Laser acupuncture: past, present, and future

Laser acupuncture to reduce temporomandibular disorder (TMD) symptoms: systematic review and meta-analysis

The application of low-level laser therapy (LLLT) to acupuncture points may produce effects similar to that of needle stimulation in patients with temporomandibular disorders (TMD). This systematic review was conducted according to the Cochrane Collaboration guidelines and aimed to address clinical questions using the following strategy: Patient/Problem, Intervention, Comparison, and Outcome (PICO). A comprehensive literature search was performed upto April 26, 2023, across nine electronic databases (BVS, PubMed, Scopus, Embase, Web of Science, ScienceDirect, Cochrane Library, Latin American and Caribbean Health Sciences Literature (LILACS), and Google Scholar) supplemented with gray literature. The risk of bias in randomized and nonrandomized clinical trials was assessed using two tools: risk-of-bias (RoB) 2 and Risk Of Bias In Non-randomised Studies-of Interventions (ROBINS-I). Meta-analysis involved the extraction of mean and standard deviation values for spontaneous pain and mouth opening levels. Seven studies were included in this review, all of which used LLLT. The applied wavelengths ranged from 690 to 810 nm without significant variations in light emission patterns. LLLT demonstrated a significant reduction in instantaneous pain levels (standard mean difference [SMD] = 3.85; 95% confidence interval [CI] = 2.09, 5.62; p < 0.003) and an improvement in instantaneous mouth opening ability (mean difference [SMD] = -7.15; 95% CI = -11.73, -2.58; p < 0.002), with low certainty of evidence. LLLT may alleviate symptoms in patients with TMD; however, caution should be exercised when interpreting the results because of protocol variations among studies and the limited number of studies included in the meta-analysis.

Treatment of Dry Eye Disease (DED) in Asia: Strategies for Short Tear Film Breakup Time-Type DED

Dry eye disease (DED) is a multifactorial disorder in which tear fluid homeostasis is lost, resulting in increased tear film osmolarity and ocular surface irritation. In Asia, the short tear film breakup time-type DED, which has become a global problem in recent years, is common. While the mainstay of DED treatment in the West is the suppression of inflammation, the first goal of treatment is the stabilization of the tear film in Asia. To date, artificial tears and steroid eye drops have been the main treatment for DED. However, artificial tears require frequent administration of eye drops and thus pose adherence problems, while steroids have problems with side-effects (cataracts, increased intraocular pressure). This review evaluates the new generation therapies in Asia based on what is known about them and demonstrates that they are more effective for DED than traditional therapies such as artificial tears and steroids. Based on considerations, it is proposed that the optimal treatment for the short tear film breakup time-type DED is the initial application of mucin-secretion-enhancing eye drops (long-acting diquafosol) and oral supplements; and if additional treatment is needed, cyclosporine eye drops and the adjunctive therapies presented in this review are added.

Effects of radial extracorporeal shockwave therapy versus high intensity laser therapy in individuals with plantar fasciitis: A randomised clinical trial

This study aimed to compare the effects of radial extracorporeal shockwave therapy (rESWT) to the effects of high-intensity laser therapy (HILT) in the treatment of individuals with plantar fasciitis. Thirty-two individuals with unilateral plantar fasciitis were randomized into two groups: rESWT and HILT. In each group, the individuals underwent the intervention two sessions per week, for three weeks. Outcome measures included morning pain, resting pain, pain at 80 newtons (N) pressure, skin blood flow and temperature, plantar fascia (PF) and flexor digitorum brevis (FDB) thickness, and Foot Function Index (FFI). There was no significant difference in baseline characteristics of the individuals in both groups. All outcome measures, except skin blood flow and temperature, and FDB thickness, were significantly different (p < 0.05) over time. Skin blood flow was significantly different between groups at the end of the program. Either HILT or rESWT could alleviate pain in individuals with plantar fasciitis significantly. However, HILT was better at reducing FFI (functional limitation domain) rather than rESWT. This study was a randomized clinical trial and was approved by Mahidol University-Central Institutional Review Board (MU-CIRB) following the Declaration of Helsinki, COA no. MU_CIRB 2020/207.0412, the Thai Clinical Trials Registry (TDTR) numbered TCTR2021012500.

Effect of laser acupuncture on pain and density of bone in osteoporotic postmenopausal women: a randomized controlled trial

OBJECTIVE

This study aimed to evaluate the value of laser acupuncture (LA) on forearm bone mineral density (BMD) and wrist pain in osteoporotic postmenopausal women.

METHODS

Sixty-eight postmenopausal women diagnosed with osteoporosis were randomly allocated equally to one of two sets. The drug-only group received calcium and vitamin D 3 supplement containing fluoride daily for 12 weeks, whereas the drug/LA group received LA therapy for 20 minutes per session, three sessions weekly, in addition to the same supplementation. The primary outcome parameter was assessment of BMD of the nondominant arm. Other outcomes included wrist pain.

RESULTS

There was a highly significant improvement in the T-score of forearm BMD in both groups (-2.844 ± 0.476 to -2.597 ± 0.478 and -2.944 ± 0.486 to -1.652 ± 0.728 in the drug-only and drug/LA groups, respectively; P < 0.0001) and visual analog scale score (7.50 ± 0.79 to 4.24 ± 1.07 and 7.24 ± 0.82 to 3.09 ± 0.75 in the drug-only and drug/LA group, respectively; P < 0.0001). The improvement of both BMD and pain score was significantly higher in the drug/LA group (-1.303 and 4.15) compared with the drug-only group (-0.247 and 3.26; P < 0.0001).

CONCLUSIONS

LA in combination with calcium and vitamin D supplementation containing fluoride is an effective modality in improving forearm BMD and reducing pain in osteoporotic postmenopausal women.

Effect of 650 nm laser photobiomodulation therapy on the HT-7 (shenmen) acupoint in the Mus musculus model of Parkinson's disease

Background

Parkinson's disease is one of the neurodegenerative conditions that impacts 1-2% of the world's population. The only effective therapy for this condition today is to restore the biochemical function of the diseased dopamine neurons by giving them Levodopa or L-3,4-dihydroxyphenylalanine (l-DOPA). The risk of progenitor stem cells, though, is the growth of teratomas or the uncontrolled growth of cells. As a result, an alternative or additional method is needed, such as photobiomodulation therapy using a laser diode. In this research, male mice (Mus musculus), which were used as models for Parkinson's disease in an in vivo paraquat study, to determine the optimal dose of photobiomodulation therapy and a laser diode was used as a treatment.

Methods

The three sample groups are Group P-L- (control group, induced by 0.9% NaCl), Group P + L- (only caused by paraquat), and Group P + L+. (Treatment group, treated by paraquat and photobiomodulation therapy with a laser diode). Photobiomodulation treatment doses of 0.14 J, 0.29 J, 0.37 J, 0.76 J, 1.14 J, and 1.52 J were used in the P+L+ subgroups (6 groups). The laser diode generated a continuous wave with a wavelength of 658 nm, a beam spot of 2.10 mm, and an output power of 15.42 mW. After treatment, the histopathology results of each sample were inspected under a microscope.

Result

In Parkinson's disease-affected mice, paraquat has been shown to reduce the number of neurons. According to the results of the histopathological examination, photobiomodulation therapy using a laser diode (P + L+) on the HT-7 (Shenmen) may raise the quantity of neurons and the proportion of healthy cells in the mouse brain.

Conclusion

The effective radiated energy of the photobiomodulation therapy using laser diode treatment on the muscle musculus cell model of Parkinson's disease is 0.76 J.

Effect of low-level laser stimulation of acupuncture points in pediatric dentistry: a systematic review

The biomodulatory potential of low-level laser therapy (LLLT) has prompted investigations of different outcomes in health. One line of research is the stimulation of acupuncture points for the relief of different signs and symptoms related to the stomatognathic system. In dentistry, some studies in pediatric dentistry have demonstrated the benefit of LLLT therapies in the management of dental anxiety in children. This systematic review aimed to analyze previous clinical studies on the application of LLLT at acupoints among pediatric dental patients. This systematic review was conducted according to the Cochrane Collaboration guidelines and the population, intervention, comparison, and outcome strategy. A broad literature search up to June 17, 2022, was performed using four electronic databases (PubMed, Scopus, Embase, and Google Scholar). The risk of bias in randomized clinical trials was assessed using the RoB 2 tool. A total of four studies using LLLT for photobiomodulation were included (n = 4). The most common wavelengths used were in the infrared range (variation between 716 nm and 980 nm). There were little variations in the application time (14 s to 1 min) and exposure dose (1 to 5 joules). LLLT acted positively on different acupuncture points. LLLT provided various benefits and optimized dental practice by reducing the gag reflex during radiography and impression taking, preanesthetic pain, and symptoms of sleep bruxism in the pediatric dental population. Only one of the evaluated studies had a high risk of bias. The LLLT at acupuncture points is associated with positive results on sleep bruxism, preanesthetic pain, and gag reflex in pediatric dentistry. Future research studies should prioritize standardization of the study design and the methods of analysis.

