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Low level laser therapy for sports injuries
Abstract
Background and aims:
Our hospital has used LLLT in the treatment of athletes since 1990. We had a good result about LLLT for sports injuries. However, few articles have attempted to evaluate the efficacy of LLLT for sports injuries. The aims of this study was to evaluate the efficacy of LLLT for sports injuries. Materials (Subjects) and Methods: Forty one patients underwent LLLT in our hospital. These patients included 22 men and 19 women with an average age of 38.9 years old. Patients were irradiated by diode laser at points of pain and/or acupuncture points. Patients underwent LLLT a maximum treatment of 10 times (mean 4.1 times). We evaluated the efficacy of LLLT using a Pain relief score (PRS). A score of 2 to 5 after treatment was regarded as very good, 6 to 8 as good, and 9 to 10 as poor. A PRS score of less than 5 was regarded as effective.
Results:
The rate of effectiveness (PRS of 5 or less) after LLLT was 65.9% (27/41 patients).
Discussion:
In this study, the resulting rate of effectiveness was 65.9% for all sports injuries. However, we have a high rate of effectiveness for Jumper's knee, tennis elbow and Achilles tendinitis and cases that were irradiated laser by a physician.
Conclusions:
LLLT is an effective treatment for sports injuries, particularly jumper's knee, tennis elbow and Achilles tendinitis.
... 65,69 LLLT is proved to increase nitric oxide production, which promotes vasodilatation and accelerates wound healing. [70][71][72][73] The mechanism of LLLT analgesia is not fully understood. However, three hypotheses may be indicated: endogenous endorphin secretion increase, pain threshold rise, and conduction velocity decrease or inhibition. ...
... However, three hypotheses may be indicated: endogenous endorphin secretion increase, pain threshold rise, and conduction velocity decrease or inhibition. 70,72,74 Besides, local circulation improvement increases pain reduction in irradiated areas. 72 LLLT-mediated fibroblasts proliferation is an important aspect of chronic wound treatment. ...
... 70,72,74 Besides, local circulation improvement increases pain reduction in irradiated areas. 72 LLLT-mediated fibroblasts proliferation is an important aspect of chronic wound treatment. 75 Intracellular calcium increase (Ca 2+ ) stimulates DNA and RNA synthesis, followed by protein production. ...
Introduction Chronic wounds are the ones that present no healing progress for more than three months. The most common reasons for the chronic wound development in the lower limbs include long-lasting diabetes mellitus, venous insufficiency and peripheral arterial disease. However, it is estimated that 15%–20% of the lower limb chronic wounds are of mixed etiology. Standard treatments such as pharmacotherapy, debridement or skin grafting may be supplemented with physical medicine modalities. Aim The aim of the paper was to indicate the utility and biological effects of the physical medicine modalities frequently applied in chronic wound treatment. Discussion The physical medicine modalities widely used in the lower limbs chronic wounds treatment are variable magnetic fields, low-level laser therapy and hyperbaric oxygen therapy. Those modalities are proved to stimulate various biological reactions which may promote chronic wound healing. Stimulation of angiogenesis and collagen proliferation are factors that promote histological wound maturation and closure. Local circulation improvement mediated by hypocoagulation and vasodilatation is a factor accelerating wounds healing. Modalities-mediated pain reduction is a result of anti-inflammatory activity as well as of endogenous endorphin secretion. Modalities-mediated bacteriostatic and bactericidal effects are also observed. All those effects are mediated by activation of the immune system. An anti-inflammatory effect is due to the inhibition of pro-inflammatory cytokines secretion and the increase in interleukins activity. Conclusions Variable magnetic fields, low-level laser therapy and hyperbaric oxygen therapy are modalities revealing various working mechanisms. The significance of their administration in chronic wounds treatment can be attributed to a variety of their biological effects.
... All laser irradiation treatments were applied over a period of 4 weeks, once a week for a total of five sessions. A laser therapy device (Pulse 10, Panasonic Healthcare Inc., Japan) was used for treatment with a diode laser [30]. The wave length of this machine was 830 nm, peak output power was 10 W, and power density was 6-7W/cm 2 . ...
... For laser therapy, the device (Gallium-Alminium-Arsenide Diode) we used in the current study can produce pulsed laser light with a peak output power of 10 W, which simultaneously reduces the strong thermal effect and allows transmission of the laser light into deeper tissue. The device can deliver the laser light more deeply while maintaining average irradiation energy of 1 W which is equivalent to that of conventional laser devices [30]. In deep parts of the body, the intensity of the laser light becomes very low due to diffusion. ...
... Low-level laser therapy, also known as photobiomodulation (PBM), is considered to be a promising drug-free therapeutic approach to treating several pathological conditions [1][2][3]. Importantly, transcranial therapy of neurological diseases using visible and near-infrared radiation (NIR) is of particular interest to studies in photobiology [4][5][6]. ...
... After the modeling, the first experimental group of mice ("H + Pt" group) was exposed to transcranial irradiation (frontal and parietal lobes) with low-intensity LED (light-emitting diode) red light (wavelength 650 nm, continuous mode, beam area 0.002 m 2 , irradiance 50 mW/cm 2 , fluence (energy density) 6 J/cm 2 , irradiation time 3 min, 1 PBM session, irradiation with 3 cm distance), in the second experimental group only the isolated mitochondrial sample was exposed to the same irradiation ("H + Pm" group), and the hypoxia control group was left untreated ("H" group). To test the effect of PBM in intact mitochondria, in a separate group without hypoxia the mitochondrial samples were treated in the same manner ("C + (2) in the Control + Mitochondrial Irradiation (C + Pm) group the mitochondrial samples isolated from untreated animals were irradiated with low-intensity LED red light for 3 min, (3) in the Hypoxia (H) group the acute hypobaric hypoxia (AHH) conditions were simulated for 6 min, (4) in the Hypoxia + Mitochondrial Irradiation (H + Pm) the mitochondrial samples were irradiated with low-intensity LED red light for 3 min following 24 h after 6-min AHH modeling, (5) in the Hypoxia + Transcranial Irradiation (H + Pt) the animals' crania were irradiated with low-intensity LED red light for 3 min after 6-min AHH modeling. In all groups the respiratory function and membrane potential of crude mitochondrial fractions of the left murine cerebral cortex isolated 24 h after the treatment was assessed using High-Resolution Respirometry (HRR). ...
Low-level laser therapy, or photobiomodulation, utilizes red or near-infrared light for the treatment of pathological conditions due to the presence of intracellular photoacceptors, such as mitochondrial cytochrome c oxidase, that serve as intermediates for the therapeutic effects. We present an in-detail analysis of the effect of low-intensity LED red light irradiation on the respiratory chain of brain mitochondria. We tested whether low-level laser therapy at 650 nm could alleviate the brain mitochondrial dysfunction in the model of acute hypobaric hypoxia in mice. The irradiation of the mitochondrial fraction of the left cerebral cortex with low-intensity LED red light rescued Complex I-supported respiration during oxidative phosphorylation, normalized the initial polarization of the inner mitochondrial membrane, but has not shown any significant effect on the activity of Complex IV. In comparison, the postponed effect (in 24 h) of the similar transcranial irradiation following hypoxic exposure led to a less pronounced improvement of the mitochondrial functional state, but normalized respiration related to ATP production and membrane polarization. In contrast, the similar irradiation of the mitochondria isolated from control healthy animals exerted an inhibitory effect on CI-supported respiration. The obtained results provide significant insight that can be beneficial for the development of non-invasive phototherapy.
... Recently, noninvasive nonpharmacological treatments such as transcutaneous nerve stimulation therapy (TENS), laser, and ultrasound therapy have been added to treatment regimens as standalone or adjunctive therapies [37][38][39][40][41][42][43][44][45][46][47]. TENS acts through inhibition of Aβ-fibers activated pain [42,43], laser therapy actives cellular metabolism, increasing growth factor production and matrix production. ...
