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Low-level laser therapy

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For more general use of light in therapy, see Light therapy.

Low level laser therapy (LLLT, also known as photobiomodulation, cold laser therapy and laser biostimulation) is a medical and veterinary technique which uses low-level lasers or light-emitting diodes to stimulate or inhibit cellular function.[1] The technique is also known by some other ambiguous terms such as laser therapy and phototherapy (though the latter more accurately refers to light therapy), which may also be used to describe other medical techniques. Clinical and laboratory research investigating optimal wavelengths, power densities, treatment duration and treatment intervals being published at a rate of about 25 papers a month..[2] The treatment is not yet accepted as routine medical therapy despite a significant body of published evidence (over 200 RCT's) that is at least equal to pharmaceutical, surgical and manual therapies for a range of pathologies including neck pain [3][4][5][6], tendinopathies [7] [8][9][10] and osteoarthritis. [11][12][13]

History

In 1967 a few years after the first working laser was invented, Endre Mester in Semmelweis University experimented with the effects of lasers on skin cancer. While applying lasers to the backs of shaven mice, he noticed that the shaved hair grew back more quickly on the treated group than the untreated group.[14]

US Food and Drug Administration has cleared the use of Low level lasers for the treatment of lymphedema (November 2006),[15] osteoarthritis (March 2009), and chronic pain.[16]

Clinical applications

Clinical applications that show some potential of effectiveness include treating soft tissue injury, chronic pain, and wound healing. More uses include tinnitus and nerve regeneration. Resolution of viral and bacterial infections has been claimed, but no plausible mechanism for this has been proposed. A Cochrane Library review has concluded that there is insufficient data to draw a firm conclusion on the clinical effectiveness of low-level laser therapy for low back pain.[17]

Mechanism

Certain wavelengths of light at certain intensities (or irradiance to use the technically correct term) delivered by laser, LED or another monochromatic source may affect tissue regeneration, inflammation, or pain.[18][19][20][21][22][23][24][25][26][27][28][29][30]

The exact mechanism is still being explored and debated but it is likely that the mechanism is photochemical rather than heat-related.[31][32][33]The primary biological and physiological effects include, up-regulation and down-regulation of adenosine triphosphate[34][35][36][37], Reactive oxygen species[38][39][40][41][42], and nitric oxide.[43][44][45][46]

The factors of wavelength, effective dose, dose-rate effects, beam penetration, the role of coherence and pulses (peak power and repetition rates) are still poorly understood in the clinical setting. Laser average power is typically in the range of 1-500 mW; some high peak power, short pulse width devices are in the range of 1-100 W with typically 200 ns pulse widths. The average beam irradiance then is typically 10 mW/cm2 - 5 W/cm2. The wavelength is typically in the range 600-1000 nm (red to near infrared) but some research has been done and products are available outside this range.[47]