Efficacy of various forms of acupuncture for the treatment of urinary incontinence in women: A systematic review and meta-analysis

BACKGROUND AND PURPOSE

Evidence regarding the efficacy of various forms of acupuncture for the treatment of urinary incontinence (UI) in women is outdated and inconclusive. This review aims to determine the efficacy of different forms of acupuncture for the treatment of UI in women.

METHODS

Multiple databases were searched from inception to June 2020. Randomized controlled trials that compared various forms of acupuncture to control were included.

RESULTS

Ten trials were included in this review. The pooled analysis demonstrated that an increased proportion of women with stress UI (SUI) reported fewer UI episodes (1.73 [95% CI 1.46, 2.04]; p < 0.00001) in the electroacupuncture group than in the sham group. The meta-analysis also revealed a significantly increased number of women who reported the complete cure of SUI in the electroacupuncture combined with pelvic floor muscle training group than in the medication group (RR 2.67 [95% CI 1.51, 4.71]; p = 0.0007). Body and laser acupuncture caused significant decreases in the number of urge accidents (-2.70 [95% CI -4.86, -0.54]; p = 0.01) and the occurrence of urgency symptoms (-3.60[95% CI -5.34, -1.86]; p < 0.0001), compared with sham acupuncture.

CONCLUSIONS

Based on the findings of this review, electroacupuncture may be able to improve SUI in women in clinical settings. This review also identified evidence supporting the use of body, electro,- and laser acupuncture for the treatment of urge UI; however, these results were obtained from single studies, and further research remains necessary to confirm the effects of these interventions on the treatment of urge UI in women.

Reporting and methodological quality of acupuncture network meta-analyses could be improved: an evidence mapping

BACKGROUND AND OBJECTIVES

To evaluate and map the reporting and methodological quality of network meta-analysis (NMA) on acupuncture.

METHODS

Published acupuncture NMAs were searched through eight databases from inception to February 2022. The reporting and methodological quality of included studies was assessed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Network Meta-Analysis (PRISMA-NMA) statement and the Assessment of Multiple Systematic Reviews 2 (AMSTAR-2) checklist.

RESULTS

A total of 113 NMAs were identified. Most (99, 87.61%) studies were performed in China. Most studies focused on multiple acupuncture techniques (82.30%), and the main studied ailments were pain and poststroke sequelae (20.24%). The median (interquartile range (IQR)) score of the reporting quality was 26.5 (25-28.5). However, poor reporting rates in the protocol and registration (33.63%) and geometry of the network (35.40%), especially for China-based studies, were identified. The methodological quality of only 2 (1.77%) English studies was high. The reporting rate of Chinese studies was below 15% on each of items 4, 7, 10, and 12.

CONCLUSION

The reporting quality of the NMAs was moderate, but the methodological quality was very low. The reporting and methodological quality of future NMAs, especially for Chinese studies, need further improvement.

Acupuncture Case Registry Study: Rationale, Implementations, and Achievements

The acupuncture case registry study is focusing on acupuncture therapy data from patient cases. The main objective is to collect real-world data and integrate clinically meaningful outcome evaluation indicators to uncover and evaluate real-world acupuncture efficacy and safety, explore factors affecting acupuncture efficacy, and provide real-world evidence to complement RCTs. Since the International Acupuncture Case Registry data collection system’s establishment in 2017, 16 projects have been underway, including two acupuncture specialty therapies and 15 diseases. Data from 3404 patients included extensive information on the diagnosis and treatment of acupuncture and the evaluation of its efficacy. In order to serve as a guide for future studies, this article discusses the value of and rationale for establishing acupuncture case registry studies, how to distinguish them from patient registries, and crucial techniques for implementing registry studies in terms of applications, patient recruitment, costakeholder collaboration, data collection and management, study quality control, and ethics.

Therapeutic Effect of a Low-Level Laser on Acute Pain and Post-operative Mouth Opening After Closed Reduction of Mandibular-Condylar Fracture

Introduction: The purpose of this study was to determine the therapeutic effect of low-level laser therapy (LLLT) on acute pain and the range of mouth opening after condylar closed reduction surgery. The use of low-level lasers, especially to reduce inflammation and pain, has received more attention in recent years. The results of many studies performed in this field are contradictory, and the effectiveness of low-level lasers in the treatment of patients is still uncertain. Methods: This study was performed as a randomized, double-blinded clinical trial on 40 patients with condylar closed reduction surgery. Patients were randomly assigned to two groups of 20 patients, including the placebo and intervention groups. In the intervention group, the patients received LLLT (100 mw, 2 J/cm², 20 S/point, 14 extraoral points, 7 days). The range of jaw movements after opening the intermaxillary-fixation was measured. Patients' pain was assessed using the visual analog scale (VAS). Data were analyzed using SPSS software version 21, the chi-square test, and repeated measures ANOVA. Results: There was no significant difference between the study groups in terms of the range of jaw motions. The mean VAS score was 56.85 (SD=3.817) in the intervention group and 60.95 (SD=4.861) in the placebo group, showing a statistically significant difference between the two groups at the end of the study (P=0.007) Conclusion: The results of this study indicated the effectiveness of low-level lasers in reducing acute pain in patients undergoing closed condylar surgery. Iranian Registry of Clinical Trials (IRCT20200520047519N1).

Efficacy of invasive laser acupuncture in treating chronic non-specific low back pain: A randomized controlled trial

This study aimed to provide preliminary evidence for the efficacy of invasive laser acupuncture (ILA) for chronic non-specific low back pain (CNLBP). This was a single-center, randomized, patient and assessor-blinded, placebo-controlled, parallel-arm, clinical trial with a 1:1:1 allocation ratio that included a full analysis set. Forty-five participants with CNLBP were randomly assigned to the control group (sham laser), 650 group (650 nm-wavelength ILA), or 830 group (830 nm-wavelength ILA) (n = 15/group). All participants received ILA for 10 min, followed by electroacupuncture for 10 min on the same day. The treatment was performed once per day, twice per week for 4 weeks at bilateral BL23, BL24, BL25, and GB30. The primary outcome was the among-group difference of changes in the visual analog scale (VAS) scores at intervention endpoint (week 4). The secondary outcomes were the among-group difference of changes in VAS at 4 weeks after intervention completion (week 8), those in the Korean version of the Oswestry Disability Index (ODI) and the European Quality of Life Five-Dimension- Five-Level (EQ-5D-5L) at intervention endpoint (week 4) and 4 weeks after intervention completion (week 8). The VAS scores of the 650 group decreased significantly compared with those of the control group (p = 0.047; week 4 vs. week 0). The ODI scores of the 650 group (p = 0.018, week 4 vs. week 0; p = 0.006, week 8 vs. week 0) and 830 group (p = 0.014, week 4 vs. week 0) decreased significantly compared with those of the control group. There was no adverse event related to ILA and no significant difference in changes in vital signs among the three groups. The 650 group showed significant improvements in pain intensity and functional disability. The 830 group showed significant improvements in functional disability. Therefore, ILA therapy at 650 nm and 830 nm wavelengths can be used to treat CNLBP.

Traditional acupuncture and laser acupuncture in chronic nonspecific neck pain: study protocol for a randomized controlled trial

Background

Nonspecific neck pain is a multifactorial and very common condition in adult individuals, traditional acupuncture (TA) and laser acupuncture (LA) may be treatment options for certain individuals in such a condition. However, no reports were found in the literature comparing the effectiveness of TA and LA in cases of chronic nonspecific neck pain. Therefore, the aim of the present study is to investigate the effectiveness of TA and LA therapies in individuals with chronic nonspecific neck pain, noting which one is more efficient for this condition. The result of this research will have direct implications for pain management and, consequently, may benefit individuals suffering from nonspecific chronic neck pain.

Methods/design

This will be a controlled and randomized clinical trial. Eighty-four individuals will be recruited and distributed equally and randomly into 3 groups: TA (which will receive the acupuncture treatment with needles), LA (which will receive the laser acupuncture treatment), and Sham (who will receive the placebo intervention). The acupuncture points (Tianzhu, Fengchi, Jianjing, and Jianzhongshu) will be stimulated bilaterally. The primary outcome will be pain intensity, determined using the Numerical Rating Scale. The secondary outcomes will be pressure pain threshold, temporal summation of pain, conditioned pain modulation, use of analgesic medicines after treatment, and the global perceived effect scale. The assessments will be performed immediately before and after the treatment, which will be a single session, at the follow-up and 1 month after the end of the treatments; evaluation will be made of the pain intensity and the global perceived effect. Statistical analysis of the data obtained will consider a significance level of p < 0.05.

