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increased exertion and introduction of unfamiliar physical
activities.[2] DOMS, which occurs 48-72 h after activity,
is more common following eccentric contraction due to
the significantly greater force produced.[3-5] In addition
to pain, DOMS is associated with loss of strength, loss
of motion, and swelling of the involved musculature.[1,3]
According to Clarkson and Sayers,[6] immediately after
exercise, there is up to 60% loss in muscle strength
that could persist for 10 days. The pain and discomfort
INTRODUCTION
Delayed onset muscle soreness (DOMS) is the perception
of pain and discomfort in muscles following an exercise
regime that involves increased intensity, longer
duration, unfamiliar movements, or eccentric muscular
work. It is commonly experienced by anyone who has
undergone unaccustomed exercises and suffered from
exercise-induced muscle damage (EIMD).[1] It is typically
experienced by all individuals regardless of their
fitness level and is a normal physiological response to
ABSTRACT
Introduction: Delayed onset muscle soreness (DOMS) is associated with temporary morbidity
as a result of pain, soreness, and reduced muscular performance that affects the overall
performance of the individual. Several interventional modalities have been studied without a
conclusive evidence of efficacy. Objective: This study was carried out as part of a continuous
attempt to find an effective and quick relief for DOMS. The study investigated the comparative
effects of warm‑up exercises and infrared radiation in ameliorating the symptoms associated
with DOMS. Materials and Methods: Sixty volunteer subjects between the age of 16 years
and 35 years had DOMS induced in the left biceps brachii muscle. They were randomized into
three groups with 20 subjects in each group. The groups were allocated as follows: Group A as
control that received no treatment, Group B had a bout of warm‑up exercises consisting of 10
sets of maximal elbow flexion and extension after which DOMS was experimentally induced,
and Group C had infrared radiation for 20 min after which DOMS was experimentally induced.
Assessment for muscle soreness, pain, and joint range of motion (ROM) was carried out
immediately after inducing DOMS and it was repeated 24 h and 48 h later using the Numerical
Pain Rating Scale (NPRS), deep palpation (DP), and goniometry, respectively. Results: The
infrared group (Group C) had significantly lower scores on NPRS and DP throughout the 3 days
compared with the control while the significant effects of warm‑up exercises were seen from
day 2. There was, however, no significant difference (P > 0.05) in the range of movement (ROM)
scores. Compared with warm‑up exercises (Group B), infrared resulted in significantly lower
NPRS and DP scores and greater ROM only on day 1. Conclusion: Infrared radiation (IRR) is
effective in ameliorating the symptoms of DOMS immediately after treatment on day 1 while
the effect of warm‑up exercises is seen 24 h later. IRR, thus, has a better effect than warm‑up
exercises in ameliorating the symptoms associated with DOMS.
Key words: Delayed onset muscle soreness, infrared radiation, warm‑up exercises
A comparative study of the effects of infrared radiation
and warm‑up exercises in the management of DOMS
Ayoola I. Aiyegbusi, Adebimpe J. Aturu1, Adegoke M. Akinfeleye2
Departments of Physiotherapy and 1Anatomy, 2Department of Physiotherapy, Lagos University Teaching Hospital, Lagos, Nigeria
Address for correspondence:
Dr. Ayoola I. Aiyegbusi,
Department of Physiotherapy,
College of Medicine, University
of Lagos, Lagos, Nigeria.
E‑mail:aaiyegbusi@unilag.edu.ng
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DOI:
10.4103/2408-7408.179681
How to cite this article: Aiyegbusi AI, Aturu AJ, Akinfeleye AM.
A comparative study of the effects of infrared radiation and warm-up
exercises in the management of DOMS. J Clin Sci 2016;13:77-81.
