The Utility of Photobiomodulation as a Supplement to Orthobiologic Interventions A Contemporary Review
Main Article Content
Keywords
photobiomodulation, low-level light therapy, low power laser irradiation
Abstract
Several mechanisms may influence recovery and act as a complementary intervention to regenerative medicine. One area of consideration that may improve clinical outcomes in patients receiving regenerative medicine treatments is the utilization of supplementary interventions referred to as regenerative rehabilitation. One such intervention may be the use of light therapy also known as photobiomodulation (PBM). Terms synonymous with PBM include low-level light therapy (LLLT), low-power laser irradiation or cold laser. As a musculoskeletal intervention, PBM is administered via a mechanism that creates light through optical amplification. These interventions describe a form of PBM or light therapy that uses specific param-eters to target tissues through direct or indirect contact with or without heat or structural tissue alterations. PBM may improve treatment outcomes based on synergistic effects that are thought to modulate inflammation and facilitate cellular repair. This manuscript provides an overview of the current evidence supporting the use of PBM as a complementary intervention to regenerative medicine with a focus on managing conditions related to the musculoskeletal system.
References
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18. Tonk G, Kumar A, Gupta A. Platelet rich plasma versus laser therapy in lateral epicondylitis of elbow. Indian J Orthop. Jul 2014;48(4):390-3. doi:10.4103/0019-5413.136260
19. Pocai BL, Provensi É, Serighelli F, et al. Effect of photobiomodulation in the patellofemoral pain syndrome; randomized clinical trial in young women. J Bodyw Mov Ther. Apr 2021;26:263-267. doi:10.1016/j.jbmt.2021.01.003
20. Zagatto AM, de Paula Ramos S, Nakamura FY, de Lira FS, Lopes-Martins R, de Paiva Carvalho RL. Effects of low-level laser therapy on performance, inflammatory markers, and muscle damage in young water polo athletes: a double-blind, randomized, placebo-controlled study. Lasers Med Sci. Apr 2016;31(3):511-21. doi:10.1007/s10103-016-1875-1
21. Dohan Ehrenfest DM, Rasmusson L, Albrektsson T. Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF). Trends Biotechnol. Mar 2009;27(3):158-67. doi:10.1016/j.tibtech.2008.11.009
22. Gonçalves AB, Bovo JL, Gomes BS, et al. Photobiomodulation (λ=808nm) and platelet-rich plasma (PRP) for the treatment of acute rheumatoid arthritis in wistar rats. J Lasers Med Sci. 2021;12:e60. doi:10.34172/jlms.2021.60
23. Alzyoud JAM, Al Najjar SA, Talat S, Abu-Irmaileh B, Bustanji Y, Al-Shudiefat AAS. Effect of light-emitting diodes, platelet-rich plasma, and their combination on the activity of sheep tenocytes. Lasers Med Sci. Jun 2019;34(4):759-766. doi:10.1007/s10103-018-2657-8
24. Ozaki GA, Camargo RC, Koike TE, et al. Analysis of photobiomodulation associated or not with platelet-rich plasma on repair of muscle tissue by Raman spectroscopy. Lasers Med Sci. Dec 2016;31(9):1891-1898. doi:10.1007/s10103-016-2067-8
25. Kolber MJ, Purita J, Fabio Santos Duarte Lana J, Salamh PA, Hanney WJ. The effect of combined bone marrow aspirate, lipoaspirate, and platelet rich plasma injection on pain, function, and perceived change amongst individuals with severe knee osteoarthritis. Biologic Ortho J. 2021;3(1):e29-39. doi:https://doi.org/10.22374/boj.v3i1.25