See also

References

  1. ^ Huang, Y.Y. (2009). {{cite journal}}: Cite journal requires |journal= (help); Missing or empty |title= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)|"Biphasic Dose Response in Low Level Light Therapy" (PDF). Dose Response. pp. Pre Press.
  2. ^ "Abstracts from 7th international congress of the world association for laser therapy october 19-22, 2008". Photomed Laser Surg. 27 (1): 155–209. 2009. doi:10.1089/pho.2009-9959. PMID 19250054. {{cite journal}}: Unknown parameter |month= ignored (help)
  3. ^ Chow, RT.; Johnson, MI.; Lopes-Martins, RA.; Bjordal, JM. (2009). "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". Lancet. doi:10.1016/S0140-6736(09)61522-1. PMID 19913903. {{cite journal}}: Unknown parameter |month= ignored (help)
  4. ^ Chow RT, Heller GZ, Barnsley L. "The effect of 300 mW, 830 nm laser on chronic neck pain: a double-blind, randomized, placebo-controlled study". Pain 2006 Sep 124(1-2) 201-10. PMID 16806710.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  5. ^ Ozdemir F, Birtane M, Kokino S. "The clinical efficacy of low-power laser therapy on pain and function in cervical osteoarthritis". Clin Rheumatol 2001 20(3) 181-4. PMID 11434469.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  6. ^ Gur A, Sarac AJ, Cevik R, Altindag O, Sarac S. "Efficacy of 904 nm gallium arsenide low level laser therapy in the management of chronic myofascial pain in the neck: a double-blind and randomize-controlled trial". 2004 Lasers Surg Med. 2004;35(3):229-35. PMID 15389743.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  7. ^ Tumilty, S.; Munn, J.; McDonough, S.; Hurley, DA.; Basford, JR.; Baxter, GD. (2009). "Low Level Laser Treatment of Tendinopathy: A Systematic Review with Meta-analysis". Photomed Laser Surg. doi:10.1089/pho.2008.2470. PMID 19708800. {{cite journal}}: Unknown parameter |month= ignored (help)
  8. ^ Bjordal, JM.; Lopes-Martins, RA.; Joensen, J.; Couppe, C.; Ljunggren, AE.; Stergioulas, A.; Johnson, MI. (2008). "A systematic review with procedural assessments and meta-analysis of low level laser therapy in lateral elbow tendinopathy (tennis elbow)". BMC Musculoskelet Disord. 9: 75. doi:10.1186/1471-2474-9-75. PMID 18510742. {{cite journal}}: Cite has empty unknown parameter: |month= (help)CS1 maint: unflagged free DOI (link)
  9. ^ Stergioulas A, Stergioula M, Aarskog R, Lopes-Martins RA, Bjordal JM. "Effects of Low-Level Laser Therapy and Eccentric Exercises in the Treatment of Recreational Athletes With Chronic Achilles Tendinopathy". Am J Sports Med 2008 Feb 13. PMID 18272794.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  10. ^ Haker E, Lundeberg T. "Is low-energy laser treatment effective in lateral epicondylalgia?". J Pain Symptom Manage 1991 May 6(4) 241-6. PMID 2030299.
  11. ^ Bjordal JM, Couppe C, Chow RT, Tuner J, Ljunggren EA. "A systematic review of low level laser therapy with location-specific doses for pain from chronic joint disorders". Aust J Physiother 2003 49(2) 107-16. PMID 12775206.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  12. ^ Stelian J, Gil I, Habot B, Rosenthal M, Abramovici I, Kutok N, Khahil A. "Improvement of pain and disability in elderly patients with degenerative osteoarthritis of the knee treated with narrow-band light therapy". J Am Geriatr Soc 1992 Jan 40(1) 38525. PMID 1727843.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  13. ^ Ozdemir F, Birtane M, Kokino S. "The clinical efficacy of low-power laser therapy on pain and function in cervical osteoarthritis". Clin Rheumatol 2001 20(3) 181-4. PMID 11434469.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  14. ^ Mester, E. (1967). "Effect of laser on hair growth of mice". Kiserl Orvostud. 19: 628–631. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  15. ^ dotmed.com, Dec 27, 2006 Low Level Laser FDA Cleared for the Treatment of Lymphedema (accessed 9 Nov 09)
  16. ^ FDA website: pain relief
