, one subgroup received laser irradiation on day 1 only; the second on days 1, 3, and 5; and the third on days 1, 3, 5, 7, 9, 11, and 13. The control group was also divided into two subgroups, and movement occurred over two different periods of treatment (7 days and 14 days) without laser application; these were used as controls for the respective experimental subgroups. Inter-subgroup comparison was performed with Kruskal-Wallis, followed by Mann-Whitney and analysis of variance, followed by Tukey tests within the 7- and 14-day subgroups. Results: The subgroup with three laser applications showed significantly greater osteoclastic activity and bone resorption than the other subgroups in the 7-day movement subgroups. Conclusions: Low-level laser application significantly increased the osteoclastic but not the osteoblastic activity during the initial phases of tooth movement. In addition, the osteoclastic activity was dose-dependent.

Angle Orthod 2013 May 14

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23672280

How does LLLT / cold laser therapy work? click here

How to calculate LLLT dose click here

Get yourself trained click here

Effects of low-power LED and therapeutic ultrasound in the tissue healing and inflammation in a tendinitis experimental model in rats.

Moura Junior MD, Arisawa EA, Martin AA, de Carvalho JP, da Silva JM, Silva JF, Silveira L Jr

Biomedical Engineering Institute, Universidade Camilo Castelo Branco-UNICASTELO, Parque Tecnologico de Sao Jose dos Campos, Estr. Dr. Altino Bondesan, 500, Sao Jose dos Campos, Sao Paulo, Brazil, 12247-016, manoelmoura20@yahoo.com.br.

This work evaluated the anti-inflammatory response of low-power light-emitting diode (LED) and ultrasound (US) therapies and the quality and rapidness of tendon repair in an experimental model of tendinitis, employing histomorphometry and Raman spectroscopy. Tendinitis was induced by collagenase into the right tendon of 35 male Wistar rats with an average weight of 230 g. The animals were randomly separated into seven groups of five animals each: tendinitis without treatment-control (TD7 and TD14, where 1 and 2 indicated sacrifice on the 7th and 14th day, respectively), tendinitis submitted to US therapy (US7 and US14) and tendinitis submitted to LED therapy (LED7 and LED14). Contralateral tendons of the TD group at the 14th day were used as the healthy group (H). US treatment was applied in pulsed mode at 10 %, 1 MHz frequency, 0.5 W/cm2, 120 s. LED therapy parameters were 4 J/cm2, 120 s, daily dose at the same time and same point. Sacrifice was performed on the 7th or 14th day. Histomorphometric analysis showed lower number of fibroblasts on the 14th day of therapy for the US-treated group, compared to the TD and LED, indicating lower tissue inflammation. Raman showed that the LED group had an increase in the amount of collagen I and III from the 7th to the 14th day, which would indicate more organized fibers and a better quality of the healing, and US showed lower collagen I synthesis in the 14th day compared to H, indicating a lower tissue reorganization.

Lasers Med Sci 2013 May 10

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23660737

How does LLLT / cold laser therapy work? click here

How to calculate LLLT dose click here

Get yourself trained click here

Effect of low-level laser therapy on types I and III collagen and inflammatory cells in rats with induced third-degree burns.

Fiorio FB, Albertini R, Leal-Junior EC, de Carvalho PD

Health Sciences Center, Chapeco University (UNOCHAPECO), Av. Sen. Atilio Fontana, Chapeco, SC, Brazil.

Low-level laser therapy (LLLT) has been increasingly used to accelerate wound healing in third-degree burns. This study investigated the effects of lasers on the tissue repair process of third-degree burns. Burns were produced on the backs of male Wistar rats. The animals were divided into four groups (n = 12): control, injury, LLLT 3 J/cm2, and LLLT 4 J/cm2. Each group was further divided into two subgroups; the rats in one subgroup were killed on day 8 and those in the other, on day 16 after injury. The animals in LLLT 3 J/cm2 and LLLT 4 J/cm2 were irradiated 1 h after injury, and irradiation was repeated every 48 h. Laser (660 nm, 35 mW) treatment at fluences of 3 and 4 J/cm2 were used. After killing the rats, tissue fragments from the burnt area were removed for histological analysis. The LLLT-treated groups showed a significant decrease (p <0.05) in the number of inflammatory cells and increased collagen deposition compared to the injury group. Laser irradiation (both 3 and 4 J/cm2) resulted in reduction in the inflammatory process and improved collagen deposition, thereby ameliorating the healing of third-degree burns.

