Low-energy laser therapy: controversies and new research findings.
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Animals↗
Biomedical subjects
J R Basford
Publications and source records attributed to J R Basford.
Does low-energy helium-neon laser irradiation alter "in vitro" replication of human fibroblasts?
Cultured human fibroblasts were treated in a controlled, randomized manner to assess the effect of low-energy (0.9 mW) helium-neon (HeNe) laser irradiation on cellular proliferation. Two trials were performed: one with fibroblasts in the third to fourth passage and the other with fibroblasts in the 13th to 14th passage. In each trial, separate plastic petri dishes were inoculated with the cells, maintained in a 5% CO2-95% air atmosphere, and nourished with HB 102 media. Treatment began 48 h after inoculation with daily 60-s irradiations of the "treated" cultures over a 5-d period. Control cultures underwent the same handling but were not irradiated. A significant stimulative, or inhibitive, effect on replication was not found in either trial.
Cell Division↗
Shoe insoles in the workplace.
Ninety-six women participated in a crossover study to evaluate the effectiveness of viscoelastic polyurethane insoles in reducing back, leg, and foot pain among adults who spend the majority of each work day standing. Twenty-five of the subjects reported that the insoles made their shoes too tight to be comfortable. The remainder, however, found the insoles very comfortable (P less than .002, Wilcoxon, signed-rank test) and reported significant reductions in back pain (P less than .02), foot pain (P less than .03), and leg pain (P less than .007). When these subjects were asked whether they would prefer to wear their shoes alone or with insoles, the preference for insoles was overwhelming (P less than .007, back; P less than .03, leg; and P less than .009, foot pain). It is concluded that viscoelastic insoles can effectively improve comfort and reduce back, leg, and foot pain in individuals who must stand throughout the day.
Adolescent↗
Low-energy helium neon laser treatment of thumb osteoarthritis.
Eighty-one patients with symptomatic osteoarthritis of the thumb took part in a blinded, controlled study to assess the effectiveness of 0.9 mw continuous wave HeNe laser treatment. The subjects were randomly placed in either a control group or a treatment group. In each group the carpometacarpal (CMC), metacarpophalangeal (MCP), and interphalangeal (IP) joints of the most symptomatic thumb were "treated" with 15 sec irradiations at four equally spaced intervals around each joint three times a week for three weeks. The same protocol was used for both groups except that a hidden switch on the laser was placed in the "on" position for the treated group and in the "off" position for the control group. Although the laser-treated group noted slightly lessened tenderness of the treated MCP and IP joints (p less than 0.01 and 0.05, respectively, Wilcoxon signed-rank test), and a small increase in three-finger chuck pinch strength (p less than 0.04, paired t-test), changes in ROM, pain, joint tenderness, grip and pinch strength, activity level, and medication use, did not significantly differ between the groups. Adverse effects were rare (one in each group), minimal, and subjective. We conclude that HeNe laser irradiation at 0.9 mw is safe, but that it is not an effective treatment of osteoarthritis of the thumb.
Clinical Trials as Topic↗
Comparison of cold-quartz ultraviolet, low-energy laser, and occlusion in wound healing in a swine model.
A randomized, blind, controlled study used six pigs to examine the effectiveness of low-energy HeNe laser irradiation (632.8nm), cold-quartz UV (254nm), occlusion, and exposure in the treatment of full thickness skin wounds. Laser-treated wounds received a nominal dose of 54mW daily on a schedule of six days/week, UV-treated wounds were given two minimal erythemal dose treatments, twice daily, six days a week, and occluded wounds were checked and dressings replaced as needed twice daily, six days a week. All wounds were treated until clinically healed. Time to closure, wound strength, and bacterial colonization were monitored. There were no complications. Although the laser-treated wounds healed faster than the exposed-control wounds (20.3 +/- 0.9 days vs 21.1 +/- 2 days), only the occluded wounds healed significantly (p less than or equal to 0.05) faster than the controls (18 +/- 1.6 days vs 20.6 +/- 1.4 days). No statistically significant difference in bacterial colonization or wound strength was noted although the occlusion-treated wounds tended to be the strongest.
Animals↗
Low-energy laser treatment of pain and wounds: hype, hope, or hokum?
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Animals↗
Weightlifting, weight training and injuries.
Although millions of men and women in the United States are regularly involved in some form of weightlifting, the average physician knows, and frequently cares, little about the sports involved. As a result, his or her knowledge of the medical and physiological issues involved is limited This article attempts to address this lack by beginning with a brief introductory section outlining some of the similarities differences between the major weight lifting approaches (power lifting, olympic lifting, weight training and body building). Next it reviews major issues and controversies such as age restrictions for lifters, physiological effects, drug use, potential strength gains and hypertrophy. Finally, it discusses some of the more frequent and unique injuries that can occur in lifters.