... TENS acts through inhibition of Aβ-fibers activated pain [42,43], laser therapy actives cellular metabolism, increasing growth factor production and matrix production. Ultrasound therapy mechanically and thermally actives the targeted tissue to modulate pain [37,41,[46][47][48][49]. ...
Background
Musculoskeletal injuries account for 10 million work-limited days per year and often lead to both acute and/or chronic pain, and increased chances of re-injury or permanent disability. Conservative treatment options include various modalities, nonsteroidal anti-inflammatory drugs, and physical rehabilitation programs. Sustained Acoustic Medicine is an emerging prescription home-use mechanotransductive device to stimulate cellular proliferation, increase microstreaming and cavitation in situ, and to increase tissue profusion and permeability. This research aims to summarize the clinical evidence on Sustained Acoustic Medicine and measurable outcomes in the literature.
Methods
A systematic literature review was conducted using PubMed, EBSCOhost, Academic Search Complete, Google Scholar and ClinicalTrials.gov to identify studies evaluating the effects of Sustained Acoustic Medicine on the musculoskeletal system of humans. Articles identified were selected based on inclusion criteria and scored on the Downs and Black checklist. Study design, clinical outcomes and primary findings were extracted from included studies for synthesis and meta-analysis statistics.
Results
A total of three hundred and seventy-two participants (372) were included in the thirteen clinical research studies reviewed including five (5) level I, four (4) level II and four (4) level IV studies. Sixty-seven (67) participants with neck and back myofascial pain and injury, one hundred and fifty-six (156) participants with moderate to severe knee pain and radiographically confirmed knee osteoarthritis (Kellgren–Lawrence grade II/III), and one hundred forty-nine (149) participants with generalized soft-tissue injury of the elbow, shoulder, back and ankle with limited function. Primary outcomes included daily change in pain intensity, change in Western Ontario McMaster Osteoarthritis Questionnaire, change in Global Rate of Change, and functional outcome measures including dynamometry, grip strength, range-of-motion, and diathermic heating (temperature measurement).
Conclusion
Sustained Acoustic Medicine treatment provides tissue heating and tissue recovery, improved patient function and reduction of pain. When patients failed to respond to physical therapy, Sustained Acoustic Medicine proved to be a useful adjunct to facilitate healing and return to work. As a non-invasive and non-narcotic treatment option with an excellent safety profile, Sustained Acoustic Medicine may be considered a good therapeutic option for practitioners.
... After removing duplicates (n = 31) from a total of 1990 records identified using the search strategy, 1959 studies were screened in view of the title, abstract, or full text, and 1937 were discarded (1558 studies were unrelated to sports medicine; 142 studies were not primary studies; 100 studies were experimental studies; 30 studies were not related to intervention using acupuncture points, etc.). Finally, 22 case reports/series were included in our review [27][28][29][30][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50]. The summary of the characteristics of the inclusion studies based on the items in the CARE checklist is shown in Table 1. ...
... However, apart from the lack of evidence of recommendations for various conservative treatment options [59], there are still limitations in the application of drug therapy, one of the most used conservative managements, to all cases of the RTP strategy [60]. The case studies included in this review suggest that acupuncture is one of the conservative approaches that would merit consideration in the field of sports and may be worth trying even for unexpected disorders that are not easy to treat [27][28][29][30][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50]. ...
Acupuncture is one of the representative complementary and alternative medicine treatments used for various types of pain. This systematic review summarized and analyzed clinical case reports/series utilizing acupuncture for treating sports injuries in athletes, thereby providing the basis for further research to establish clinical evidence on acupuncture treatment in sports medicine. A comprehensive literature search was conducted in Embase including MEDLINE up to 21 August 2019 without language and publication date restrictions. Due to the heterogeneity of each study, explanatory and descriptive analyses were performed. As a result, in each case report/series, it was confirmed that acupuncture was applied for treating various types of sports injuries experienced by athletes. Acupuncture can help relieve short-term pain and recover from dysfunction and has been used as a useful, noninvasive, and conservative modality for managing sports injuries such as lateral meniscus rupture, femoral acetabular impingement, ganglion cysts, and sports hernia. In addition, acupuncture has been suggested as a treatment worth trying for diseases such as yips and delayed onset muscle soreness. The included cases showed some potential of acupuncture in the treatment of various types of sports injuries, beyond pain control in musculoskeletal disorders. However, considering that this review was based on case reports/series, a limited understanding of the clinical value of acupuncture in athletes is required. In the future, more specific research questions and hypotheses should be addressed to generate evidence based on experimental research.
... 28 The effect of PBMT has been compared with placebo PBMT, other electrophysiological agents, or exercises in a number of studies. 1,10,12,29,30 Okuni et al. and Morimoto et al. evaluated only the effectiveness of PBMT without comparison with a placebo group or other therapeutic options. Both studies concluded that PBMT was effective in treating pain. ...
... Both studies concluded that PBMT was effective in treating pain. 29,30 Exercise program is the most common treatment approach for LE. 31 The benefits of stretching and strengthening exercises of wrist extensors and eccentric exercises for the prevention and rehabilitation in LE have been shown. 32 Isometric, isotonic, and static stretching exercises of extensor carpi radialis brevis were recommended by Stasinopulos. ...
Objective: To compare the effects of photobiomodulation therapy (PBMT) and extracorporeal shock wave therapy (ESWT) on lateral epicondylitis (LE). Background: Although several authors have investigated the effects of PBMT and ESWT on LE, only one study to date has compared ESWT with PBMT. Ours is also the first study assessing patient satisfaction levels and quality of life in addition to comparing the two methods. Methods: Forty-three patients were randomly divided into two groups: 23 (mean age: 48.2 ± 9.4; 17 female, 6 male) were included in the PBMT group and 20 (mean age: 48.0 ± 9.9; 15 female, 5 male) in the ESWT group. PBMT was applied three times a week for 4 weeks, and ESWT once a week for 4 weeks. Stretching and eccentric strengthening exercises were also given to both groups as a home program. The Mayo Elbow Performance Score and disabilities of the arm, shoulder, and hand (DASH) were used for evaluating upper extremity functions. Pain intensity was evaluated using a visual analog scale (VAS), and muscle strengths were also assessed using a hand-held dynamometer. The 12-Item Short Form (SF-12) Survey Physical and Mental Component Scales were used to evaluate quality of life, and the global rating of change scale to evaluate patient satisfaction. Patients were assessed before treatment and at 12-week follow-up. Results: Improvements for elbow extension and shoulder flexion strength and for VAS movement were observed only in the PBMT group, whereas improvement of handgrip strength was present in both groups (p < 0.05). However, handgrip strength was superior in the PBMT group than in the ESWT group (p = 0.02). Conclusions: Both PBMT and ESWT are useful and can be used in the treatment of LE.
... The therapy was considered effective (with a 5/10 or lower post-treatment pain score) according to 27 patients (65.9%); however, the perception of effectiveness reached 100% for sessions conducted by a physician. 25 In 2014, Valera-Garrido et al. published a clinical trial using ultrasound-guided electroacupuncture to treat 36 patients suffering from chronic lateral epicondylitis. Patients were treated with ultrasound--guided electroacupuncture on the surface of the common extensor muscle tendon and on the surface of the short radial carpal extensor (first approach), as well as above the capsule and on the collateral ulnar ligament (second approach), once a week, for four weeks, in conjunction with eccentric exercises and stretches taught by a physiotherapist, meant to be performed at home. ...
... 36,37 A study prepared by Magra using NSAIDs to treat this type of injury observed small or no reduction of pain, 38 whereas his 2005 meta-analysis demonstrated that acupuncture causes significant short-term pain relief in lateral epicondylitis. 36 The research on the clinical trials selected for this review have presented positive results for acupuncture treatment, being such results more favorable when acupuncture is associated with another type of therapy 26,27 and when applied by a physician rather than being self-administered 25 . ...
