This pages includes research
that was conducted specifically
with the ML830 Laser
System. Below that are other studies
with low level lasers.
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Low
Level Laser Therapy for osteoarthritis and rheumatoid
arthritis: a metaanalysis.
J
Rheumatol 2000 Aug;27(8):1961-9
Brosseau L, Welch V, Wells G, Tugwell P, de Bie R, Gam A,
Harman K, Shea B, Morin M.Physiotherapy Program, School of
Rehabilitation Sciences, Faculty of Health Sciences,
University of Ottawa, Ontario, Canada. lbrossea@uottawa.ca
OBJECTIVE: Osteoarthritis (OA) and rheumatoid arthritis (RA)
affect a large proportion of the population. Low level laser
therapy (LLLT) was introduced as an alternative noninvasive
treatment for RA and OA about 10 years ago, but its
effectiveness is still controversial. We assessed the
effectiveness of LLLT in the treatment of RA and OA.
METHODS: A systematic review was conducted, following an a
priori protocol, according to the methods recommended by the
Cochrane Collaboration. Trials were identified by a
literature search of Medline, Embase, and the Cochrane
Controlled Trials Register. Only randomized controlled
trials of LLLT for the treatment of patients with a clinical
diagnosis of RA or OA were eligible. Thirteen trials were
included, with 212 patients randomized to laser and 174
patients to placebo laser, and 68 patients received active
laser on one hand and placebo on the opposite hand.
Treatment duration ranged from 4 to 10 weeks. Followup was
reported by only 2 trials for up to 3 months. RESULTS: In
patients with RA, relative to a separate control group, LLLT
reduced pain by 70% relative to placebo and reduced morning
stiffness by 27.5 min (95% CI -52.0 to -2.9), and increased
tip to palm flexibility by 1.3 cm (95% CI -1.7 to -0.8).
Other outcomes such as functional assessment, range of
motion, and local swelling were not different between
groups. There were no significant differences between
subgroups based on LLLT dosage, wavelength, site of
application, or treatment length. In RA, relative to a
control group using the opposite hand, there was no
difference between control and treatment hand, but all hands
were improved in terms of pain relief and disease activity.
For OA, a total of 197 patients were randomized. Pain was
assessed by 3 trials. The pooled estimate (random effects)
showed no effect on pain (standardized mean difference -0.2,
95% CI -1.0 to +0.6), but there was statistically
significant heterogeneity (p > 0.05). Other outcomes of
joint tenderness, joint mobility, and strength were not
significant. CONCLUSION: LLLT should be considered for short
term relief of pain and morning stiffness in RA,
particularly since it has few side effects. For OA, the
results are conflicting in different studies and may depend
on the method of application and other features of the LLLT.
Clinicians and researchers should consistently report the
characteristics of the LLLT device and the application
techniques. New trials on LLLT should make use of
standardized, validated outcomes. Despite some positive
findings, this metaanalysis lacked data on how effectiveness
of LLLT is affected by 4 factors: wavelength, treatment
duration of LLLT, dosage, and site of application over
nerves instead of joints. There is a need to investigate the
effects of these factors on effectiveness of LLLT for RA and
OA in randomized controlled clinical trials.Publication
Types:
Meta-AnalysisPMID: 10955339 [PubMed - indexed for MEDLINE]
Treatment
of medial and lateral epicondylitis - tennis and golfer's
elbow - with low level laser therapy: a multicenter double
blind, placebo-controlled clinical study on 324 patients.
J
Clin Laser Med Surg 1998 Jun;16(3):145-51
Simunovic Z, Trobonjaca T, Trobonjaca Z.
Laser Center, Locarno, Switzerland.
