Effect Of Low-level Laser Treatment Research Articles

Effectiveness and Safety of Low-Level Laser Treatment for Lumbar Disc Herniation: A Systematic Review and Meta-Analysis

Background: Low-level laser treatment (LLLT) is used to treat low back pain (LBP) however, its effects on lumbar disc herniation (LDH) remain unclear. The safety and effectiveness of LLLT for LDH was determined using a systematic review of randomized clinical trials.Methods: Studies on LLLT in adults with LDH were identified from 12 worldwide databases. A risk of bias assessment and a meta-analysis with categorization according to the type of control used (inactive, active, or add-on) was performed. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation.Results: The quantitative analyses included five studies. LLLT was significantly more effective at treating LDH [leg pain visual analog scale (VAS) mean difference (MD): -1.90, 95% confidence interval (CI): -2.01, -1.80, I2 80%; LBP VAS MD: -0.79, 95% CI: -0.87, -0.71, I2 80%] than inactive controls (placebo or sham). The quality of the evidence ranged from “low” to “very low.” As an add-on to usual care, LLLT significantly improved pain intensity and disability compared with usual care (leg pain VAS MD: -2.52, 95% CI: -2.65, -2.40, I2 97%; LBP VAS MD: -1.47, 95% CI: -1.58, -1.36; Oswestry Disability Index MD: -4.10, 95% CI: -4.55, -3.65, I2 6%). However, the quality of the evidence ranged from “moderate” to “low.”Conclusion: LLLT significantly improved outcomes compared with the inactive controls, but was not more effective than usual care for LDH. In combination with usual care, LLLT was significantly more effective than usual care alone highlighting the potential of LLLT.

Empirical Studies on Effect of Low-Level Laser Treatment on Glioblastoma Multiforme in Combination with Ag-PMMA-PAA Nanoparticles: Paired Red Region Optical-Property Treatment Platform

Glioblastoma multiforme is an aggressive, invasive, fatal primary heterogenic brain tumor. New treatments have not significantly improved the dismal survival rate. Low-level laser therapy reports indicate different tumor cells respond distinctly to low-level laser therapy based on laser dose (J/cm2) or with nanotherapeutics. We investigated the effects of pairing two optical property-driven treatment agents—a low-level laser on glioblastoma multiforme (U251) using an He-Ne laser (632.8 nm) with 18.8 nm spherical Ag-PMMA-PAA nanoparticles, with an absorbance peak at 400 nm with a broad shoulder to 700 nm. The He-Ne treatment parameters were power (14.87 ± 0.3 mW), beam diameter (0.68 cm), and exposure time 5 min leading to a 12.28 J/cm2 dose. A dose of 12.28 J/cm2 was applied to Ag-PMMA-PAA nanoparticle concentrations (110–225 μM). An amount of 110 μM Ag-PMMA-PAA nanoparticles combined with an He-Ne dose at 18 h yielded 23% U251 death compared to He-Ne alone which yielded 8% U251 death. A 225 μM Ag-PMMA-PAA nanoparticle He-Ne combination resulted in an earlier, more significant, U251 death of 38% at 6 h compared to 30% with 225 μM alone at 18 h. Both treatment agents possess inherent physical and functional properties capable of redesign to enhance the observed cell death effects. Our results provide evidence supporting next-step studies to test “the redesign hypothesis” that these paired optical-driven agents provide a tunable platform that can generate significant U251 cell death increase.

