Extracorporeal irradiation of blood using ultraviolet light has been well-documented particularly in the Russian literature as having efficacy in the treatment of a number of diseases and conditions, but the technique required a high level of technical skill and was relatively invasive. The extracorporeal approach was necessary due to the poor penetration of UV light into living tissue. The development over the past 3 decades of efficient and comparatively inexpensive laser devices delivering low levels of laser energy in the visible red and near infrared wavebands offered deep penetration of light into living tissue and allowed the application of the transcutaneous approach for irradiating blood in vivo. This approach, although noninvasive, could not deliver laser energy efficiently and precisely to the main target, i.e., the blood, due to the non-specificity of these wavebands for hemoglobin, so the next stage was the minimally invasive delivery of laser energy concentrated directly into the blood itself using the intravenous approach, and intravenous laser blood irradiation (ILBI) successfully developed. Applications rapidly expanded in the 1980’s and 1990’s, including heart diseases and arrhythmias, pulmonary disease, problems of the exocrine and endocrine systems, treatment of postoperative sepsis, oncology and autoimmune disease, amongst others. Currently in Russia, many pathologies are successfully treated with ILBI, and the successfully treated patient numbers have reached the hundreds of thousands. The current review article traces the development of ILBA, examines devices and wavelengths used, and categorizes clinical applications. Based on the available data, we can conclude that ILBI improves the rheological properties of the irradiated blood thereby stimulating blood and tissue cells and enhancing the autoimmune system. ILBI offers high efficacy, shorter treatment periods and increased treatment latency. When used in combination therapy, ILBI improves the efficacy and results of the other therapy or therapies. Finally, it would appear that a frequency modulated beam is more efficient than the same system or wavelength applied in continuous wave.
Since 1993, we have applied a combination of brace treatment and near infrared irradiation therapy (NIIT) in 23 cases of Perthes disease. We previously reported that in patients in whom this combined therapy was started before the early fragmentation stage, lateral pillar formation through ossification of the lateral femoral head occurred quickly and exacerbation of femoral head deformity was mild, thereby shortening the period required for treatment. However, of the 16 patients who began to receive the combination of brace treatment and near infrared irradiation therapy during the early stage of Perthes disease, 4 developed evident femoral head collapse of varying degrees during treatment and 2 of these 4 were rated as poor according to Mose’s criteria. Collapse occurred 5-6 months after the start of treatment. In the 2 cases rated as poor according to Mose’s criteria, it seemed that weight-bearing and one-month suspension of treatment had also affected the onset of collapse. To improve the outcome of near infrared irradiation therapy, it seems desirable to continue daily application without allowing any intervals to the treatment of one week or longer. Furthermore, it is essential to ensure the correct parameters of the NIIT system and the number of sessions, restrict weight bearing and use a brace carefully during the first 7 months of treatment.
The purpose of this study was to investigate the effect of low level laser therapy (LLLT) on shoulder joint contracture caused by periarthritis scapulohumeralis (frozen shoulder). Twenty-four patients received treatment at our hospital between April, 2004 and March, 2007. We used a 1000 mW semiconductor laser device delivering 830 nm in continuous wave. We treated the shoulder joint contracture with the laser therapy system for 30 sec/point for a total of three minutes for each treatment session per shoulder, at an energy density per 30 sec treatment of 20.1 J/cm2. As a result of the four-week trial, the range of motion (ROM) in both flexion and extension improved. The efficacy ratio was 75% (p<0.05). We consider that the increase of pain threshold and improved blood circulation were the main mechanisms of action. However, we also emphasized the importance of life style education to patients.
Periodically, new ideas and treatment modalities are introduced into our lives. Some treatments may not have all the answers, and in some cases no answers at all. Working with a combination of treatments some of which may be relatively new, may provide benefit to those suffering, and further options for practitioners. An open mind, understanding and on-going research is important. In New Zealand, and some other countries, the use of low level laser therapy, otherwise known as LLLT, is not well known. Most of us have heard of industrial lasers and surgical lasers. In comparison to the latter, the therapeutic laser uses a much lower energy, and is easier to work with. I believe that every medical centre and hospital could benefit from introducing LLLT into patient care to speed up the healing of soft and hard body tissue and as this occurs, the drainage of toxins and excess fluid via the lymphatic system is encouraged. This is why lymphoedema, amongst many other debilitating conditions, may be treated and managed well with the use of low level laser therapy. The present article introduces LLLT from a nursing perspective, and in particular examines the benefits of LLLT applied for post-mastectomy lymphoedema.