As acupuncture is growing in popularity in Brazil and worldwide, it is necessary to study the benefits and possibilities of this type of treatment more in depth, especially as it is believed to produce fast results with few side effects and does not involve substances banned in sports. Thus, it seems like a good option to be considered as main or adjuvant therapy in sports-related injuries. In order to gain more knowledge about this subject, this article is an integrative review analyzing the publications of the period between January 2012 and January 2017 on the Cochrane and Pubmed platforms that analyzed acupuncture in the treatment of sports injuries. We found 49 articles, 11 of which fulfilled the inclusion criteria: two case reports, three clinical trials and six literature reviews. Although all the articles analyzed produced favorable results with the use of the therapeutic technique in question, flaws in the designs of the studies and the difficulty of creating a placebo control group in acupuncture hinder the qualification of the articles on evidence rating scales. Therefore, it is suggested to the researchers that further studies be published with experimental animal models and observational studies, and that STRICTA recommendations be followed to improve the level of evidence of acupuncture research. Level of Evidence II; Systematic review of level II studies.
... HILT has the advantage that can target deep joints and tissues and stimulate a wider area compared to LLLT. [74][75][76][77] Laser therapy has been shown to be successful in treating different musculoskeletal disorders such as non-specific LBP 74 , neck pain, 78 foot and ankle pain 79 and knee osteoarthritis. 80 Despite strong evidence for laser therapy in musculoskeletal conditions, there is insufficient knowledge about musculoskeletal laser treatment during pregnancy. ...
Introduction: Currently, lasers are used to treat many diseases and their complications. However, the use of lasers in pregnant patients is still controversial.
Methods: In this review, the application of lasers in the fields of urology, surgery, obstetrics, dermatology, and musculoskeletal disorders is evaluated. The following keywords were used to search through PubMed, Google Scholar, and Scopus: pregnancy, laser, urolithiasis, endovenous laser ablation (EVLA) or treatment, leg edema, varicose vein, venous insufficiencies, hair removal, pigmentation, telangiectasia, vascular lesions, Q switch laser, diode laser, holmium, holmium-YAG laser, erbium laser and Pulsed dye laser, low-level laser therapy, high-intensity laser therapy, pain, musculoskeletal disorders, twin to twin transfusion syndrome (TTTS), amnioreduction, and safety.
Results: Totally, 147 articles were found, and their abstracts were evaluated; out of 53 articles extracted, 14 articles were about dermatology, 24 articles were about urology, 12 articles were about obstetrics and gynecology, 10 articles were about musculoskeletal disorders and three articles were related to surgery.
Conclusion: Laser therapy can be used as a safe treatment for urolithiasis, skin diseases, TTTS, and varicose veins of the lower extremities. However, the use of laser therapy for musculoskeletal disorders during pregnancy is not recommended due to lack of evidence, and also we cannot recommend endovenous ablation.
... Both in vitro and in vivo studies report biologic effects of this type of treatment, such as increased fibroblast proliferation and collagen production , improvement of collagen-fiber alignment , increase in tendon tensile strength Demir et al., 2013;Marcos et al., 2014;, increased collateral circulation and angiogenesis , decreased levels of pro-inflammatory mediators, such as PGE-2, TNF-α, IL-1β and IL-6 Laraia et al., 2012;. Reports on clinical effects are ambiguous (Pryor, 2011;Wiegerinck et al., 2012;Morimoto et al., 2013;Lam and Cheing, 2007;Stergioulas et al., 2008;Bingol et al., 2005;Basford et al., 2008), which may be related to the fact that the depth of penetration of low-power laser devices is deemed to be insufficient to treat deeper tissues . For this reason, in human medicine various pathologies such as tendinopathies , whiplash injuries , back-and neck pain and other orthopedic sports injuries are treated with high-power laser (output > 500 mW). ...
... The flow diagram shows the study selection process (Supplementary Figure 1). After the screening by title and abstract, the full-text versions of the remaining nine publications were assessed and two were excluded due to wrong study design (one editorial comment 6 and one retrospective cohort study), 22 and one due to wrong intervention (highlevel laser therapy). 23 Furthermore, one study 24 was classified as awaiting classification because we could not access the full text and the authors were contacted, with no response. ...
Objective
The purpose of this study was to determine the benefits and harms of low-level laser therapy for Achilles tendinopathy.
Data sources
Search strategies were conducted (from inception to February 2020) in Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Literatura Latino Americana em Ciências da Saúde e do Caribe (LILACS), Physiotherapy Evidence Database (PEDro), SPORTDiscus, ClinicalTrials.gov, World Health Organization (WHO)-ICTRP and OpenGrey databases, to retrieve all randomized controlled trials that compared laser therapy with inactive/active interventions.
Review methods
This study was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The risk of bias was assessed using the Cochrane Risk of bias table. Meta-analyses were performed on dependence of homogeneity, otherwise results were reported narratively. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
Results
Four trials (119 participants) were analyzed. Laser therapy associated to eccentric exercises when compared to eccentric exercises and sham had very low to low certainty of evidence in pain and function assessment. Despite one trial favored laser therapy at two months (mean difference (MD) −2.55, 95% confidence interval (95% CI) −3.87 to −1.23), the CIs did not include important differences between groups at 3 and 13 months. The function assessment showed an improvement favoring the placebo group at one month (MD 9.19, 95% CI −16.16 to −2.23) and non-significant difference between groups at 3 and 13 months. Adverse events were poorly reported but restricted to minor events related to the exercises.
Conclusion
The certainty of evidence was low to very low, and the results are insufficient to support the routine use laser therapy for Achilles tendinopathy.
... There is also good evidence that after a short period of immobilization, functional rehabilitation is better than the traditional treatment of 6 weeks in a cast (5,6). Many possible physical therapies may be used to improve pain reduction and tissue healing, including Transfer of Energy Capacitive and Resistive therapy, laser therapy, ultrasound therapy, and other form of electric therapies (7,8). ...
Ankle injuries are very common between professional athletes and recreational sports. Lateral stable ligaments injury can be treated conservatively. Noninvasive interactive neurostimulation (NIN) is a form of electric therapy that works by locating areas of lower skin impedance. The objective of this prospective, double-blinded, random-ized controlled trial was to compare the results in terms of improvement of a foot functional score, lower level of reported pain, and return to sports in 2 groups of contact sport athlete affected by a grade I or II lateral ankle sprain. Patients were randomized using random blocks to the NIN program (group I) or a sham device (group II). The outcome measurements were the use of a self-reported Inability Walking Scale, patient-reported subjective assessment of the level of pain using a standard visual analogue scale, and daily intake of nonsteroidal antiinflam-matory drugs (etoricoxib 60 mg). Patients were also reached by telephone at 2 and 4 months of follow-up to register their return to sport activity. Beyond baseline evaluation, follow-ups were done after 5 (1 week) and 10 sessions (2 weeks) of treatment, and then at 30 days after the end of therapy. Of the 70 athletes admitted to the study, 61 eligible patients were randomized using random blocks to group I (n = 32) and group II (n = 29). Group I patients showed better improvement in terms of functional impairment (Inability Walking Scale), reported pain (visual analogue scale), and daily intake of etoricoxib 60 mg. Athletes of group I registered a faster resuming of sport activities. This prospective, randomized trial showed NIN can improve short-term outcomes in athletes with acute grade I or II ankle sprain and that it can hasten resuming of sport activities.
... According to the current literature, low level laser therapy can be considered being a second-line treatment in chronic tendon injuries, however there is no clear link to sports-related tendon pain [95]. In sports, an observational study in athletes suffering from sports injuries contributed a very good pain relieving effect to the laser application [96]. Stergioulas et al. showed LLLT in addition to eccentric exercise to significantly reduce pain in recreational athletes with chronic Achilles tendinopathy, when compared to placebo LLLT in combination with the same exercise [97]. ...