A Clinical Study of the Effect of Low-Level Laser Treatment on the Clinical Stability of Immediately Loaded Implants in Posterior Maxilla

A Clinical Study of the Effect of Low-Level Laser Treatment on the Clinical Stability of Immediately Loaded Implants in Posterior Maxilla

The evaluation of healing effect of low-level laser treatment following gingivectomy

BackgroundLasers have been investigated as an alternative or adjunctive tool to conventional procedures commonly used in periodontology. The application of low-level laser therapy (LLLT) in dentistry was proposed to provide minimally invasive and painless treatment as well as increasing the comfort for the patient following surgery. Thus, the purpose of the current study was to evaluate the effect of LLLT on healing following gingivectomy.MethodsTwenty patients with inflammatory gingival enlargement on their maxillary or mandibular anterior region were included in this study. Patients were divided randomly into two groups (test group consist of ten patients) after gingivectomy a diode laser (660 nm) was applied to the wound area immediately post-surgery, 3 and 5 days post-surgery. The control group (ten patients) did not receive laser irradiation. Healing was evaluated clinically using healing score and visual analogue scale (VAS).ResultsThe laser-treated group had significant improvement regarding the healing score at 5, 7, and 14 days p.s., and significant improvement in visual analogue scale (VAS) score was observed at day 3, 5, and 7 p.s., than the control group.ConclusionLLLT can be used as an effective adjunctive treatment following gingivectomy procedure to promote healing and decrease patients’ discomfort.

No Clear Evidence for the Effect of Low-Level Laser Treatment on Orthodontically Induced Inflammatory Root Resorption: More Human Clinical Studies Are Needed

Influence of low-level laser therapy on orthodontically induced inflammatory root resorption. A systematic review. Michelogiannakis D, l-Shammery D, Akram Z, Rossouw PE, Javed F, Romanos GE. Arch Oral Biol 2019;100:1-13. The authors reported that this article did not receive any specific grants from funding agencies in the public, commercial, or nonprofit sectors. Systematic review.

The effect of laser irradiation and doxycycline application on the production of matrix metalloproteinase-8 and collagen I from cultured human periodontal ligament cells

Periodontal ligament fibroblasts (PDLF) play a key role in periodontal wound healing and tooth-supporting structures. Various approaches have been tried to enhance the fibroblastic activity such as laser irradiation or doxycycline application. The current study explored the influence of laser irradiation and doxycycline application on human PDLF. The aim of the study was the effect of low-level laser treatment and doxycycline application on the expression of collagen I and matrix metalloproteinase-8 (MMP8) from cultured human periodontal ligament cells. In this experimental study After preparation of human PDLF in three replications, they were divided into five treatment groups. The first group was day 0, which was used for standardization. The second group was the control group, which received no treatment within 4 days of the study. The third group was treated with doxycycline 30, daily for 4 consecutive days. The fourth group was treated with diode laser 2 daily for 4 consecutive days. The fifth group was treated with both doxycycline and laser irradiation pertaining to the third and fourth groups. After 4 days of treatment, cells were tested for collagen I and MMP-8 secretion through real-time-polymerase chain reaction and ELISA reader. The data were analyzed using the ANOVA and least significant difference pair tests ( P < 0.05 ). Treatment of human PDLF either with diode laser or doxycycline reduced the secretion of MMP-8 significantly. The maximum reduction was related to doxycycline application. Regarding collagen, I, only doxycycline application significantly increased collagen I secretion. Other groups showed no significant increase in collagen I secretion. This study showed that treatment of human PDLF either with diode laser or doxycycline significantly reduced MMP-8. Treatment with doxycycline significantly increased the secretion of collagen I.

Effectiveness of Dry Needling and Low-Level Laser Therapy in Nonspecific Low Back Pain

