LOW LEVEL LASER THERAPY(LLLT)

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1 LOW LEVEL LASER THERAPY(LLLT) NEVADA HEALTH FORUM DR. REINHARD BRUCH PRESIDENT, APPLIED PHOTONICS WORLDWIDE INC. PROFESSOR OF PHYSICS, UNR 12/4/2003 1

2 Outline Introduction Basics of Lasers Low Level Laser Therapy (LLLT) Applications of LLLT Instrumentation 2

3 Introduction Historically humans used sun therapy. Later color therapy was applied. More than 30 years ago Low Level Power Laser Therapy was introduced for biostimulation and photo biomodulation. At present lasers and Light Emitting Diodes (LED s) are used for Low Level Laser Therapy (LLLT). 3

4 Photon Picture of the Process of Stimulated Emission and Absorption according to Einstein 4

5 LASER: Light Amplification by Stimulated Emission of Radiation Three basic parts of a laser: pump source, active material and resonator 5

6 Schematic Energy Level Diagrams of Three and Four Level Laser Systems 6

7 Ultra Compact Diode Pumped Solid State Lasers Characteristics CW & Pulsed Low Noise UV Visible to IR Biophotonics Applications Laser Fluorescence, Absorption Raman, Raleigh, Mie Scattering Light Transport Phenomena 7

8 Method of LLLT Main therapeutic effects occur due to light absorption by cellular photoacceptors. Creation of electronically excited states in body tissues and cells leads to measurable biological effects. 8

9 Parameters for LLLT Wavelength (1nm = 10-9 m) Output Power and Light Intensity Power Density/Dose Continuous Wave (CW) or Pulse Mode Coherence Polarization 9

10 Coherence Properties of Light Temporal Coherence τ coh = 1/ υ, where υ is the beam spectral width in Hz. Longitudinal Coherence Length L coh = c/ υ, where c is the velocity of light 3 x cm/s Lateral Coherence Length l coh = λ / φ, where φ is the beam divergence Examples He-Ne laser L coh 100cm and for LED L coh µm (monolayer of cells) 10

11 Coherence Volumes and Coherence Lengths of Light from Different Types of Light Sources L coh = length of longitudinal coherence l coh = Size of spatial (lateral) coherence = Diameter of light beam = Diameter of non-coherent light source = Beam Divergence υ = Beam spectral width 11 11

12 Depth ( l) in which the Beam Coherency is Manifested and Coherence Length L coh in Various Irradiated Systems 12

13 Frequently used Light Sources for Low Level Laser Therapy 13 13

14 Comparison of Laser and LED Light Sources In most cases Laser and LED light sources provide same biological effects. In general the coherent properties of laser light don t play an important role for interaction with the tissue at a molecular level. 14

15 Laser Light Interaction with Thin Layers of Biomolecules, Cells and Tissues Spectra of (a) DNA (b) RNA (c) Plasma Membrane (d) Absorption Spectra for HeLa Cells for the Same Spectral Region from Red to NIR 15

16 Absorption Spectra of HeLa cell monolayer. (A) Before Laser Irradiation and (B) After Laser Irradiation Karu T.I et al. IEEE J. Sel. Top. Quantum Electron, 7, 982, 2001 Evaluated by the UNR Biophotonics Group 16

17 Primary Reactions After Laser Light Absorption The primary mechanism of light action after absorption of light quanta and the promotion of electronically excited states have not been established. When electronic states are excited with laser light a fraction of the energy is converted to heat. The local rise in temperature of absorbing molecules can cause conformational changes and may trigger biochemical activities. 17

18 Primary Suggested Reactions Following Laser Light Absorption for Singlet States of Biological Systems reactive oxygen species. 18

19 Suggested Scheme of Cellular Secondary Reactions after Laser Light Interaction with Mammalian Cells Mitochondria are organelles in cells the size of bacteria with their membranes containing proteins (outer membrane contains porins). Photon REDOX COENZYMES involve the transfer of electrons or group of atoms/ions. (NAD + ) Nicotinamide Adenine Dinucleotide (NADH) Nicotinamide Adenin Dinucleotide Dehydrogenase (ATP) Adenosine Triphosphate is the most important storage form of chemical energy. 19

20 Schematic Illustration of the Action Principle of Monochromatic Visible and NIR Radiation at a Cellular Level In Redox reactions electrons are transferred from one reaction partner to another. The less electron-rich component is the Oxidized form. The more electron-rich component is called the reduced form of the system. 20

21 Selected Clinical Applications of LLLT Physiotherapists to treat a wide variety of acute and chronic musculoskeletal aches and pains. Dentists to treat inflamed oral tissues and to heal diverse ulcerations Dermatologists to treat edema, indolent ulcers, burns and dermatitis Rheumatologists to relieve pain and chronic inflammations and autoimmune diseases Veterinary Clinics Other Specialists and Practitioners Sports medicine and Rehabilitation clinics 21

22 22

23 Therapeutic Laser System Used for Many Medical Therapies Effective, easy-to-use, time efficient, versatile, adaptable & portable 23

24 Ear Acupuncture 24

25 Medical Laser Optical Systems Various medical laser optical systems are shown, namely: 1. Handylaser trion 2. Physiolaser 3. Photonic Polylaser Trion 25

26 Handylaser trion Handylaser trion is an ideal mini laser which is compact, strong and versatile 26

27 Physiolaser Contains various therapy programs like Derma, Dental, Acupuncture 27

28 Photonic 500 High performance, large area therapy and deep effect system 28

29 Polylaser Trion A multi cluster probe for large area therapy 29

30 Conclusion The LLLT technique is very versatile for numerous medical applications. More research has to be done to understand the interaction of Laser light with cells and tissues. To our knowledge, treatment with LLLT technique is not available in Reno/Tahoe area. Depending on the demand, Applied Photonics Worldwide Inc. in collaboration with CrystaLaser LLC. Reno could produce such systems for specific medical applications. 30

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