This is an open access article distributed under the terms of the Creative
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ORIGINAL RESEARCH REPORT
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Aiyegbusi, et al.: Infrared and warm‑up exercises in treatment of DOMS
JOURNAL OF CLINICAL SCIENCES, VOLUME 13, NUMBER 2, APRIL-JUNE 2016
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associated with DOMS generally peaks 24-48 h following
the activity and resolves itself within 3-7 days without any
special treatment.[2,7] In the bid to find effective and quick
relief for DOMS, many treatment modalities have been
investigated without a conclusive result.[8] These include
cryotherapy, repeat bout exercise, preventive training,
anti-inflammatory medications, and electrotherapeutic
modalities such as electrical stimulation and therapeutic
ultrasound.[3,6] A prior study on the effects of ice massage
on the signs and symptoms associated with EIMD
showed that it had no effect on the symptoms of DOMS.[9]
Also, a study by Brock et al., (2004)[10] on the effect of
ultrasound-induced increase muscle temperature on
the symptoms of DOMS failed to provide significant
prophylactic effects. Warm-up exercises have been
advocated to improve athletes’ performance and reduce
muscle injury.[11] These are gentle exercises preceding
vigorous physical activity and are believed to reduce
muscle strain injuries by increasing muscle temperature
and hence, muscle compliance.[11] Warm-up could be
either active or passive. Passive warm-up occurs when the
muscles are warmed by means of external heating such
as direct heat application (heat packs) or in the form of
therapeutic ultrasound while active warm-up refers to a
warm-up of the muscles by active contraction. This could
be in the form of a jog or any other exercise where the
muscles to be stretched are repeatedly contracted prior
to stretching.[12]
Several studies have reported that concentric warm-up
before eccentric exercises prepare the body for the
stress caused by overloading the muscles with eccentric
activity.[7] Stretching is generally the first activity in the
warm-up whether it is static, ballistic, or proprioceptive
neuromuscular facilitation (PNF).[13] However, previous
studies have reported the ineffectiveness of stretching
exercises in preventing DOMS and that these exercises
could actually compromise performance and increase the
rate of injury.[14-16] On the other hand, a number of studies
have been carried out on the effect of warm-up exercises in
the management of DOMS but there are conflicting reports
of its efficacy in ameliorating the symptoms associated
with it.
Infrared radiation has been shown to be effective in
the treatment of muscle or joint pain including muscle
spasm and stiffness. It has been reported to speed up the
healing process in musculoskeletal injuries by increasing
microcirculation through the release of nitrous oxide
from hemoglobin.[9] However, its efficacy as a treatment
modality in the management of symptoms associated
with DOMS has not been thoroughly investigated; the
few studies in this area have given conflicting results
on the efficacy. Glasgow et al., (2001)[17] for instance,
reported on the results of a randomized controlled
clinical trial of low-level infrared therapy in 24 subjects
with experimentally induced muscle soreness and found
no significant differences between the treatment and
placebo groups. In the study, infrared radiation (IRR)
was administered for consecutive 5 days following the
inducement of DOMS.
Though the effect of DOMS is associated with only
temporary morbidity as a result of pain, soreness, and
reduced muscular performance, it affects the overall
performanceofthepersonwhoisaffected. Italsoincreases
the risk of injury,[18] thereby preventing or reducing
the symptoms resulting from DOMS will be a welcome
relief to all. This study aims to evaluate the comparative
effectiveness of warm-up exercises and infrared in the relief
of the associated symptoms.
MATERIALS AND METHODS
The subjects for this study were 60 nonathlete volunteers
between the ages of 16 years and 35 years with no prior
history of musculoskeletal injury that could interfere
with the results. They were recruited from the students’
population of the College of Medicine, University of Lagos,
Lagos, Yoruba State, Nigeria.
A short oral interview was conducted to ascertain that
the subjects were neither athletes nor participating in
any sports activity or regular routine exercise at the time
of study. The subjects who did not meet the criteria were
excluded from the study.
The purpose and procedure of the study were explicitly
communicated to the subjects and their consent was
sought and obtained. The ethical approval was sought and
obtained from the Research and Ethical Committee of the
College of Medicine, University of Lagos.
A Phillips150Wbulbinfraredlamp(Delhi,India),made
in India, a calibrated goniometer (baseline 12-inch plastic
360°ISOM/STFR goniometer madeby Prohealthcare in
Lehi,Utah, USA), a 5 kg dumbbell, and a calibrated line
for Numerical Pain Rating Scale (NPRS) were used for this
study.
Methods
A measurement of the muscle girth of both the right and
left biceps was taken to ensure no appreciable difference
between the two. The subjects were then instructed not to
take any oral analgesic or use any topical analgesic, energy
boosting drug, dietary supplement, or perform any sports
or unusual exercise during the experimental period.
