Over 3,000 clinical research studies worldwide have proven the success of therapeutic lasers in the healing of neural muscular-skeletal conditions.

But don’t just take our word for it, we have posted a sample of clinical research studies substantiating the incredible clinical results we are getting everyday at Ace Physio. Call us today and experience the results for yourself!

Cold Laser LLLT

Excerpts from Studies:

 

Laser Therapy Treatment for Acne vulgaris

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Laser Therapy Treatment for Arthritis

Anti-Inflammatory Effect of Low-Level Laser and Light-Emitting Diode in Zymosan-Induced Arthritis

de Morais NC, Barbosa AM, Vale ML, Villaverde AB, de Lima CJ, Cogo JC, Zamuner SR.

Laboratory of Inflammation, Institute of Research and Development, University of Vale do Paraí ba , Sáo José dos Campos, Brazil.

Photomed Laser Surg. 2009 Sep 25. [PMID: 19780633]

Abstract Objective: The aim of this work was to investigate the effect of low-level laser therapy (LLLT) and light-emitting diode (LED) on formation of edema, increase in vascular permeability, and articular joint hyperalgesia in zymosan-induced arthritis.

Background Data: It has been suggested that low-level laser and LED irradiation can modulate inflammatory processes.

Material and Methods: Arthritis was induced in male Wistar rats (250-280 g) by intra-articular injection of zymosan (1 mg in 50 muL of a sterile saline solution) into one rear knee joint. Animals were irradiated immediately, 1 h, and 2 h after zymosan administration with a semiconductor laser (685 nm and 830 nm) and an LED at 628 nm, with the same dose (2.5 J/cm(2)) for laser and LED. In the positive control group, animals were injected with the anti-inflammatory drug dexamethasone 1 h prior to the zymosan administration. Edema was measured by the wet/dry weight difference of the articular tissue, the increase in vascular permeability was assessed by the extravasation of Evans blue dye, and joint hyperalgesia was measured using the rat knee-joint articular incapacitation test.

Results: Irradiation with 685 nm and 830 nm laser wavelengths significantly inhibited edema formation, vascular permeability, and hyperalgesia. Laser irradiation, averaged over the two wavelengths, reduced the vascular permeability by 24%, edema formation by 23%, and articular incapacitation by 59%. Treatment with LED (628 nm), with the same fluence as the laser, had no effect in zymosan-induced arthritis.

Conclusion: LLLT reduces inflammatory signs more effectively than LED irradiation with similar irradiation times (100 sec), average outputs (20 mW), and energy doses (2 J) in an animal model of zymosan-induced arthritis. The anti-inflammatory effects of LLLT appear to be a class effect, which is not wavelength specific in the red and infrared parts of the optical spectrum.

The effect of low-level laser in knee osteoarthritis: a double-blind, randomized, placebo-controlled trial

Hegedus B, Viharos L, Gervain M, Gálfi M.

Physio- and Balneotherapy Center, Orosháza-Gyopáros, Hungary. arthrodent@freemail.hu

Photomed Laser Surg. 2009 Aug;27(4):577-84. [PMID: 19530911]

INTRODUCTION: Low-level laser therapy (LLLT) is thought to have an analgesic effect as well as a biomodulatory effect on microcirculation. This study was designed to examine the pain-relieving effect of LLLT and possible microcirculatory changes measured by thermography in patients with knee osteoarthritis (KOA).

MATERIALS AND METHODS: Patients with mild or moderate KOA were randomized to receive either LLLT or placebo LLLT. Treatments were delivered twice a week over a period of 4 wk with a diode laser (wavelength 830 nm, continuous wave, power 50 mW) in skin contact at a dose of 6 J/point. The placebo control group was treated with an ineffective probe (power 0.5 mW) of the same appearance. Before examinations and immediately, 2 wk, and 2 mo after completing the therapy, thermography was performed (bilateral comparative thermograph by AGA infrared camera); joint flexion, circumference, and pressure sensitivity were measured; and the visual analogue scale was recorded.

RESULTS: In the group treated with active LLLT, a significant improvement was found in pain (before treatment [BT]: 5.75; 2 mo after treatment : 1.18); circumference (BT: 40.45; AT: 39.86); pressure sensitivity (BT: 2.33; AT: 0.77); and flexion (BT: 105.83; AT: 122.94). In the placebo group, changes in joint flexion and pain were not significant. Thermographic measurements showed at least a 0.5 degrees C increase in temperature—and thus an improvement in circulation compared to the initial values. In the placebo group, these changes did not occur. CONCLUSION: Our results show that LLLT reduces pain in KOA and improves microcirculation in the irradiated area.

Reduction of CXCR4 expression in Rheumatoid Arthritis rat joints by Low Level Diode Laser Irradiation

Lin Zhang, Hiroki Kajiwara, Noboru Kuboyama and Yoshimitsu Abiko

Department of Biochemistry and Molecular Biology, Nihon University School of Dentistry
Department of Oral Molecular Pharmacology, Nihon University School of Dentistry

(Received December 21, 2010)(Accepted February 18, 2011)

Abstract
Background: Rheumatoid arthritis (RA) is an inflammatory joint disorder, whose progression leads to the destruction of cartilage and bone. Chemokines and their receptors are potential therapeutic targets in RA. Among these, it has been suggested that CXC chemokine 4 (CXCR4) and its ligand CXC ligand 12 (CXCL12) are involved in RA pathogenesis. Low-level laser irradiation (LLLI) is currently being evaluated for the treatment of RA; however, the molecular mechanisms underlying its effectiveness remain unclear.
Aim: To understand the anti-inflammatory effect of LLLI, we used the collagen-induced arthritis (CIA) rat as RA model and analyzed the gene expression profile in synovial membrane in the hindpaw joints of control, CIA and CIA + LLLI. Expression of CXCR4 and CXCL12 genes were also studied.
Materials and Methods: Total RNA was isolated from the synovial membrane tissue of CIA rat joints or CIA joints treated with LLLI (830 nm Ga-Al-As diode), and gene expression profiles were analyzed by DNA microarray (41,000 rat genes). The mRNA levels were confirmed by reverse transcription polymerase chain reaction (RT-PCR) and real-time PCR. Immunohistochemical examination to examine CXCR4 protein expression was also carried out.
Results: DNA microarray analysis showed that CXCR4 gene expression was increased in CIA tissue and LLLI treatment significantly decreased CIA-induced CXCR4 mRNA levels. In contrast, CXCL12 did not show any significant changes. The microarray data of CXCR4 mRNA levels were further validated using RT-PCR and real-time PCR. Increased CXCR4 mRNA levels by CIA and its reduction following LLLI was successfully confirmed. CXCR4 production was increased in CIA joints and its production was decreased by LLLI.
Conclusion: Decreased CXCR4 expression may be one of the mechanisms in LLLI-mediated reduction of RA inflammation.

Laser Therapy Treatment for Back pain

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Laser Therapy Treatment for Carpal Tunnel Syndrome (CTS)

Carpal tunnel syndrome treated with a diode laser: a controlled treatment of the transverse carpal ligament

Chang WD, Wu JH, Jiang JA, Yeh CY, Tsai CT.