26. Kolber MJ, Purita J, Hanney WJ. The effect of combined bone marrow aspirate, lipoaspirate, and platelet-rich plasm injections on pain, function, and perceived change amongst individuals with glenohumeral osteoarthritis. Biologic Ortho J. 2022 Nov. 30 [cited 2023 Jan. 30];4(SP1):e83-e95. Available from: https://biologicortho.com/index.php/BiologicOrtho/article/view/49
27. Chen X, Jones IA, Park C, Vangsness CT, Jr. The efficacy of platelet-rich plasma on tendon and ligament healing: A systematic review and meta-analysis with bias assessment. Am J Sports Med. Jul 2018;46(8):2020-2032. doi:10.1177/0363546517743746
28. Zhevago NA, Samoilova KA. Pro- and anti-inflammatory cytokine content in human peripheral blood after its transcutaneous (in vivo) and direct (in vitro) irradiation with polychromatic visible and infrared light. Photomed Laser Surg. Apr 2006;24(2):129-39. doi:10.1089/pho.2006.24.129
29. World Association for Photobiomodulation Therapy (WALT). Recommended anti-inflammatory dosage for photobiomodulation (PBM/ Low Level Laser Therapy). WALT; 2022. https://waltpbm.org/wp-content/uploads/2022/11/Dosage-recommendation-904nm-REVISED-OCTOBER-2022.pdf
30. McKay J, Frantzen K, Vercruyssen N, Hafsi K, Opitz T, Davis A, Murrell W. Rehabilitation following regenerative medicine treatment for knee osteoarthritis-current concept review. J Clin Orthop Trauma. 2019 Jan-Feb;10(1):59-66. doi: 10.1016/j.jcot.2018.10.018. Epub 2018 Oct 26. PMID: 30705534; PMCID: PMC6349636.
2. Wickenheisser VA, Zywot EM, Rabjohns EM, Lee HH, Lawrence DS, Tarrant TK. Laser light therapy in inflammatory, musculoskeletal, and autoimmune disease. Curr Allergy Asthma Rep. Jul 2 2019;19(8):37. doi:10.1007/s11882-019-0869-z
3. Chung H, Dai T, Sharma SK, Huang YY, Carroll JD, Hamblin MR. The nuts and bolts of low-level laser (light) therapy. Ann Biomed Eng. Feb 2012;40(2):516-33. doi:10.1007/s10439-011-0454-7
4. de Freitas LF, Hamblin MR. Proposed mechanisms of photobiomodulation or low-level light therapy. IEEE J Sel Top Quantum Electron. May-Jun 2016;22(3)doi:10.1109/jstqe.2016.2561201
5. Gao X, Xing D. Molecular mechanisms of cell proliferation induced by low power laser irradiation. J Biomed Sci. Jan 12 2009;16(1):4. doi:10.1186/1423-0127-16-4
6. Tumilty S, Mani R, Baxter GD. Photobiomodulation and eccentric exercise for Achilles tendinopathy: a randomized controlled trial. Lasers Med Sci. Jan 2016;31(1):127-35. doi:10.1007/s10103-015-1840-4
7. Bjordal JM, Lopes-Martins RA, Joensen J, et al. A systematic review with procedural assessments and meta-analysis of low level laser therapy in lateral elbow tendinopathy (tennis elbow). BMC Musculoskelet Disord. May 29 2008;9:75. doi:10.1186/1471-2474-9-75
8. Hagiwara S, Iwasaka H, Hasegawa A, Noguchi T. Pre-Irradiation of blood by gallium aluminum arsenide (830 nm) low-level laser enhances peripheral endogenous opioid analgesia in rats. Anesth Analg. Sep 2008;107(3):1058-63. doi:10.1213/ane.0b013e31817ee43e
9. Clijsen R, Brunner A, Barbero M, Clarys P, Taeymans J. Effects of low-level laser therapy on pain in patients with musculoskeletal disorders: a systematic review and meta-analysis. Eur J Phys Rehabil Med. Aug 2017;53(4):603-610. doi:10.23736/s1973-9087.17.04432-x
10. Girasol CE, Braz GA, Bachmann L, Celli J, Guirro RRJ. Laser light sources for photobiomodulation: The role of power and beam characterization in treatment accuracy and reliability. PLoS One. 2022;17(3):e0266193. doi:10.1371/journal.pone.0266193