Discussion

This study will provide evidence concerning the effects of LA treatment, in comparison with TA and sham intervention, leading to benefits for individuals suffering from chronic nonspecific neck pain.

Trial registration

Brazilian Registry of Clinical Trials - ReBEC RBR-7vbw5gd. Date of registration: August 06th, 2021.

Light acupuncture and five-element music therapy for nurses' mental health and well-being during and post-COVID-19: protocol for a randomised cross-over feasibility study

INTRODUCTION

Australian nurses have experienced higher levels of anxiety during the COVID-19 pandemic compared with the prepandemic. This may have affected their long-term mental health and intention to stay in the profession resulting in a workforce shortage, which further impacts the health of the public. Management is urgently required to improve nurses' well-being. However, there is limited evidence available. The proposed clinical trial aims to evaluate the feasibility and therapeutic effects of using a combination of light acupuncture and five-element music therapy to improve nurses' mental health and well-being during and post-COVID-19.

METHODS AND ANALYSIS

This randomised, single blinding, two-arm cross-over feasibility study involves a 1-week run-in period, 2-week intervention and 1-week run-in period in between interventions. Thirty-six eligible nurses will be recruited from the community and randomised into either a combination of light acupuncture treatment and five-element music therapy group or no treatment group for 2 weeks. After a 1-week run in period, they will be swapped to the different group. The primary outcome of this study is to evaluate the feasibility of a combination of light acupuncture treatment and five-element music therapy to improve nurses' mental health and well-being. The secondary outcomes will include anxiety and depression, work productivity and activity, and quality of life assessments. Participants will be asked to complete a set of online questionnaires throughout the trial period. All analyses will be performed in R Studio V.1.1.463.

ETHICS AND DISSEMINATION

Ethical approval was attained from Edith Cowan University's Human Research Ethics Committee (No. 2021-02728-WANG). Research findings will be shared with hospitals and in various forms to engage broader audiences, including national and international conferences, presentations, open-access peer-reviewed journal publications, and local community workshop dissemination with healthcare professionals.

TRIAL REGISTRATION NUMBER

Australian New Zealand Clinical Trials Registry: ACTRN12621000957897p https://www.anzctr.org.au/ACTRN12621000957897p.aspx.

Effects of Laser Acupuncture Therapy for Patients With Inadequate Recovery From Bell's Palsy: Preliminary Results From Randomized, Double-Blind, Sham-Controlled Study

Introduction: Inadequate recovery from Bell's palsy exists in a third of patients and results in physical and social impairments. The controversial nature of existing medical treatment options means that novel, alternative approaches are needed. In basic and clinical studies, low-level laser therapy (LLLT) has proven successful in regenerating peripheral nerves. Laser acupuncture therapy (LAT) is a rapidly growing treatment modality; however, its effectiveness for treating chronic Bell's palsy is unknown. The feasibility of this innovative approach is the focus of this pilot study. Methods: A two-armed, parallel, randomized, investigator-subject-assessor-blinded, sham-controlled pilot study was conducted, and 17 eligible subjects were randomly allocated to either LAT (n=8) or sham LAT (n=9). The LAT group received three treatments each week for six weeks (18 sessions), while the sham LAT group received the same procedure but with a sham laser device. The change from baseline to week 6 in the social subscale of the Facial Disability Index (FDI) was the primary outcome. Secondary outcomes were changes in the House-Brackmann facial paralysis scale (HB), the Sunnybrook facial grading system (SB) and a stiffness scale at weeks 3 and 6. Results: A significant difference was shown in the HB score (P=0.0438) between baseline and week 3 and borderline significance was observed in both SB and stiffness scores from baseline to week 6 (P=0.0598 and P=0.0980 respectively). There was no significant difference in the FDI score between baseline and week 6. Conclusion: To the best of our knowledge, this clinical trial is the first such investigation on this topic. Our findings suggest that using LAT may have clinical effects on long-term complications of Bell's palsy and justify further large-scale studies.

Feasibility and therapeutic efficacy of a two-week low-level laser acupuncture therapy for shoulder and neck pain in office workers: Protocol for a pilot, single-blind, double-armed, randomised controlled trial

BACKGROUND

Shoulder and neck pain (SNP) is common in office workers and represents a serious public health problem given its detrimental impact on quality of life, physical functioning, personal finances, employers, and the health care system. Management with painkillers has adverse implications such as tolerance, addiction, and opioid abuse. Safe, sustainable, cost-effective, and evidence-based solutions are urgently needed. The non-invasive, painless, non-infectious, and safe modality of low-level laser acupuncture (LLLA) has shown promise for SNP management.

OBJECTIVE

The overarching aim of this study is to provide evidence of the feasibility and therapeutic efficacy of LLLA for office workers with SNP.

METHODS

This is a pilot, single-blind, double-armed, randomised controlled trial on the feasibility and therapeutic efficacy of a two-week LLLA therapy for office workers with SNP, aged 18 to 65 years. Each of the two study groups will contain 35 participants: the intervention group will receive LLLA from a licensed acupuncturist at the researchers' university clinic (10-20 min/session, 3 sessions/week) for two weeks; the control group will receive usual care without painkillers. Outcomes will be measured at baseline, throughout the two-week intervention, and at trial end. Surveys including open-ended questions will be completed. The primary outcome of this study is to evaluate the feasibility of a two-week LLLA therapy for office workers with SNP, as measured by recruitment and completion rates, patient safety, and treatment adherence and compliance. Participants' attitudes, motivation, and challenges to participation, intervention non-compliance, and experience of participating in the trial will be investigated via qualitative data. The secondary outcome is to evaluate the therapeutic efficacy of LLLA on SNP using the visual analogue scale (VAS) and the Short-Form McGill Pain Questionnaire (SF-MPQ); the work productivity and activity assessment (WPAI:SHP); 12-Item Short Form Survey (SF-12) for quality of life assessment; and the past 3-month out-of-pocket (OOP) cost for prescription and non-prescription SNP therapy, which is an indicative of the economic burden of SNP on patients and health care systems. This study was approved by Edith Cowan University's Human Research Ethics Committee (No. 2021-02225-WANG).

RESULTS

Data collection will commence in December 2021 with anticipated completion by December 2022.

CONCLUSIONS

Safe, sustainable, cost-effective, evidence-based interventions are needed to minimise the negative implications of SNP in office workers. LLLA is a promising modality in managing SNP. However, more consolidated evidence is required to provide insight regarding the effectiveness of LLLA. This study is expected to contribute to the challenging work of reducing the burden of SNP in office workers.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12621000426886p; https://www.anzctr.org.au/ACTRN12621000426886p.aspx.

Effect of Low-Level Laser Irradiation on Accommodation and Visual Fatigue

Purpose

This study used low-level laser irradiation on auricular points for the eyes of junior college teenagers with myopia to observe the changes in refractive errors and eye accommodation. According to the Sterner’s study, we used the relationship between the amplitude and subjective symptoms to assess the degree of improvement in visual fatigue caused by changes in accommodation.

Methods

Participants were 49 healthy junior college teenagers, with an average age of 16.04±0.80 years old, and the refractive errors of both eyes were between −1.50 D and −5.00 D. All participants underwent refractive error tests before and after class and after a 30-min break. In a 30-min break, all participants underwent two tests of with (experimental group) and without (control group) low-level laser irradiation on the auricular points. Then, refractive error tests were conducted to evaluate the participants’ eye accommodation.

Results

The results revealed that with treatment of the auricular points with and without low-level laser irradiation, the refractive error of the participants’ binocular left and right eyes decreased by −0.12 D (−0.18 D) in the experimental grou and by −0.05 D (−0.02D) in the control group. For the amplitudes of accommodation (AA) examination, the AA of the participants’ binocular in the experimental group became 7.98 ± 1.35 D (7.65 ± 1.37 D). The AA of participants’ binocular can recover to the level before the class.

Conclusion

The results indicated that low-level laser irradiation at auricular points restored the eye accommodation faster than did natural closing of the eyes.