Department of Bio-Industrial Mechatronics Engineering, National Taiwan University, Taipei, Taiwan.

Photomed Laser Surg. 2008 Dec;26(6):551-7. [PMID: 19025407]

OBJECTIVE: The purpose of this placebo-controlled study was to investigate the therapeutic effects of the 830-nm diode laser on carpal tunnel syndrome (CTS).

BACKGROUND DATA: Many articles in the literature have demonstrated that low-level laser therapy (LLLT) may help to alleviate various types of nerve pain, especially for CTS treatment. We placed an 830-nm laser directly above the transverse carpal ligament, which is between the pisiform and navicular bones of the tested patients, to determine the therapeutic effect of LLLT. MATERIALS AND METHODS: Thirty-six patients with mild to moderate degree of CTS were randomly divided into two groups. The laser group received laser treatment (10 Hz, 50% duty cycle, 60 mW, 9.7 J/cm(2), at 830 nm), and the placebo group received sham laser treatment. Both groups received treatment for 2 wk consisting of a 10-min laser irradiation session each day, 5 d a week. The therapeutic effects were assessed on symptoms and functional changes, and with nerve conduction studies (NCS), grip strength assessment, and with a visual analogue scale (VAS), soon after treatment and at 2-wk follow-up.

RESULTS: Before treatment, there were no significant differences between the two groups for all assessments (p > 0.05). The VAS scores were significantly lower in the laser group than the placebo group after treatment and at follow-up (p < 0.05). After 2 wk of treatment, no significant differences were found in grip strengths or for symptoms and functional assessments (p > 0.05). However, there were statistically significant differences in these variables at 2-wk follow-up (p < 0.05). Regarding the findings of NCS, there was no statistically significant difference between groups after treatment and at 2-wk follow-up.

CONCLUSIONS: LLLT was effective in alleviating pain and symptoms, and in improving functional ability and finger and hand strength for mild and moderate CTS patients with no side effects.

Ultrasound and laser therapy in the treatment of carpal tunnel syndrome

Bakhtiary AH, Rashidy-Pour A.

Rehabilitation Faculty, Semnan Medical Sciences University, Senman, Iran. amir822@yahoo.com.

Aust J Physiother. 2004;50(3):147-51. [PMID: 15482245]

This study was designed to compare the efficacy of ultrasound and laser treatment for mild to moderate idiopathic carpal tunnel syndrome. Ninety hands in 50 consecutive patients with carpal tunnel syndrome confirmed by electromyography were allocated randomly in two experimental groups. One group received ultrasound therapy and the other group received low level laser therapy. Ultrasound treatment (1 MHz, 1.0 W/cm(2), pulse 1:4, 15 min/session) and low level laser therapy (9 joules, 830 nm infrared laser at five points) were applied to the carpal tunnel for 15 daily treatment sessions (5 sessions/week). Measurements were performed before and after treatment and at follow up four weeks later, and included pain assessment by visual analogue scale; electroneurographic measurement (motor and sensory latency, motor and sensory action potential amplitude); and pinch and grip strength. Improvement was significantly more pronounced in the ultrasound group than in low level laser therapy group for motor latency (mean difference 0.8 m/s, 95% CI 0.6 to 1.0), motor action potential amplitude (2.0 mV, 95% CI 0.9 to 3.1), finger pinch strength (6.7 N, 95% CI 5.0 to 8.2), and pain relief (3.1 points on a 10-point scale, 95% CI 2.5 to 3.7). Effects were sustained in the follow-up period. Ultrasound treatment was more effective than laser therapy for treatment of carpal tunnel syndrome. Further study is needed to investigate the combination therapy effects of these treatments in carpal tunnel syndrome patients.

Noninvasive laser neurolysis in carpal tunnel syndrome

Weintraub MI, MD, FACP

Muscle Nerve (1997) 20:1029-1031.

The peripheral nervous system is photosensitive, the scientific rationale for this study which determines the efficacy and safety to laser light exposure in 30 cases with CTS. Nine joules of energy over 5 points (7-15 treatments) reversed CTS in 77% of cases with three-fold normalization of CMAP. A photobiologic response was seen in 80%. This unique and novel approach is cost-effective and has a role in future management of CTS.

Treatment of repetitive use carpal tunnel syndrome

Smith CF, Vangsness CT, Anderson T & Good W (1995)

Proceedings SPIE (1995) 2395; 658-661.

A randomized, double-blind study was initiated in 1990 to evaluate an eight-point conservative treatment program in carpal tunnel syndrome. 160 patients were delineated with symptoms of carpal tunnel syndrome and these patients were then divided into two groups. Both groups were subjected to an ergonomically correct eight-point work modification program. A counterfeit LLLT unit was used in Group A, while an actual LLLT unit was used in Group B. Groups A and B were statistically significantly different in terms of return to work, conduction study improvement, and certain range of motion.

Laser Therapy Treatment for Degenerative disc disease

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Laser Therapy Treatment for Dental Applications

Effects of low-level laser therapy and orthodontic tooth movement on dental pulps in rats

Abi-Ramia LB, Sasso Stuani A, Sasso Stuani A, Sasso Stuani MB, de Moraes Mendes A.

Angle Orthod. 2010 Jan;80(1):116-22. [PMID: 19852650]

Abstract Objectives: To describe the microscopic pulpal reactions resulting from orthodontically induced tooth movement associated with low-level laser therapy (LLLT) in rats.

Materials and Methods: Forty-five young male Wistar rats were randomly assigned to three groups. In group I (n = 20), the maxillary right first molars were submitted to orthodontic movement with placement of a coil spring. In group II (n = 20), the teeth were submitted to orthodontic movement plus LLLT at 4 seconds per point (buccal, palatal, and mesial) with a GaAlAs diode laser source (830 nm, 100 mW, 18 J/cm(2)). Group III (n = 5) served as a control (no orthodontic movement or LLLT). Groups I and II were divided into four subgroups according to the time elapsed between the start of tooth movement and sacrifice (12 hours, 24 hours, 3 days, and 7 days).

Results: Up until the 3-day period, the specimens in group I presented a thicker odontoblastic layer, no cell-free zone of Weil, pulp core with differentiated mesenchymal and defense cells, and a high concentration of blood vessels. In group II, at the 12- and 24-hour time points, the odontoblastic layer was disorganized and the cell-free zone of Weil was absent, presenting undifferentiated cells, intensive vascularization with congested capillaries, and scarce defense cells in the cell-rich zone. In groups I and II, pulpal responses to the stimuli were more intense in the area underneath the region of application of the force or force/laser.

Conclusions: The orthodontic-induced tooth movement and LLLT association showed reversible hyperemia as a tissue response to the stimulus. LLLT leads to a faster repair of the pulpal tissue due to orthodontic movement.

The short-term effects of low-level lasers as adjunct therapy in the treatment of periodontal inflammation

Qadri T, Miranda L, Tuné r J, Gustafsson A.