Objectives: Acute pain in sports tells us what not to do. Persisting pain limits the athletes’ activity and threatens his career. The reduction of pain is sought being highly beneficial for the sportsman, as it is shown that pain has only a weak connection to injury but a strong connection to the body image. Thus, pain therapy in sports medicine is a primary need of the athlete. Principle treatment goals are pain relief and return to play as quick as possible. Therapies in sports should primarily focus on conservative than on invasive approaches, with drugs being avoided as far as possible. There is a broad range of treatment approaches that could be applied in concert based on scientific and clinical decision making to reduce symptom severity, pain-associated dysfunction, and the risk of pain to be a tremendous cut in an elite athlete's career. Knowledge on this non-pharmacologic conservative pain medicine should not be restricted to health professionals, but the whole entourage of the athlete. This review highlights the current evidence with a focus on recreational and elite athletes. Based on their clinical evidence, it is hands-on techniques that can be recommended (Grade A: nerve blocks and injection techniques, ultrasound and laser therapy, manipulation mobilization, massage and traction; Grade B: acupuncture and dry needling). The occurrence of possible side-effects is, as far as reported, very unlikely. However, the methodological quality of the majority of retrieved studies limits the overall generalizability. Conclusion: Conservative non-pharmacologic therapies reflect an adequate strategy to relief pain in elite athletes. Chronic states of pain reflect more complex scenarios requiring further comprehensive techniques. Future research should thus also address multimodal approaches combining several of the mentioned therapies.
... Both in vitro and in vivo studies report biologic effects of this type of treatment, such as increased fibroblast proliferation and collagen production [13], improvement of collagen-fiber alignment [14], increase in tendon tensile strength [15,16,17,18], increased collateral circulation and angiogenesis [19,20], decreased levels of pro-inflammatory mediators, such as PGE-2, TNF-α, IL-1β and IL-6 [21,22,23,24]. Reports on clinical effects are ambiguous [25,26,27,28,29,30,31], which may be related to the fact that the depth of penetration of low-power laser devices is deemed to be insufficient to treat deeper tissues [32]. For this reason, in human medicine various pathologies such as tendinopathies [33], whiplash injuries [34], back-and neck pain and other orthopedic sports injuries [19] are treated with high-power laser (output >500 mW). ...
... Recently, the use of laser acupuncture to treat musculoskeletal injuries has been studied for pathologies such as adhesive capsulitis (17), lumbago (18), carpal tunnel syndrome (19), and jumper's knee, Achilles tendinitis, and tennis elbow with good results in general (20). This type of treatment is considered an effective alternative to the traditional use of needles, with the advantage that it can be used on acupuncture points that require complicated needle applications (21,22). ...
The objective of this study was to determine whether application of laser beam on acupuncture points has a positive effect on the rehabilitation of patients with a diagnosis of distal radius fracture (1.5 inches proximal to distal articular surface of the radius) when applied with active conventional physical therapy exercises. Patients with a distal radius fracture treated with closed reduction, percutaneous pinning, and a short cast for six weeks was included and were assigned to one of two study groups. The control group was given simulated laser acupuncture with the laser off, while the experimental group received laser beam on acupuncture points. A low power infrared 980 nm, 50 mW laser (Diller & Diller Laser Performance) electric energy, was used; each acupuncture point was irradiated for 30 seconds at 8,000 Hz at each therapy session. In both groups, treatment was applied to the following points: Ipsilateral- Yanggu (SI5), Yangchi (SJ4), Waiguan (SJ15), Yangxi (LI5), Daling (PC7); Bilateral- Hegu (LI4); Contralateral- Shenmail (VL62), Kulun (V60), Taixi (KID3). All of the patients underwent a total of 10 sessions, at a frequency of three times per week. They were evaluated using the VAS, the Patient-Rated Wrist Evaluation (PRWE), and wrist mobility ranges at the beginning of treatment, at the end of the fifth session, at the 10th session, and a week after the 10th session. The patients treated with laser beam exposure on acupuncture points showed 44% reduction in pain and 33% of improvement in the functional status of the wrist compared with the control group. Application of laser beam on acupuncture points combined with active rehabilitation exercises show benefits in the rehabilitation of patients with a distal radius fracture managed with percutaneous pinning and a short cast.
... Light absorption induces photochemical effects thereby causing changes in cells, which enhance cell proliferation 11 . It has been successfully used to treat skin conditions 12 , wounds 13 , sports injuries 14 , chronic pain 15 and several other medical conditions 16 . ...
Human immunodeficiency virus (HIV-1) infection remains a major health problem despite the use of highly active antiretroviral therapy (HAART), which has greatly reduced mortality rates. Due to the unavailability of an effective vaccine or a treatment that would completely eradicate the virus, the quest for new and combination therapies continues. In this study we explored the influence of Low Level Laser Therapy (LLLT) in HIV-1 infected and uninfected cells. Literature reports LLLT as widely used to treat different medical conditions such as diabetic wounds, sports injuries and others. The technique involves exposure of cells or tissue to low levels of red and near infrared laser light. Both HIV infected and uninfected cells were laser irradiated at a wavelength of 640 nm with fluencies ranging from 2 to 10 J/cm2 and cellular responses were assessed 24 hours post laser treatment. In our studies, laser therapy had no inhibitory effects in HIV-1 uninfected cells as was indicated by the cell morphology and proliferation results. However, laser irradiation enhanced cell apoptosis in HIV-1 infected cells as the laser fluencies increased. This led to further studies in which laser irradiation would be conducted in the presence of HAART to determine whether HAART would minimise the detrimental effects of laser irradiation in infected cells.
... Its effects are not thermal, but biochemical, and therefore it cannot cause damage to cells (8). It has been used in different medical fields to treat skin conditions [9], wounds [10], sports injuries [11], chronic pain [12] and other medical conditions [13]. For LLLT to be effective there are several parameters that need to be considered, these include, but not limited to fluence, wavelength, and power density [14]. ...
Human immunodeficiency virus (HIV-1) infection remains a major health problem despite the use of highly active antiretroviral therapy (HAART), which has greatly reduced mortality rates. Due to the unavailability of an effective vaccine and treatment that would completely eradicate the virus in infected individuals, the quest for new therapies continues. Low level laser therapy (LLLT) involves the exposure of cells to low levels of red or infrared light. LLLT has been widely used in different medical conditions, but not in HIV-1 infection. This study aimed to determine the effects of LLLT on HIV-1 infected and uninfected TZM-bl cells. Both infected and uninfected cells were irradiated at a wavelength of 660 nm with different fluences from 2 J/cm(2) to 10 J/cm(2) . Changes in cellular responses were assessed using cell morphology, viability, proliferation, cytotoxicity and luciferase activity assays. Upon data analysis, uninfected irradiated cells showed no changes in cell morphology, viability, proliferation and cytotoxicity, while the infected irradiated cells did. In addition, laser irradiation reduced luciferase activity in infected cells. Finally, laser irradiation had no inhibitory effect in uninfected cells, whereas it induced cell damage in a dose dependent manner in infected cells.
... Niskoenergetyczna terapia laserowa (LLLT) jest wykorzystywana przez wiele ośrodków jako jedna z metod leczenia łokcia tenisisty. Morimoto [35] prowadząc badania z użyciem LLLT ocenił efektywność tej metody na ok. 66%. ...
STRESZCZENIE Łokieć tenisisty jest stosunkowo częstym zaburzeniem układu mięśniowo-szkieletowego, dla którego skuteczna strategia leczenia jest nadal nieznana. Odpowiedzialny jest za znaczny ból i utratę funkcji chorej kończyny. Charakterystyczne dla schorzenia są degeneracyjne zmiany w strukturze kolagenu oraz nieprawidłowości w ukrwieniu związane z procesem neowaskularyzacji. Patologia jest wynikiem powtarzających się mikrourazów prowadzących do uszkodzenia tkanek. Czułość diagnostyki obrazowej zależna jest od czasu trwania schorzenia. Pierwszy okres choroby zazwyczaj wywoływany jest urazem, któremu może towarzyszyć stan zapalny, dlatego najbardziej skuteczną metodą leczenia może być terapia przeciwzapalna i unieruchomienie kończyny. Okres późniejszy to zmiany zwyrodnieniowe, a leczenie polega głównie na zwalczaniu bolesnych objawów. Stany oporne na leczenie zachowawcze kwalifikowane są do leczenia chirurgicznego.
