Publications by authors named "E-Liisa Laakso"

14 Publications

  • Page 1 of 1

Pre-Conditioning and Post-Operative Photobiomodulation Therapy by a Novel Light Patch System for Knee Arthroplasty: A Protocol for a Phase 1 Study.

Photobiomodul Photomed Laser Surg 2020 Apr 18;38(4):206-214. Epub 2020 Mar 18.

Mater Research, South Brisbane, Australia.

To determine the potential efficacy and feasibility of photobiomodulation therapy (PBMT) before and after knee arthroplasty (KA) surgery. Total knee replacements (total knee arthroplasty, TKA) are one of the most common and successful surgical interventions for osteoarthritis. Up to 20,000 knee replacement arthroplasties are performed in Australia annually. Although TKA aims to restore knee alignment and relieve pain in the long term, the initial post-operative period is difficult and rehabilitation is often hindered by persistent pain and swelling. A promising therapeutic approach, PBMT using a novel self-adhesive light patch system, may be feasible for reducing post-operative pain and swelling and aiding recovery. This is an interventional clinical feasibility study protocol. Patients from a surgical waitlist will be invited to take part. PBMT will be applied for 30 min daily for 7 days pre-operatively using a novel light patch system (CareWear) with both 450 nm (6.75 mW/cm) and 640 nm (2.25 mW/cm) microdiodes. Post-operative treatment will utilize the same device second daily for 1 week after removal of compression bandages. Outcomes will be evaluated at seven time points: baseline at week 1 pre-operatively, 1 day before surgery, day 4 after surgery, weekly for a further 2 weeks, and fortnightly until 6 weeks post-hospital discharge. Outcome measures include the following: Numeric Pain Rating Scale, stair climb test, 30-sec chair stand test, timed up and go test, 40-m fast-paced walk test, modified Iowa Level of Assistance Scale, muscle strength, knee range of motion, Knee Injury and Osteoarthritis Outcome Score, and Lower Limb Functional Index. This study will provide an assessment of feasibility of using PBMT applied using a novel light patch system for management of pain symptoms and swelling, and aiding recovery of patients undergoing TKA. The results of this feasibility study will contribute to planning of the design and methods of a large clinical trial.
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http://dx.doi.org/10.1089/photob.2019.4751DOI Listing
April 2020

The Beneficial Effects of High-Intensity Laser Therapy and Co-Interventions on Musculoskeletal Pain Management: A Systematic Review.

J Lasers Med Sci 2020 18;11(1):81-90. Epub 2020 Jan 18.

Department of Orthopaedics, Orthopaedic Research Center, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

High-intensity laser therapy (HILT) has been used more recently in the therapeutic protocols of pain managements. Adding therapeutic interventions to laser therapy is usual in clinical practice. This study aimed to evaluate the efficacy of HILT and beneficial effects of adding cointerventions to HILT in musculoskeletal pain management. The following databases were searched up to August 2018: Medline, PubMed, EMBASE, Cochrane, Google Scholar, Springer and ISI. The keywords of pain, HILT, high power laser therapy, laser therapy, photobiomodulation, physical therapy and rehabilitation were searched. The quality of the articles was assessed using the PEDro scale. The primary measure was pain severity expected to be reported in all studies. Effect size was calculated as standardized mean differences divided by the standard deviation of either the treatment or other group. Initially 52 potential studies were found. Eighteen of these studies were excluded based on title and abstract. The full text of 34 remaining articles was screened and 15 of the studies were excluded. All included studies had high quality (PEDro ≥7). Approximately, 94% of included articles (n=18) revealed positive effects of HILT on pain. The effect sizes for HILT and placebo/comparator groups were 0.9-9.11 and 0.21-11.22 respectively. Also, the differences of effect size between two groups were between 0.03 to 5.85. It is early to determine that HILT may be an effective non-invasive agent in the management of musculoskeletal pain, as few studies have shown its clinical efficacy. Adding related co-interventions to HILT may enhance the beneficial effects of laser therapy. The variability of the study methods and outcomes suggests that further long-term follow-up, randomized controlled clinical trials with appropriate methodological design are needed regarding the effectiveness of HILT on pain.
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http://dx.doi.org/10.15171/jlms.2020.14DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7008744PMC
January 2020

A comparative study of the dose-dependent effects of low level and high intensity photobiomodulation (laser) therapy on pain and electrophysiological parameters in patients with carpal tunnel syndrome.