Department of Periodontology, Institute of Odontology, Karolinska Institutet, Huddinge, Sweden. talat.qadri@mbox.lidnet.se

J Clin Periodontol. 2005 Jul;32(7):714-9. [PMID: 15966876]

OBJECTIVES: The aim of this split-mouth, double-blind controlled clinical trial was to study the effects of irradiation with low-level lasers as an adjunctive treatment of inflamed gingival tissue.

MATERIALS AND METHODS: Seventeen patients with moderate periodontitis were included. After clinical examination, all teeth were scaled and root planed (SRP). One week after SRP, we took samples of gingival crevicular fluid (GCF) and subgingival plaque. The laser therapy was started 1 week later and continued once a week for 6 weeks. One side of the upper jaw was treated with active laser and the other with a placebo. The test side was treated with two low-level lasers having wavelengths of 635 and 830 nm. The patients then underwent another clinical examination with sampling of GCF and plaque. The GCF samples were analysed for elastase activity, interleukin-1beta (IL-1beta) and metalloproteinase-8 (MMP-8). We examined the subgingival plaque for 12 bacteria using DNA probes.

RESULTS: The clinical variables i.e. probing pocket depth, plaque and gingival indices were reduced more on the laser side than on the placebo one (p<0.01). The decrease in GCF volume was also greater on the laser side, 0, 12 microl, than on the placebo side, 0.05 microl (p=0.01). The total amount of MMP-8 increased on the placebo side but was slightly lower on the laser side (p=0.052). Elastase activity, IL-1beta concentration and the microbiological analyses showed no significant differences between the laser and placebo sides.

CONCLUSION: Additional treatment with low-level lasers reduced periodontal gingival inflammation.

Infrared laser photobiomodulation (lambda 830 nm) on bone tissue around dental implants: a Raman spectroscopy and scanning electronic microscopy study in rabbits.

Lopes CB, Pinheiro AL, Sathaiah S, Da Silva NS, Salgado MA.

Instituto de Pesquisa & Desenvolvimento [Institute for Research & Development] (IP&D), Universidade do Vale do Paraíba (UNIVAP), São José dos Campos, Brazil., Department of Dentistry, UNIVAP, São José dos Campos, Brazil.

Photomed Laser Surg. 2007 Apr;25(2):96-101. [PMID: 17508844]

OBJECTIVES: The aim of this study was to assess, through Raman spectroscopy, the incorporation of calcium hydroxyapatite (CHA; approximately 960 cm(1)), and scanning electron microscopy (SEM), the bone quality on the healing bone around dental implants after laser photobiomodulation (lambda830 nm).

BACKGROUND DATA:Laser photobiomodulation has been successfully used to improve bone quality around dental implants, allowing early wearing of prostheses. METHODS: Fourteen rabbits received a titanium implant on the tibia; eight of them were irradiated with lambda830 nm laser (seven sessions at 48-h intervals, 21.5 J/cm(2) per point, 10 mW, phi approximately 0.0028 cm(2), 86 J per session), and six acted as control. The animals were sacrificed 15, 30, and 45 days after surgery. Specimens were routinely prepared for Raman spectroscopy and SEM. Eight readings were taken on the bone around the implant.

RESULTS: The results showed significant differences on the concentration of CHA on irradiated and control specimens at both 30 and 45 days after surgery (p < 0.001).

CONCLUSION: It is concluded that infrared laser photobiomodulation does improve bone healing, and this may be safely assessed by Raman spectroscopy or SEM./p>

Effect of low-level laser therapy on Candida albicans growth in patients with denture stomatitis.

Maver-Biscanin M, Mravak-Stipetic M, Jerolimov V.

Department of Prosthodontics, Clinical Hospital Centre, Zagreb, Croatia. mirela.maver@zg.htnet.hr

Photomed Laser Surg. 2005 Jun;23(3):328-32. [PMID: 15954824]

OBJECTIVE: The purpose of our report is to present the effect of low-level laser therapy on Candida albicans growth and palatal inflammation in two patients with denture stomatitis. BACKGROUND DATA: The most common oral mucosal disorder in denture wearers is denture stomatitis, a condition that is usually associated with the presence of the yeast Candida albicans. Different treatment methods have been suggested to treat this symptom, none of which is proven to be absolutely effective.

METHODS: Two denture-wearing patients, both with palatal inflammation diagnosed as Newton type II denture stomatitis were treated with low-power semiconductor diode laser (BTL-2000, Prague, Czech Republic) at different wavelengths (685 and 830 nm) for 5 d consecutively. In both patients, palatal mucosa and acrylic denture base were irradiated in noncontact mode (probe distance of 0.5 cm from irradiated area) with different exposure times-5 min (830 nm, 3.0 J/cm2, 60 mW) and 10 min (685 nm, 3.0 J/cm2, 30 mW). The effect of laser light on fungal growth in vivo was evaluated after the final treatment using the swab method and semiquantitative estimation of Candida albicans colonies growth on agar plates. The severity of inflammation was evaluated using clinical criteria.

RESULTS: After lowlevel laser treatment, the reduction of yeast colonies on the agar plates was observed and palatal inflammation was diminished.

CONCLUSION: LLLT is effective in the treatment of denture stomatitis. Further placebo controlled studies are in progress.

Laser therapy in the treatment of dentine hypersensitivity

Ladalardo TC, Pinheiro A, Campos RA, Brugnera Júnior A, Zanin F, Albernaz PL, Weckx LL.

Federal University of Sã o Paulo, UNIFESP-EPM, Sã o Paulo, SP, Brazil. t.chris@uol.com.br

Braz Dent J. 2004;15(2):144-50. Epub 2005 Mar 11. [PMID: 15776198]

Cervical dentine hypersensitivity is the most frequent complaint among reported odontalgias. Thus, this study evaluated the effectiveness of two types of lasers (660 nm wavelength red, and 830 nm wavelength infrared) as dentine desensitizers, as well as both the immediate and late therapeutic effects in individuals 25 to 45 years of age. A total of 40 teeth with cervical exposure were treated in 4 sessions. They were divided into 2 groups according to treatment. A 660 nm wavelength red diode laser and an 830 nm wavelength infrared diode laser were used. Dentine sensitivity to cold nociceptive stimulus was evaluated by means of a pain numeric scale from zero to 10 before each treatment session, at 15 and 30 min after irradiation, and in a follow-up period of 15, 30 and 60 days after the end of treatment. Significant levels of dentinal desensitization were only found in patients ranging in age from 25 to 35 years. The 660 nm red diode laser was more effective than the 830 nm infrared laser and a higher level of desensitization was observed at the 15 and 30 minute post-irradiation examinations. The immediate and late therapeutic effects of the 660 nm red diode laser were more evident in 25-35-year-old patients compared with those of the 830 nm infrared diode laser, in terms of the different age groups.

Laser Therapy Treatment for Fibromyalgia

Efficacy of low power laser therapy in fibromyalgia: a single-blind, placebo-controlled trial

Gü r A, Karakoç M, Nas K, Cevik R, Saraç J, Demir E.