Experimental procedure
The subjects were randomly assigned to three groups by
using computer-generated numbers with 20 subjects in
each group. DOMS was experimentally induced in the left
biceps of all 60 subjects by 100 maximal elbow flexion and
extension while lifting the 5 kg dumbbell in 10 sets of 10
lifts each with 3 s rest interval after each set.
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Group A (control) had DOMS that was experimentally
induced on day 1. The subjects were immediately tested
formuscle soreness andpain and the joint range of
motion (ROM) in order to get the baseline readings. The
assessment was repeated 24 h and 48 h later.
Group B had a bout of warm-up exercises consisting of 10
sets of maximal elbow flexion and extension after which
DOMS was experimentally induced. Assessment for muscle
soreness, pain, and joint ROM was carried out and repeated
24 h and 48 h later.
Group C had DOMS that was experimentally induced
after which the subjects were tested for muscle soreness,
pain, and joint ROM. This was followed immediately by
the application of infrared radiation therapy for 20 min
followed by a repetition of the assessments. The subjects
had the biceps muscle irradiated for 20 min with the
infrared lamp positioned at a distance of 45 cm (18 in) and
well-focused on the muscle. The assessment was repeated
24 h and 48 h later. Muscle soreness was measured using
NPRS and digital palpation.
Digital pressure was applied with the tip of the fingers
against the deep tissues for 3 s. The subject was then asked
to assess the discomfort felt and classify it as no pain, mild,
moderate, or severe pain that were graded as 0, 1, 2, and 3,
respectively.
The NPRS represented by a calibrated line from 0 (no pain)
to 10 (greatest pain) was also shown to the subjects and
they were asked to rate the pain they felt on maximum
flexion and extension of the elbow joint and with activities
of daily living (ADL). The subjects were given a standard
description of ADL that included brushing of teeth, opening
of a bottle, driving a car, or opening doors.[6]
ElbowROM was measured using a standard plastic
goniometer with the subjects in a standing position.
The axis of the goniometer was placed over the lateral
epicondyle of the elbow. The stationary arm of the
goniometer was placed in line with the long axis of the
humerus pointed at the acromion process. The movable
arm of the goniometer was placed in line with the long axis
of the forearm. The placement locations of the goniometer
axis, movement arm, and stationary arm were marked
with ink for consistency throughout the trials. The relaxed
angle measurement on the goniometer was read before
the subject was asked to flex the elbow fully in order to
measure the range of movement.
Data analysis
The data were summarized in mean (rank) and standard
deviation (SD). All the outcome measures in this study did
not meet the assumptions for a parametric test and thus,
nonparametric statistical test was employed. Friedman
test was employed to test changes in the outcome
measures between day 1 and day 3 in each of the groups.
Kruskal-Wallis test was used to compare the differences in
the means between the groups for all outcome measures.
Wilcoxin signed-rank test and Tukey’s honest significant
differences (HSD) post hoc analysis was performed for
significant difference tests to identify where the true
differences lay. The level of significance was set at 0.05.
RESULTS
In the control group, there was no significant
difference (P > 0.05) in the numeric rating scale (NRS)
and deep palpation (DP) scores though the ROM increased
significantly (P < 0.05) over the 3 days [Table 1].
On Table 2, subjects in the infrared group had a
significant (P < 0.05) increase in the DP scores and ROM
between day 1 and day 2 and day 1 and day 3 though the
differences between day 2 and day 3 were quite marginal.
The NRS increased significantly (P < 0.05) only between
day 1 and day 2.
For the subjects who had warm-up exercises, DP
decreased significantly on day 2 only to increase again
significantly (P < 0.05) on day 3; NRS also decreased
significantly on day 2 but marginally increased on day 3.
There was also a significant (P < 0.05) increase in ROM
between day 1 and the subsequent days [Table 3].
Table 4 showed a comparison of all the variables across
the three groups over 3 days. It was observed that the
infrared group had the lowest NRS and DP scores over
the 3 days though on day 1, the differences were quite
significant (P < 0.05) compared with the other two groups.