BACKGROUND AND OBJECTIVE: Among the other treatment
modalities of medial and lateral epicondylitis, low level
laser therapy (LLLT) has been promoted as a highly
successful method. The aim of this clinical study was to
assess the efficacy of LLLT using trigger points (TPs) and
scanner application techniques under placebo-controlled
conditions. STUDY DESIGN/MATERIAL AND METHODS: The current
clinical study was completed at two Laser Centers (Locarno,
Switzerland and Opatija, Croatia) as a double-blind, placebo
controlled, crossover clinical study. The patient population
(n = 324), with either medial epicondylitis (Golfer's elbow;
n = 50) or lateral epicondylitis (Tennis elbow; n = 274),
was recruited. Unilateral cases of either type of
epicondylitis (n = 283) were randomly allocated to one of
three treatment groups according to the LLLT technique
applied: (1) Trigger points; (2) Scanner; (3) Combination
Treatment (i.e., TPs and scanner technique). Bilateral cases
of either type of epicondylitis (n = 41) were subject to
crossover, placebo-controlled conditions. Laser devices used
to perform these treatments were infrared (IR) diode laser (GaAlAs)
830 nm continuous wave for treatment of TPs and HeNe 632.8
nm combined with IR diode laser 904 nm, pulsed wave for
scanner technique. Energy doses were equally controlled and
measured in Joules/cm2 either during TPs or scanner
technique sessions in all groups of patients. The treatment
outcome (pain relief and functional ability) was observed
and measured according to the following methods: (1) short
form of McGill's Pain Questionnaire (SF-MPQ); (2) visual
analogue scales (VAS); (3) verbal rating scales (VRS); (4)
patient's pain diary; and (5) hand dynamometer. RESULTS:
Total relief of the pain with consequently improved
functional ability was achieved in 82% of acute and 66% of
chronic cases, all of which were treated by combination of
TPs and scanner technique. CONCLUSIONS: This clinical study
has demonstrated that the best results are obtained using
combination treatment (i.e., TPs and scanner technique).
Good results are obtained from adequate treatment technique
correctly applied, individual energy doses, adequate medical
education, clinical experience, and correct approach of
laser therapists. We observed that under- and
overirradiation dosage can result in the absence of positive
therapy effects or even opposite, negative (e.g.,
inhibitory) effects. The current clinical study provides
further evidence of the efficacy of LLLT in the management
of lateral and medial epicondylitis.
Publication Types:
Clinical Trial
Multicenter Study
Randomized Controlled Trial
PMID: 9743652 [PubMed - indexed for MEDLINE]
Low-level
laser therapy is an important tool to treat disorders of the
maxllofacial region (TMJ).
J Clin Laser Med Surg 1998 Aug;16(4):223-6
Pinheiro AL, Cavalcanti ET, Pinheiro TI, Alves MJ, Miranda
ER, De Quevedo AS, Manzi CT, Vieira AL, Rolim AB.
Laser Center, School of Dentistry, Universidade Federal de
Pernambuco, Brazil.
OBJECTIVES: The authors report on the effects of low-level
laser therapy (LLLT) in the treatment of maxillofacial
disorders. SUMMARY AND BACKGROUND DATA: Further to our
previous studies, this paper reports the results of the use
of LLLT on the treatment of several disorders of the oral
and maxillofacial region. This paper presents LLLT as an
effective method of treating such disorders. METHODS: Two
hundred and five female and 36 male patients ages between 7
and 81 years old (average 38.9 years old), suffering from
disorders of the maxillofacial region, were treated with
632.8, 670, and 830 nm diode lasers at the Laser Center of
the Universidade Federal de Pernambuco, Recife, Brazil (UFPE).
The disorders included temporomandibular joint (TMJ) pain,
trigeminal neuralgia, muscular pain, aphatae, inflammation,
and tooth hypersensitivity postoperatively and in small
hemangiomas. Most treatment consisted of a series of 12
applications (twice a week) and in 15 cases a second series
was applied. Patients were treated with an average dose of
1.8 J/cm2. RESULTS: One hundred fifty four out of 241
patients were asymptomatic at the end of the treatment, 50
improved considerably, and 37 were symptomatic. CONCLUSIONS:
These results confirm that LLLT is an effective tool and is
beneficial for the treatment of many disorders of the
maxillofacial region.