Introduction: Musculoskeletal spinal disorders are an immense problem in industrialised societies resulting in tremendous personal and economic costs. Younger adults (30 to 60-year-old) are more likely to experience Low Back Pain (LBP) from the disc space or from back muscle strain or other soft tissue strain. Experiencing it earlier in life may lead to recurrent and chronic LBP in adulthood. Dry Needling (DN) which are utilised to treat low back torment in current patterns. Low Level Laser Treatment (LLLT) is utilised to treat LBP by concentrating on the trigger focuses. Aim: To identify the effectiveness of DN and LLLT in the management of selected outcome variables among patients with nonspecific LBP. Materials and Methods: The Quasi experimental study was conducted among a total of 30 subjects who met the inclusion criteria. The subjects were divided into 15 each as group A (DN) and group B (LLLT). The Numerical Pain Distress Scale (NPDS), Quebec Back Pain Disability Scale (QBPDS) and lumbar flexion range of motion were assessed, before and after two weeks of intervention program to identify the effectiveness. Data analysis was done through SPSS and graph pad, using paired t-test and independent t-test. Results: Both groups have shown improvement after two weeks of intervention treatment program. Both groups showed significant difference in relieving pain, reducing disability and improving lumbar range of motion on nonspecific LBP individually. However, there was no significant difference found between the groups, thus null hypothesis was accepted and rejecting the alternate hypothesis. Conclusion: Both the techniques are equally effective in reducing the pain, disability level and improving range of motion individually after two weeks of intervention.

Evaluation of The Bio-Stimulatory Effect of Platelet Rich Fibrin Augmented by Diode LASER Compared to Platelet Rich Fibrin Alone on Dental Implant Replacing Posterior Mandibular Teeth. Randomised Clinical Trial: Split Mouth Study.

BACKGROUND:Restoring masticatory function and replacing missing teeth with minimal pain and discomfort are the most important issues for the patient and clinician. Nowadays dental implants became the most popular line of treatment to replace missing teeth; offering a comfortable long lasting prosthesis. Osseo-integration reflects the long term success of a dental implant. Many bio-modulators are used aiming to improve the osseointegration and healing around dental implants such as Low-Level Laser treatment (LLLT) and Platelet Rich Fibrin (PRF). PRF has been proven to improve bone repair process around the dental implant. LLLT is considered a noninvasive, safe technique that stimulates osteogenesis and alleviates post-operative pain.AIM:Evaluation of the bio-stimulatory effect of LLLT on a dental implant with PRF compared to PRF alone clinically and radiographically.METHODS:A randomised clinical trial with the split-mouth design was conducted on nine patients with bilaterally missing lower posterior tooth. All patients received one dental implant on each side with PRF. LASER application was performed to one side twice weekly for one month starting on the day of insertion. Post-operative pain was assessed daily through the first week using numerical rating pain scale (NRS) as the primary outcome. Relative peri-implant bone density was measured using direct digital intraoral radiography immediately after insertion, one, four and nine months postoperatively. Implants stability were measured using radio frequency assessment immediately after insertion, four and nine months post-operative as secondary outcomes.RESULTS:The NRS for pain was significantly decreased by the end of the first-week postoperatively in the intervention and control group with a mean of (2.22 ± 1.56) (2.11 ± 1.83) respectively. However, there was no statistically significant difference between the test groups at P-Value (0.892). The relative bone density values were decreased by the end of the ninth month of follow-up in the intervention and control group with a mean of (134.42 ± 16.13) (128.77 ± 33.54) respectively. No statistically significant difference was observed between the two test groups at P-value (0.863). The radiofrequency values for implant stability showed no statically significant difference after nine months of follow up when compared to the initial stability values at the day of insertion in the intervention and control group. The mean radiofrequency values were (67.24 ± 1.79) and (66.9 ± 2.57) respectively, and no statistically significant difference was observed between the two test groups at P-value (0.793)CONCLUSION:There are no statistically significant differences in post-operative pain values, implant stability and bone density between the implant sites treated with PRF augmented by Diode laser compared to implant sites treated by PRF alone.

Effect of Low-level Laser Treatment in Stellate Ganglion Area Irradiation Compared with Stellate Ganglion Block on Buccal Blood Flow and Surface Temperature

Effect of Low-level Laser Treatment in Stellate Ganglion Area Irradiation Compared with Stellate Ganglion Block on Buccal Blood Flow and Surface Temperature

Combined Treatment with Low-Level Laser and rhBMP-2 Promotes Differentiation and Mineralization of Osteoblastic Cells under Hypoxic Stress.