Physical Medicine and Rehabilitation, School of Medicine, Dicle University, Diyarbakir, Turkey. alig@dicle.edu.tr

Lasers Med Sci. 2002;17(1):57-61. [PMID: 11845369]

Low energy lasers are widely used to treat a variety of musculoskeletal conditions including fibromyalgia, despite the lack of scientific evidence to support its efficacy. A randomised, single-blind, placebo-controlled study was conducted to evaluate the efficacy of low-energy laser therapy in 40 female patients with fibromyalgia. Patients with fibromyalgia were randomly allocated to active (Ga-As) laser or placebo laser treatment daily for two weeks except weekends. Both the laser and placebo laser groups were evaluated for the improvement in pain, number of tender points, skinfold tenderness, stiffness, sleep disturbance, fatigue, and muscular spasm. In both groups, significant improvements were achieved in all parameters (p<0.05) except sleep disturbance, fatigue and skinfold tenderness in the placebo laser group (p>0.05). It was found that there was no significant difference between the two groups with respect to all parameters before therapy whereas a significant difference was observed in parameters as pain, muscle spasm, morning stiffness and tender point numbers in favour of laser group after therapy (p<0.05). None of the participants reported any side effects. Our study suggests that laser therapy is effective on pain, muscle spasm, morning stiffness, and total tender point number in fibromyalgia and suggests that this therapy method is a safe and effective way of treatment in the cases with fibromyalgia.

Laser Therapy Treatment for Herniated discs

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Laser Therapy Treatment for Inflammation

Effects of Laser on the Synovial Fluid in the Inflammatory Process of the Knee Joint of the Rabbit

Sandoval MC, Mattiello-Rosa SM, Soares EG, Parizotto NA.

School of Physical Therapy, Industrial University of Santander, Bucaramanga, Columbia.

Photomed Laser Surg. 2009 Feb 2 [PMID: 19187016]

Abstract Objective: The purpose of this study was to evaluate the effects of low-level laser (LLL) energy on the clinical signs of inflammation and the cellular composition of synovial fluid (SF) in the inflamed knee of the rabbit. Background Data: There are few findings related to the effects of LLL on SF in inflammatory processes and there is little knowledge about the optimal parameters for reducing joint inflammation. Materials and Methods: Inflammation in the right knee of 36 rabbits was induced by intracapsular injection (0.2 mL) of Terebinthina commun (Tc). The animals were randomly assigned to three groups: acute experimental group (AEG), chronic experimental group (CEG), and control group (CG), which only received Tc. Each group was divided in two subgroups of six animals each. The AEG and CEG groups began to receive laser treatment 2 and 5 d after the induction of inflammation, respectively. Laser irradiation at a wavelength of 830 nm, power output of 77 mW, and power density of 27.5 W/cm(2) was applied daily for 7 d for either 0.12 sec or 0.32 sec, resulting in doses of 3.4 J/cm(2) and 8 J/cm(2), respectively. Body mass, joint perimeter, joint temperature, and the morphology of the SF were analyzed. Results: There was no statistically significant differences between groups in the body mass, joint perimeter, and SF morphology. Conclusion: Laser irradiation with the selected parameters produced only a few subtle differences in the inflammatory signs and the SF. The lack of effects may have been due to the short irradiation time.

Laser-Accelerated INFLAMMATION/PAIN REDUCTION AND HEALING

by Richard Martin, BS, CLT

Practical Pain Management, Nov/Dec 2003

Injured cells and tissues have greater affinity for LLLT than healthy cells and tissues. LLLT in the treatment of inflammation, pain and healing is a highly integrated process, but the author separates those processes categorically for identification.

Acute Inflammation Reduction(flowchart provided in the original article) – After injury, tissues initiate a series of biological responses and cellular membrane reactions which manifest in a combination of edema, inflammation, pain and functional debility. LLLT mediates by: (1) Stabilizing cellular membranes; (2) Enhancing molecule ATP production and synthesis; (3) Stimulating vasodilation via increased Histamine, Nitric Oxide and Serotonin; (4) Accelerating leukocytic activity; (5) Increasing Prostaglandin synthesis; (6) Reducing Interleukin-1; (7) Enhancing lymphocyte response; (8) Increasing angiogenesis; (9) Modulation temperature; (10) Enhancing superoxide dismutase levels; and (11) Decreasing C-reactive protein and neopterin levels.

Pain Reduction(flowchart provided in the original article) – Evidence justifies a conclusion that LLLT reduces pain by combination of processes: (1) Increase in b-Endorphins; (2) Blocked depolarization of C-fiber afferent nerves; (3) Increased nitric oxide production; (4) Increased nerve cell action potential; (5) Axonal sprouting and nerve cell regeneration; (6) Decreased Bradykinin levels; (7) Increased release of acetylcholine; and (8) Ion channel normalization.

Tissue HealingLLLT enhances wound healing by: (1) Enhanced leukocyte infiltration; (2) Increased macrophage activity; (3) Increased neovascularization; (4) Increased fibroblast proliferation; (5) Keratinocyte proliferation; (6) Early epithelialization; (7) Growth factor increases; (8) Enhanced cell proliferation and differentiation, and (9) Greater healed wound tensile strength.

Laser Therapy Treatment for Joint pain

LLLT with trigger points technique: clinical study on 243 patients

Simunovic Z

Journal of Clinical Laser Medicine and Surgery (Aug. 1996) 14(4):163-167.

Among the various methods of application techniques in LLLT (He-Ne 632.8 nm visible red or infrared 820-830 nm continuous wave and 904 nm pulsed emission) there are very promising “trigger points”, i.e., myofascial zones of particular sensibility and of highest projection of focal pain points, due to ischemic conditions. The effect of LLT and the results obtained after clinical treatment of >200 patients (headaches and facial pain, skeletomuscular ailments, myogenic neck pain, shoulder and arm pain, epicondylitis, tenosynovitis, low back and radicular pain, Achilles tendonitis) to whom the “trigger points” were applied were better than expected. It was also observed that rigidity decreases, mobility is restored (functional recovery), and spontaneous or induced pain decreases or even disappears, by movement. LLLT improves local microcirculation and it can also improve oxygen supply to hypoxic cells in the treated areas and can remove collected waste products. Normalization of the microcirculation interrupts the “circulus vitiosus” of the origin of the pain and its development (Melzak: muscular tension?pain?increased tension?increased pain, etc.). Results measured according to VAS/VRS/PTM: in acute pain, diminished >70%; in chronic pain >60%. Clinical effectiveness depends on correctly applied energy dose – over/under dosage produces opposite, negative effects on cellular metabolism. No negative effects were noted and the use of analgesic drugs could be reduced or completely excluded. LLLT may be used as monotherapy or as a supplement to other therapeutic procedures for pain treatment.

Laser Therapy Treatment for Lesions

Analysis of Low-Level Laser Radiation Transmission in Occlusive Dressings

de Jesus Guirro RR, de Oliveira Guirro EC, Martins CC, Nunes FR.