Eur J Phys Rehabil Med 2020 Dec 18;56(6):733-740. Epub 2019 Nov 18.

Neuroscience Research Center, Department of Neurology, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran.

Background: Carpal tunnel syndrome (CTS) is a common peripheral nerve disorder of the wrist. Nonsurgical treatments e.g. laser therapy may cause potential beneficial effects.

Aim: To compare the dose dependent effects of low level laser therapy (LLLT) and high intensity laser therapy (HILT) on pain and electrophysiology studies in patients with CTS.

Design: Double-blind randomized controlled trial.

Setting: Outpatient physiotherapy clinic.

Population: Ninety-eight participants with CTS, aged between 20 to 60 years, were randomly assigned to five groups.

Methods: All participants undertook four standard exercises, with one group serving as exercise-only controls. Patients were randomly allocated to either high or low fluence LLLT or high or low fluence HILT received over 5 sessions. All patients were assessed by visual analogue scale, median compound muscle action potential (CMAP) and sensory nerve conduction studies before and 3 weeks after the interventions.

Results: VAS was significantly lower in all groups after 3 weeks (P<0.05). CMAP latency decreased in all groups. The interaction of group and time (5×2) was significant for pain (P<0.001), the latency of CMAP (P=0.001) and CMAP amplitude (P=0.02). The interaction of group and time was not significant for the CMAP conduction velocity, sensory nerve latency and amplitude (P>0.05).

Conclusions: HILT with a power of 1.6 W and low fluence of 8 J/cm was superior in reduction of pain and improvement of the median motor nerve electrophysiological studies compared to LLLT and exercise-only control groups.

Clinical Rehabilitation Impact: LLLT and HILT in conjunction with exercise program are effective in reducing pain and improving median motor nerve conduction studies of the patients with CTS. It seems that high power and low fluence laser therapy is better than LLLT and exercise interventions to treat these patients.
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http://dx.doi.org/10.23736/S1973-9087.19.05835-0DOI Listing
December 2020

What Is the Importance and Status of International Multicenter Photobiomodulation Trials?

Authors:
E-Liisa Laakso

Photobiomodul Photomed Laser Surg 2019 03;37(3):131-132

1 Mater Research, South Brisbane, Australia.

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http://dx.doi.org/10.1089/photob.2018.4605DOI Listing
March 2019

Does the performance of five back-associated exercises relate to the presence of low back pain? A cross-sectional observational investigation in regional Australian council workers.

BMJ Open 2018 08 8;8(8):e020946. Epub 2018 Aug 8.

School of Health Professions, Zurich University of Applied Sciences, Winterthur, Switzerland.

Objectives: Investigate the relationships between the ability/inability to perform five physical test exercises and the presence or absence of low back pain (LBP).

Setting: Regional Australian council training facility.

Participants: Consecutive participants recruited during 39 back education classes (8-26 participants per class) for workers in general office/administration, parks/gardens maintenance, roads maintenance, library, child care and management. Total sample (n=539) was reduced through non-consent and insufficient demographic data to n=422. Age 38.6±15.3 years, range 18-64 years, 67.1% male.

Methods: Cross-sectional, exploratory, observational investigation. LBP presence was ascertained from a three-response option questionnaire: 0=none/rarely (no) 1=sometimes (some), 2=mostly/always (most). Statistical correlation was performed with the number of the five test exercises the individual successfully performed: (1) extension in lying: 3 s; (2) 'toilet squat'; feet flat, feet touched: 3 s; (3) full squat then stand up: 5 times; (4) supine sit-up, knees flexed: 10 times; and (5) leg extension, supine bilateral: 10 times.

Interventions: Nil.

Results: For the group 'no-some', 94.3% completed 4-5 test exercises, while for group 'With', 95.7% completed 0-1 test exercises. The relationship between LBP presence and number of exercises performed was highly significant (χ=300.61, p<0.001). Furthermore, multinomial logistic regression predicting LBP (0=no, 1=some, 2=most) from the number of exercises completed, substantially improved the model fit (initial-2LL=348.246, final-2LL=73.620, χ=274.626, p<0.001). As the number of exercises performed increased, the odds of reporting 'some LBP' or 'most LBP' dropped substantially (ORs of 0.34 and 0.17, respectively).