Laser Acupuncture Improves Tear Film Stability in Patients with Dry Eye Disease: A Two-Center Randomized-Controlled Trial

Objectives: To investigate the efficacy of laser acupuncture (LA) therapy in patients with dry eye disease (DED). Design: A two-center randomized controlled trial. Settings/Location: The Department of Ophthalmology, Chinese Medicine at the Kaohsiung Chang Gung Memorial Hospital, and the Sunming Eye Clinic in South Taiwan. Subjects: Fifty-nine participants ages 20 to 65 years were enrolled and randomly assigned to the experimental group (LA plus conventional treatment) or the sham control group (LA without laser output plus conventional treatment). Interventions: Subjects underwent LA treatment three times a week for 12 weeks. The subjects in the experimental group sequentially received 0.375 J of energy at each of the following acupoints: BL2, TE23, ST2, LI4, ST36, and GB37. Subjects in the control group received a sham LA treatment, without any laser output. Outcome Measures: The primary outcome measure was ocular surface disease index (OSDI). The secondary outcome measures included tear film breakup time (TFBUT), Schirmer-I test finding, and visual analog scale (VAS) score. Results: At 4 and 12 weeks after the first visit, the experimental group showed significant improvement of dry eye symptoms as measured by OSDI, TFBUT, Shirmer-I test, and VAS. Compared with the control group, the OSDI (7.23, p = 0.001) and TFBUT (-1.78, p = 0.001) significantly improved in the experimental group at 12 weeks of treatment. Conclusions: LA improved the symptoms and tear stability related to DED in conjunction with conventional treatment. The authors suggest that LA be considered a complementary therapy for DED when conventional treatment does not provide satisfactory effects. Trial Registration: ClinicalTrials.gov Identifier NCT03204903.

The Effectiveness of Laser Acupuncture for Treatment of Musculoskeletal Pain: A Meta-Analysis of Randomized Controlled Studies

Objective

To evaluate the treatment effectiveness of laser acupuncture (LA) in patients with musculoskeletal pain.

Methods

Major electronic databases, including Medline, PubMed, Embase, Cochrane Library, CINAHL, and Scopus were searched to identify double-blind, randomized controlled trials of LA in musculoskeletal disorders. The primary outcome was the treatment efficacy for pain. The secondary outcomes included the comparison of disability, functional impairment, and dropout rate between LA and sham treatment, as well as the effect of sham treatment for pain. The results from included studies were synthesized with the random effects model.

Results

In total, 20 articles comprising 568 patients receiving LA and 534 patients receiving sham treatment were included in the current study. Our analysis showed LA significantly reduced pain (g=0.88, 95% confidence interval [CI]=0.35 to 1.42, p=0.001), disability (g=0.68, 95% CI=0.29 to 1.08, p<0.001), and functional impairment (g=0.67, 95% CI=0.32 to 1.03, p<0.001). Through meta-regression analysis, we found these effects were not moderated by mean age, the percentage of females, or treatment duration. Additionally, there was no significant difference between the two groups in dropout rate (risk ratio=0.73, p=0.08), and the sham treatment significantly reduced only pain intensity (g=0.54, 95% CI=0.32 to 0.77, p<0.001).

Conclusion

Our findings supported that LA significantly reduced pain, disability, and functional impairment in patients with musculoskeletal disorders. Further researches are required to determine the optimal therapeutic parameters and the suitable patients for receiving LA.

Protocol Registration

CRD42020190919.

Increasing Quantity and Internal Quality of Japanese Quail (Coturnix coturnix japonica) Eggs by Shooting Laser Puncture at Reproductive Acupuncture Points

This study aims to determine the effect of laser puncture shooting on the reproductive acupuncture points of Japanese quail (Coturnix coturnix japonica) egg quantity (egg production) and internal egg quality (Haugh unit, yolk index, and yolk colour). This research was conducted for 30 days using a sample of Japanese quail aged 4 weeks because for the first 2 weeks, the quail did not produce and it was in production in the last 2 weeks. There were 4 treatments and 25 replications each. So, there were a total of 100 quails. Laser puncture shooting was carried out at 3-day intervals at the Ova point and 6-day intervals at Hu Men, Bei Ji, and Wei Gen points. So, on the first day, laser puncture shooting was carried out at 4 points, on the 4th day, only at 1 point, and then, on the 7th day, it returned to 4 points. And so, it was carried out for 4 weeks. T0 (-) was considered as a negative control because quails are not given laser puncture shooting; T0 (+) was considered as a positive control because quails are treated with laser puncture shooting which is deactivated or a dose of 0 Joule; T1 was a group treated with laser puncture shooting at a dose of 0.2 Joule, and T2 was a group treated with laser puncture shooting at a dose of 0.5 Joule. Then, the research results were analyzed using Analysis of Variance and followed by Duncan's Multiple Range Test. Laser puncture shooting at the reproductive acupuncture point of Japanese quail (Coturnix coturnix japonica) can increase the quantity of eggs (p < 0.05). While the results of the egg internal quality in the form of the Haugh unit value and the yolk index increased (p < 0.05), the value of the yolk colour did not change compared to the control (p > 0.05). Laser puncture shooting at the reproductive acupuncture point of Japanese quail (Coturnix coturnix japonica) can increase egg quantity (egg production) and internal egg quality (Haugh unit and yolk index) with the best dose of 0.5 Joule.

The Application of Laser Acupuncture in Animal Experiments: A Narrative Review of Biological Aspects

Experimental studies on animals are conducted in almost all areas of medical research. The experiments offer insights into diseases and expand biomedical knowledge. Animal experiments are also imperative for studying acupuncture treatment mechanisms and the exploration of innovative acupuncture techniques. Laser acupuncture (LA), as a promising alternative to traditional manual acupuncture (MA), has the characteristics of painless and controllable stimulation. Today, society is more aware of animal welfare than previous generations. The use of noninvasive LA as a substitute for invasive MA in basic experimental research of acupuncture should be encouraged. Thus, we conducted an overview of animal experiments in the research field of LA from January 1978 to April 2020. After careful research, 52 studies were included in the work. Among these studies, both single-point and multipoint LA studies have been reported. To make noninvasive LA better in replacing invasive MA in experimental animal research of acupuncture, further experiments should focus on exploring uniform criteria for selecting laser parameters and revealing the extent to which the curative effect of LA depends on the property of acupuncture points rather than the characteristics of photobiomodulation.

Laser Acupuncture: 35 Years of Successful Application in Russia (Narrative Review)

Introduction: Laser acupuncture is one of the low-level laser therapy (LLLT) methods, replacing the traditional technique of Chinese needle acupuncture. This article describes the main principles and parameters of laser acupuncture based on the analysis of 35 years of successful experience in applying the method in Russia. Methods: The search of the literature on laser acupuncture was made in the Russian Medical Library and the Russian State Library (1498 publications in Russian), and PubMed/Medline (117 publications in English). 96 studies on laser acupuncture techniques were selected and a narrative review was conducted. Results: The optimal parameters of the technique were worked out by Russian specialists in the 1970s, and are perfectly confirmed by the wide practice of clinical application. The literature review showed that the most optimal parameters of laser acupuncture are wavelength - 635 nm (red spectrum), power - no more than 2-3 mW, the diameter of special nozzle attachment - not more than 1-1.5 mm, and exposure - 20-40 s (for corporal points) or 5-10 s (for auricular points). The impact on acupuncture points (APs) is carried out consistently in accordance with the recipe (protocol), with no more than 10-12 daily procedures. Conclusion: Laser acupuncture is a very effective and reproducible technique to treat patients with different diseases. Any specialist can apply this method because of its simplicity, but using the most effective parameters.

The Effect of Laser Acupuncture on Spasticity in Children with Spastic Cerebral Palsy

BACKGROUND

Spasticity in cerebral palsy is one of the most common disabilities of children in developing countries.

OBJECTIVES

The objective of this study was to determine the efficacy of laser acupuncture on spasticity in children with spastic cerebral palsy.

METHODS

This clinical trial was conducted on 60 patients with spastic cerebral palsy at 2 to 10 years. The patients were categorized into two groups: the control group and treatment group. Laser acupuncture was applied on GV20, GV14, LI4, GB34, and LR3 (power 50 mW, 785 nm, 1 Joule, 40 seconds) three times a week for 12 sessions in the treatment group and placebo laser acupuncture on the same points in the control group. The spasticity was measured using the Modified Ashworth Scale before and after complete sessions.

RESULTS

The results showed that there was a significant reduction in the Modified Ashworth Scale score in the treatment group compared with the control group (p = 0.003).

CONCLUSIONS

This study suggest that laser acupuncture on GV20, GV14, LI4, GB34, and LR3 can reduce spasticity for children with spastic cerebral palsy.

The Safety of Laser Acupuncture: A Systematic Review

Objective: Laser acupuncture has become increasingly attractive in clinical practice, especially for patients with needle phobias well as elderly people and children. However, literature concerning the safety of laser acupuncture has been limited. This systematic review synthesizes the current available literature on the safety of laser acupuncture. Methods: Ovid MEDLINE,^® Epub Ahead of Print, In-Process & Other Non-Indexed Citations Daily, Ovid Embase, Scopus, and EBM Reviews-Cochrane Central Register of Controlled Trials databases were searched for available randomized controlled trials (RCTs) on laser acupuncture. Safety data were extracted from the included studies. Adverse events (AEs) data were extracted and assessed in terms of severity and causality. Results: Of 737 articles, 21 RCTs were included. The majority of these RCTs reported that laser acupuncture was safe, without AEs; 6 trials reported AEs (including tingling, pain flare-ups, and transient fatigue). All AEs were mild and resolved spontaneously within 24 hours. The causal relationship between AEs and laser acupuncture was felt to be "certain" in 4 studies, "probable" in 1 study, and "possible" in 1 study. AEs were collected and monitored by evaluation methods in 7 trials: 5 with AE questionnaires, 1 with a checklist, and 1 with oral reports. Conclusions: Laser acupuncture appears to be a safe therapy associated with few mild and transient AEs. However, given the heterogeneity of current studies, large, well-designed placebo-controlled RCTs with rigorous evaluation methods are needed to assess the safety of laser acupuncture more completely.