The aim of this study was to evaluate the combined effect of low-level laser treatment (LLLT) and recombinant human bone morphological protein-2 (rhBMP-2) applied to hypoxic-cultured MC3T3-E1 osteoblastic cells and to determine possible signaling pathways underlying differentiation and mineralization of osteoblasts under hypoxia. MC3T3-E1 cells were cultured under 1% oxygen tension for 72h. Cell cultures were divided into four groups: normoxia control, low-level laser (LLL) alone, rhBMP-2 combined with LLLT, and rhBMP-2 under hypoxia. Laser irradiation was applied at 0, 24, and 48h. Cells were treated with rhBMP-2 at 50ng/mL. Alkaline phosphatase activity was measured at 3, 7, and 14days to evaluate osteoblastic differentiation. Cell mineralization was determined with Alizarin red S staining at 7 and 14days. Western blot assays were performed to evaluate whether p38/protein kinase D (PKD) signaling was involved. The results indicate that LLLT and rhBMP-2 synergistically increased alkaline phosphatase (ALP) activity and mineralization. Western blot analyses showed that expression of type I collagen, runt-related transcription factor 2 (RUNX2), and Osterix (Osx), increased and expression of hypoxia-inducible factor 1-alpha (HIF-1α), decreased more in the LLLT and rhBMP-2 combined group than in the rhBMP-2 or LLL alone groups. Moreover, LLLT and rhBMP-2 stimulated p38 phosphorylation and rhBMP-2 and LLLT increased Prkd1 phosphorylation. Combined treatment with rhBMP-2 and LLL induced differentiation and mineralization of hypoxic-cultured MC3T3-E1 osteoblasts by activating p38/PKD signaling in vitro.

Combined Effect of Low-Level Laser Treatment and Levothyroxine on Wound Healing in Rats With Hypothyroidism.

Introduction: Hypothyroidism delays wound healing by reducing the synthesis of keratinocytes, fibroblast cells, and collagen. Methods for enhancement of wound healing include laser therapy and hormone therapy. The current study evaluated the combined effect of laser and levothyroxine therapy to cure wounds in male rats with hypothyroidism. Methods: Sixty male Wistar rats were randomly divided into 5 groups: (1) healthy controls; (2) controls with hypothyroidism; (3) hypothyroidism + laser treatment; (4) hypothyroidism + levothyroxine treatment; (5) hypothyroidism + laser + levothyroxine treatment. Hypothyroidism was induced by dissolving 4 mg of methimazole in 100 mL of drinking water daily for 28 days. After hypothyroidism had been confirmed, a longitudinal incisional wound was created on the dorsal rib cages of the rats. The wounds that received laser treatment were divided into 12 sections and treated at 810 nm wavelength and 0.2 J/cm2 of energy density for 200 seconds. Levothyroxine was administrated in doses of 20 µg/kg/d i.p. All groups were divided into 3 subgroups for testing on days 4, 7 and 14. Samples were collected in all the subgroups. Results: The results showed that hypothyroidism reduced fibrous tissue volume, fibroblasts, and basal cell numbers. The combined effect of laser and levothyroxine improved all parameters. Conclusion: Combined laser and levothyroxine treatment showed the best effect on wound healing and accelerated the closure of the wounds.

Clinical effectiveness of low-level laser treatment on peripheral somatosensory neuropathy.