Conclusion: The ability to complete/not complete five test exercises correlated statistically and significantly with a higher LBP absence/presence in a general working population. Training individuals to complete such exercises could facilitate reductions in LBP incidence; however, causality cannot be inferred. Randomised trials are recommended to establish the potential efficacy of exercise-based approaches, considering these five selected exercises, for predicting and managing LBP.
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http://dx.doi.org/10.1136/bmjopen-2017-020946DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6089271PMC
August 2018

Photobiomodulation (PBM) therapy at 904 nm mitigates effects of exercise-induced skeletal muscle fatigue in young women.

Lasers Med Sci 2018 Aug 17;33(6):1197-1205. Epub 2018 Feb 17.

Menzies Health Institute Queensland, Griffith University, Parklands Drive, Southport, Qld, Gold Coast, 4222, Australia.

Muscle fatigue is a process influenced by several mechanisms such as concentration of metabolic substrates, changes in blood flow, and increases in reactive oxygen species that impair contractile muscle function. In this context, photobiomodulation has been investigated for preventing muscle fatigue, with reports of positive effects on muscle performance. This study aimed to investigate the effects of 904-nm LASER photobiomodulation on rectus femoris muscle performance in young women. Eighteen young women participated in a randomized, participant and assessor-blinded crossover trial with placebo control. Active LASER (904 nm, 60 mW, 250 Hz, 3.6 J per diode, total dose of 129.6 J) intervention was applied prior to an isokinetic fatigue protocol consisting of a set of 60 concentric quadricep contractions at a constant dynamometer angular velocity of 180°/s. Compared to placebo, LASER photobiomodulation significantly reduced muscle fatigue across a range of indicators including reduced ratings of perceived exertion (P = 0.0139), and increased electromyographic fatigue index (EFI) (P = 0.005). The isokinetic dynamometer performance analysis demonstrated that LASER photobiomodulation increased peak torque (P = 0.04), time to peak torque (P = 0.042), total work (P = 0.032), average power (P = 0.0007), and average peak torque (P = 0.019) between both experimental conditions. No significant difference was observed for work fatigue index (P = 0.29) or for lactate concentration (P > 0.05). Photobiomodulation at 904 nm was effective in reducing fatigue levels and increasing muscle performance in young active women but had no effect on lactate levels.
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http://dx.doi.org/10.1007/s10103-018-2454-4DOI Listing
August 2018

Personalizing Photobiomodulation Therapy.

Authors:
E-Liisa Laakso

Photomed Laser Surg 2017 Jan;35(1):1-2

Menzies Health Institute Queensland, Griffith University , Gold Coast, Queensland, Australia .

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http://dx.doi.org/10.1089/pho.2016.4218DOI Listing
January 2017

Effect of 830-nm laser phototherapy on olfactory neuronal ensheathing cells grown in vitro on novel bioscaffolds.

J Appl Biomater Funct Mater 2015 Oct 16;13(3):e234-40. Epub 2015 Oct 16.

School of Physiotherapy and Exercise Science, Griffith University, Gold Coast, Queensland - Australia.

Background: The purpose of this study was to analyze olfactory ensheathing cell (OEC) proliferation and growth on Biosilicate and collagen bioscaffolds, and to determine whether the application of laser phototherapy would result in increased OEC proliferation on the scaffolds. The use of bioscaffolds is considered a promising strategy in a number of clinical applications where tissue healing is suboptimal. As in vitro OEC growth is a slow process, laser phototherapy could be useful to stimulate proliferation on bioscaffolds.

Methods: OEC cells were seeded on the Biosilicate and collagen scaffolds. Seeded scaffolds were irradiated with a single exposure of 830-nm laser. Nonirradiated seeded scaffolds acted as negative controls. Cell proliferation was assessed 7 days after irradiation.

Results: OECs were successfully grown on discs composed of a glass-ceramic and collagen composite. Laser irradiation produced a 32.7% decrease and a 13.2% increase in OEC proliferation on glass-ceramic discs and on collagen scaffolds, respectively, compared with controls. Laser phototherapy resulted in a reduction in cell growth on the Biosilicate scaffolds and an increase in cell proliferation on collagen scaffolds.