11. Gavish L, Spitzer E, Friedman I, et al. Photobiomodulation as an adjunctive treatment to physiotherapy for reduction of anterior knee pain in combat soldiers: A prospective, double-blind, randomized, pragmatic, sham-controlled trial. Lasers Surg Med. Dec 2021;53(10):1376-1385. doi:10.1002/lsm.23442
12. Langella LG, Casalechi HL, Tomazoni SS, et al. Photobiomodulation therapy (PBMT) on acute pain and inflammation in patients who underwent total hip arthroplasty-a randomized, triple-blind, placebo-controlled clinical trial. Lasers Med Sci. Dec 2018;33(9):1933-1940. doi:10.1007/s10103-018-2558-x
13. de Paula Gomes CAF, Leal-Junior ECP, Dibai-Filho AV, et al. Incorporation of photobiomodulation therapy into a therapeutic exercise program for knee osteoarthritis: A placebo-controlled, randomized, clinical trial. Lasers Surg Med. Oct 2018;50(8):819-828. doi:10.1002/lsm.22939
14. Alqualo-Costa R, Rampazo É P, Thome GR, Perracini MR, Liebano RE. Interferential current and photobiomodulation in knee osteoarthritis: A randomized, placebo-controlled, double-blind clinical trial. Clin Rehabil. Oct 2021;35(10):1413-1427. doi:10.1177/02692155211012004
15. Medeiros DM, Aimi M, Vaz MA, Baroni BM. Effects of low-level laser therapy on hamstring strain injury rehabilitation: A randomized controlled trial. Phys Ther Sport. Mar 2020;42:124-130. doi:10.1016/j.ptsp.2020.01.006
16. Mamais I, Papadopoulos K, Lamnisos D, Stasinopoulos D. Effectiveness of low level laser therapy (LLLT) in the treatment of lateral elbow tendinopathy (LET): an umbrella review. Laser Ther. Sep 30 2018;27(3):174-186. doi:10.5978/islsm.27_18-OR-16
17. Haslerud S, Magnussen LH, Joensen J, Lopes-Martins RA, Bjordal JM. The efficacy of low-level laser therapy for shoulder tendinopathy: a systematic review and meta-analysis of randomized controlled trials. Physiother Res Int. Jun 2015;20(2):108-25. doi:10.1002/pri.1606
18. Tonk G, Kumar A, Gupta A. Platelet rich plasma versus laser therapy in lateral epicondylitis of elbow. Indian J Orthop. Jul 2014;48(4):390-3. doi:10.4103/0019-5413.136260
19. Pocai BL, Provensi É, Serighelli F, et al. Effect of photobiomodulation in the patellofemoral pain syndrome; randomized clinical trial in young women. J Bodyw Mov Ther. Apr 2021;26:263-267. doi:10.1016/j.jbmt.2021.01.003
20. Zagatto AM, de Paula Ramos S, Nakamura FY, de Lira FS, Lopes-Martins R, de Paiva Carvalho RL. Effects of low-level laser therapy on performance, inflammatory markers, and muscle damage in young water polo athletes: a double-blind, randomized, placebo-controlled study. Lasers Med Sci. Apr 2016;31(3):511-21. doi:10.1007/s10103-016-1875-1
21. Dohan Ehrenfest DM, Rasmusson L, Albrektsson T. Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF). Trends Biotechnol. Mar 2009;27(3):158-67. doi:10.1016/j.tibtech.2008.11.009
22. Gonçalves AB, Bovo JL, Gomes BS, et al. Photobiomodulation (λ=808nm) and platelet-rich plasma (PRP) for the treatment of acute rheumatoid arthritis in wistar rats. J Lasers Med Sci. 2021;12:e60. doi:10.34172/jlms.2021.60
23. Alzyoud JAM, Al Najjar SA, Talat S, Abu-Irmaileh B, Bustanji Y, Al-Shudiefat AAS. Effect of light-emitting diodes, platelet-rich plasma, and their combination on the activity of sheep tenocytes. Lasers Med Sci. Jun 2019;34(4):759-766. doi:10.1007/s10103-018-2657-8
24. Ozaki GA, Camargo RC, Koike TE, et al. Analysis of photobiomodulation associated or not with platelet-rich plasma on repair of muscle tissue by Raman spectroscopy. Lasers Med Sci. Dec 2016;31(9):1891-1898. doi:10.1007/s10103-016-2067-8