  17. ^ Yousefi-Nooraie, R (2008). "Low level laser therapy for nonspecific low-back pain". Cochrane Database Syst Rev. 16 (2): CD005107. doi:10.1002/14651858.CD005107.pub4. PMID 18425909. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  18. ^ Chow RT, Heller GZ, Barnsley L. "The effect of 300 mW, 830 nm laser on chronic neck pain: a double-blind, randomized, placebo-controlled study". Pain 2006 Sep 124(1-2) 201-10. PMID 16806710.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  19. ^ Stergioulas A, Stergioula M, Aarskog R, Lopes-Martins RA, Bjordal JM. "Effects of Low-Level Laser Therapy and Eccentric Exercises in the Treatment of Recreational Athletes With Chronic Achilles Tendinopathy". Am J Sports Med 2008 Feb 13. PMID 18272794.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  20. ^ Bjordal JM, Lopes-Martins RA, Iversen VV. "A randomised, placebo controlled trial of low level laser therapy for activated Achilles tendinitis with microdialysis measurement of peritendinous prostaglandin E2 concentrations". Br J Sports Med 2006 Jan 40(1) 76-80; discussion 76-80. PMID 16371497.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  21. ^ Ozcelik O, Cenk Haytac M, Kunin A, Seydaoglu G. "Improved wound healing by low-level laser irradiation after gingivectomy operations: a controlled clinical pilot study". J Clin Periodontol 2008 Mar 35(3) 250-4. PMID 18269665.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  22. ^ Kuhn A, Porto FA, Miraglia P, Brunetto AL. "Low-level infrared laser therapy in chemotherapy-induced oral mucositis: a randomized placebo-controlled trial in children". J Pediatr Hematol Oncol 2009 Jan 31(1) 33-7. PMID 19125084.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  23. ^ Ozdemir F, Birtane M, Kokino S. "The clinical efficacy of low-power laser therapy on pain and function in cervical osteoarthritis". Clin Rheumatol 2001 20(3) 181-4. PMID 11434469.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  24. ^ Stergioulas, A. "Low-level laser treatment can reduce edema in second degree ankle sprains". J Clin Laser Med Surg 2004 Apr 22(2) 125-8. PMID 15165387.
  25. ^ Markovic AB, Todorovic L. "Postoperative analgesia after lower third molar surgery: contribution of the use of long-acting local anesthetics, low-power laser, and diclofenac". Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006 Nov 102(5) e4-8. PMID 17052624.
  26. ^ Aras MH, Gungormus M. "The Effect of Low-Level Laser Therapy on Trismus and Facial Swelling Following Surgical Extraction of a Lower Third Molar". Photomed Laser Surg 2009 Jan 16. PMID 19196113.
  27. ^ Bjordal JM, Johnson MI, Iversen V, Aimbire F, Lopes-Martins RA. "Low-Level Laser Therapy in acute pain: a systematic review of possible mechanisms of action and clinical effects in randomized placebo-controlled trials". Photomed Laser Surg 2006 Apr 24(2) 158-68. PMID 16706694.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  28. ^ Schubert, V. "Effects of phototherapy on pressure ulcer healing in elderly patients after a falling trauma. A prospective, randomized, controlled study". Photodermatol Photoimmunol Photomed 2001 Feb 17(1) 32-8. PMID 11169174.
  29. ^ Gupta AK, Filonenko N, Salansky N, Sauder DN. "The use of low energy photon therapy (LEPT) in venous leg ulcers: a double-blind, placebo-controlled study". Dermatol Surg. 1998 Dec 24(12) 1383-6. PMID 9865208.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  30. ^ Minatel DG, Frade MA, Franca SC, Enwemeka CS. "Phototherapy promotes healing of chronic diabetic leg ulcers that failed to respond to other therapies". Lasers Surg Med 2009 Aug 41(6) 433-41. PMID 19588536.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  31. ^ Karu, T. "Primary and secondary mechanisms of action of visible to near-IR radiation on cells". J Photochem Photobiol B 1999 Mar 49(1) 1-17. PMID 10365442.
  32. ^ Lane N. "Power Games". Nature. 2006 Oct 26;443(7114):901-3. PMID 17066004.
  33. ^ Tafur J, Mills PJ. "Low-intensity light therapy: exploring the role of redox mechanisms". Photomed Laser Surg 2008 Aug 26(4) 323-8. PMID 18665762.