Conclusions: These results were probably due to the nature of the materials. Future research combining laser phototherapy and glass-ceramic scaffolds should take into account possible interactions of the laser with matrix compounds.
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http://dx.doi.org/10.5301/jabfm.5000220DOI Listing
October 2015

Contributing factors, prevention, and management of playing-related musculoskeletal disorders among flute players internationally.

Med Probl Perform Art 2014 09;29(3):155-62

Faculty of Music and Performing Arts, Universiti Pendidikan Sultan Idris. Tanjung Malim, Perak 35900, Malaysia. Tel +60 19 5990 128.

Major studies have shown that flutists report playing-related pain in the neck, middle/upper back, shoulders, wrists, and hands. The current survey was designed to establish the injury concerns of flute players and teachers of all backgrounds, as well as their knowledge and awareness of injury prevention and management. Questions addressed a range of issues including education, history of injuries, preventative and management strategies, lifestyle factors, and teaching methods. At the time of the survey, 26.7% of all respondents were suffering from flute playing-related discomfort or pain; 49.7% had experienced flute playing-related discomfort or pain that was severe enough to distract while performing; and 25.8% had taken an extended period of time off playing because of discomfort or pain. Consistent with earlier studies, the most common pain sites were the fingers, hands, arms, neck, middle/upper back, and shoulders. Further research is needed to establish possible links between sex, instrument types, and ergonomic set up. Further investigation is recommended to ascertain whether certain types of physical training, education, and practice approaches may be more suitable than current methods. A longitudinal study researching the relationship between early education, playing position, ergonomic set-up, and prevalence of injury is recommended.
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http://dx.doi.org/10.21091/mppa.2014.3032DOI Listing
September 2014

The Second Physical Therapy Summit on Global Health: developing an action plan to promote health in daily practice and reduce the burden of non-communicable diseases.

Physiother Theory Pract 2014 May 19;30(4):261-75. Epub 2013 Nov 19.

Department of Physical Therapy, University of British Columbia , Vancouver , Canada .

Based on indicators that emerged from The First Physical Therapy Summit on Global Health (2007), the Second Summit (2011) identified themes to inform a global physical therapy action plan to integrate health promotion into practice across the World Confederation for Physical Therapy (WCPT) regions. Working questions were: (1) how well is health promotion implemented within physical therapy practice; and (2) how might this be improved across five target audiences (i.e. physical therapist practitioners, educators, researchers, professional body representatives, and government liaisons/consultants). In structured facilitated sessions, Summit representatives (n = 32) discussed: (1) within WCPT regions, what is working and the challenges; and (2) across WCPT regions, what are potential directions using World Café(TM) methodology. Commonalities outweighed differences with respect to strategies to advance health-focused physical therapy as a clinical competency across regions and within target audiences. Participants agreed that health-focused practice is a professional priority, and a strategic action plan was needed to develop it as a clinical competency. The action plan and recommendations largely paralleled the principles and objectives of the World Health Organization's non-communicable diseases action plan. A third Summit planned for 2015 will provide a mechanism for follow-up to evaluate progress in integrating health-focused physical therapy within the profession.
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http://dx.doi.org/10.3109/09593985.2013.856977DOI Listing
May 2014

Inhibitory effects of laser irradiation on peripheral mammalian nerves and relevance to analgesic effects: a systematic review.

Photomed Laser Surg 2011 Jun 1;29(6):365-81. Epub 2011 Apr 1.

Nerve Research Foundation, Brain and Mind Research Institute, The University of Sydney, Camperdown, New South Wales, Australia.

Objective: The objective of this review was to systematically identify experimental studies of non-ablative laser irradiation (LI) on peripheral nerve morphology, physiology, and function. The findings were then evaluated with special reference to the neurophysiology of pain and implications for the analgesic effects of low-level laser therapy (LLLT).

Background: LLLT is used in the treatment of pain, and laser-induced neural inhibition has been proposed as a mechanism. To date, no study has systematically evaluated the effects of LI on peripheral nerve, other than those related to nerve repair, despite the fact that experimental studies of LI on nerves have been conducted over the past 25 years.