Lasers Med Sci 2013 May 16

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23677436

How does LLLT / cold laser therapy work? click here

How to calculate LLLT dose click here

Get yourself trained click here

Effect of low-level laser therapy on the release of interleukin-6 and basic fibroblast growth factor from cultured human skin fibroblasts in normal and high glucose mediums.

Esmaeelinejad M, Bayat M

Abstract Introduction: This study evaluated the effects of low-level laser therapy (LLLT) on human skin fibroblasts (HSFs) that have been cultured in high glucose concentration media. Materials and Methods: HSFs were cultured under physiologic glucose condition medium, and then cultured in high glucose concentration medium (15 mM/L) for one or two weeks prior to LLLT. Experimental HSFs were irradiated with three energy densities (0.5, 1, and 2 J/cm2) once daily on three consecutive days. Release of interleukin-6 (IL-6) and basic fibroblast growth factor (bFGF) were evaluated by the enzyme-linked immunosorbent assay (ELISA) method. Results: Statistical analysis showed three doses of 0.5 (p=0.049), 1 (p=0.027), and 2 J/cm2 (p=0.004) stimulated the release of IL-6 in HSFs cultured in high glucose concentration medium compared to non-irradiated HSFs that were cultured in the same medium. LLLT with 2 J/cm2 induced the release of bFGF from HSFs cultured in high glucose concentration medium for one (p=0.047) or two weeks (both p=0.04). Conclusion: Our study showed LLLT stimulated the release of IL-6 and bFGF from HSFs cultured in high glucose concentration medium. LLLT was more effective in releasing IL-6 and bFGF while HSFs which were cultured in physiologic glucose concentration medium during laser irradiation.

J Cosmet Laser Ther 2013 May 8

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23656570

How does LLLT / cold laser therapy work? click here

How to calculate LLLT dose click here

Get yourself trained click here

The efficacy of the use of IR laser phototherapy associated to biphasic ceramic graft and guided bone regeneration on surgical fractures treated with miniplates: a histological and histomorphometric study on rabbits.

Pinheiro AL, Aciole GT, Ramos TA, Gonzalez TA, da Silva LN, Soares LG, Aciole JM, Dos Santos JN

Center of Biophotonics, School of Dentistry, Federal University of Bahia, Av. Araujo Pinho, 62, Canela, Salvador, BA, 40110-150, Brazil, albp@ufba.br.

The aim of the present study was to assess, by light microscopy and histomorphometry, the repair of surgical fractures fixed with internal rigid fixation (IRF) treated or not with IR laser (lambda780 nm, 50 mW, 4 x 4 J/cm2 = 16 J/cm2, varphi = 0.5cm2, CW) associated or not to the use of hydroxyapatite and guided bone regeneration. Surgical tibial fractures were created under general anesthesia on 15 rabbits that were divided into 5 groups, maintained on individual cages, at day/night cycle, fed with solid laboratory pelted diet, and had water ad libidum. The fractures in groups II, III, IV, and V were fixed with miniplates. Animals in groups III and V were grafted with hydroxyapatite and GBR technique used. Animals in groups IV and V were irradiated at every other day during two weeks (4 x 4 J/cm2, 16 J/cm2 = 112 J/cm2). Observation time was that of 30 days. After animal death, specimens were taken, routinely processed to wax, cut and stained with HA and Sirius red, and used for histological assessment. The results of both analyses showed a better bone repair on all irradiated subjects especially when the biomaterial and GBR were used. In conclusion, the results of the present investigation are important clinically as they are suggestive that the association of hydroxyapatite, and laser light resulted in a positive and significant repair of complete tibial fractures treated with miniplates.

Lasers Med Sci 2013 May 7

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23649614

How does LLLT / cold laser therapy work? click here

How to calculate LLLT dose click here

Get yourself trained click here

Laser phototherapy at high energy densities do not stimulate pre-osteoblast growth and differentiation.

Pacheco PS, de Oliveira FA, Oliveira RC, Sant’ana AC, de Rezende ML, Greghi SL, Damante CA

Bauru School of Dentistry , Bauru, SP, Brasil.

Abstract Objective: The aim of this study is to evaluate the effects of red and infrared lasers at high energy densities on pre-osteoblast MC3T3 proliferation and differentiation. Background data: The acceleration of bone regeneration by low intensity laser irradiation may hold potential benefits in clinical therapy in orthopedics and dentistry. Materials and methods: Cells were irradiated with red (660 nm) and infrared (780 nm) lasers (90 and 150 J/cm(2), 40 mW). The control group did not receive irradiation. Cell growth was assessed by a colorimetric test (MTT) (24, 48, 72, 96 h) and cell differentiation was evaluated by alkaline phosphatase (ALP) quantification after growth in osteogenic medium (72, 96 h; 7, 14 days). Results: None of the irradiation groups had an enhancement in cell growth (p<0.05). The production of ALP was not influenced by irradiation at any period of time (p>0.05). Conclusions: The low intensity laser stimulated neither cell growth nor the production of alkaline phosphatase.