The differences in the NRS and DP scores between the
warm-up and infrared groups were only significant on
day 1. The table also showed that compared with the control
Table 1: Days 1-3: Changes in NRS, DP, and ROM
in the control group
Day 1 Day 2
Mean±SD
Day 3 P value Post hoc
NRS 6.6±2.3 6.0±2.0 6.6±2.1 0.210 NA
DP 2.5±0.6 2.2±0.8 2.4±0.7 0.062 NA
ROM a110.7±22.1 b112.4±13.2 c123.1±13.0 <0.001* a and b, b and c
NRS=Numerical rating scale a and b=Post hoctruedierencebetweenaandb,DP=Deep
palpation,ROM=Rangeofmotion,SD=Standarddeviation.*SignicantatP<0.05
Table 2: Days 1-3: Changes in NPRS, DP, and ROM
means in the warm-up group
Day 1 Day 2
Mean±SD
Day 3 P value Post hoc
NRS 5.8±1.9a3.9±2.0b4.1±3.5c<0.001* a and b, a and c
DP 2.0±1.7a1.7±0.6b2.0±0.7c0.02* a and b, b and c
ROM (0) 113.7±10.1a123.8±9.7b122.6±12.9c<0.001* a and b, a and c
NPRS=Numerical pain rating scale a and b=Post hoctruedierencebetweenaand
b,DP=Deeppalpation,ROM=Rangeofmotion,SD=Standarddeviation.*Signicant
at P<0.05
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group, treatment with infrared and warm-up exercises had
no significant effect on the ROM scores over the 3 days.
Administration of IRR immediately after the inducement
of DOMS resulted in significant reduction in the NRS and
DP scores [Table 5].
DISCUSSION
This study was carried out to address the issue of trauma to
the muscles due to unaccustomed physical activity, especially
as there is a potential for injury during participation in all
types of sports.[19] In the bid to find effective and quick relief
for DOMS, many treatment modalities including cryotherapy
and therapeutic ultrasound have been investigated without
a conclusive result.
This present study was carried out to investigate the effects
of IRR in ameliorating the associated symptoms of DOMS
when administered once immediately after the inducement
of DOMS and compare the same with that of warm-up
exercises. The results clearly show that warm-up exercises
are especially effective in reducing the pain and muscle
soreness associated with DOMS 24 h and 48 h after injury
but had no significant effect on day 1 when compared with
the control group [Tables 1 and 2]. These exercises also
had no significant impact on the ROM scores. These results
are in concordance with the study carried out by Law and
Herbert (2007)[11] that showed that warm-up exercises
reduced perceived muscle soreness 48 h after exercises
but is contrary to the results of the study by Weltman
et al. (1979)[20] that concluded that quadriceps stretches
and warm-up prior to soreness-inducing step-up exercises
did not result in a significant reduction in the symptoms
of DOMS. The differences in their findings could be due to
the inclusion of stretches that have been found to have no
significant effect in relieving the symptoms of DOMS.[14-16]
Treatment with IRR immediately after the inducement
of DOMS resulted in a significant reduction in pain and
muscle soreness and a marginal increase in the ROM on
day 1 [Tables 3 and 4]. The IRR group had the least pain
and muscle soreness over the 3 days when compared with
the control and warm-up groups [Table 5]. The significant
reduction of pain and muscle soreness by IRR may be
attributed to the analgesic effect of heat therapy since
temperature elevation results in vasodilatation and an
increase in blood flow. The increased blood flow facilitates
tissue healing by supplying protein, nutrients, and oxygen at
the site of injury that aids the healing process by increasing
both catabolic and anabolic reactions needed to degrade and
remove metabolic by-products of tissue damage.[21]
The significant decrease in muscle soreness immediately
after treatment with IRR suggests that IRR aids in muscle
repair, especially as prior studies have shown that it causes
the release of nitric oxide (NO) from hemoglobin that causes
vasodilatation with a resultant increase in blood flow that
enhances healing.[9] Moreover,thisisbecauseredinfrared
has been found to have the deepest penetration among the
infrared range and aids healing at any wavelength.[22,23]
These results may also suggest a positive role for IRR
in ameliorating the symptoms of DOMS, especially as
treatment was given only on day 1 immediately after the
inducement of DOMS. It will be pertinent to observe the
effect of IRR on these symptoms if given consecutively for
3 days after the inducement of DOMS.