Methods: We searched computerized databases and reference lists for studies of LI effects on animal and human nerves using a priori inclusion and exclusion criteria.

Results: We identified 44 studies suitable for inclusion. In 13 of 18 human studies, pulsed or continuous wave visible and continuous wave infrared (IR) LI slowed conduction velocity (CV) and/or reduced the amplitude of compound action potentials (CAPs). In 26 animal experiments, IR LI suppressed electrically and noxiously evoked action potentials including pro-inflammatory mediators. Disruption of microtubule arrays and fast axonal flow may underpin neural inhibition.

Conclusions: This review has identified a range of laser-induced inhibitory effects in diverse peripheral nerve models, which may reduce acute pain by direct inhibition of peripheral nociceptors. In chronic pain, spinal cord changes induced by LI may result in long-term depression of pain. Incomplete reporting of parameters limited aggregation of data.
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http://dx.doi.org/10.1089/pho.2010.2928DOI Listing
June 2011

The effect of laser irradiation on proliferation of human breast carcinoma, melanoma, and immortalized mammary epithelial cells.

Photomed Laser Surg 2010 Feb;28(1):115-23

School of Medical Science, Griffith University, Gold Coast, Queensland, Australia.

Objective: This study compared the effects of different doses (J/cm(2)) of laser phototherapy at wavelengths of either 780, 830, or 904 nm on human breast carcinoma, melanoma, and immortalized human mammary epithelial cell lines in vitro. In addition, we examined whether laser irradiation would malignantly transform the murine fibroblast NIH3T3 cell line.

Background: Laser phototherapy is used in the clinical treatment of breast cancer-related lymphoedema, despite limited safety information. This study contributes to systematically developing guidelines for the safe use of laser in breast cancer-related lymphoedema.

Methods: Human breast adenocarcinoma (MCF-7), human breast ductal carcinoma with melanomic genotypic traits (MDA-MB-435S), and immortalized human mammary epithelial (SVCT and Bre80hTERT) cell lines were irradiated with a single exposure of laser. MCF-7 cells were further irradiated with two and three exposures of each laser wavelength. Cell proliferation was assessed 24 h after irradiation.

Results: Although certain doses of laser increased MCF-7 cell proliferation, multiple exposures had either no effect or showed negative dose response relationships. No sign of malignant transformation of cells by laser phototherapy was detected under the conditions applied here.

Conclusion: Before a definitive conclusion can be made regarding the safety of laser for breast cancer-related lymphoedema, further in vivo research is required.
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http://dx.doi.org/10.1089/pho.2008.2445DOI Listing
February 2010

Nociceptive scores and endorphin-containing cells reduced by low-level laser therapy (LLLT) in inflamed paws of Wistar rat.

Photomed Laser Surg 2005 Feb;23(1):32-5

School of Physiotherapy and Exercise Science, Griffith University, Gold Coast Campus, PMB50 Gold Coast Mail Centre, Queensland 9726, Australia.

Objective: This study aimed to investigate how local pain relief is mediated by laser therapy and how dose affects the relationship.

Methods: Inflammation was induced in the hind-paws of Wistar rats. Two groups of rats received 780-nm laser therapy (Spectra-Medics Pty Ltd.) at one of two doses (2.5 and 1 J/cm(2)). One group acted as a control. Scores of nociceptive threshold were recorded using paw pressure and paw thermal threshold measures.

Results: A dose of 1 J/cm(2) had no statistically significant effect on antinociceptive responses. A dose of 2.5 J/cm(2) demonstrated a statistically significant effect on paw pressure threshold ( p < 0.029) compared to controls. There was no difference in paw thermal threshold responses and paw volumes at either dose. Immunohistochemistry in control animals demonstrated normal beta-endorphin containing lymphocytes in control inflamed paws but no beta-endorphin containing lymphocytes in rats that received laser at 2.5 J/cm(2).

Conclusion: The results confirm previous findings that the effect of laser therapy is dose-related. The mechanism of effect may occur via a differentiated pressure-sensitive neural pathway rather than a thermal-sensitive neural pathway. The significance of the immunohistochemistry findings remains unknown.
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http://dx.doi.org/10.1089/pho.2005.23.32DOI Listing
February 2005