Development of the theragnostic optical system for a high-intensity laser therapy (HILT)

Recently, high-intensity laser therapy (HILT) has been introduced for muscle disorders, but its efficacy has not been confirmed due to the absence of quantitative assessments and treatment feedback data in real-time. In this clinical study, a theragnostic optical system comprised of a high-intensity laser and a non-invasive optical monitoring system was developed to assess spasticity. To avoid interference between the two different light sources, the therapeutic wavelength for HILT was selected at 808 nm, one of the isosbestic points. The monitoring system based on a near-infrared spectroscopy (NIRS) was utilized for measuring hemoglobin concentrations according to a modified Beer-Lambert’s law. The transitory HILT effect was evaluated from patients experiencing spasticity after stroke. Our results showed the proportionate relationship between manual muscle testing grades and the HILT effect on hemiplegic patients. The developed system proved to be useful for the simultaneous assessment and treatment of spasticity, and it holds promise for real-time monitoring of hemoglobin concentrations during laser therapy.

[1]  F. Gonzalez-Lima,et al.  In Vivo Low‐level Light Therapy Increases Cytochrome Oxidase in Skeletal Muscle , 2010, Photochemistry and photobiology.

[2]  M. Hopman,et al.  Shear stress levels in paralyzed legs of spinal cord-injured individuals with and without nerve degeneration. , 2002, Journal of applied physiology.

[3]  Christian Couppé,et al.  A systematic review of low level laser therapy with location-specific doses for pain from chronic joint disorders. , 2003, The Australian journal of physiotherapy.

[4]  Hanli Liu,et al.  Determination of Hemoglobin Oxygen Saturation from Turbid Media Using Reflectance Spectroscopy with Small Source-Detector Separations , 2001 .

[5]  Maria Bryszewska,et al.  Effect of low-intensity (3.75-25 J/cm2) near-infrared (810 nm) laser radiation on red blood cell ATPase activities and membrane structure. , 2004, Journal of clinical laser medicine & surgery.

[6]  O W van Assendelft,et al.  Extinction coefficients for use in equations for the spectrophotometric analysis of haemoglobin mixtures. , 1975, Analytical Biochemistry.

[7]  J. Jeon,et al.  Quadriceps muscle deoxygenation during functional electrical stimulation in adults with spinal cord injury , 2000, Spinal Cord.

[8]  S. C. Gandevia,et al.  Changes in muscle afferents, motoneurons and motor drive during muscle fatigue , 2000, European Journal of Applied Physiology.

[9]  L. Logan,et al.  A review of the complications of intrathecal baclofen in patients with cerebral palsy. , 2007, NeuroRehabilitation.

[10]  Interferometry, 2nd. ed.: By W. H. Steel. Pp. 308. Cambridge University Press. 1983. £35.00 , 1984 .

[11]  R. Larsson,et al.  Changes of trapezius muscle blood flow and electromyography in chronic neck pain due to trapezius myalgia , 1999, Pain.

[12]  Mark I. Johnson,et al.  Low-level laser therapy in acute pain: a systematic review of possible mechanisms of action and clinical effects in randomized placebo-controlled trials. , 2006, Photomedicine and laser surgery.

[13]  B Chance,et al.  Recovery from exercise-induced desaturation in the quadriceps muscles of elite competitive rowers. , 1992, The American journal of physiology.

[14]  J. Meythaler.  Intrathecal baclofen for spastic hypertonia in brain injury , 1997 .

[15]  Sheila Lennon,et al.  The Bobath concept: a critical review of the theoretical assumptions that guide physiotherapy practice in stroke rehabilitation , 1996 .

[16]  B. Bhakta,et al.  Management of spasticity in stroke. , 2000, British medical bulletin.

[17]  Dimitri Van De Ville,et al.  A new method to measure local oxygen consumption in human skeletal muscle during dynamic exercise using near-infrared spectroscopy , 2010, Physiological measurement.

[18]  A. Hulme,et al.  Baclofen in the elderly stroke patient its side-effects and pharmacokinetics , 2004, European Journal of Clinical Pharmacology.

[19]  T. S. Vrbanić,et al.  Analgesic effect of high intensity laser therapy in knee osteoarthritis. , 2011, Collegium antropologicum.

[20]  Roger Chou,et al.  Comparative efficacy and safety of skeletal muscle relaxants for spasticity and musculoskeletal conditions: a systematic review. , 2004, Journal of pain and symptom management.

[21]  Britton Chance,et al.  The use of muscle near-infrared spectroscopy in sport, health and medical sciences: recent developments , 2011, Philosophical Transactions of the Royal Society A: Mathematical, Physical and Engineering Sciences.

[22]  Curtis A. Merring,et al.  Muscle spasticity associated with reduced whole-leg perfusion in persons with spinal cord injury , 2011, The journal of spinal cord medicine.

[23]  C. Richards,et al.  Evaluation of reflex- and nonreflex-induced muscle resistance to stretch in adults with spinal cord injury using hand-held and isokinetic dynamometry. , 1998, Physical therapy.

[24]  R. Benesch,et al.  DETERMINATION OF OXYGEN EQUILIBRIA WITH A VERSATILE NEW TONOMETER. , 1965, Analytical biochemistry.

[25]  J J Fredberg,et al.  On the theory of muscle contraction: filament extensibility and the development of isometric force and stiffness. , 1996, Biophysical journal.

[26]  F. Panza,et al.  Short-term Effects of High-Intensity Laser Therapy Versus Ultrasound Therapy in the Treatment of People With Subacromial Impingement Syndrome: A Randomized Clinical Trial , 2009, Physical Therapy.

[27]  B. Chance,et al.  Time-dependent blood flow and oxygenation in human skeletal muscles measured with noninvasive near-infrared diffuse optical spectroscopies. , 2005, Journal of biomedical optics.

[28]  Korosh Mansouri,et al.  A neurophysiological and clinical study of Brunnstrom recovery stages in the upper limb following stroke , 2010, Brain injury.

[29]  C M Cobb,et al.  Biostimulation of wound healing by low-energy laser irradiation. A review. , 1996, Journal of clinical periodontology.

[30]  K. Nas,et al.  Efficacy of Low Power Laser Therapy in Fibromyalgia: A Single-blind, Placebo-controlled Trial , 2002, Lasers in Medical Science.

[31]  M. Baggish.  High-power--density carbon dioxide laser therapy for early cervical neoplasia. , 1980, American journal of obstetrics and gynecology.

[32]  L. Huguenin.  Myofascial trigger points: the current evidence , 2004 .