Department of Biomechanics, Medicine and Rehabilitation of the Locomotor System, School of Medicine of Ribeirã o Preto, University Sã o Paulo, Brazil

Photomed Laser Surg. 2009 Oct 9. [PMID: 19817516]

Abstract Objective: The purpose of this study is to analyze the power transmitted by low-level laser therapy (LLLT) into occlusive dressings using different wavelengths for the treatment of cutaneous lesions.

Background Data: LLLT has been largely used to treat several cutaneous lesions commonly associated with occlusive dressings to accelerate the healing process.

Materials and Methods: Radiation transmission was measured by a digital power analyzer connected to a laser emitter with wavelengths of 660, 830, and 904 nm and mean levels of 30, 30, 6.5 mW, respectively, previously calculated. Thirteen different occlusive dressings were analyzed and interposed between the laser emitter and the power analyzer sensor, with 15 measurements made for each dressing. Statistics were provided by the analysis of variance (ANOVA), followed by Student’s t-test (p < 0.05).

Results: The power transmitted ranged between 98.6% and 0%, depending on the material and wavelength. The dressings tested were BioFill, Hydrofilm, Confeel Plus 3533, Confeel 3218, DuoDERM Extra Thin, Hydrocoll, Micropore Nexcare, CIEX tape, Emplasto Sábia, CombiDERM, Band-aid, Actisorb Plus, in addition to polyvinylchloride (PVC) film, and transmitted power higher than 40% of the incident power, independently from the wavelength indicated for the association with LLLT.

Conclusion: The results showed that LLLT transmission depends on the occlusive dressing material and the wavelength irradiated.

Effect of low level laser therapy (830 nm) with different therapy regimes on the process of tissue repair in partial lesion calcaneous tendon

Oliveira FS, Pinfildi CE, Parizoto NA, Liebano RE, Bossini PS, Garcia EB, Ferreira LM.

Department of Plastic Surgery, Sã o Paulo Federal University-UNIFESP, Sã o Paulo, SP 04024-900, Brazil.

Lasers Surg Med. 2009 Apr;41(4):271-6. [PMID: 19347936]

BACKGROUND AND OBJECTIVE: Calcaneous tendon is one of the most damaged tendons, and its healing may last from weeks to months to be completed. In the search after speeding tendon repair, low intensity laser therapy has shown favorable effect. To assess the effect of low intensity laser therapy on the process of tissue repair in calcaneous tendon after undergoing a partial lesion.

STUDY DESIGN/MATERIALS AND METHODS: Experimentally controlled randomized single blind study. Sixty male rats were used randomly and were assigned to five groups containing 12 animals each one; 42 out of 60 underwent lesion caused by dropping a 186 g weight over their Achilles tendon from a 20 cm height. In Group 1 (standard control), animals did not suffer the lesion nor underwent laser therapy; in Group 2 (control), animals suffered the lesion but did not undergo laser therapy; in Groups 3, 4, and 5, animals suffered lesion and underwent laser therapy for 3, 5, and 7 days, respectively. Animals which suffered lesion were sacrificed on the 8th day after the lesion and assessed by polarization microscopy to analyze the degree of collagen fibers organization.

RESULTS: Both experimental and standard control Groups presented significant values when compared with the control Groups, and there was no significant difference when Groups 1 and 4 were compared; the same occurred between Groups 3 and 5.

CONCLUSION: Low intensity laser therapy was effective in the improvement of collagen fibers organization of the calcaneous tendon after undergoing a partial lesion.

Laser Therapy Treatment for Muscle spasms

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Laser Therapy Treatment for Neck pain

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

Chow RT, Johnson MI, Lopes-Martins RA, Bjordal JM.

Nerve Research Foundation, Brain and Mind Research Institute, University of Sydney, Sydney, NSW, Australia. robertachow@iinet.net.au

Lancet. 2009 Dec 5;374(9705):1897-908. Epub 2009 Nov 13. [PMID: 19913903]

BACKGROUND: Neck pain is a common and costly condition for which pharmacological management has limited evidence of efficacy and side-effects. Low-level laser therapy (LLLT) is a relatively uncommon, non-invasive treatment for neck pain, in which non-thermal laser irradiation is applied to sites of pain. We did a systematic review and meta-analysis of randomised controlled trials to assess the efficacy of LLLT in neck pain.

METHODS: We searched computerised databases comparing efficacy of LLLT using any wavelength with placebo or with active control in acute or chronic neck pain. Effect size for the primary outcome, pain intensity, was defined as a pooled estimate of mean difference in change in mm on 100 mm visual analogue scale.

FINDINGS: We identified 16 randomised controlled trials including a total of 820 patients. In acute neck pain, results of two trials showed a relative risk (RR) of 1.69 (95% CI 1.22-2.33) for pain improvement of LLLT versus placebo. Five trials of chronic neck pain reporting categorical data showed an RR for pain improvement of 4.05 (2.74-5.98) of LLLT. Patients in 11 trials reporting changes in visual analogue scale had pain intensity reduced by 19.86 mm (10.04-29.68). Seven trials provided follow-up data for 1-22 weeks after completion of treatment, with short-term pain relief persisting in the medium term with a reduction of 22.07 mm (17.42-26.72). Side-effects from LLLT were mild and not different from those of placebo.

INTERPRETATION: We show that LLLT reduces pain immediately after treatment in acute neck pain and up to 22 weeks after completion of treatment in patients with chronic neck pain. FUNDING: None.

The effect of 300 mW, 830 nm laser on chronic neck pain: a double-blind, randomized, placebo-controlled study

Chow RT, Heller GZ, Barnsley L.

Castle Hill Medical Centre, 269-271 Old Northern Road, Castle Hill, NSW 2154, Australia. rtchow@bigpond.net.au

Pain. 2006 Sep;124(1-2):201-10. Epub 2006 Jun 27. [PMID: 16806710]

A randomized, double-blind, placebo-controlled study of low-level laser therapy (LLLT) in 90 subjects with chronic neck pain was conducted with the aim of determining the efficacy of 300 mW, 830 nm laser in the management of chronic neck pain. Subjects were randomized to receive a course of 14 treatments over 7 weeks with either active or sham laser to tender areas in the neck. The primary outcome measure was change in a 10 cm Visual Analogue Scale (VAS) for pain. Secondary outcome measures included Short-Form 36 Quality-of-Life questionnaire (SF-36), Northwick Park Neck Pain Questionnaire (NPNQ), Neck Pain and Disability Scale (NPAD), the McGill Pain Questionnaire (MPQ) and Self-Assessed Improvement (SAI) in pain measured by VAS. Measurements were taken at baseline, at the end of 7 weeks’ treatment and 12 weeks from baseline. The mean VAS pain scores improved by 2.7 in the treated group and worsened by 0.3 in the control group (difference 3.0, 95% CI 3.8-2.1). Significant improvements were seen in the active group compared to placebo for SF-36-Physical Score (SF36 PCS), NPNQ, NPAD, MPQVAS and SAI. The results of the SF-36 – Mental Score (SF36 MCS) and other MPQ component scores (afferent and sensory) did not differ significantly between the two groups. Low-level laser therapy (LLLT), at the parameters used in this study, was efficacious in providing pain relief for patients with chronic neck pain over a period of 3 months.