Comparative analysis of the NRS and DP scores between the
warm-up and IRR groups shows that IRR had a significant
effect over warm-up exercises in alleviating pain and
muscle soreness only on day 1. On the subsequent 2 days,
warm-up exercises were as effective as IRR in ameliorating
these symptoms [Table 5]. It is seen on Table 5 that though
Table 3: Day 1-3: Changes in NPRS, DP, and ROM
means in the infrared group
Day 1 Day 2
Mean±SD
Day 3 P value Post hoc
NRS 2.8±1.9 3.7±2.7 4.0±3.2 0.07 NA
DP 0.9±1.0a1.3±0.9b1.5±1.1c0.005* a and b, a and c
ROM (0) 113.7±10.1a123.8±9.7b122.6±12.5c<0.001* a and b, a and c
NPRS=Numerical pain rating scale a and b=Post hoctruedierencebetweenaandb,
DP=Deeppalpation,ROM=RangeofMotion,SD=Standarddeviation.*Signicant
at P<0.05
Table 4: Comparison of means of VAS, DP, and
ROM scores before and after infrared radiation
NRS DP ROM
Before IRR 5.9±2.9 1.9±2.0 110.7±22.1
After IRR 2.8±1.9 0.9±1.0 113.7±10.1
Meandierence 3.1±0.1 1.0±0.1 3.0±2.5
P value <0.001* 0.027* 0.07
*SignicantatP<0.05
Table 5: Comparison of means of NPRS, DP, and
ROM scores between the control, warm-up, and
infrared groups
Variable Mean ± SD P value Post hoc
Control Warm‑up IRR
NRS
Day 1 6.6±2.3a5.8±1.9b2.8±2.9c<0.01* a and c, b and c
Day 2 6.0±2.0a3.9±2.0b3.7±2.9c<0.01* a and b, a and c
Day 3 6.6±2.5 4.1±3.5 4.0±3.2 0.02* a and b, a and c
DP
Day 1 2.5±0.6a2.0±0.7b0.9±1.0c<0.01* a and b, a and c, b
and c
Day 2 2.2±0.8a1.7±0.6b1.3±0.9c<0.01* a and b, a and c
Day 3 2.4±0.7a2.0±0.7b1.5±1.1c<0.01* a andc
ROM
Day 1 110.7±22.1 106.9±9.9 113.7±10.1 0.36 NA
Day 2 112.4±13.2 123.0±7.3 123.8±9.9 0.90 NA
Day 3 123.1±13.0 122.4±9.7 122.6±12.5 0.98 NA
NRS=Numerical rating scale a and b=Post hoctruedierencebetweenaandb,
DP=Deeppalpation,ROM=Rangeofmotion,SD=StandardDeviation.*Signicant
at P<0.05
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the IRR and warm-up groups experienced an increase in
NPRS and DP scores on day 2 and day 3, the values were still
significantly lower than the control groups. This indicates
that both the protocols were able to significantly reduce
the symptoms on day 2 and day 3 that are known to be
the peak time for the symptoms of DOMS to appear.[5] Both
the treatment protocols, however, had no significant effect
on the ROM scores. The results of this study suggest that
both warm-up exercises and IRR ameliorate the symptoms
of pain and muscle soreness in DOMS. Since the effect of
IRR is seen immediately after administration on day 1, it
appears to have a better effect on the management of the
symptoms associated with DOMS. Our findings are contrary
to the results of the study by Glassgow et al.[17] in which
there was no appreciable difference in the symptoms of
DOMS between the placebo group and those who had IRR.
Further studies need to be conducted on the combined
administration of IRR and warm-up exercises and also on
the administration of IRR for consecutive 3 days following
the inducement of DOMS.
CONCLUSION
IRR is effective in ameliorating the symptoms of DOMS
immediately after administration on day 1 while the effect
of warm-up exercises is seen 24 h later. IRR, thus, has a
better effect than warm-up exercises in ameliorating the
symptoms associated with DOMS.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
REFERENCES
1. MacIntyre DL, Reid WD, McKenzie DC. Delayed muscle
soreness. The inflammatory response to muscle injury and its
clinical implications. Sports Med 1995;20:24-40.