History of Laser Acupuncture: A Narrative Review of Scientific Literature

Background: Laser acupuncture is a relatively young modality in the field of acupuncture, used successfully for the treatment of various conditions since the early 1970s. It has, despite its ∼50 years of existence, already a comprehensive history behind it. This review deals with facts of this history and summarizes the most-important milestones. Materials and Methods: Scientific articles from the PubMed, Google Scholar, and China National Knowledge Infrastructure databases served as research documents. In addition, the research on laser acupuncture history included material published in scientific books. Results: A total of 38 listed articles were identified, 7 of which were considered relevant. In addition to a generally recognized definition of laser acupuncture, the beginnings of laser acupuncture and the first clinical applications worldwide, this review also shows the most-important milestones in the development of this discipline. The latter are, of course, the development of laser acupuncture systems, the first clinical studies, the implementation of multichannel laser acupuncture devices with laser-needle technology, and, ultimately, the combination of laser acupuncture with methods from research on photobiomodulation. Conclusions: Although considerable progress has been made in evaluating this innovative method of laser acupuncture, further research is needed in the coming years and decades.

Effect of Laser Moxibustion for Knee Osteoarthritis: A Multisite, Double-blind Randomized Controlled Trial

OBJECTIVE

To examine the effects of laser moxibustion on pain and function in patients with knee osteoarthritis (OA).

METHODS

A double-blind randomized clinical trial (4-week treatment, 20-week follow-up) was conducted. A total of 392 symptomatic knee OA patients with moderate to severe clinically significant knee pain were randomly assigned to laser treatment or sham laser control group (1:1). Twelve sessions of laser moxibustion or sham laser treatments on the acupuncture points at the affected knee(s) were performed 3 times a week for 4 weeks. The primary outcome measurement was change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score from baseline to Week 4.

RESULTS

Among the 392 randomized participants, 364 (92.86%) completed the trial. The median WOMAC pain score decreased significantly at Week 4 in the active group than in the sham group (2.1, 95% CI 1.6-2.6, P < 0.01). At Week 24, compared to the sham laser, active laser treatment resulted in significant pain reduction and function improvement (3.0, 95% CI 2.5-3.6, P < 0.01, and 14.8, 95% CI 11.9-17.6, P < 0.01, respectively). The physical component of the quality of life significantly improved in the active group vs the sham controls at Week 4 (3.2, 95% CI 1.3-5.0, P = 0.001) up to Week 24 (5.1, 95% CI 3.3-7.0, P < 0.001). No serious adverse effects were reported.

CONCLUSION

Laser moxibustion resulted in statistically and clinically significant pain reduction and function improvement following a 4-week treatment in patients with knee OA.

[Acupuncture for pain and allergic rhinitis-from clinical experience to evidence]

BACKGROUND

Acupuncture is a traditional Chinese medicine therapy method that is also frequently used in the western world. It has been the subject of intensive scientific research over the past two decades.

AIM OF THE WORK

To describe the efficacy, therapy safety, and health economic relevance of acupuncture for chronic pain disorders and allergic diseases.

MATERIAL AND METHODS

In the context of a review (narrative review) the relevant literature was selected, presented, and interpreted.

RESULTS

Acupuncture is effective in chronic pain disorders such as chronic knee joint pain in osteoarthritis, migraine, tension headache, chronic lumbar spine pain, chronic cervical spine pain, shoulder pain, dysmenorrhea, and fibromyalgia under routine conditions. In addition, specific efficacy is shown in most chronic pain indications. Acupuncture is also effective in patients with allergic diseases. In large clinical studies, acupuncture has proven to be a relatively safe therapy, but severe complications (e.g. pneumothorax cases, hepatitis B) also occur in rare instances. Acupuncture is usually associated with higher therapy costs, but is considered a cost-effective treatment strategy for pain disorders.

DISCUSSION

As a nonpharmacological procedure, acupuncture is becoming increasingly important in pain and allergy therapy and is therefore increasingly included in current guidelines. In further studies, the efficacy of acupuncture should be determined in other indications and the mechanisms of action of this therapy method should be investigated.

Comparison of the effects between lasers applied to myofascial trigger points and to classical acupoints for patients with cervical myofascial pain syndrome

Background

To compare the immediate effectiveness of low-level laser therapy (LLLT) applied to classical acupoints versus trigger points for patients with cervical myofascial pain syndrome (MPS).

Methods

This was a single-blinded, randomized, placebo-controlled trial. This study was performed in a university-affiliated medical center. One hundred participants with cervical myofascial pain syndrome were randomly allocated to four treatment groups, including (1) acupoint therapy (AcuT), (2) acupoint control (AcuC), (3) trigger point therapy (TriT), and (4) trigger point control (TriC) groups. Low-level laser (810-nm) therapy was used in both therapy groups, while the same procedure was performed without laser in the acupoint control groups. The patients were evaluated based on visual analogue scale (VAS) pain score, pressure pain threshold, and cervical range of motion (ROM) before and after the therapy.

Results

Immediate pain relief was observed in the TriT group (p < 0.01). The TriT group showed improved cervical ROM in ipsilateral bending (p < 0.01), while the AcuT group did not.

Conclusions

LLLT applied to trigger points could significantly relieve myofascial pain and was effective in relieving cervical ROM limitations. Considering the risk of pneumothorax, laser therapy at trigger points for patients with cervical MPS may be a choice when acupuncture therapy is unavailable.

Trial registration

ClinicalTrials.gov ID: NCT01516502.

Laser photobiomodulation for cartilage defect in animal models of knee osteoarthritis: a systematic review and meta-analysis

To review and assess the efficacy of laser photobiomodulation for cartilage defect in animal models of knee osteoarthritis (KOA). Medline, Web of Science, and EMBASE were searched. Studies were considered if the global quality score of cartilage were parallelly reported between laser and untreated control groups. The methodological quality of each study was assessed using a modified 10-item checklist. The effect size was estimated by standardized mean difference (SMD) and pooled based on the random-effects model. Stratified analysis and regression analysis were conducted to partition potential heterogeneity. An adjusted significant level of 0.01 was acceptable. Five hundred eight initial search recordings were identified, of which 14 studies (including 274 animals) were included for quantitative analysis. The global quality scores mostly weighted by the structural integrity and chondrocyte distribution were measured by different four scales including Histologic Histochemical Grading System (HHGS), Osteoarthritis Research Society International (OARSI), Pineda, and Huang. There were considerable variances on laser parameters and irradiation time among those included studies. Overall, a moderate level of methodological qualities was determined. The synthesis results indicated that the SMD effect size was significantly larger in HHGS (z = 2.61, P = 0.01) and Huang (z = 4.90, P < 0.01) groups. Stratified by irradiance, SMD of low (< 1 W/cm²) but not high (≥ 1 W/cm²) level estimated significant difference (z = 5.62, P < 0.01). Meta-regression identified a significant association for SMDs and irradiation time (P < 0.01). Yet, Egger's test detected small study effect (P < 0.01). No individual study with significant variance was found in homogeneity tests. The results demonstrated the positive effect of laser photobiomodulation for cartilage defect in animal models of KOA under proper irradiance and adequate irradiation time.

Laser Acupuncture for Patients with Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials

Objectives

To provide updated evidence from randomized controlled trials (RCTs) on the effectiveness of laser acupuncture for patients with knee osteoarthritis (KOA).

Methods

A literature search in 9 databases was conducted from their inception through February 2019. Randomized controlled trials (RCTs) written in English that compared active laser acupuncture with placebo in KOA patients were included. Two authors independently extracted data from these trials. Meta-analysis software was used to analyze the data. Included studies were assessed in terms of the follow-up period, the methodological quality, and appropriateness of their technical features.

Results

Of 357 studies, seven RCTs (totaling 395 patients) met the inclusion criteria. The short-term outcomes showed that laser acupuncture offered significant pain relief over placebo when assessed by the 100 mm visual analog scale (VAS) pain score (p = 0.02), while there was no significant difference between laser acupuncture and placebo based on Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain score (p = 0.25). For subgroup analysis, laser acupuncture had superiority over placebo in terms of both VAS and WOMAC pain scores in the appropriate technical features subgroup and the excellent methodological quality subgroup. But the effect of laser acupuncture on pain relief was not maintained in terms of either VAS (p = 0.19) or WOMAC pain score (p = 0.60). The pooled effect showed no significant difference between laser acupuncture and placebo at either time point according to WOMAC function scale, WOMAC stiffness scale, and quality of life outcome.