Adolescent↗
Autonomic dysreflexia due to medication: misadventure in the use of an isometheptene combination to treat migraine.
Autonomic dysreflexia, a syndrome sometimes occurring in spinal cord injured (SCI) individuals, may be life-threatening. It involves, in varying degrees, hypertension, diaphoresis, headache, bradycardia, anxiety, and flushing and is believed due to unrestricted sympathetic activity below the level of the lesion in individuals with injuries above T4-6. The most frequent causes of the syndrome are urinary infections, rectal impaction, bladder distention, and decubitus ulcers. To our knowledge, medication has seldom been described as causal agent. We report here on an autonomic dysreflexic syndrome following use of an isometheptene combination (Midrin), to treat migraine. The individual involved is a C4-quadriplegic man with a long history of migraines. He was given a standard initial adult dose of the medication. Over a one-hour period, he was initially relieved of the headache, but then noted a new more severe headache, diaphoresis, and flushing. His vital signs showed progressive BP elevation to 210/130 and a relative bradycardia. Treatment over the next three hours was limited to elevation of the head of the bed and observation, during which his vital signs returned to baseline and he became asymptomatic. This experience reinforces the belief that sympathomimetic drugs in general, and isometheptene in particular, should be used in caution in patients with high-level SCI.
Acetaminophen↗
Adaptive equipment for C6 quadriplegia: an approach to effective, simple, and inexpensive devices.
Three simple and inexpensive devices were developed by a man with complete C6 quadriplegia to increase his independence: a reacher that allows him to lift and move objects ranging in size from ballpoint pens to beverage cans; a wrist splint that permits him to open pop-top cans, dial a telephone, open a drawer, and page through a book; and an implement holder that stabilizes small devices.
Adult↗
Assessing fatigue with electromyographic spike parameters.
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Adult↗
Rehabilitation for stroke: a review.
Survivors of stroke are often left with severe mental and physical disabilities, which create a major social and economic burden. Many investigators have attempted to assess the role of rehabilitation in reducing such disability. Few controlled studies provide accurate assessment and documentation of benefit. Because of the presence of multiple variables and inadequate measures of outcome, it is difficult to design studies evaluating the effectiveness of rehabilitation for stroke. It is unclear how early rehabilitation should begin and what aspects of rehabilitation are important. Intensive rehabilitation is an expensive and limited resource; thus, the ability to identify the subgroup of patients with stroke who are likely to benefit is a critical issue. Although preliminary guidelines for the selection of patients who are appropriate for rehabilitation are given, no uniform criteria reliably differentiate patients who need rehabilitation from those who will recover spontaneously or do poorly. Controlled studies in the practice of rehabilitation for stroke will provide much useful information for patient management.
Activities of Daily Living↗
Disability and use of rehabilitation services following stroke in Rochester, Minnesota, 1975-1979.
Medical records of all residents of Rochester, Minnesota, who had a first stroke in 1975-1979 were reviewed to determine level of disability, disposition, and use of rehabilitation services. Of the 292 persons with a first stroke, 251 (86%) (mean age 70 years) survived greater than 1 week. The mean Rankin disability score (Grade 1, no disability, through Grade 5, severe disability) changed from 1.7 before stroke to 2.8 in survivors at hospital discharge; 29% of those discharged required further institutional care. The level of disability in survivors remained relatively constant from 6 months after stroke through 5 years of observation. Of the 112 patients with an admission score of 5, 40 (36%) were alive at 1 year and only 5 of those (13%) improved to relative independence (Rankin scores of 1 or 2). The most common comorbidity contributing to disability was cardiovascular disease (31%). After the first 18 months, the mortality in patients with stroke was similar to that in a normal population having the same age and sex distribution. Of the 251 1-week survivors, 132 (53%) had rehabilitation (physiatrist) evaluations, 127 (51%) received physical therapy, 103 (41%) received occupational therapy, and 33 (13%) received speech therapy. Thirty-four of the 132 patients (26%) referred for rehabilitation evaluations were transferred to the rehabilitation unit.
Aged↗
The clinical status of low energy laser therapy in 1989.
Low energy laser therapy has gained varying acceptance as a treatment for a broad range of soft tissue, musculoskeletal and neurological conditions. A controversial, but surprisingly large body of research with cell cultures suggests that laser irradiation can nondestructively alter cellular processes. Unfortunately, animal and human studies are often contradictory and difficult to evaluate due to differing study designs. As a result, the clinical effectiveness of low energy laser therapy remains debatable. Nevertheless, the findings are intriguing and deserve further investigation.
Analgesia↗