CEL BADAŃ: Przedstawienie aktualnej wiedzy na temat diagnostyki i leczenia entezopatii nadkłykcia bocznego kości ramiennej.
MATERIAŁ I METODY: Praca oparta na przeglądzie piśmiennictwa z Baz PubMed, Scopus oraz Web of Science.
WNIOSKI: Podstawowym badaniem obrazowym w diagnostyce łokcia tenisisty jest badanie ultrasonograficzne. Klasyczna radiologia jest raczej wykorzystywana do różnicowania innych chorób dotyczących łokcia. Współczesne metody leczenia łokcia tenisisty oparte są na terapii zmian zwyrodnieniowych. Leczenie przeciwzapalne jest nieskuteczne w powyższej jednostce chorobowej.
Introduction. Tennis elbow is a relatively common disorder of the musculoskeletal system, for which effective treatment strategy is still unknown. It is responsible for considerable pain and loss of function of the affected limb. Characteristic for the diseases are degenerative changes in the structure of collagen and abnormalities in blood supply associated with the process of neovascularization. Pathology is due to cycles of repetitive stress leading to tissue damage. The sensitivity of imaging depends on the duration of the disease. The first period of the disease is usually caused by trauma, which may be accompanied by inflammation, which is why the most effective treatment may be anti-inflammatory therapy and immobilization of a limb. The subsequent period is connected with degenerative changes, and treatment relies mainly on combating the painful symptoms. Conditions refractory to conservative treatment are eligible for surgery.
The objective of the study. Presentation of current knowledge about diagnosis and treatment of enthesopathy of the lateral epicondyle of the humerus.
Materials and method. The work is based on a review of literature of Baz PubMed, Scopus and Web of Science.
Conclusions. The primary imaging technique for the diagnosis of tennis elbow is ultrasound. Classic radiology is rather used for the differentiation of other diseases related to the elbow. Modern methods of treatment of tennis elbow are based on the treatment of degenerative changes. Anti-inflammatory treatment is ineffective in the above disease.
... Considering the characteristics of these micronutrients and the need to find a simple and rapid therapy, that was effective and would allow the resolution of the symptoms in a reasonably short time, it was decided to use the aloe gel in a group of athletes, suffering from tendinitis. To better understand the real effectiveness of topical gel, a group of athletes has been treated with a physical therapy of proven effectiveness, the low-level laser therapy, in order to compare the results [23]. The comparison of the data relating to the reduction of pain showed a short-term efficacy (5 days) of treatment with the topical gel, no statically significant differences compared to the low-level laser treatment. ...
Purpose
Using a controlled randomized trial, two therapeutic methods, topical use of an aloe gel and low-level laser therapy were compared. The aim of this study was to demonstrate the effectiveness of the topical aloe gel to treat tendinitis in a team of elite volleyball players.
Methods
35 athletes were enrolled and divided into two groups: 19 athletes belonging to group G, who have been subjected to three daily topical application of an aloe gel; 16 athletes, belonging to group L, were subjected to a daily session of low-level laser therapy for 10 days.
Results
In all athletes of both groups, we observed a progressive reduction of the pain, but more significant in patients with an Achilles tendinitis (P < 0.004), treated with gel. There was a statistically significant difference (P < 0.0001) between the groups about the time elapsed since the start of the treatment and the restart of the training in gym and the return to play volley, especially in athletes treated with gel.
Conclusions
Based on our data, we have shown that it is possible to obtain a remission of tendinitis through the constant application of aloe gel. This is a great advantage, especially for professional athletes, who can use it anywhere and at any time of the day, continuing to care even when they have to travel to play away from home, according to the calendar of the season.
... Although the diagnosis of TE is fairly straightforward, its management is often difficult. Therefore, various treatments have been applied [17][18][19][20][21][22] . ESWT and US therapy play important roles in the treatment of TE-associated pain; they are used to provoke painful levels of stimulation to relieve pain, which is termed "hyperstimulation analgesia." ...
[Purpose] This study compared the analgesic effects of extracorporeal shock wave therapy with those of ultrasound therapy in patients with chronic tennis elbow. [Subjects] Fifty patients with tennis elbow were randomized to receive extracorporeal shock wave therapy or ultrasound therapy. [Methods] The extracorporeal shock wave therapy group received 5 treatments once per week. Meanwhile, the ultrasound group received 10 treatments 3 times per week. Pain was assessed using the visual analogue scale during grip strength evaluation, palpation of the lateral epicondyle, Thomsen test, and chair test. Resting pain was also recorded. The scores were recorded and compared within and between groups pre-treatment, immediately post-treatment, and 3 months post-treatment. [Results] Intra- and intergroup comparisons immediately and 3 months post-treatment showed extracorporeal shock wave therapy decreased pain to a significantly greater extent than ultrasound therapy. [Conclusion] Extracorporeal shock wave therapy can significantly reduce pain in patients with chronic tennis elbow.
... Among pharmacological agents, a combination of opioids, nonopioid analgesics, Faced with wide variations in pain scores in postoperative patients, it was felt that a laser with its well established analgesic properties could be studied for its suitability to relieve acute postoperative pain. Laser, though well established as a therapeutic modality in sports medicine and physical therapy for pain relief, [8][9][10][11] has never been used for acute postoperative pain relief, and thus merited a pilot study to evaluate its feasibility and efficacy in the new setting. ...
Laser therapy, for its established analgesic properties with minimal side effects, has been used for the treatment of chronic pain. However, it has not been used for the treatment of acute postoperative pain. This pilot study was designed to assess the feasibility and efficacy of Class IV laser on postoperative pain relief following off-pump coronary artery bypass graft (OPCABG) surgery, as a component of multimodal analgesia (MMA) technique.
This open observational prospective study comprised of 100 adult patients (84 male, 16 female) who underwent OPCABG through sternotomy. For postoperative analgesia, they were subjected to laser therapy subjected to laser therapy in addition to the standard institutional pain management protocol comprising of IV infusion/bolus of tramadol and paracetamol and fentanyl bolus as rescue analgesic. Pain intensity was measured by Verbal Rating Scale (VRS). The laser therapy was scheduled as once a day regime for three consecutive postoperative days (PODs) starting on POD 1, 30 min following tracheal extubation. The subsequent laser applications were also scheduled at the same time of the day as on day 1 if VRS was ≥5. 10 W Class IV laser was applied over 150 cm 2 sternal wound area for 150 s. VRS was used to assess pain severity and was recorded for statistical analysis using Friedman Test.
The mean (standard deviation [SD]) VRS of all the 100 patients just before application of the first dose of laser was 7.31 (0.94) while on MMT; the same fell to 4.0 (1.279) and 3.40 (2.697) at 1 h and 24 h respectively following first dose of laser. The change of VRS over first 24 h among all the 100 patients was statistically significant (P = 0.000). Laser was re-applied in 40 patients whose VRS was ≥5 (mean [SD] - 6.38 [0.868]) at 24 th h. After receiving the 2 nd dose of laser the VRS scores fell significantly (P = 0.000) and became 0 at 54 th h. No patients required 3 rd dose of the laser. No patient required rescue analgesic while on laser therapy.
Class IV laser can be an effective technique for postoperative analgesia following OPCABG surgery through sternotomy when included as a component of MMA technique.
... Near infrared radiation (NIR) can penetrate biological tissue, and low intensity lasers that emit at or close to the NIR range (600 to 1,000 nm) have been applied as a noninvasive technology to modulate intracellular biochemistry and metabolism in many model systems (Karu 1999). Clinically, low intensity NIR lasers have been used as a potential therapy for a variety of conditions including pain relief (Brosseau et al. 2005;Morimoto et al. 2013), treatment of inflammation (Wang et al. 2013;Xavier et al. 2010), and wound healing (Peplow et al. 2010). ...