Conclusions

Our findings indicate that laser acupuncture can effectively reduce knee pain for patients with KOA at short term when appropriate technical features are applied, but the effect likely fades away during the subsequent follow-up period.

Effect of Compound Laser Acupuncture-Moxibustion on Blood Glucose, Fasting Insulin and Blood Lipids Levels in Type 2 Diabetic Rats

OBJECTIVE

To investigate the effect of compound laser acupuncture-moxibustion on blood glucose, fasting insulin and blood lipids levels in type 2 diabetes mellitus (T2DM) rats.

METHODS

Forty male Wistar rats were randomly divided into 4 groups, including the normal group, model control group, laser group and sham laser group (n=10 per group). The rats in the normal group were fed with a standard diet. Rats in other groups were fed with a high-sugar and high-fat diet for 4 weeks, then intraperitoneally injected with 1% streptozotocin to induce T2DM model. The laser group was irradiated by 10.6 µm and 650 nm compound laser on bilateral Pishu (BL 20), Shenshu (BL 23) and Sanyinjiao (SP 6) for 5 min, 6 times a week for 5 weeks. The sham laser group received the same treatment as the laser group, but without laser output. The model control group and normal group were not treated. Blood glucose levels were measured before and after 1, 2, 3, 4 and 5 weeks of treatment. The serum levels of fasting insulin, total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) were analyzed after the last treatment.

RESULTS

The blood glucose levels in the model control group increased during the 5 weeks of treatment compared with the normal group (P<0.05), while those in the laser group were significantly lower than the model control group after weekly treatment (P<0.01 or P<0.05). After 1, 2 and 3 weeks of treatment, the blood glucose levels in the laser group decreased obviously compared with the sham laser group (P<0.01 or P<0.05). Compared with the normal group, the levels of fasting insulin, TC and LDL in the model control group notably increased (P<0.01 or P<0.05), while their levels in the laser group were significantly lower than the model control group after 5 weeks of treatment (P<0.05 or P<0.01). However, no statistically significant differences were observed in TG or HDL levels among the 4 groups (P>0.05).

CONCLUSION

The compound laser acupuncture-moxibustion of 10.6 µm and 650 nm had positive effects on the regulation of hyperglycemia and insulin resistance in T2DM rats, which may be a potential treatment for T2DM, and also provide an alternative to the traditional acupuncture and moxibustion therapy.

Efficacy of laser acupuncture for carpal tunnel syndrome: A study protocol for a prospective double-blind randomized controlled trial

INTRODUCTION

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy that causes hand discomfort and work disability. Since no satisfactory conventional treatments for mild to moderate CTS exist, we apply complementary alternative medicine (CAM) to this problem. Laser acupuncture (LA), a new, non-invasive therapy which uses low-level-laser therapy (LLLT) in acupuncture could help to manage CTS. However, only one small randomized, double-blind and crossover trial had been conducted, which is not enough to provide an evidence-based assessment of the effects of LA on CTS.

OBJECTIVES

The aim of this study protocol is to investigate the efficacy of LA therapy on patients with mild to moderate CTS through sonography of the median nerve and offer clear parameters of LLLT.

METHODS

This study protocol is a prospective double-blind randomized controlled trial. Forty subjects aged 20 to 80 years old and diagnosed as having mild to moderate CTS will be randomly assigned to the intervention group (real LA, 3-sessions a week for 2 weeks) and control group (sham LA, 3-sessions a week for 2 weeks). All subjects will be asked to wear night splints as the fundamental management approach. The laser parameters will include a wavelength of 808 nm, power output of 300 mW and power density of 300 mW/mm, with ten seconds of treatment for each acupuncture point (PC4, PC6, PC7, PC8, LI4, LI10, LI11, HT3, HT7, and LU10). Sham LA treatment will be applied without any laser power output. The primary outcome will be based the Boston Carpal Tunnel Syndrome Questionnaire and secondary outcomes included a visual analog scale, cross sectional area of median nerve by sonography and electrophysiological test before interventions and after 2, 4, 8, 12 weeks postintervention.

TRIAL REGISTRATION

ClinicalTrials.gov (Identifier: NCT03580265).

Laser Acupuncture: A Concise Review

Background: Laser acupuncture (LA)-the use of nonthermal, low-intensity laser irradiation to stimulate acupuncture points-has become more common among acupuncture practitioners in recent years. LA is promoted as a safer pain-free alternative to traditional acupuncture, with minimal adverse effects and greater versatility. However, little is known about the mechanism of action of LA, laser characteristics, and effectiveness of LA therapy. Objective: This concise review of LA describes basic parameters and procedures, potential mechanisms of action, and the current evidence for its clinical efficacy. The article also highlights the need for more robust research on LA that can be translated into evidence-based clinical practices. Conclusions: LA has many features that make it an attractive option as a treatment modality, including minimal sensation; short duration of treatment; and minimal risks of infection, trauma, and bleeding complications. Future studies with high-quality methodologies, ample sample sizes, and consistent and reproducible laser parameters are critically needed to increase understanding and establish potential future clinical applications.

Effectiveness of Laser Acupuncture in Alleviating Chronic Insomnia: A Single-Blinded Randomized Controlled Trial

Study Objectives

This study investigates the therapeutic effect of Low Level Laser Therapy (LLLT) acupuncture for chronic insomnia.

Methods

Thirty-seven adult subjects with chronic insomnia were recruited and randomly assigned to three groups, namely, Group A (6 pairs of acupoints: Ex-HN 22, HT 7, SP 6, KI 3, LR 3, and PC 6, bilaterally distributed); Group B (acupoints as for Group A other than PC 6, which was applied only on the left side [i.e., the dominant side of the PC meridian] and the addition of DU 20, which is the main tonic acupoint for integration of all the meridians); and a control group (sham LLLT). The subjects in the treatment groups (i.e., Groups A and B) received LLLT acupuncture and those in the control group received sham LLLT for 15 minutes per session twice a week for five weeks. The sleep quality of all the subjects was evaluated using the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), the Hospital Anxiety and Depression Scale (HADS), and a sleep diary. In addition, the sympathetic activity before and after every treatment sessions was measured using the Heart Rate Variability (HRV).

Results

All three groups showed an improved PSQI score. However, only Group A showed a significant reduction in the sleep onset latency and number of awakenings at night and a higher sleep efficiency and ESS score. Furthermore, Group B showed an increased low frequency power and normalized low frequency of the HRV signal and a lower normalized high frequency power, suggesting an increased sympathetic activity and decreased parasympathetic activity.

Conclusions

For chronic insomnia insomniacs, LLLT appears to shorten the sleep latency, decrease the number of awakening events at night, and improve the sleep efficiency.

Effects of laser acupuncture in a patient with a 12-year history of facial paralysis: A case report

Background

Traumatic facial palsy, whether accidental or iatrogenic, is a common cause of facial paralysis. Laser acupuncture therapy (LAT) is a non-invasive, pain-free method to stimulate traditional acupuncture points with non-thermal laser irradiation. Low-level laser therapy has proven beneficial in the regeneration of peripheral nerves. This case report describes the feasibility of this innovative treatment in a patient with a 12-year history of traumatic facial palsy and severe sequelae.

Case summary

A52-year-old male presented with a severe left-sided facial paralysis that had lasted for 12 years. At initial presentation, the man could not fully close his left eye and had difficulty eating solid foods. The paralysis of his left-sided facial muscles had resulted in dysarthria. He was administered 30 LAT sessions in the Acupuncture Department of China Medical University Hospital, Taichung, Taiwan, over a 4-month period. His recovery was monitored by scores on the Facial Disability Index, the Sunnybrook Facial Nerve Grading System and measurements of the vertical palpebral distance in his left eye. Photographs were taken after every treatment. On the 10th treatment, a change in closure of the left eye was noticed and facial muscle strength was improved. After 22 treatments, the patient could fully close his left eye.