2. Maes J, Kravitz L. Treating and Preventing DOMS. IDEA
Personal Trainer 2003. p. 41.
3. Cleak MJ, Eston RG. Delayed onset muscle soreness:
Mechanisms and management. J Sports Sci 1992;10:325-41.
4. Fox EL, Robinson S, Wiegman D. Metabolic Energy Sources
during continuous and interval running. J Appl Physiol
1969;27:174-8.
5. Gulik DT, Kimura IF. Delayed onset muscle soreness: What is
it and how do we treat it? J Sports Rehab 1996;5:234-43.
6. Clarkson PM, Sayers SP. Etiology of exercise-induced muscle
damage. Can J Appl Physiol 1999;24:234-48.
7. Szymanski DJ. Recommendations for the avoidance of
delayed-onset muscle soreness. J Strength Cond Res
2001;23:7-13.
8. Torres R, Ribeiro F, Alberto Duarte J, Cabri JM. Evidence
of the physiotherapeutic interventions used currently after
exercise-induced muscle damage: Systematic review and
meta-analysis. Phys Ther Sport 2012;13:101-14.
9. Howatson G, Van Someren KA. Ice massage. Effects on
exercise-induced muscle damage. J Sports Med Phys Fitness
2003;43:500-5.
10. Brock TS, Clasey JL, Gater DR, Yates JW. Increased muscle
temperature [by ultrasound] failed to provide significant
prophylactic effects on the symptoms of DOMS. J Strength
Cond Res 2004;18:155-61.
11. Law RY, Herbert RD. Warm-up reduces delayed-onset muscle
soreness but cool-down does not: A randomized controlled
trial. Aust J Physiother 2007;53:91-5.
12. Flexibility SM. Joint range of motion. In: Frontera WR, editor.
Rehabilitation of sports injuries: Scientific basis. Volumexof
the encyclopedia of sports medicine. An IOC medical
committee publication in collaboration with the international
federation of sports medicine. 2003. p. 250.
13. Fleck SJ, Kraemer WJ. Resistance training: Basic principles
part knee extension (KE) and chest press (CP) exercises.
Phys Sportsmed 1988;16:160-71.
14. Johansson PH, Lindström L, Sundelin G, Lindström B. The
effects of pre-exercise stretching on muscle soreness,
tenderness and force loss following heavy eccentric exercise.
Scand J Med Sci Sports 1999;9:219-25.
15. Shrier I. Stretching before exercises does not reduce the risk
of local muscle injury: A critical review of the clinical and
basic science literature. Clin J Sports Med 1999;9:221-7.
16. Wessel J, Wan A. Effect of stretching on the intensity
of delayed-onset muscle soreness. Clin J Sports Med
1994;4:83-7.
17. Glasgow PD, Hill ID, McKevitt AM, Lowe AS, Baxter D. Low
intensity monochromatic infrared therapy: A preliminary study
of the effects of a novel treatment unit upon experimental
muscle soreness. Lasers Surg Med 2001;28:33-9.
18. Imtiyaz S, Veqar Z, Shareef MY. To compare the effect of
vibration therapy and massage in prevention of delayed onset
muscle soreness (DOMS). J Clin Diagn Res 2014;8:133-6.
19. Burkow L, Onyekachi I, Sockwell N, Morency E, Sosa P.
The use of near infrared light emitting diodes in treating
sports-related injuries: A review. Research 2014;1:1277.
20. Weltman A, Stamford BA, Fulco C. Recovery from maximal
effort exercise: Lactate disappearance and subsequent
performance. J Appl Physiol Respir Environ Exerc Physiol
1979;47:677-82.
21. Cameron MH. Thermal agents: Physical principles, cold and
superficial heat. In: Cameron MH, editor. Physical Agents
in Rehabilitation: From Research to Practice. Philadelphia:
Saunders; 1999. p. 149-75.
22. Held G. Introduction to Light Emitting Diode Technology and
Applications: CRC Press Science; 2008. p. 1-192.
23. Jagdeo J, Adams L, Brody N, Siegel D. Transcranial red and
near infrared light transmission in a cadaveric model. PLoS
One 2012;7:e47460.
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