Near infrared radiation (NIR) is known to penetrate and affect biological systems in multiple ways. Recently, a series of experimental studies suggested that low intensity NIR may protect neuronal cells against a wide range of insults that mimic diseases such as stroke, brain trauma and neurodegeneration. However, the potential molecular mechanisms of neuroprotection with NIR remain poorly defined. In this study, we tested the hypothesis that low intensity NIR may attenuate hypoxia/ischemia-induced mitochondrial dysfunction in neurons. Primary cortical mouse neuronal cultures were subjected to 4 h oxygen-glucose deprivation followed by reoxygenation for 2 h, neurons were then treated with a 2 min exposure to 810-nm NIR. Mitochondrial function markers including MTT reduction and mitochondria membrane potential were measured at 2 h after treatment. Neurotoxicity was quantified 20 h later. Our results showed that 4 h oxygen-glucose deprivation plus 20 h reoxygenation caused 33.8 ± 3.4 % of neuron death, while NIR exposure significantly reduced neuronal death to 23.6 ± 2.9 %. MTT reduction rate was reduced to 75.9 ± 2.7 % by oxygen-glucose deprivation compared to normoxic controls, but NIR exposure significantly rescued MTT reduction to 87.6 ± 4.5 %. Furthermore, after oxygen-glucose deprivation, mitochondria membrane potential was reduced to 48.9 ± 4.39 % of normoxic control, while NIR exposure significantly ameliorated this reduction to 89.6 ± 13.9 % of normoxic control. Finally, NIR significantly rescued OGD-induced ATP production decline at 20 min after NIR. These findings suggest that low intensity NIR can protect neurons against oxygen-glucose deprivation by rescuing mitochondrial function and restoring neuronal energetics.
O esporte mais praticado no mundo é o futebol. Entretanto, no futebol profissional, o número excessivo de jogos e de sessões de treinamentos, tempo insuficiente de recuperação, alta demanda emocional e histórico de lesões prévias, podem aumentar o risco do desenvolvimento de microlesões e lesões. O objetivo deste estudo consistiu em investigar a utilização de inovações tecnológicas que emitem luz para prevenir e tratar lesões em jogadores de futebol. Foi realizada uma pesquisa de revisão narrativa a partir da busca de estudos publicados até Outubro de 2021 através de plataformas digitais, como Google Scholar, Lilacs, Scielo e Pubmed. Equipamentos inovadores a base de LASER e LED podem ser aplicados antes, durante e após o exercício físico. Efeitos agudos e crônicos do exercício podem ser potencializados com a fotobiomodulação e são de extrema relevância para aumentar o rendimento esportivo, acelerar a recuperação pós-treino bem como prevenir e reabilitar as lesões esportivas, mas, a prática clínica deve ser baseada em evidências científicas.
Abstract Quantification of collagen degradation is an important parameter to evaluate dentin caries for preventive aid. Objectives: Evaluate preventive methods against root collagen degradation by the hydroxyproline assay (HYP) and microradiography technique (MRT). Methodology: Five bovine root dentin blocks were obtained and subjected to an artificial demineralization process by acetate buffer (pH 5) to induce carious lesion formation. Samples were subjected to the following therapeutic treatments: 1) 0.12% chlorhexidine for 1 min, 2) 2% fluoride for 1 min, 3) Nd:YAG Laser (400 μm diameter optical fiber, 10 Hz frequency, 60 mJ/pulse energy, 48 J/cm2 energy density, in noncontact mode for 10 s), 4) deionized water (control) for 1 min, 5) MRT control group (without treatment and removal of collagen). Samples were exposed to degradation by a collagenase enzyme for five days. The enzyme solution was collected, by colorimetry in a spectrophotometer, from the collagen matrix for the hydroxyproline release analysis. The same samples were subjected to an additional two days of demineralization to induce the progression of mineral loss. Samples were analyzed by MRT for the visualization of their degraded areas (estimation of lesion depth and mineral loss). ANOVA was applied to compare hydroxyproline release rates. MRT data were subjected to the Kruskal-Wallis test, followed by the Dunn’s test. Comparisons between the initial five-day and the subsequent two-day demineralization processes were performed by repeated t-test or Wilcoxon (p
Background and purpose
Overuse injuries and painful symptoms in athletes and dancers (especially classical ballerinas) may lead to reduced functional performance. However, laser application may reduce pain and increase physical conditioning. The aim of the current study was to evaluate the immediate and long-term effects of infrared laser on classical ballerinas’ feet.
Methods
Eight female adults who perform classical ballet training and feel pain in their foot, but report no injuries in the last 6 months participated in the study. Infrared laser (808 nm) was applied on ballerina’s feet twice a week during three months. The laser parameters utilized were 100 mW average optical power and spot size of 0.04 cm² applied during 1 minute, leading to 6 J and 125 J/cm² per point. Thermography, algometry and unipodal static standing balance test were performed.
Results
There was a significant increase in plantar arch temperature (1.6 ºC for center and 2.3 ºC for border, p<0.05) immediately after laser treatment for all ballerinas. The pressure pain thresholds (PPT) were significantly increased for 5 of 7 analyzed sites (p<0.05). Regarding to the static standing balance, the time on one-foot showed a significant increases (from 23±12 s to 34±13 s, p<0.05) only when the test was performed on the left foot (support foot).
Conclusion
Then, there were pain relief and improvement of functional performance in ballerinas. The possible mechanism of laser action in reducing pain and thus enhancing performance, like higher blood flow of foot due to an increase of cutaneous temperature, will be discussed.
Chronic pain located on the lateral surface of the elbow in the area of the lateral epicondyle of the humerus is characteristic for a disease called tennis elbow, which belongs to the group of enthesopathies, i. e. diseases related to bone tendon attachment. The cause of the disease are micro-injuries caused by repetitive movements and chronic overloads. Degenerative changes occur in the tendons of the finger and wrist extensor muscles which attach to the lateral epicondyle of the humerus. The problem usually affects the extensor carpi radialis brevis muscle. A typical location for pain is the lateral side of the elbow joint but it can often radiate to the forearm and wrist. In our paper we presented the most commonly used and most effective methods of treatment of the disease. The least invasive methods of physiotherapy and rehabilitation include home exercise, ultrasound and phonophoresis, cryotherapy, light therapy, laser therapy and radial shock wave terapy. We compared the efficacy of pharmacological methods such as non-steroidal anti-inflammatory drugs, steroid injections with lidocaine, platelet-rich plasma, hyaluronic acid, botulinum toxin, collagen. We also mentioned the indications and surgical techniques of the tennis elbow.
In recent years, “physical therapies” gained increasing interest and scientific dignity, unlike in the past, based on a better knowledge of their “biophysical” effects, which are the result of a cascade of biological reactions, induced by the physical stimulus and aimed to the treatment of some musculoskeletal diseases.
Background:
Nerve injury often results in persistent or chronic neuropathic pain characterized by spontaneous burning pain accompanied by allodynia and hyperalgesia. Low level laser therapy (LLLT) is a noninvasive method that has proved to be clinically effective in reducing pain sensitivity and consequently in improving the quality of life. Here we examined the effects of LLLT on pain sensitivity induced by chronic constriction injury (CCI) in rats. CCI was performed on adult male rats, subjected thereafter to 10 sessions of LLLT, every other day, and starting 14 days after CCI. Over the treatment period, the animals were evaluated for nociception using behavioral tests, such as allodynia, thermal and mechanical hyperalgesia. Following the sessions, we observed the involvement of satellite glial cells in the dorsal root ganglion (DRG) using immunoblotting and immunofluorescence approaches. In addition we analyzed the expression levels of interleukin 1 (IL-1β) and fractalkine (FKN) after the same stimulus.
Results:
LLLT induced an early reduction (starting at the second session; p ≤ 0.001) of the mechanical and thermal hyperalgesia and allodynia in CCI rats, which persisted until the last session. Regarding cellular changes, we observed a decrease of GFAP (50%; p ≤ 0.001) expression after LLLT in the ipsilateral DRG when compared with the naive group. We also observed a significant increase of pro-inflammatory cytokines after CCI, whereas LLLT dramatically inhibited the overexpression of these proteins.