Conclusion

LAT significantly improved the sequelae of long-term facial paralysis in this patient. Large-scale prospective studies are needed to confirm this observation [added]

Effectiveness of Laser Acupoints on Women With Polycystic Ovarian Syndrome: A Randomized Controlled Trial

Introduction: Polycystic ovarian syndrome (PCOS) is one of the most widely recognized reasons for infertility. The aim of this study was to examine the impact of laser acupuncture on PCOS women. Methods: Twenty-five PCOS women were randomly allocated to either the study group (SG; n=13), treated by laser acupuncture, or the control group (CG; n = 12). Blood hormonal levels and insulin resistance were measured at baseline and after 12 weeks of intervention. Results: The pre-intervention levels showed no statistically significant differences between SG and CG for baseline characteristics (P>0.05). After 12 weeks of intervention, within-group analyses showed that body mass index (BMI), blood hormonal levels, and insulin resistance were significantly decreased (P<0.05), while no significant changes in follicle-stimulating hormone (P>0.05) were recorded in the 2 groups. Between-groups analyses showed that most outcomes measures were significantly decreased (P<0.05) in SG compared with CG, with no significant changes in FSH and BMI (P>0.05). Conclusion: Laser acupuncture can be suggested as an effective management for PCOS women.

Examination of the cellular mechanisms of leukocyte elevation by 10.6 μm and 650 nm laser acupuncture-moxibustion

To investigate the cell cycle and cellular mechanisms of leukocyte elevation by laser acupuncture in rats with cyclophosphamide (CTX)-induced leukopenia. Sixty-six rats were randomized into six groups: normal, model control group, sham treatment group, 10.6 μm laser treatment group, 650 nm laser treatment group, and 10.6 μm-650 nm compound laser treatment group. Eleven rats were used in the normal group and 55 were models that were injected with cyclophosphamide to induce leukopenia. For the three laser treatment groups, 10.6-μm and 650-nm lasers, and 10.6-μm-650-nm compound lasers were used to irradiate the DU14 (Dazhui) and bilateral ST36 (Zusanli) for 5 min each. The sham laser group received the same operation as the laser group but without irradiation. The normal group and model group were not treated. Differences in the number of nucleated cells in the femoral bone marrow, and cell cycle and cellular apoptosis of peripheral leukocytes in rats in various groups were compared. Compared with the model group and the sham laser group, the number of nucleated cells in the femoral bone marrow in the 10.6-μm laser, 650-nm laser, and 10.6-μm-650-nm compound laser group was significantly increased after treatment (P = 0.001, 0.002, 0.034, respectively) and did not show any significant difference with the normal group (P = 0.964, P = 0.838, P = 0.287, respectively). The number of cells in G2 phase in the 10.6 μm laser group was similar to that of the normal group (P = 0.973). The number of cells in G2 phase in the model, sham, 650-nm laser group, and 10.6-μm-650-nm compound laser group were significantly lower than in the normal group and 10.6-μm laser group (P = 0.016, P = 0.023, P = 0.044, P = 0.039, respectively). In the model group and the sham treatment group, the apoptosis rates of peripheral leukocytes were increased compared with the normal group (P = 0.001), while the proportion of cells in the G2 phase was significantly lower than in the normal group (P = 0.016), and the proportion of cells in S phase was higher than in the normal group (P = 0.014). The incidence of apoptosis in peripheral blood cells in the three laser treatment groups did not show any statistically significant difference when compared with the normal group (P > 0.05). Treatment with the 10.6-μm, 650-nm, and 10.6-μm-650-nm compound lasers increased the number of nucleated cells in the bone marrow, decreased the unfavorable effects of cyclophosphamide on the cell cycle, induced the cell cycle towards proliferation, decreased apoptosis, improved the intramedullary hematopoietic system, and increased peripheral leukocyte count.

Photobiomodulation Therapy in Veterinary Medicine: A Review

Laser therapy, or photobiomodulation, has rapidly grown in popularity in human and veterinary medicine. With a number of proposed indications and broad, sometimes anecdotal, use in practice, research interest has expanded aimed at providing scientific support. Recent studies have shown that laser therapy alters the inflammatory and immune response as well as promotes healing for a variety of tissue types. This review will cover the history of the modality, basic principles, proposed mechanisms of action, evidence-based clinical indications, and will guide the practitioner through its application in practice.

Laser stimulating ST36 with optical fiber induce blood component changes in mice: a Raman spectroscopy study

ST36 is a commonly-used acupoint in traditional Chinese medicine (TCM) for treatment of inflammations, pains and gastrointestinal disturbs. For decades, the low power laser acupuncture has been widely applied as an alternative therapy to traditional metal needle acupuncture and achieved relatively fine therapeutic effect for ST36-related symptoms with reduction of uncomfortableness and infection risks. However its disadvantages of low penetrativity and lack of manipulation skills limit its potential performance. An optical fiber laser acupuncture introduced by the previous study combines traditional needling acupuncture and the laser stimulation together, making a stronger therapeutic effect and showing a potential value in clinical application. To evaluate its acupunctural effect on blood, mice are taken as experimental model and Raman spectroscopic technique is used to analysis the changes of blood components after stimulating on ST36. The results show that both the traditional needling acupuncture and optical fiber acupuncture could lead to some spectral changes of blood in mice. This study explores the optical fiber acupuncture's effect on blood in mice using Raman spectroscopy technique for mechanism of acupuncture therapy.

Treatment for neuropathic pain and chronic inflammation using LASER in animal models

The ST36 (Zusanli) acupuncture point is used to treat inflammatory processes, pain and gastrointestinal disturbs. For this reason, the aim of the present study was to evaluate the antinociceptive effect of Low-level Laser Treatment (LLLT) on ST36 acupoint using models of chronic nociception and inflammation. Male Swiss mice were treated with LLLT on ST36 30 minutes before the mechanical allodynia (von Frey) performed on the partial sciatic nerve ligation (PSNL) method and Complete Freund's Adjuvant (CFA). The results demonstrated that application of LLLT on ST36 inhibited the mechanical allodynia response induced by PSNL and CFA, with total reversion at 30 minutes after application. Long-term treatment of animals with LLLT on the same acupoint, once a day, also reduced the PNSL and CFA-induced mechanical allodynia response during 8 days of treatment. As conclusion, the results demonstrated that photonic stimulus on ST36 with LLLT produces antinociceptive effect in chronic models of nociception and inflammation. These findings suggest that LLLT may constitute an important therapeutic alternative to control chronic pain.

Effect of aerobic exercises versus laser acupuncture in treatment of postmenopausal hot flushes: a randomized controlled trial

[Purpose] To compare the effect of aerobic exercises versus laser acupuncture in treatment of postmenopausal hot flushes. [Subjects and Methods] This study was designed as single blind randomized controlled trial. A total of 48 postmenopausal women complained of hot flushes. Their ages ranged between 45 to 55 years and were randomly assigned into 2 equal groups: group (A), which received an aerobic exercises, and group (B), which received laser acupuncture. Both groups recieved 3 sessions per week for two months. The level of follicular stimulating hormone, lutelizing hormone, and hot flushes dairy card were assessed the severity of hot flahes before and after treatment program. [Results] There were Significant reduction in FSH, LH, and menopausal daily hot flush scale in group A compared with group B at the post treatment. [Conclusion] Eight week program of an aerobic exercises yields improvement in FSH, LH, and decrease in severity of hot flushes assessed by hot flush dairy card than laser acupuncture in the treatment of postmenopausal hot flashes.

Laser Acupuncture Treatment Improves Pain and Functional Status in Patients with Subacromial Impingement Syndrome: A Randomized, Double-Blind, Sham-Controlled Study

Objective

The present study aims to determine the effect of laser acupuncture in patients with subacromial impingement syndrome (SAIS).

Design

Randomized, double-blind, sham-controlled study.

Setting

Physical medicine and rehabilitation outpatient clinic.

Subjects

A total 73 patients with SAIS were randomly assigned into a treatment group (n = 36) and a control group (n = 37).

Methods

The treatment group received laser acupuncture, and the control group received sham laser acupuncture. Eleven acupuncture points (GB 21, LI 4, LI 11, LI 14, LI 15, LI 16, SI 9, SI 10, SI 11, TE 14, and TE 15) were irradiated using a gallium-aluminium-arsenide continuous wave diode-laser, with a wavelength of 850 nm and a power output of 100 mV. The laser acupuncture treatment at each acupuncture point was administered at 4 joules/cm 2 (total dose = 40 joules). All patients were also treated with a hot pack. The patients were assessed at baseline and after 15 sessions of laser treatment. Pain severity and doctor's and patient's global assessments were measured via visual analog scale (VAS). Range of motion (ROM) and functional status were measured using a digital inclinometer and the Shoulder Pain Disability Index, respectively.

Results

Statistically significant improvements were observed in all parameters in the treatment group. All parameters of pain and functional status in the treatment group were significantly better than those in the control group at week 3.

Conclusions

To the best of our knowledge, this is the first study that investigates the effect of laser acupuncture in SAIS. The positive results of the present study should lead to further laser acupuncture studies with combinations of different acupuncture points, at different wavelengths, and with long-term follow-up periods.