Peripheral sensory neuropathy treatment is one of the common treatment problems and causes morbidity and mortality in people suffering from that. Although treatment depends on the underlying cause of the condition, nevertheless, in some cases, there is no cure for it, and it requires palliative and symptomatic treatment. In laboratory studies, low-level laser has been effective in the nerves protection and restoration. The aim of this article is to investigate the clinical efficacy of low-level laser on improvement of the peripheral somatosensory neuropathy. Search in the articles published up to 30 October 2015 (full text and abstracts) in databases PubMed (Medline), Cochrane library, Physiotherapy Evidence Database was performed. The studies of low-level laser trials on patients with peripheral neuropathy were carried out and evaluated in terms of the exclusion criteria. There are 35 articles among which 10 articles had the intended and required criteria. 1, 3, and 6 articles study the patients with diabetes, neuropathy caused by trauma, and carpal tunnel syndrome, respectively. In six studies, laser led to a reduction in sensory impairment and improvement of the physiological function of the sensory nerves. In these articles, lasers (Diode, GaAlAs, He-Ne) had wavelength range 660-860nm, radiation power 20-250mW, energy density 0.45-70J/cm2. The intervention sessions range was 6-21 times and patient follow-up was 0-6months. According to the results of these studies, low-level laser therapy can improve sensory function in patients with peripheral somatosensory neuropathy, although little research have not been done, laser treatment regimens are varied and do not recommend a specific treatment protocol. It seems it requires more research to sum up better, particularly in relation to diabetes.

Treatment for neuropathic pain and chronic inflammation using LASER in animal models.

The ST36 (Zusanli) acupuncture point is used to treat inflammatory processes, pain and gastrointestinal disturbs. For this reason, the aim of the present study was to evaluate the antinociceptive effect of Low-level Laser Treatment (LLLT) on ST36 acupoint using models of chronic nociception and inflammation. Male Swiss mice were treated with LLLT on ST36 30 minutes before the mechanical allodynia (von Frey) performed on the partial sciatic nerve ligation (PSNL) method and Complete Freund's Adjuvant (CFA). The results demonstrated that application of LLLT on ST36 inhibited the mechanical allodynia response induced by PSNL and CFA, with total reversion at 30 minutes after application. Long-term treatment of animals with LLLT on the same acupoint, once a day, also reduced the PNSL and CFA-induced mechanical allodynia response during 8 days of treatment. As conclusion, the results demonstrated that photonic stimulus on ST36 with LLLT produces antinociceptive effect in chronic models of nociception and inflammation. These findings suggest that LLLT may constitute an important therapeutic alternative to control chronic pain.

Trials needed to identify best management of iatrogenic inferior alveolar and lingual nerve injuries.

The Cochrane Oral Health Group's Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), Medline and Embase databases were searched with no language or date restrictions. Three reviewers independently selected studies. Randomised controlled trials (RCTs) involving interventions to treat patients with neurosensory defect of the inferior alveolar or lingual nerve or both as a sequela of iatrogenic injury were considered. Standard Cochrane methodological procedures were followed. Two studies considered at high risk of bias, reporting data from 26 analysed patients were included. Both studies investigated the effectiveness of low-level laser treatment compared to placebo laser therapy on inferior alveolar sensory deficit as a result of iatrogenic injury. Two studies assessed as at high risk of bias, reporting data from 26 analysed participants were included in this review. The age range of participants was from 17 to 55 years. Both trials investigated the effectiveness of low-level laser treatment compared to placebo laser therapy on inferior alveolar sensory deficit as a result of iatrogenic injury.Patient-reported altered sensation was partially reported in one study and fully reported in another. Following treatment with laser therapy, there was some evidence of an improvement in the subjective assessment of neurosensory deficit in the lip and chin areas compared to placebo, though the estimates were imprecise: a difference in mean change in neurosensory deficit of the chin of 8.40 cm (95% confidence interval (CI) 3.67 to 13.13) and a difference in mean change in neurosensory deficit of the lip of 21.79 cm (95% CI 5.29 to 38.29). The overall quality of the evidence for this outcome was very low. No studies reported on the effects of the intervention on the remaining primary outcomes of pain, difficulty eating, speaking or taste. No studies reported on quality of life or adverse events. There is clearly a need for randomised controlled clinical trials to investigate the effectiveness of surgical, medical and psychological interventions for iatrogenic inferior alveolar and lingual nerve injuries. Primary outcomes of this research should include: patient-focused morbidity measures including altered sensation and pain, pain, quantitative sensory testing and the effects of delayed treatment.