Conclusions:
These data provide evidence that LLLT reverses CCI-induced behavioral hypersensitivity, reduces glial cell activation in the DRG and decreases pro-inflammatory cytokines; we suggest that this involvement of glial cells can be one potential mechanism in such an effect.
Forword
Sports injuries are common, and vary from minor toe injuries to major complex trauma. Usually, only soft tissue is damaged, but there can also be fracturing of bone. Soft tissue injuries include sprains, strains and bruising. A sprain is a partial or complete rupture of a ligament, a strain is a partial tear of muscles and a bruise is a rupture of tissue leading to a haematoma. Any soft-tissue injury can lead to a tenderness, swelling, haematoma, scarring, fibrosis and loss of function.
After a sports injury or sprain, immediate first aid is very important. The acronym RICE summarizes the approach:
• Rest the injured part as soon as it is hurt to avoid further injury.
• Ice the area of pain to decrease swelling and bleeding.
• Compress the area with an elastic bandage to limit swelling and bleeding.
• Elevate the injured part above the level of the heart to increase drainage of fluids out of the injured area.
But that's not all you can do. In the next few days after injury, you can greatly improve recovery time by taking nutrients that decrease inflammation and speed healing. Here are four especially good strategies:
Most commonly, sports injuries affect the lower limb, particularly the ankle (e.g. Achilles tendinopathy, sprains) and knee (e.g. patellofemoral pain syndrome, ligament injuries). Other common sporting injuries include those of the shoulder (e.g. dislocations, acromioclavicular joint injuries, rotator cuff injuries); elbow (e.g. tennis, golfer's); wrist (e.g. strains, sprains, breaks); leg (e.g. shin splints, stress fractures, hamstring injuries); foot (e.g. plantar fasciitis); groin (strain); and back (e.g. acute lumbar sprain). Injuries can be caused by trauma as a result of a sudden impact or awkward movement, or can develop over time often due to continual use of the same joints or muscle groups. Contributing factors can be not warming, using inadequate equipment or training too hard for current level of fitness.
The aims of therapy are to relieve pain, control inflammation, hasten resolution of a haematoma, and accelerate repair. Also, there should be restoration of function and recovery of muscle power. Conventional approaches to sports injuries include RICE, anti-inflammatory drugs and analgesics, immobilisation, corticosteroid injections, physiotherapy and surgery.
Injured sport men no longer have to rely on the standard sports medicine regimen of anti-inflammatories, rest, and even surgery to bounce back. Recent clinical studies have endorsed an array of alternatives—everything from innovative massage techniques to injection treatments to laser therapies. Even ancient remedies, like acupuncture, are being fused with new technology for sports medicine purposes. Anyone who has suffered a sports injury should consult a doctor as soon as possible. However, once the injury is stabilized, patient should take the time to consult an expert in alternative treatments for sports injuries. Alternative medicine methods for pain management treatment varied widely. One holistic practitioners take a comprehensive approach to identity the root causes the pain.
Athletes have always been progressive in finding therapies or treatments thought to increase power, speed, and overall performance. There are a variety of choices available which can provide specific and individualized results with the guidance of a qualified practitioner.
As you can see, complementary and alternative medicine has found its way not only into the healthcare arena of the general public, but also onto the practice fields and into the equipment bags of both amateur and professional athletes. We must find a way to guide and educate those active and athletic patients who are trying to navigate this maze of healthcare options. Integration of complementary and alternative medicine into the sport arena is only going to increase in the future, which calls for more collaboration and discussion between healthcare practitioners of both conventional and complementary medicine.
This education has purpose to promote integrative medicine methods for sport prevention and treatment of injuries, and increasing sport men performances. This publication is consist of personal experience and consulting studies.
Ramova and Angelovska
Background: Low-level laser is a kind of therapeutic laser and has great potential application value in the field of sports medicine. Objective: To discuss the repairing mechanism of low-level laser therapy in early enthesiopathy of achilles tendon in rats through observing the change of transforming growth factor-β1 expression after low-level laser therapy. Methods: A total of 96 male Wistar rats aged 4 weeks were randomly divided into control group (n=8) and model group (n=88). Then model group was assigned randomly into two subgroups: model control group (n=48) and laser groups (n=40). The laser group was further allocated to 1, 2, 3, 7, 14 days of laser radiation, with eight rats in each. The rats of model group were trained by electrical stimulation for 5 weeks, and the rats of laser groups received laser radiation. The expression of transforming growth factor-β1 mRNA level in Achilles tendon was analyzed by real-time quantitative PCR. The transforming growth factor-β1 content was tested by double antibody ABC-ELISA. Results And Conclusion: The transforming growth factor-β1 in model control group was increased significantly compared with control group immediately after modeling (P < 0.05). Then, transforming growth factor-β1 was gradually decreasing as the time prolonged. Compared with laser groups, transforming growth factor-β1 in model control group was decreased significantly at 7 and 14 days (P < 0.05). Low-level laser therapy promotes the early healing of achilles tendon enthesiopathy in rats, delays the decrease of transforming growth factor-β1 content, and maintains high level of transforming growth factor-β1 at 7-14 days. Low-level laser therapy plays an important role in regulating extracellular matrix.
Purpose: This study was conducted to know the evidence case to assessment about literatures of extensor carpi radialis therapeutic strategy of tennis elbow about dysfunction wrist extension with anatomy, biomechanic and function. Method: Patient was received the physical therapy program with medication for two weeks. Physical therapy program consists of strengthening exercise, stretching exercise and extracopereal shock wave therapy. Results: Patients could do computer and house works at three weeks significant with improved pain. The amounts used repetitive muscle was reduced slowly over a period of a day or two days for wrist moving. Wrist flexor strengthening exercise and could reduced the wrist extensor injury. Conclusion: Clinicians certainly realized biomechanic effects and anatomy of extensor carpiradialis and elbow joint.
From hypertension to diabetes, cancer to HIV, stroke to memory loss and learning disorders to septic shock, male impotence to tuberculosis, there is probably no pathological condition where nitric oxide does not play an important role. Nitric oxide is an analgesic, immune-modulator, vasodilator, anti-apoptotic, growth modulator, angiogenetic, anti-thrombotic, anti-inflammatory and neuro-modulator. Because of the above actions of nitric oxide, many clinical conditions associated with abnormal Nitric oxide (NO) production and bioavailability. Our novel therapeutic approach is to restore the homeostasis of nitric oxide and replace the lost cells by combining nitric oxide therapy, anti-oxidative therapy, low level laser therapy, plasma rich platelet therapy and stem cell therapy.
Background:
Canine atopic dermatitis is a genetically predisposed inflammatory skin disease often requiring multimodal treatment. There is a need to find further low-risk adjunctive therapies.
Hypothesis/objectives:
To evaluate the localized effect of low-level laser therapy (LLLT) on the paws of dogs with atopic dermatitis using a localized canine atopic dermatitis severity score (LCADSS) and owner localized pruritic visual analog score (LPVAS) in comparison to treatment with a placebo.
Animals:
Thirty client-owned dogs with symmetrical pedal pruritus due to canine atopic dermatitis.
Methods:
Dogs were randomly assigned into two groups. In each group, one paw was treated with LLLT and one paw treated with a placebo laser (comparing either both fore- or hindpaws). Treatments were administered at 4 J/cm(2) (area from carpus/tarsus to distal aspect of digit 3) three times per week for the first 2 weeks and two times per week for the second 2 weeks. Scores were assessed for each paw at weeks 0, 2, 4 and 5.
Results:
There were no significant differences in LCADSS or LPVAS between LLLT and placebo treatments between weeks 0 and 5 (P = 0.0856 and 0.5017, respectively). However, LCADSS and LPVAS significantly decreased from week 0 at weeks 2, 4 and 5 in both LLLT and placebo groups (P < 0.0001 for all).
Conclusions and clinical importance:
Low-level laser therapy is not an effective localized treatment for pedal pruritus in canine atopic dermatitis.