Systematic review of the literature of low-level laser therapy (LLLT) in the management of neck pain

Chow RT, Barnsley L.

Castle Hill Medical Centre, Castle Hill Medical Centre, 269-271 Old Northern Road, Castle Hill, New South Wales 2154, Australia. rtchow@bigpond.net.au

Lasers Surg Med. 2005 Jul;37(1):46-52. [PMID: 15954117]

BACKGROUND AND OBJECTIVES: Low-level laser therapy (LLLT) is widely used in the treatment of musculoskeletal pain. However, there is controversy over its true efficacy. We aimed to determine the efficacy of LLLT in the treatment of neck pain through systematically reviewing the literature.

STUDY DESIGN/MATERIALS AND METHODS: A search of computerized bibliographic databases covering medicine, physiotherapy, allied health, complementary medicine, and biological sciences was undertaken undertaken from date of inception until February 2004 for randomized controlled trials of LLLT for neck pain. A comprehensive list of search terms was applied and explicit inclusion criteria were developed a priori. Twenty studies were identified, five of which met the inclusion criteria.

RESULTS: Significant positive effects were reported in four of five trials in which infrared wavelengths (lambda = 780, 810-830, 904, 1,064 nm) were used. Heterogeneity in outcome measures, results reporting, doses, and laser parameters precluded formal meta-analysis. Effect sizes could be calculated for only two of the studies.

CONCLUSIONS: This review provides limited evidence from one RCT for the use of infrared laser for the treatment of acute neck pain (n = 71) and chronic neck pain from four RCTs (n = 202). Larger studies are required to confirm the positive findings and determine the most effective laser parameters, sites and modes of application. © 2005 Wiley-Liss, Inc.

Laser Therapy Treatment for Plantar Fasciitis

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Laser Therapy Treatment for Post-surgical pain

Effects of Low-Level Laser Therapy on Pain and Scar Formation after Inguinal Herniation Surgery: A Randomized Controlled Single-Blind Study

de Paiva Carvalho RL, Alcâ ntara PS, Kamamoto F, Cressoni MD, Casarotto RA.

Postgraduate Program in Rehabilitation Sciences , University of Sã o Paulo, Sã o Paulo, Brazil.

Photomed Laser Surg. 2009 Oct 12. [PMID: 19821701]

Abstract Objective: The aim of this study was to investigate the efficacy of an infrared GaAlAs laser operating with a wavelength of 830 nm in the postsurgical scarring process after inguinal-hernia surgery. Background: Low-level laser therapy (LLLT) has been shown to be beneficial in the tissue-repair process, as previously demonstrated in tissue culture and animal experiments. However, there is lack of studies on the effects of LLLT on postsurgical scarring of incisions in humans using an infrared 830-nm GaAlAs laser. Method: Twenty-eight patients who underwent surgery for inguinal hernias were randomly divided into an experimental group (G1) and a control group (G2). G1 received LLLT, with the first application performed 24 h after surgery and then on days 3, 5, and 7. The incisions were irradiated with an 830-nm diode laser operating with a continuous power output of 40 mW, a spot-size aperture of 0.08 cm(2) for 26 s, energy per point of 1.04 J, and an energy density of 13 J/cm(2). Ten points per scar were irradiated. Six months after surgery, both groups were reevaluated using the Vancouver Scar Scale (VSS), the Visual Analog Scale, and measurement of the scar thickness. Results: G1 showed significantly better results in the VSS totals (2.14 +/- 1.51) compared with G2 (4.85 +/- 1.87); in the thickness measurements (0.11 cm) compared with G2 (0.19 cm); and in the malleability (0.14) compared with G2 (1.07). The pain score was also around 50% higher in G2.

Conclusion: Infra-red LLLT (830 nm) applied after inguinal-hernia surgery was effective in preventing the formation of keloids. In addition, LLLT resulted in better scar appearance and quality 6 mo postsurgery.

Comparative study using 685-nm and 830-nm lasers in the tissue repair of tenotomized tendons in the mouse

Carrinho PM, Renno AC, Koeke P, Salate AC, Parizotto NA, Vidal BC.

Laboratory of Electro-Thermo-Phototherapy, Department of Physiotherapy, Federal University of Sã o Carlos, Sã o Carlos, Brazil.

Photomed Laser Surg. 2006 Dec;24(6):754-8. [PMID: 17199477]

OBJECTIVE: The objective of this study was to evaluate the effects of 685- and 830-nm laser irradiations, at different fluences on the healing process of Achilles tendon (Tendon calcaneo) of mice after tenotomy.

BACKGROUND DATA: Some authors have shown that low-level laser therapy (LLLT) is able to accelerate the healing process of tendinuos tissue after an injury, increasing fibroblast cell proliferation and collagen synthesis. However, the mechanism by which LLLT acts on healing process is not fully understood.

METHODS: Forty-eight male mice were divided into six experimental groups: group A, tenomized animals, treated with 685 nm laser, at the dosage of 3 J/cm(2); group B, tenomized animals, treated with 685-nm laser, at the dosage of 10 J/cm(2); group C, tenomized animals, treated with 830-nm laser, at dosage of 3 J/cm(2); group D, tenomized animals, treated with 830-nm laser, at the dosage of 10 J/cm(2); group E, injured control (placebo treatment); and group F, non-injured standard control. Animals were killed on day 13 post-tenotomy, and their tendons were surgically removed for a quantitative analysis using polarization microscopy, with the purpose of measuring collagen fibers organization through the birefringence (optical retardation [OR]).

RESULTS: All treated groups showed higher values of OR when compared to injured control group. The best organization and aggregation of the collagen bundles were shown by the animals of group A (685 nm, 3 J/cm(2)), followed by the animals of group C and B, and finally, the animals of group D.

CONCLUSION: All wavelengths and fluences used in this study were efficient at accelerating the healing process of Achilles tendon post-tenotomy, particularly after the 685-nm laser irradiation, at 3 J/cm(2). It suggests the existence of wavelength tissue specificity and dose dependency. Further studies are required to investigate the physiological mechanisms responsible for the effects of laser on tendinuos repair.

Laser Therapy Treatment for Post-trauma acute pain

THE USE OF LASER THERAPY AND ADDITIONAL THERAPEUTIC MODALITIES AFTER ARTHROSCOPY OF THE KNEE AT ALPINE SKI TEAM

Lilic Alen, physiotherapist; 2Kozlevcar ivec Maja, dr. med. spec.fiz.reh.med.; 3Marcan Radoslav, dr.med., spec.ortop 1FIZIO, Ilirska Bistrica, Slovenija, 2Iskra Medical, Ljubljana, Slovenija, 3Ortopedska bolninica Valdoltra, Slovenija.