PMID: 9796491 [PubMed - indexed for MEDLINE]
Efficacy
of low power laser therapy in fibromyalgia: a single-blind,
placebo-controlled trial.
Gur A, Karakoc M, Nas K, Cevik R, Sarac J, Demir E.
Physical Medicine and Rehabilitation, School of Medicine,
Dicle University, Diyarbakir, Turkey. alig@dicle.edu.tr
Low energy lasers are widely used to treat a variety of
musculoskeletal conditions including fibromyalgia, despite
the lack of scientific evidence to support its efficacy. A
randomised, single-blind, placebo-controlled study was
conducted to evaluate the efficacy of low-energy laser
therapy in 40 female patients with fibromyalgia. Patients
with fibromyalgia were randomly allocated to active (Ga-As)
laser or placebo laser treatment daily for two weeks except
weekends. Both the laser and placebo laser groups were
evaluated for the improvement in pain, number of tender
points, skinfold tenderness, stiffness, sleep disturbance,
fatigue, and muscular spasm. In both groups, significant
improvements were achieved in all parameters (p<0.05)
except sleep disturbance, fatigue and skinfold tenderness in
the placebo laser group (p>0.05). It was found that there
was no significant difference between the two groups with
respect to all parameters before therapy whereas a
significant difference was observed in parameters as pain,
muscle spasm, morning stiffness and tender point numbers in
favour of laser group after therapy (p<0.05). None of the
participants reported any side effects. Our study suggests
that laser therapy is effective on pain, muscle spasm,
morning stiffness, and total tender point number in
fibromyalgia and suggests that this therapy method is a safe
and effective way of treatment in the cases with
fibromyalgia.
Publication Types:
Clinical Trial
Randomized Controlled Trial
PMID: 11845369 [PubMed - indexed for MEDLINE]
Low
level laser therapy with trigger points technique: a
clinical study of 243 patients. (headaches & faacial
pain, skeletomuscular ailments, myogenic neck pain, shoulder
and arm pain, epicondylitis humery, tensosynovitis, low back
& radicular pain & archilles tendinitis)
J Clin Laser Med Surg 1996 Aug;14(4):163-7
Simunovic Z.
Laser Center, Locarno, Switzerland.
Among the various methods of application techniques in low
level laser therapy (LLLT) (HeNe 632.8 nm visible red or
infrared 820-830 nm continuous wave and 904 nm pulsed
emission) there are very promising "trigger
points" (TPs), i.e., myofascial zones of particular
sensibility and of highest projection of focal pain points,
due to ischemic conditions. The effect of LLLT and the
results obtained after clinical treatment of more than 200
patients (headaches and facial pain, skeletomuscular
ailments, myogenic neck pain, shoulder and arm pain,
epicondylitis humery, tenosynovitis, low back and radicular
pain, Achilles tendinitis) to whom the "trigger
points" were applied were better than we had ever
expected. According to clinical parameters, it has been
observed that the rigidity decreases, the mobility is
restored (functional recovery), and the spontaneous or
induced pain decreases or even disappears, by movement, too.
LLLT improves local microcirculation and it can also improve
oxygen supply to hypoxic cells in the TP areas and at the
same time it can remove the collected waste products. The
normalization of the microcirculation, obtained due to laser
applications, interrupts the "circulus vitiosus"
of the origin of the pain and its development (Melzak:
muscular tension > pain > increased tension >
increased pain, etc.). Results measured according to VAS/VRS/PTM:
in acute pain, diminished more than 70%; in chronic pain
more than 60%. Clinical effectiveness (success or failure)
depends on the correctly applied energy dose--over/underdosage
produces opposite, negative effects on cellular metabolism.
We did not observe any negative effects on the human body
and the use of analgesic drugs could be reduced or
completely excluded. LLLT suggests that the laser beam can
be used as monotherapy or as a supplementary treatment to
other therapeutic procedures for pain treatment.
Publication Types:
Clinical Trial
Controlled Clinical Trial
PMID: 9456632 [PubMed - indexed for MEDLINE] |