Background and aims:
Electromyography (EMG) is considered the gold-standard for the evaluation of muscle activity. Transversal and dimensional changes of the muscle, during muscle activity, generate vibrational phenomena which can be measured by Laser Doppler Vibrometry (LDVi). There is a relationship between muscle contraction and vibrational activity, therefore, some information on fundamental muscle parameters can be assessed without contact with LDVi. In this paper, we explore the possibility to relate the EMG signal causing the muscle contraction and the vibrational activity also measureable on the muscle. A novel non-contact measurement method - Laser Doppler myography (LDMi) - aiming to measure the vibrational behavior of muscle during contraction, is presented herein. Correlations with some parameters normally measured with EMG are reported.
Materials and methods:
The proposed method has been compared with standard superficial EMG (sEMG). Signals produced with sEMG and laser Doppler myography have been simultaneously acquired and processed to test correlations on a population of 20 healthy volunteers. Tests have been carried out on the flexor carpi ulnaris and the tibialis anterior muscles (left and right).
Results:
RESULTS show that it is possible to measure: The timing of muscle activation (max differences: 440 ms), the amplitude of the signals acquired during activation respect to the signals during rest (S/N), the correlation between the S/N of the sEMG and LDMi signals at different levels of force (P> 0.89), and to assess muscle fatigue.
Conclusions:
LDMi is a valid measurement technique for the assessment of muscle activity and fatigue. It is a non-contact method and this characteristic could suggest its use together with low level laser therapy pre-, intra- and post-LLLT sessions to evaluate the efficacy and effects of the treatments without the need for invasive electrodes.
We reported earlier on the effectivity of the diode laser in relieving pain in athletes. We would like to present a thermographic evaluation of 92 new cases and compare them to the previous report. Immediate and overall effects are assessed in terms of pain alleviation, improved mobility, and patient satisfaction. Both amateur and professional tennis, baseball and golf players were treated, and a thermographic analysis of the symptoms and treatment were done. Younger athletes recovered faster than older ones.
Sumo wrestling is a very powerful and competitive contact sport played by extremely fit and highly trained competitors. Due to the extremely competitive nature of the sport and the required training, injuries are common both during training and the actual competition. Long-term lay-up of the competitor has to be avoided in order to maintain the level of muscle tone and mental concentration generated by the grueling training, so postinjury recovery time is kept to a minimum. A noninvasive therapy is therefore required, and the recent interest in the successful application of low level laser therapy (LLLT) in pain attenuation for a large number of pain types suggested that it might offer a new tool for sumo-related injuries. The current trial, with ten sports university sumo wrestlers, examined the effect of LLLT on injuries of the knee (five subjects) and foot (five subjects), using laser speckle flowmetry to assess the possible increase in superficial blood flow which has been associated with both pain attenuation and accelerated wound healing. An 830 nm 60 mW GaAlAs diode LLLT system was applied on one point for 5 min (approximately 15 J/cm2), and laser speckle flowmetry was performed before, during, immediately after, at 30 min and 60 min after irradiation. Decreased blood flow was seen intrairradiation, but an increase, significant in 7 of the 10 subjects was seen immediately postirradiation. This was maintained at significantly elevated levels in 4 subjects, while the remaining six decreased slightly, but in all ten subjects elevated levels of superficial blood flow were seen at one hour postirradiation, compared with preirradiation. LLLT is noninvasive, easy to apply, well tolerated and adverse side effect free. It is suggested that, following further trials to elucidate dosimetry and possible wavelength specificity, LLLT may well offer an exciting new tool to the sports clinician treating injured sumo wrestlers.
The scoring of pain attenuation in laser therapy (and other modalities) has traditionally been accomplished by using the visual analog scale (VAS), recognized as a very subjective method and thus open to possibly severe patient-specific skewing of the scoring data. An easy to use but objective method has yet to be developed. Through special symposia in their 11th and 12th meetings, (1999 and 2000), the Japan Laser Therapy Association (JaLTA) sought to improve the objectivity of the method of pain attenuation scoring while maintaining ease-of-use and minimizing expense, by comparing the results of questionnaires to participating institutes using laser therapy in pain attenuation for a specific set of four pain types; shoulder, lumbar and knee pain, and post-herpetic neuralgia (PHN). The VAS was initially used in combination with the pain relief score (PRS). Unlike the VAS, the PRS always has an initial value of 10 (maximum pain), and the patient's pain relief post-therapy is scored from 10 down to 0 (pain free). Ten sessions were set for both trials, and at the end of the tenth session, the patient's satisfaction index (SI) was recorded, in which the patients rated their satisfaction with the treatment over four grades in1999, ('Very satisfied', 'Satisfied', 'Dissatisfied' and 'Exacerbation’), which was subsequently increased to five grades in 2000, with the addition of 'Fairly satisfied' inserted before 'Dissatisfied'. In the 2000 meeting report, when the results of the five point SI were graphically compared with the overall PRS at the 10th treatment, a good statistical correlation was seen. In conclusion, it was decided that all JaLTA members should use the following assessment protocol: the VAS was to be used only at the initial consultation and the PRS exclusively hereafter, as the PRS incorporated VAS data but with the advantage of a standardized starting point and a larger movement on the scale; the SI should be assessed at the end of the 10th session, since the SI, while still subjec-tive, in combination with the averaged results of the PRS, can provide a more objective overview of the efficacy of the particular treatment regimen. Finally it was pro-posed that, after a suggested period of 3-5 yrs, these data for all pain entities should be collected in summary from JaLTA members, together with the treatment regimens, and could well be useful in the formulation of guidelines for the ideal and most satisfactory laser therapy regimen for each pain entity.
Low reactive level laser therapy (LLLT) involving low incident levels of laser light, is known for its normalizing effect on abnormalities of living bodies. A joint study by Keio University Institute of Physical Education Japan Medical Laser Laboratory and the Ohshiro Clinic was conducted to investigate the application of the GaAlAs diode laser in the field of sports medicine during pre-training or pre-competition warm up and post-training cooling down. The ‘Sit and Reach’ test, blood oxygenation and pulse rates were measured in 17 athletes, 15 males and 2 females, before laser irradiation (A), after the first laser irradiation (B), after physical exertion (C) and after a second laser irradiation (D). The Oh-Lase HT 2001 semi-conductor laser was applied to the neck while the subject adopted a sitting position on the floor with the legs stretched forward. The subjects were requested to stretch (toe-touch) as far as possible followed by another 8 seconds of laser irradiation while the subjects were stretched and were measured for maximum stretching distance. The procedure was repeated. When statistical significance was evaluated there were significant changes between A and B, A and C, A and D, B and D, and C and D in the performance of the Sit and Reach Test, whereas significant differences in heart rate were seen between A and C, B and C, B and D, and C and D, and significant differences between A and B, A and D, B and C, and C and D in the blood oxygen saturation level. The results where significant differences between A and B, and C and D imply that the use of the GaAlAs laser during warm up and cool down is beneficial.
Methods and Standard for Scoring Laser Therapy Pain Attenuation: A Retrospective Two-year Overview
- T Oshiro
- K Saito
- T Katagiri
- M Ogawa
- S Matsumoto
- J Kubota
- T Ohshiro
- T Tsukamoto
- T Okumura
- S Nakaji
- T Umeda
Oshiro T (2000): The Evolution of the Japan Laser
Therapy Association (JALTA) Methods and
Standard for Scoring Laser Therapy Pain
Attenuation: A Retrospective Two-year Overview.
Laser Therapy, 13 (1): 65-72.
4: http://www.photobiology.info/Hamblin.html
5: Saito K, Katagiri T, Ogawa M, Matsumoto S,
Kubota J, Ohshiro T, Tsukamoto T, Okumura T,
Nakaji S, Umeda T (2005): Effects of Diode Laser
Irradiation on Superficial Blood Flow in College
Sumo Wrestlers: A Preliminary Study. Laser
Therapy, 14(2): 83-86.