We review different kinds of injuries in the alpine ski sport concentrate on the injuries of the ligamentar part of the knees and meniscs in slovenian ski team. After the description of the injuries is a detailed presentation of the rehabilitational procedures from the first day of the injury till the return in to the competition arena. We explain the modalities of the rehabilitational procedures and their influence in the tissues, their main and side effects. Our main attention is focused on the use of the biostimulative lasers of higher power – 1,2 W and wavelength of 830 nm and their influence speedy recovery of the patients and their success in later competitions.

Laser Therapy Treatment for Posterior facet syndrome

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Laser Therapy Treatment for Sciatica

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Laser Therapy Treatment for Sprains and strains

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Laser Therapy Treatment for Tendonitis

A systematic review with procedural assessments and meta-analysis of low level laser therapy in lateral elbow tendinopathy (tennis elbow)

Bjordal JM, Lopes-Martins RA, Joensen J, Couppe C, Ljunggren AE, Stergioulas A, Johnson MI.

Institute of Physiotherapy, Faculty of Health and Social Sciences, Bergen University College, Moellendalsvn, 6, 5009 Bergen, Norway. jmb@hib.no

BMC Musculoskelet Disord. 2008 May 29;9:75. [PMID: 18510742]

BACKGROUND: Recent reviews have indicated that low level level laser therapy (LLLT) is ineffective in lateral elbow tendinopathy (LET) without assessing validity of treatment procedures and doses or the influence of prior steroid injections.

METHODS: Systematic review with meta-analysis, with primary outcome measures of pain relief and/or global improvement and subgroup analyses of methodological quality, wavelengths and treatment procedures.

RESULTS: 18 randomised placebo-controlled trials (RCTs) were identified with 13 RCTs (730 patients) meeting the criteria for meta-analysis. 12 RCTs satisfied half or more of the methodological criteria. Publication bias was detected by Egger’s graphical test, which showed a negative direction of bias. Ten of the trials included patients with poor prognosis caused by failed steroid injections or other treatment failures, or long symptom duration or severe baseline pain. The weighted mean difference (WMD) for pain relief was 10.2 mm [95% CI: 3.0 to 17.5] and the RR for global improvement was 1.36 [1.16 to 1.60]. Trials which targeted acupuncture points reported negative results, as did trials with wavelengths 820, 830 and 1064 nm. In a subgroup of five trials with 904 nm lasers and one trial with 632 nm wavelength where the lateral elbow tendon insertions were directly irradiated, WMD for pain relief was 17.2 mm [95% CI: 8.5 to 25.9] and 14.0 mm [95% CI: 7.4 to 20.6] respectively, while RR for global pain improvement was only reported for 904 nm at 1.53 [95% CI: 1.28 to 1.83]. LLLT doses in this subgroup ranged between 0.5 and 7.2 Joules. Secondary outcome measures of painfree grip strength, pain pressure threshold, sick leave and follow-up data from 3 to 8 weeks after the end of treatment, showed consistently significant results in favour of the same LLLT subgroup (p < 0.02). No serious side-effects were reported.

CONCLUSION: LLLT administered with optimal doses of 904 nm and possibly 632 nm wavelengths directly to the lateral elbow tendon insertions, seem to offer short-term pain relief and less disability in LET, both alone and in conjunction with an exercise regimen. This finding contradicts the conclusions of previous reviews which failed to assess treatment procedures, wavelengths and optimal doses.

Laser Therapy Treatment for TMJ

Effectiveness of low-level laser therapy in temporomandibular joint disorders: a placebo-controlled study

Fikácková H, Dostálová T, Navrátil L, Klaschka J.

Institute of Biophysics and Informatics, 1st Medical Faculty, Charles University, Prague, Czech Republic.

Photomed Laser Surg. 2007 Aug;25(4):297-303. [PMID: 17803388]

OBJECTIVE: Low-level laser therapy (LLLT) treatment for pain caused by temporomandibular joint disorders (TMD) was investigated in a controlled study comparing applied energy density, subgroups of TMD, and duration of disorders.

BACKGROUND DATA: Although LLLT is a physical therapy used in the treatment of musculoskeletal disorders, there is little evidence for its effectiveness in the treatment of TMD. METHODS: The study group of 61 patients was treated with 10 J/cm(2) or 15 J/cm(2), and the control group of 19 patients was treated with 0.1 J/cm(2). LLLT was performed by a GaAlAs diode laser with output of 400 mW emitting radiation wavelength of 830 nm in 10 sessions. The probe with aperture 0.2 cm(2) was placed over the painful muscle spots in the patients with myofascial pain. In patients with TMD arthralgia the probe was placed behind, in front of, and above the mandibular condyle, and into the meatus acusticus externus. Changes in pain were evaluated by self-administered questionnaire.

RESULTS: Application of 10 J/cm(2) or 15 J/cm(2) was significantly more effective in reducing pain compared to placebo, but there were no significant differences between the energy densities used in the study group and between patients with myofascial pain and temporomandibular joint arthralgia. Results were marked in those with chronic pain. CONCLUSION: The results suggest that LLLT (application of 10 J/cm(2) and 15 J/cm(2)) can be considered as a useful method for the treatment of TMD-related pain, especially long lasting pain.

Arthralgia of the temporomandibular joint and low-level laser therapy

Fikácková H, Dostálová T, Vosická R, Peterová V, Navrátil L, Lesák J.

Institute of Biophysics and Informatics, 1st Medical Faculty, Charles University, Prague, Czech Republic. hfikackova@hotmail.com

Photomed Laser Surg. 2006 Aug;24(4):522-7. [PMID: 16942435]

OBJECTIVE: This case report describes the treatment of a patient with arthralgia of the temporomandibular joint (TMJ) caused by disc displacement.

BACKGROUND DATA: The goal of the treatment of TMJ arthralgia is to decrease pain by promotion of the musculoskeletal system’s natural healing ability.

METHODS: This report describes the complex treatment of TMJ arthralgia. Low-level laser therapy (LLLT) was chosen for its antiinflammatory and analgesic effects. Laser therapy was carried out using the GaAlAs diode laser with an output power of 400 mW, emitting radiation with a wavelength of 830 nm, and having energy density of 15 J/cm2; the laser radiation was applied by contact mode on four targeted spots in 10 sessions. Physiotherapy was recommended to this patient to prevent the injury of intraarticular tissue caused by incorrect movement during opening of the mouth. Splint stabilization and prosthetic treatment were used to reduce overloading of the TMJ, resulting from unstable occlusion and to help repositioning of the dislocated disc.

RESULTS: Five applications of LLLT led to decrease of pain in the area of the TMJ on the Visual Analog Scale, from 20 to 5 mm. The anti-inflammatory effect of the laser was confirmed by thermographic examination. Before treatment, the temperature differences between the areas of the normal TMJ and TMJ with arthralgia was higher than 0.5 degrees C. However, at the conclusion of LLLT, temperatures in the areas surrounding the TMJ were equalized. CONCLUSION: This study showed the effectiveness of complex non-invasive treatment in patients with arthralgia of the TMJ. The analgesic and anti-inflammatory effects of LLLT were confirmed by infrared thermography.