25. Kolber MJ, Purita J, Fabio Santos Duarte Lana J, Salamh PA, Hanney WJ. The effect of combined bone marrow aspirate, lipoaspirate, and platelet rich plasma injection on pain, function, and perceived change amongst individuals with severe knee osteoarthritis. Biologic Ortho J. 2021;3(1):e29-39. doi:https://doi.org/10.22374/boj.v3i1.25
26. Kolber MJ, Purita J, Hanney WJ. The effect of combined bone marrow aspirate, lipoaspirate, and platelet-rich plasm injections on pain, function, and perceived change amongst individuals with glenohumeral osteoarthritis. Biologic Ortho J. 2022 Nov. 30 [cited 2023 Jan. 30];4(SP1):e83-e95. Available from: https://biologicortho.com/index.php/BiologicOrtho/article/view/49
27. Chen X, Jones IA, Park C, Vangsness CT, Jr. The efficacy of platelet-rich plasma on tendon and ligament healing: A systematic review and meta-analysis with bias assessment. Am J Sports Med. Jul 2018;46(8):2020-2032. doi:10.1177/0363546517743746
28. Zhevago NA, Samoilova KA. Pro- and anti-inflammatory cytokine content in human peripheral blood after its transcutaneous (in vivo) and direct (in vitro) irradiation with polychromatic visible and infrared light. Photomed Laser Surg. Apr 2006;24(2):129-39. doi:10.1089/pho.2006.24.129
29. World Association for Photobiomodulation Therapy (WALT). Recommended anti-inflammatory dosage for photobiomodulation (PBM/ Low Level Laser Therapy). WALT; 2022. https://waltpbm.org/wp-content/uploads/2022/11/Dosage-recommendation-904nm-REVISED-OCTOBER-2022.pdf
30. McKay J, Frantzen K, Vercruyssen N, Hafsi K, Opitz T, Davis A, Murrell W. Rehabilitation following regenerative medicine treatment for knee osteoarthritis-current concept review. J Clin Orthop Trauma. 2019 Jan-Feb;10(1):59-66. doi: 10.1016/j.jcot.2018.10.018. Epub 2018 Oct 26. PMID: 30705534; PMCID: PMC6349636.
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Published
Feb 4, 2023
Article Details
How to Cite
Hanney, W., Rodriguez, J., Wilson, A., Rothschild, C., Kolber, M., Varela, A., & Salamh, P. (2023). The Utility of Photobiomodulation as a Supplement to Orthobiologic Interventions: A Contemporary Review. Biologic Orthopedics Journal, 4(SP1), e106-e115. https://doi.org/10.22374/boj.v4iSP1.53
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Review Articles
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Author Biographies
William Hanney, School of Kinesiology and Physical Therapy, Orlando, Florida
School of Kinesiology and Physical Therapy, Orlando, Florida
Juan Rodriguez, School of Kinesiology and Physical Therapy, Orlando, Florida
School of Kinesiology and Physical Therapy, Orlando, Florida
Abigail Wilson, School of Kinesiology and Physical Therapy, Orlando, Florida
School of Kinesiology and Physical Therapy, Orlando, Florida
Carey Rothschild, School of Kinesiology and Physical Therapy, Orlando, Florida
School of Kinesiology and Physical Therapy, Orlando, Florida
Morey Kolber, Nova Southeastern University, College of Health Care Sciences, Physical Therapy Program, Fort Lauderdale, Florida
Nova Southeastern University, College of Health Care Sciences, Physical Therapy Program, Fort Lauderdale, Florida
Antonio Varela, Arkansas Colleges of Health Education, School of Physical Therapy, Fort Smith, Arkansas
Arkansas Colleges of Health Education, School of Physical Therapy, Fort Smith, Arkansas
Paul Salamh, University of Indianapolis, College of Health Sciences, Krannert School of Physical Therapy, Indianapolis, Indiana
University of Indianapolis, College of Health Sciences, Krannert School of Physical Therapy, Indianapolis, Indiana