  34. ^ Lapchak PA, De Taboada L. "Transcranial near infrared laser treatment (NILT) increases cortical adenosine-5'-triphosphate (ATP) content following embolic strokes in rabbits". Brain Res 2009 Oct 23. PMID 19837048.
  35. ^ Karu T, Pyatibrat L, Kalendo G. "Irradiation with He-Ne laser increases ATP level in cells cultivated in vitro". J Photochem Photobiol B 1995 Mar 27(3) 219-23. PMID 7769534.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  36. ^ Kujawa J, Zavodnik L, Zavodnik I, Buko V, Lapshyna A, Bryszewska M. "Effect of low-intensity (3.75-25 J/cm2) near-infrared (810 nm) laser radiation on red blood cell ATPase activities and membrane structure". J Clin Laser Med Surg 2004 Apr 22(2) 111-7. PMID 15165385.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  37. ^ Wong-Riley MT, Liang HL, Eells JT, Chance B, Henry MM, Buchmann E, Kane M, Whelan HT. "Photobiomodulation directly benefits primary neurons functionally inactivated by toxins: role of cytochrome c oxidase". J Biol Chem 2005 Feb 11 280(6) 4761-71. PMID 15557336.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  38. ^ Zhang J, Xing D, Gao X. "Low-power laser irradiation activates Src tyrosine kinase through reactive oxygen species-mediated signaling pathway". J Cell Physiol 2008 Jul 9. PMID 18615581.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  39. ^ Karu, TI. "Mitochondrial signaling in mammalian cells activated by red and near-IR radiation". Photochem Photobiol 2008 Sep-Oct 84(5) 1091-9. PMID 18651871.
  40. ^ Lubart R, Lavi R, Friedmann H, Rochkind S. "Photochemistry and photobiology of light absorption by living cells". Photomed Laser Surg 2006 Apr 24(2) 179-85. PMID 16706696.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  41. ^ Wu S, Xing D, Wang F, Chen T, Chen WR. "Mechanistic study of apoptosis induced by high-fluence low-power laser irradiation using fluorescence imaging techniques". J Biomed Opt 2007 Nov-Dec 12(6) 064015. PMID 18163831.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  42. ^ Liang, HL, Whelan, HT, Eells, JT, Wong-Riley, MT. "Near-infrared light via light-emitting diode treatment is therapeutic against rotenone- and 1-methyl-4-phenylpyridinium ion-induced neurotoxicity". Neuroscience 2008 Jun 2 153(4) 963-74. PMID 18440709.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  43. ^ Lohr NL, Keszler A, Pratt P, Bienengraber M, Warltier DC, Hogg N. "Enhancement of nitric oxide release from nitrosyl hemoglobin and nitrosyl myoglobin by red/near infrared radiation: Potential role in cardioprotection". J Mol Cell Cardiol 2009 Mar 25. PMID 19328206.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  44. ^ Zhang R, Mio Y, Pratt PF, Lohr N, Warltier DC, Whelan HT, Zhu D, Jacobs ER, Medhora M, Bienengraeber M. "Near infrared light protects cardiomyocytes from hypoxia and reoxygenation injury by a nitric oxide dependent mechanism". J Mol Cell Cardiol 2009 Jan 46(1) 40268. PMID 18930064.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  45. ^ Samoilova KA, Zhevago NA, Petrishchev NN, Zimin AA. "Role of nitric oxide in the visible light-induced rapid increase of human skin microcirculation at the local and systemic levels: II. healthy volunteers". Photomed Laser Surg 2008 Oct 26(5) 443-9. PMID 18922087.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  46. ^ Kipshidze N, Keelan MH, Petersen JR, Bachutashvili I, Vossoughi J, Karanian J, Ghosh C, Iversen P, Roubin GS, Leon MB, Moses JW. "Photoactivation of vascular iNOS and elevation of cGMP in vivo: possible mechanism for photovasorelaxation and inhibition of restenosis in an atherosclerotic rabbit models". Photochem Photobiol 2000 Oct 72(4) 579-82. PMID 11045733.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  47. ^ Huang, Y.Y. (2009). {{cite journal}}: Cite journal requires |journal= (help); Missing or empty |title= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)|"Biphasic Dose Response in Low Level Light Therapy" (PDF). Dose Response. pp. Pre Press.
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