The effects of low-level laser therapy in patients with wrist pain: is this Mickey Mouse science?

Objective: Low level laser treatment (LLLT) is widely used in physical therapy practice. It is combined with physical therapy or LLLT alone. The purpose of this study is to evaluate the effectiveness of LLLT on patients` perception of general wrist pain. Design: Longitudinal study. Methods: Forty-eight subjects with wrist pain who were in the age range of 18-70 years old were examined. The subjects were asked, via an interview and a visual analog scale, to grade their wrist pain. They were asked to rotate their wrists through full range of motion and the angle at which any pain occurred was assessed. Each subject was then exposed to one of the following: 1) treatment with an infrared laser with the power turned off (placebo), 2) treatment with an infrared therapeutic laser, 3) treatment with a red therapeutic laser, 4) treatment with an ultraviolet laser, 5) treatment with a blue laser, 6) treatment with a Mickey Mouse flashlight. The duration of the treatment was 3 sessions in 3 days. Results: The results of the experiments showed that while pain was reduced both immediately after and the next day after laser therapy (p<0.05), there was no significant difference between the laser groups and the placebo group. However, the Mickey Mouse flashlight treatment groups had a greater range of motion than the laser groups (p<0.05). Conclusions: While pain was reduced in all laser groups, it was probably a placebo effect. The Mickey Mouse flashlight group probably received benefit from the heat of the flashlight.

The effects of low level laser radiation on bacterial growth

Objective: The low level lasers currently in the market vary in wavelength, dosage, and frequency. These devices are used with much different clinical pathology. Most notably, some studies claim that wounds heal faster with low level laser therapy due to the fact that bacteria commonly found in wounds are killed by laser light. Systemic and meta-analysis studies found the difficulty of comparison of numerous research studies because of differences in the intensities and frequencies of low level laser treatment (LLLT). The purpose of this study was to determine the effectiveness of LLLT on controlling bacterial growth. Design: Cross-sectional study. Methods: Variables included LLLT dosage and wavelength on 3 bacteria commonly seen in wounds, strains of Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa were used on commercially available 5.0-cm agar plates. Blue, green, and red, ultraviolet (UV) and infrared laser light sources were adjusted to either low or high intensity settings. Five Petri dishes at a time were placed directly beneath laser light sources with the exception of UV which was placed six inches below the suspended light and infrared which was placed directly on top of the Petri dish lid. Each group of five Petri dishes was irradiated for 15 minutes. Results: The results showed no effect of any of 9 different LLLT intensities or colors on bacteria growth compared to sham light. Conclusions: At least for claims of bacterial growth inhibition with LLLT, no support for this claim can be found here.

Interventions for iatrogenic inferior alveolar and lingual nerve injury.

