Pulsed Red and Blue Photobiomodulation for the Treatment of Thigh Contusions and Soft Tissue Injury: A Randomized Controlled Trial.

CONTEXT: Contusion and soft tissue injuries are common in sports. Photobiomodultion, light and laser therapy, is an effective aid to increase healing rates and improve function after various injury mechanisms. However, it is unclear how well photobiomodulation improves function after a contusion soft tissue injury. This study aimed to determine the effects of a pulsed red and blue photobiomodulation light patch on muscle function following a human thigh contusion injury. DESIGN: Single-blinded randomized control trial design. METHODS: We enrolled 46 healthy participants. Participants completed 5 visits on consecutive days. On the first visit, participants completed a baseline isokinetic quadriceps strength testing protocol at 60°/s and 180°/s. On the second visit, participants were struck in the rectus femoris of the anterior thigh with a tennis ball from a serving machine. Immediately following, participants were treated for 30 minutes with an active or placebo photobiomodulation patch (CareWear light patch system, CareWear Corp). Following the treatment, participants completed the same isokinetic quadriceps strength testing protocol. Participants completed the treatment and isokinetic quadriceps strength test during the following daily visits. We normalized the data by calculating the percent change from baseline. We used a mixed model analysis of covariance, with sex as a covariate, to determine the difference between treatment groups throughout the acute recovery process. RESULTS: We found the active photobiomodulation treatment significantly increased over the placebo group, quadriceps peak torque during the 180°/s test (P = .030), and average power during both the 60°/s (P = .041) and 180°/s (P ≤ .001) assessments. The mean peak torque and average power of 180°/s, at day 4, exceeded the baseline levels by 8.9% and 16.8%, respectively. CONCLUSIONS: The red and blue photobiomodulation light patch improved muscle strength and power during the acute healing phase of a human thigh contusion injury model.

Optimizing the bactericidal effect of pulsed blue light on Propionibacterium acnes - A correlative fluorescence spectroscopy study.

Propionibacterium acnes infection is the eighth most prevalent disease, affecting 80% of people worldwide. Resistance to antibiotics has been on the rise; over 40% of acne infections now resist commonly used topical and oral anti-acnes antibiotics, making treatment difficult. In our effort to refine blue light as an alternative safe clinically effective treatment, we determined if 100% bacterial suppression is attainable at ultralow irradiances and radiant energies, and explored the relationship between bacterial suppression and fluorescence during treatment. P. acnes were irradiated in vitro repeatedly three times per day at 3- or 4-hour intervals over three or more days, using 3 or 5 J/cm2 radiant energy of 450 nm pulsed blue light (PBL) at irradiances as low as 2 mW/cm2. In another series of experiments, we measured changes in P. acnes fluorescence as bacteria were repeatedly irradiated at various radiant exposures over three to four days. Our results showed that (1) 33% PBL, applied three times per day at 3-hour intervals each day over a three-day period at 2 mW/cm2 irradiance and 5 J/cm2 radiant exposure, resulted in100% bacterial suppression (7 log10 reduction), (2) the absorbed 450 nm light caused P. acnes to fluoresce predominantly in the red spectrum, with the fluorescence diminishing correlatively as treatment was repeated at 3-hour intervals and rising significantly during long periods of no treatment, and (3) treatment at 3-hour intervals gave better results than treatment at 4-hour intervals.

Pulsed 450 nm blue light significantly inactivates Propionibacterium acnes more than continuous wave blue light.

Infection with Propionibacterium acnes is ubiquitous, and drug resistant strains have been on the rise as the use of pharmaceutical antimicrobials continues to engender the emergence of further resistant strains. In previous studies, we showed that treatment with blue light serves as an alternative to pharmaceutical intervention. As a part of our ongoing effort to improve the antimicrobial efficacy of blue light, we studied the effect of pulsed 450 nm light on P. acnes in vitro and compared two pulsed rates with continuous wave irradiation. We irradiated cultures of P. acnes at various irradiances and radiant energies either singly or repeatedly at various time intervals, using printed micro-LEDs, with the goal of finding the lowest combination of irradiance and radiant energy that would yield 100% bacterial suppression. Our results show that treatment with 33% pulsed light gave the best result compared to 20% pulsed wave or continuous wave. Timing irradiation to coincide with the replication cycle of P. acnes produced a significantly better antimicrobial effect. Furthermore, repeated irradiation at 3-h or 4-h interval enabled significant bacterial suppression even at lower irradiances; thus, making single irradiation at high irradiances unnecessary. Moreover, combining repeated irradiation with appropriate duration of treatment and 33% irradiation pulse rate gave optimal 100% [7 log10] bacterial suppression.

Absorption of iontophoresis-driven 2% lidocaine with epinephrine in the tissues at 5 mm below the surface of the skin.

CONTEXT: In a recent study, we were unable to measure lidocaine in the human calf at a 5-mm depth via iontophoresis. We surmised that this might be due to a lack of epinephrine in the compound. Because epinephrine is a vasoconstrictor, it might allow the drug to pass beyond the capillaries and be delivered to the deeper tissues. OBJECTIVE: To determine if iontophoresis could deliver lidocaine with epinephrine 5 mm under the surface of human skin, as measured by microdialysis. DESIGN: Descriptive laboratory study. SETTING: Therapeutic modalities research laboratory. PATIENTS OR OTHER PARTICIPANTS: Ten volunteers (5 males, 5 females; age, 15-28 years) with less than 5 mm of adipose tissue in the area we measured and with no allergies to lidocaine participated. The measurement area had been free of any injury, swelling, or infection for at least 3 months before the study. INTERVENTION(S): We inserted a microdialysis probe 0.5 cm under the skin of the right lower leg. Next, microdialysis was performed through this area for 60 minutes, which allowed local skin blood flow to return to baseline. We then performed iontophoresis at 40 mA/min using 2 mL of 2% lidocaine. Iontophoresis was performed over this area for 10.5 minutes to collect the lidocaine samples. After this stage, the electrode was left in place for another 50 minutes for a total of 60 minutes. MAIN OUTCOME MEASURE(S): The samples of the drug were analyzed via reverse-phase high-performance liquid chromatography (RP-HPLC) in the chemistry department. RESULTS: The RP-HPLC analysis confirmed the presence of lidocaine in all 10 participants. The mean concentration of lidocaine detected at the 5-mm depth was calculated as 3.63 mg/ mL (greater than 18% of delivered concentration). CONCLUSIONS: We found that 2% lidocaine can be delivered up to 5 mm below the surface of the skin when the drug compound contains epinephrine and when passive delivery occurs for at least 50 minutes after the active delivery has terminated.