Photomed Laser Surg 2013 May 31(5) 225-9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23639292

How does LLLT / cold laser therapy work? click here

How to calculate LLLT dose click here

Get yourself trained click here

Effects of laser irradiation at different wavelengths (660, 810, 980, and 1,064 nm) on mucositis in an animal model of wound healing.

Usumez A, Cengiz B, Oztuzcu S, Demir T, Aras MH, Gutknecht N

Department of Prosthodontics, Bezmialem Vakif University, Vatan Street, Istanbul, Turkey, asli_u@hotmail.com.

The aim of the present study was to compare the effectiveness of four different laser wavelengths (660, 810, 980, and 1,064 nm) used for low-level laser therapy (LLLT) on the healing of mucositis in an animal model of wound healing by investigating the expression of platelet-derived growth factor (PDGF), transforming growth factor beta (TGF-beta), and blood-derived fibroblast growth factor (bFGF). Thirty-five male Wistar albino rats with a weight of 250-300 g body mass and 5 months old were used in the study. All animals were intraperitoneally injected with 100 mg/kg of 5-fluorouracil (5-FU) on the first day and 65 mg/kg of 5-FU on the third day. The tip of an 18-gauge needle was used in order to develop a superficial scratching on the left cheek pouch mucosa by dragging twice in a linear movement on third and fifth days. After ulcerative mucositis were clinically detected on the animals’ left cheek pouch mucosa, the laser therapy was started. Four different laser wavelengths (660 nm, HELBO, Bredent; 810 nm, Fotona XD, Fotona; 980 nm, ARC Fox; and 1,064 nm, Fidelis Plus 3, Fotona) used for LLLT at ED 8 J/cm2 daily from the first to the fourth days. Oval excisional biopsy was taken from the site of the wound, and the expression of PDGF, TGF-beta, and bFGF was evaluated. The obtained data were analyzed by one2-way ANOVA, and then Tukey HSD tests were used for pairwise comparisons among groups (alpha = 0.05). The one-way ANOVA test indicated that expression values of the growth factors, PDGF and bFGF, were significantly affected by irradiation of different wavelengths of lasers (p < 0.001). However, expression value of the TGF-beta was not affected by irradiation of different wavelengths of lasers (p > 0.05). The highest PDGF expression was detected in neodymium-doped yttrium aluminum garnet (Nd:YAG) laser group (p < 0.05), and there were no statistically significant differences among the other groups (p > 0.05). The highest bFGF expression was detected in 980-nm diode and Nd:YAG laser groups (p < 0.05), and there were no statistically significant differences among the other groups (p > 0.05). These findings suggest that low-level Nd:YAG and 980-nm diode laser therapy accelerate the wound healing process by changing the expression of PDGF and bFGF genes responsible for the stimulation of the cell proliferation and fibroblast growth.

Lasers Med Sci 2013 May 1

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23636299

How does LLLT / cold laser therapy work? click here

How to calculate LLLT dose click here

Get yourself trained click here

About James Carroll

Founder and CEO at THOR Photomedicine Ltd. About THOR
This entry was posted in Research. Bookmark the permalink.

2 Responses to THOR Literature watch for May 2013 Low Level Laser Therapy / Cold Laser / Photobiomodulation PBM

  1. Brian Bennett says:

    My own feeling about high powered lasers that develop heat in tissues is that they are effective (1) Because the patient/client can feel something pleasant the Dopamine system is activated in the brain (2)Because the painting technique treats broad areas which can influence other muscle chains, nerves, lymphatics and circulation not fogetting the PASER effects of Mary Dyson.
    The effects as you rightly point out have nothing to do with power or presumed depth in tissue. It is wavelength that determines the depth in tissue and the type of tissue response is my understanding of the therapy.

    • Hi Brian. Interesting you should comment on heat, they measured an 8ºC rise which is huge compared with 3B devices which are typically 1 or 2 degrees. The problem with painting is you never know what “dose” you gave. As you know I am a fan of the PASER story and treatment of lymphatics is something we recommend. As for penetration / wavelength , they use mostly 970nm which is a non penetrating wavelength , less than red light! Thats because it is mostly absorbed by water and that explains the 8º rise in temperature.

Leave a Reply

Your email address will not be published.