Iatrogenic injury of the inferior alveolar or lingual nerve or both is a known complication of oral and maxillofacial surgery procedures. Injury to these two branches of the mandibular division of the trigeminal nerve may result in altered sensation associated with the ipsilateral lower lip or tongue or both and may include anaesthesia, paraesthesia, dysaesthesia, hyperalgesia, allodynia, hypoaesthesia and hyperaesthesia. Injury to the lingual nerve may also affect taste perception on the affected side of the tongue. The vast majority (approximately 90%) of these injuries are temporary in nature and resolve within eight weeks. However, if the injury persists beyond six months it is deemed to be permanent. Surgical, medical and psychological techniques have been used as a treatment for such injuries, though at present there is no consensus on the preferred intervention, or the timing of the intervention. To evaluate the effects of different interventions and timings of interventions to treat iatrogenic injury of the inferior alveolar or lingual nerves. We searched the following electronic databases: the Cochrane Oral Health Group's Trial Register (to 9 October 2013), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 9), MEDLINE via OVID (1946 to 9 October 2013) and EMBASE via OVID (1980 to 9 October 2013). No language restrictions were placed on the language or date of publication when searching the electronic databases. Randomised controlled trials (RCTs) involving interventions to treat patients with neurosensory defect of the inferior alveolar or lingual nerve or both as a sequela of iatrogenic injury. We used the standard methodological procedures expected by The Cochrane Collaboration. We performed data extraction and assessment of the risk of bias independently and in duplicate. We contacted authors to clarify the inclusion criteria of the studies. Two studies assessed as at high risk of bias, reporting data from 26 analysed participants were included in this review. The age range of participants was from 17 to 55 years. Both trials investigated the effectiveness of low-level laser treatment compared to placebo laser therapy on inferior alveolar sensory deficit as a result of iatrogenic injury.Patient-reported altered sensation was partially reported in one study and fully reported in another. Following treatment with laser therapy, there was some evidence of an improvement in the subjective assessment of neurosensory deficit in the lip and chin areas compared to placebo, though the estimates were imprecise: a difference in mean change in neurosensory deficit of the chin of 8.40 cm (95% confidence interval (CI) 3.67 to 13.13) and a difference in mean change in neurosensory deficit of the lip of 21.79 cm (95% CI 5.29 to 38.29). The overall quality of the evidence for this outcome was very low; the outcome data were fully reported in one small study of 13 patients, with differential drop-out in the control group, and patients suffered only partial loss of sensation. No studies reported on the effects of the intervention on the remaining primary outcomes of pain, difficulty eating or speaking or taste. No studies reported on quality of life or adverse events.The overall quality of the evidence was very low as a result of limitations in the conduct and reporting of the studies, indirectness of the evidence and the imprecision of the results. There is clearly a need for randomised controlled clinical trials to investigate the effectiveness of surgical, medical and psychological interventions for iatrogenic inferior alveolar and lingual nerve injuries. Primary outcomes of this research should include: patient-focused morbidity measures including altered sensation and pain, pain, quantitative sensory testing and the effects of delayed treatment.

Low-level laser and local corticosteroid injection in the treatment of subacromial impingement syndrome: a controlled clinical trial

Objective: To investigate the effectiveness of low-level laser treatment and local corticosteroid injection in patients with subacromial impingement syndrome. Design: Controlled clinical trial. Setting: Physical Medicine and Rehabilitation outpatient clinic. Subjects: One hundred thirty-five patients with subacromial impingement syndrome. Intervention: The patients were allocated to three groups: local corticosteroid injection (group I); sham laser treatment (group II); and low-level laser treatment (group III). Low-level laser treatment was performed three times per week for a total of nine sessions. Local corticosteroid injections were administered twice, with an interval of 10 days between each. The patients were assessed at pre-treatment, post-treatment and three and six months after the first visit. Main measures: The primary outcome of the study was pain intensity (visual analog scale) during activity and at rest. The secondary outcomes were, shoulder functional status and quality of life measured by the University of California at Los Angeles rating score (UCLA) and Nottingham Health Profile (NHP) scale respectively. Results: Significant differences were observed between groups I and II and between groups II and III regarding pain during activity and at rest scores at all of the visits (p<0.05). Nevertheless, significant improvement was observed between groups I and III regarding pain during activity only at post-treatment (p=0.013). The UCLA scores were significantly changed in all three study groups at all of the visits (p<0.05). Conclusion: The effectiveness of low-level laser treatment was similar to that of local corticosteroid injection in patients with subacromial impingement syndrome. We concluded that both low-level laser treatment and corticosteroid injection were more effective than sham laser treatment.

