A PILOT RANDOMIZED TRIAL EVALUATING LOW-LEVEL LASER THERAPY AS AN ALTERNATIVE TREATMENT TO MANUAL LYMPHATIC DRAINAGE FOR BREAST CANCER-RELATED LYMPHEDEMA
Sheila H. Ridner, PhD, RN, FAAN, Ellen Poage-Hooper, MPH, MSN, NP-C, CLT-LANA, Collin Kanar, MD, Jennifer K. Doersam, BS, Stewart M. Bond, PhD, RN, AOCN, and Mary S. Dietrich, PhD
BACKGROUNDPURPOSE/OBJECTIVES: To examine the impact of advanced practice nurse (APN) administered low level laser therapy (LLLT) as both a stand-alone and complementary treatment for arm volume, symptoms, and quality of life (QOL) in women with breast cancer related lymphedema.
DESIGN: A three-group, pilot, randomized clinical trial.
SETTING: A private rehabilitation practice with two locations in the southwestern United States.
SAMPLE: 46 breast cancer survivors with treatment related lymphedema.
METHODS: Patients were screened for eligibility and then randomized to either manual lymphatic drainage (MLD) for 40 minutes, LLLT for 20 minutes, or, 20 minutes of MLD followed by 20 minutes of LLLT. Compression bandaging was applied after each treatment. Data were collected pre-treatment, daily, weekly, and at the end of treatment.
MAIN RESEARCH VARIABLES: Independent variables consisted of three types of APN administered lymphedema treatment. Outcome variables included limb volume, extracellular fluid, psychological and physical symptoms, and QOL.
FINDINGS: No statistically significant between group differences were found in volume reduction; however, all groups had clinically and statistically significant reduction in volume. No group differences were noted in psychological and physical symptoms, or QOL; however, treatment related improvements were noted in symptom burden within all groups. Skin improvement was noted in each group that received LLLT.
CONCLUSIONS: LLLT with bandaging may offer a time saving therapeutic option to conventional MLD. Alternatively compression bandaging alone could account for the demonstrated volume reduction.
IMPLICATIONS FOR NURSING: APNs can effectively treat lymphedema. APNs in private healthcare practices can serve as valuable research collaborators.
(Oncol Nurs Forum. Jul 2013; 40(4): 10.1188/13.ONF.383-393)
Full article available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3887507/
EFFECTS OF PRE-IRRADIATION OF LOW-LEVEL LASER THERAPY WITH DIFFERENT DOSES AND WAVELENGTHS IN SKELETAL MUSCLE PERFORMANCE, FATIGUE, AND SKELETAL MUSCLE DAMAGE INDUCED BY TETANIC CONTRACTIONS IN RATS
Santos LA, Marcos RL, Tomazoni SS, Vanin AA, Antonialli FC, Grandinetti VD, Albuquerque-Pontes GM, de Paiva PR, Lopes-Martins RA, de Carvalho PD, Bjordal JM, Leal-Junior EC
This study aimed to evaluate the effects of low-level laser therapy (LLLT) immediately before tetanic contractions in skeletal muscle fatigue development and possible tissue damage. Male Wistar rats were divided into two control groups and nine active LLLT groups receiving one of three different laser doses (1, 3, and 10 J) with three different wavelengths (660, 830, and 905 nm) before six tetanic contractions induced by electrical stimulation. Skeletal muscle fatigue development was defined by the percentage (%) of the initial force of each contraction and time until 50 % decay of initial force, while total work was calculated for all six contractions combined. Blood and muscle samples were taken immediately after the sixth contraction. Several LLLT doses showed some positive effects on peak force and time to decay for one or more contractions, but in terms of total work, only 3 J/660
nm and 1 J/905 nm wavelengths prevented significantly (p < 0.05) the development of skeletal muscle fatigue. All doses with wavelengths of 905 nm but only the dose of 1 J with 660 nm wavelength decreased creatine kinase (CK) activity (p < 0.05). Qualitative assessment of morphology revealed lesser tissue damage in most LLLT-treated groups, with doses of 1-3 J/660 nm and 1, 3, and 10 J/905 nm providing the best results. Optimal doses of LLLT significantly delayed the development skeletal muscle performance and protected skeletal muscle tissue against damage. Our findings also demonstrate that optimal doses are partly wavelength specific and, consequently, must be differentiated to obtain optimal effects on development of skeletal muscle fatigue and tissue preservation. Our findings also lead us to think that the combined use of wavelengths at the same time can represent a
therapeutic advantage in clinical settings.
(Lasers Med Sci. 2014 Mar 21)
Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/24651950