Laser Therapy Treatment for Wound healing

Effect of low-level laser therapy on inflammatory reactions during wound healing: comparison with meloxicam

Viegas VN, Abreu ME, Viezzer C, Machado DC, Filho MS, Silva DN, Pagnoncelli RM.

School of Dentistry, Laser Center, Pontif í cia Universidade Cató lica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil.

Photomed Laser Surg. 2007 Dec;25(6):467-73. [PMID: 18158747]

OBJECTIVE: This study evaluated the action of low-level laser therapy (LLLT) on the modulation of inflammatory reactions during wound healing in comparison with meloxicam. BACKGROUND DATA: LLLT has been recommended for the postoperative period because of its ability to speed healing of wounds. However, data in the literature are in disagreement about its anti-inflammatory action.

METHODS: Standardized circular wounds were made on the backs of 64 Wistar rats. The animals were divided into four groups according to the selected postoperative therapy: group A-control; group B-administration of meloxicam; and groups C and D-irradiation with red (lambda = 685 nm) and infrared (lambda = 830 nm) laser energy, respectively. The animals were killed at 12, 36, and 72 h and 7 days after the procedure.

RESULTS: Microscopic analysis revealed significant vascular activation of irradiated sites in the first 36 h. Only group B showed decreases in the intensity of polymorphonuclear infiltrates and edema. Group D showed a higher degree of organization and maturation of collagen fibers than the other groups at 72 h. The animals in group C showed the best healing pattern at 7 days. The anti-inflammatory action of meloxicam was confirmed by the results obtained in this research. The quantification of interleukin-1beta (IL-1beta) mRNA by real-time polymerase chain reaction (PCR) did not show any reduction in the inflammatory process in the irradiated groups when compared to the other groups.

CONCLUSIONS: LLLT improves the quality of histologic repair and is useful during wound healing. However, with the methods used in this study the laser energy did not minimize tissue inflammatory reactions.

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.

J Athl Train. 2004 Sep;39(3):223-229. [PMID: 15496990]

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.

Dose and wavelength of laser light have influence on the repair of cutaneous wounds

Mendez TM, Pinheiro AL, Pacheco MT, Nascimento PM, Ramalho LM.

IP&D, Univap & School of Dentistry, Universidade do Vale do Paraí ba, Sã o José dos Campos, Sã o Paulo, Brazil.

J Clin Laser Med Surg. 2004 Feb;22(1):19-25. [PMID: 15117483]

OBJECTIVE: The objective of the present study was to compare histologically the effect of GaAlAs (lambda 830 nm, phi approximately 2 mm(2), 35 mW) and InGaAlP (lambda 685 nm, phi approximately 2 mm(2), 35 mW) lasers, alone or in association with doses of 20 or 50 J/cm(2) on cutaneous wounds in the dorsum of the Wistar rat. Background Data: The healing time of surgical wounds is of extreme importance and it is usually associated with a post-operative period free of infection and with less pain and inflammation.

MATERIALS AND METHODS: Sixty Wistar rats were divided into seven groups: Group I – control (non-irradiated); Group II – lambda 685 nm, 20 J/cm(2); Group III – lambda 830 nm, 20 J/cm(2); Group IV – lambda 685 nm and lambda 830 nm, 20 J/cm(2); Group V – lambda 685 nm, 50 J/cm(2)); Group VI – lambda 830 nm, 50 J/cm(2); and Group VII – lambda 685 nm and 830 nm, 50 J/cm(2). The animals were sacrificed 3, 5, and 7 days after surgery.

RESULTS: Light microscopic analysis using H&E and Picrosí rius stains showed that, at the end of the experimental period, irradiated subjects showed increased collagen production and organization when compared to non-irradiated controls. Inflammation was still present in all groups at this time.

CONCLUSION: Group IV (lambda 830 nm and lambda 685 nm, 20 J/cm(2)) presented better results at the end of the experimental period. It is concluded that low-level light therapy (LLLT) can have a positive biomodulatory effect on the repair of cutaneous wounds.

Wound healing of animal and human body sport and traffic accident injuries using low-level therapy treatment; a randomized clinical study of seventy-four patients with control group

Simunovic Z, Ivankovich AD, Depolo A.

Journal of Clinical Laser Medicine and Surgery (2000) Apr;18(2):67-73

The main objective was to assess the efficacy of low level laser therapy (LLLT) on wound healing in rabbits and humans. The initial research was a randomized controlled animal study, to evaluate the effects of laser irradiation on the healing of surgical wounds in rabbits. The application of LLLT on the human body is analogous to those of similar physiologic structure in animal tissue. This study was continued on humans, 74 patients with injuries to the following anatomic locations: ankle and knee, bilaterally, Achilles tendon; epicondylitis; shoulder; wrist; interphalangeal joints of hands, unilaterally. All patients has surgery prior to LLLT. Two laser devices were used: infrared diode laser (GaAIAs) 830 nm continuous wave for treatment of trigger points (TPs) and HeNe 632.8 nm combined with diode laser 904 nm pulsed wave for scanning procedure. Both were applied as monotherapy during the study. Results were observed and measured according to these clinical parameters: redness, heat, pain, swelling and loss of function, and finally submitted to statistical analysis via chi2 test. Results: After comparing the healing process between two groups of patients, the following results were noted: wound healing was significantly accelerated (25%-35%) in the patients treated with LLLT. Pain relief and functional recovery of those treated with LLLT were significantly improved compared to untreated patients. In addition to accelerated wound healing, LLLT for postoperative sport-and traffic-related injuries avoids side effects of drugs, accelerates functional recovery, allows earlier return to work, training and sport competition.

Laser and Sports Medicine in Plastic and Reconstructive Surgery

Junichiro Kubota M.D.

Department of Plastic and Reconstructive Surgery, Kyorin University School of Medicine, Tokyo, Japan.

Flap survival with diode laser therapy: Skin flap or graft surgery are major procedures in plastic and reconstructive surgery. Skin flap necrosis has been a problem. The author reported on the enhanced blood flow following the low reactive laser therapy in skin flaps. The 830 nm diode laser (20 – 60 mw) irradiated flaps showed a greater perfusion, a greater number of blood vessels, and a higher rate of survival areas than the control flaps in the rat models and clinical cases. Improvement of wound healing with diode laser therapy: Diode laser therapy was indicated for traumatic skin ulcers from sport activities and traffic accidents which were resistant to conservative treatment. The diode laser system with a wavelength of 830 nm. and output power of 150or 1000mw in continuous wave was applied with the non-contact method to the area on the wound for one minute once a day every day during the treatment period. The diode laser was used successfully for the rapid enhanced healing of traumatic skin ulcers.

Discussion: Most injured patients hope to avoid a surgical operation, trying instead conservative treatments. The diode laser therapy improved the flap circulation and wound healing of severe skin ulcers. This therapy has been applied for temporomandibular joint pain and favorable results were obtained. The diode laser therapy proved to be particularly effective for pain attenuation. The diode laser therapy offers an additional convenient, safe, and side-effect free method. On the other hand, the Q-switched Nd:YAG laser system consistently achieved good results concomitant with easy and safe operation, with lightening of the target lesions.

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