Efficacy and Safety of a Low-level Laser Device in the Treatment of Male and Female Pattern Hair Loss: A Multicenter, Randomized, Sham Device-controlled, Double-blind Study

SignificanceMale and female pattern hair loss are common, chronic dermatologic disorders with limited therapeutic options. In recent years, a number of commercial devices using low-level laser therapy have been promoted, but there have been little peer-reviewed data on their efficacy.ObjectiveTo determine whether treatment with a low-level laser device, the US FDA-cleared HairMax Lasercomb®, increases terminal hair density in both men and women with pattern hair loss.MethodsRandomized, sham device-controlled, double-blind clinical trials were conducted at multiple institutional and private practices. A total of 146 male and 188 female subjects with pattern hair loss were screened. A total of 128 male and 141 female subjects were randomized to receive either a lasercomb (one of three models) or a sham device in concealed sealed packets, and were treated on the whole scalp three times a week for 26 weeks. Terminal hair density of the target area was evaluated at baseline and at 16- and 26-week follow-ups, and analyzed to determine whether the hypothesis formulated prior to data collection, that lasercomb treatment would increase terminal hair density, was correct. The site investigators and the subjects remained blinded to the type of device they dispensed/received throughout the study. The evaluator of masked digital photographs was blinded to which trial arm the subject belonged.ResultsSeventy-eight, 63, 49, and 79 subjects were randomized in four trials of 9-beam lasercomb treatment in female subjects, 12-beam lasercomb treatment in female subjects, 7-beam lasercomb treatment in male subjects, and 9- and 12-beam lasercomb treatment in male subjects, compared with the sham device, respectively. Nineteen female and 25 male subjects were lost to follow-up. Among the remaining 122 female and 103 male subjects in the efficacy analysis, the mean terminal hair count at 26 weeks increased from baseline by 20.2, 20.6, 18.4, 20.9, and 25.7 per cm2 in 9-beam lasercomb-treated female subjects, 12-beam lasercomb-treated female subjects, 7-beam lasercomb-treated male subjects, and 9- and 12-beam lasercomb-treated male subjects, respectively, compared with 2.8 (p < 0.0001), 3.0 (p < 0.0001), 1.6 (p = 0.0017), 9.4 (p = 0.0249), and 9.4 (p = 0.0028) in sham-treated subjects (95 % confidence interval). The increase in terminal hair density was independent of the age and sex of the subject and the lasercomb model. Additionally, a higher percentage of lasercomb-treated subjects reported overall improvement of hair loss condition and thickness and fullness of hair in self-assessment, compared with sham-treated subjects. No serious adverse events were reported in any subject receiving the lasercomb in any of the four trials.Conclusions and relevanceWe observed a statistically significant difference in the increase in terminal hair density between lasercomb- and sham-treated subjects. No serious adverse events were reported. Our results suggest that low-level laser treatment may be an effective option to treat pattern hair loss in both men and women. Additional studies should be considered to determine the long-term effects of low-level laser treatment on hair growth and maintenance, and to optimize laser modality.

Effect of low-level laser treatment on cochlea hair-cell recovery after ototoxic hearing loss

The primary cause of hearing loss includes damage to cochlear hair cells. Low-level laser therapy (LLLT) has become a popular treatment for damaged nervous systems. Based on the idea that cochlea hair cells and neural cells are from same developmental origin, the effect of LLLT on hearing loss in animal models is evaluated. Hearing loss animal models were established, and the animals were irradiated by 830-nm diode laser once a day for 10 days. Power density of the laser treatment was 900 mW/cm(2), and the fluence was 162 to 194 J. The tympanic membrane was evaluated after LLLT. Thresholds of auditory brainstem responses were evaluated before treatment, after gentamicin, and after 10 days of LLLT. Quantitative scanning electron microscopic (SEM) observations were done by counting remaining hair cells. Tympanic membranes were intact at the end of the experiment. No adverse tissue reaction was found. On SEM images, LLLT significantly increased the number of hair cells in middle and basal turns. Hearing was significantly improved by laser irradiation. After LLLT treatment, both the hearing threshold and hair-cell count significantly improved.