Inhibitory modulation of cytochrome c oxidase activity with specific near-infrared light wavelengths attenuates brain ischemia/reperfusion injury

The interaction of light with biological tissue has been successfully utilized for multiple therapeutic purposes. Previous studies have suggested that near infrared light (NIR) enhances the activity of mitochondria by increasing cytochrome c oxidase (COX) activity, which we confirmed for 810 nm NIR. In contrast, scanning the NIR spectrum between 700 nm and 1000 nm revealed two NIR wavelengths (750 nm and 950 nm) that reduced the activity of isolated COX. COX-inhibitory wavelengths reduced mitochondrial respiration, reduced the mitochondrial membrane potential (ΔΨ_m), attenuated mitochondrial superoxide production, and attenuated neuronal death following oxygen glucose deprivation, whereas NIR that activates COX provided no benefit. We evaluated COX-inhibitory NIR as a potential therapy for cerebral reperfusion injury using a rat model of global brain ischemia. Untreated animals demonstrated an 86% loss of neurons in the CA1 hippocampus post-reperfusion whereas inhibitory NIR groups were robustly protected, with neuronal loss ranging from 11% to 35%. Moreover, neurologic function, assessed by radial arm maze performance, was preserved at control levels in rats treated with a combination of both COX-inhibitory NIR wavelengths. Taken together, our data suggest that COX-inhibitory NIR may be a viable non-pharmacologic and noninvasive therapy for the treatment of cerebral reperfusion injury.

Evaluation of serum beta-endorphin and substance P in knee osteoarthritis patients treated by laser acupuncture

Background Laser acupuncture is one of the complementary modalities used for treating osteoarthritis. The study was performed to evaluate the effectiveness of laser acupuncture in the treatment of grade 2 knee osteoarthritis. Patients and methods Forty patients having bilateral knee osteoarthritis were divided into two groups (20 patients in each group). The patients of the first group were subjected to 12 laser sessions at the following acupoints (St 35, St36, Sp9, Sp10 and Gb 34). During each session, laser of 90 mw was directed to each acupoint for 1 min giving energy of 5.4 joules. Energy of 21.6 joules was directed to ashi points. The laser had a wavelength of 808 nm, beam diameter 2 mm and was applied with a continuous wave. The cases of the second group were used as controls. Each patient is exposed to sham laser (laser probe is directed to the same acupoints while the device is off). Results The 20 patients receiving laser showed significant improvement in pain on (VAS), increase in serum beta-endorphin and a decrease in substance P more than those exposed to sham laser. Conclusions Laser acupuncture is a safe and cheap tool for management of grade 2 knee osteoarthritis.

Laser acupuncture-induced analgesic effect and molecular alterations in an incision pain model: a comparison with electroacupuncture-induced effects

Low-level laser acupuncture (LLLA) produces photobiomodulation through acupuncture point and is an alternative to low-level laser therapy. Although the analgesic effect of LLLA on chronic pain has been proven, its effect on acute postincisional pain has yet to be investigated. A plantar incision (PI) model was used to mimic human postsurgical pain. Male adult rats received GaAlAs laser irradiation at the right ST36 acupoint immediately after operation and on the following 4 days. Three laser treatment groups (two red laser groups with a 30- or 15-min treatment duration and one 30-min near-infrared laser group) were compared with sham LLLA and naive groups and an electroacupuncture (EA) group (separate study). Behavioral withdrawal thresholds of both hind paws were measured before and after incision. Expression of mitogen-activated protein kinases (p-ERK and p-p38), inducible nitric oxide synthase (iNOS), and tumor necrosis factor (TNF) in the spinal cord was analyzed. All three LLLA treatments attenuated post-PI tactile allodynia in the ipsilateral paw, but only the 30-min red laser treatment affected the contralateral paw and had similar efficacy to that of EA. All laser treatments barely reduced heat hyperalgesia in both hind paws. At 3 days after PI, the 30-min red laser group showed reversed increases of PI-induced p-ERK, p-p38, and iNOS but not TNF expression in the spinal cord. Repetitive LLLA treatments ameliorated PI-induced mechanical pain. The inhibition of multiple sensitization signals highlights the unique clinical role of LLLA. Thus, LLLA is an alternative to EA as an adjuvant for postoperative pain control.

Laser acupuncture treatment of neuropathic pain in a boy with brain tumour

Neuropathic pain occurrence is associated with some cytostatic and antibiotics use. Pharmacological therapy for the treatment of neuropathic pain is sometimes unsuccessful, and complementary methods like acupuncture are included. In this case report, a 14-year-old boy with cerebral tumour and neuropathic pain in his feet after chemotherapy and linezolid use is presented. A complete cessation of neuropathic pain symptoms like hyperalgesia and allodynia was accomplished after laser acupuncture application.

Effects of different-intensity laser acupuncture at two adjacent same-meridian acupoints on nitric oxide and soluble guanylate cyclase releases in human

OBJECTIVES

The aim of this study was to detect the influences of LA at nonacupoint and two adjacent acupoints of pericardium meridian on the releases of NO and sGC in 20 healthy subjects.

METHODS

Different intensities (12, 24, 48 mW) of infrared laser were used for irradiating Jianshi (PC5), Ximen (PC4) acupoints and nonacupoint for 20, 40 minutes, respectively. Semi-circular tubes were taped to the skin surface and filled with NO-scavenging compound for 20 minutes to capture NO and sGC, which were measured using spectrophotometry in a blinded fashion.

RESULTS

As the increase in the intensity of LA stimulation, the levels of NO releases over acupoints all were significantly increased, NO releases in nonacupoints following the same treatment only changed slightly, sGC amounts were observably enhanced over acupoints, but did not any change in nonacupoint area. Different intensities of LA treatments can sensitively affect the NO and sGC releases over acupoints. This indicated that LA-induced releases of the NO and sGC were specific to acupoints.

CONCLUSIONS

This is the first evidence reporting that LA induced significant elevations of NO-sGC releases over acupoints, and the enhanced signal molecules contribute to local circulation, which improves the beneficial effects of the therapy.

Low Level Laser Therapy in patients with chronic foot and ankle joint pain

BACKGROUND AND AIMS

Chronic foot and ankle joint pain is one of the most frequent complaints which is regularly seen in the out-patient clinic of our medical institute. In previous studies we have reported on the benefits of low level laser therapy (LLLT) for chronic pain in the elbow, hand, finger and the lower back. The present study examined the effects of LLLT on chronic foot and ankle joint pain.

MATERIALS AND METHODS

Over the past 5 years, 17 subjects visited the out-patient clinic with complaints of chronic foot and ankle joint pain of a variety of aetiologies. The patients received LLLT using a 1000 mW semi-conductor laser device, delivering 20.1 J/cm2 per point at 830 nm in continuous wave. Each patient was given four shots per session per foot twice a week for 4 weeks.

RESULTS

A visual analogue scale (VAS) was used to determine the effects of LLLT for the chronic pain and after the end of the treatment regimen a significant improvement was observed (p < 0.01). All but 2 of the patients showed improvement: excellent (2) and good (13). After treatment, no significant differences were observed in the ankle joint range of motion, however. Discussions with the patients revealed that it was important for them to learn how to avoid overuse of the ankle when walking, poor walking posture and a poor pacing technique that would caused them foot and ankle pain in everyday life. Following these postural guidelines could ensure continuous benefits from the treatment.

CONCLUSION

The present study demonstrated that LLLT was an effective form of treatment for chronic foot and ankle joint pain, in conjunction with postural education during all activities of daily living.

Laser Acupuncture Exerts Neuroprotective Effects via Regulation of Creb, Bdnf, Bcl-2, and Bax Gene Expressions in the Hippocampus

Acupuncture has a positive effect on cognitive deficits. However, the effects of laser acupuncture (LA) on cognitive function and its mechanisms of action are unclear. The present study aimed to evaluate the effects of LA on middle cerebral artery occlusion- (MCAO-) induced cognitive impairment and its mechanisms of action. Transient focal cerebral ischemia was modeled in adult Sprague-Dawley rats by MCAO. After LA or manual-acupuncture (MA) treatment at the GV20 and HT7 for 2 weeks, hippocampal-dependent memory was evaluated using the Morris water maze (MWM) test. The hippocampus was dissected to analyze choline acetyltransferase (ChAT) immunoreactivity and Creb, Bdnf, Bcl-2, and Bax gene expressions. MWM test demonstrated a significant improvement in hippocampal-dependent memory in the MCAO rats after LA treatment. LA treatment significantly reversed the postischemic decrease in ChAT immunoreactivity in the hippocampal CA1 region. LA treatment significantly normalized gene expression in the hippocampus which had been altered by MCAO, especially upregulating gene expression of Creb, Bdnf, and Bcl-2 and downregulating gene expression of Bax. This study suggests that LA treatment could improve cognitive impairment in MCAO rats to enhance the cholinergic system in the hippocampal CA1 region and to exert a neuroprotective effect by regulating Creb, Bdnf, Bcl-2, and Bax gene expressions.