Cytoproliferative activity of the HILT: in vitro investigation

Intro :: For some time now the use of pulsed Nd:YAG Laser has been spreading in the therapy of pain with excellent results. Studies exist which describe the anti-inflammatory, anti-oedemigenic and antalgic effects of Nd:YAG Laser, thus justifying its use in the therapy of pain. With the exception of the study by Repice et al, no bibliographical references exist indicating the cytoproliferative effect of Nd:YAG Laser in order to justify its use in reparative therapy. On the contrary, several authors report the cytoinhibiting effect of Nd:YAG Laser. More specifically, Sroka (1999) describes having obtained a mitotic increase with Laser at 410, 635 and 805 nm while he excludes this with the Nd:YAG Laser. In our study we have assessed the stimulating capacity of the cytoproliferation of the Nd:YAG Laser in vitro. We used two different cell lines for investigating the cellular proliferative response to the variation in the dosimetry and for verifying the specificity of this response of a mitotic increase with the same parameters but by varying the cell line. With the use of a molecule inhibiting the tyrosinekinasic metabolic pathway (isoflavone genistein) the metabolic interactions of the Laser radiation with one of the main metabolic pathways assigned to the cellular proliferation were assessed.

High Intensity Laser Therapy in arthrosis: experimental investigations on animal models

Intro :: Arthrosis is a disease with a high social impact as it affects 30-35% of the population. An arthrosic patient costs the public health services approximately 4,000 euro on average a year, touching peaks of almost double this amount in the most severe cases. Conventional therapy foresees the administration of anti-inflammatories, antalgics, and decontraction agents. The current trend is to use chondroprotective drugs with often encouraging results.

High Intensity Laser Therapy in the treatment of gonarthrosis: the first clinical cases and the protocol for a multicentric, randomised, double-blind study

High Intensity Laser Therapy (HILT): state of the art in sporting traumatology and pain therapy

HILT vs TENS and NSAIDs: A clinical study on low back pain from herniated inter-vertebral disk

Conclusions :: From an analysis of the results it appears that THE HILT induces a better clinical effect with respect to the other two methods being compared, not so much during the first period where the results are superimposable, but over time. In our opinion these results are encouraging and pave the way for organizing clinical studies on a wide scale aimed at confirming this data. The reasons for which the clinical effects of the HILT are evident over time are not yet known so it is to be hoped that research will be carried out that aims at analyzing these effects.

Superpulsed laser irradiation increases osteoblast activity via modulation of bone morphogenetic factors

Abstract :: Reported results show that superpulsed laser irradiation possesses osteogenic properties, including the expression of molecules known to be important mediators of bone formation and, as a consequence, increasing calcium deposits in human MG-63 cells. Moreover, the data suggest a new potential role for PPARY as a regulator of osteoblast proliferation.

Treatment of proprioceptive balance disorders: comparison between kinesistherapy and Hilterapia®.

Abstract :: Proprioceptive vertigo disorders can be caused by several mechanisms, generally of muscle-tendon origin, able to induce an irritant stimulus on vestibular nuclei and on cervical sympathetic nervous system. Such disorders are often associated with pain and functional limitation of the cervical tract. Thirty subjects, subdivided in two groups, have been included in the study. One group was treated with kinesistherapy alone and the other group with kinesistherapy combined with Hilterapia®. Treatment has been administered on a daily basis for the first week and every other day for the following 2 weeks, for a total of 10 sessions. All subjects have undergone a clinical-anamnestic evaluation before treatment (T0), at the end of the first week (T1), at the end of the therapy (T2), and one month later (T3). A computerised stabilometric test, with elaboration of the cervical interference index has also been taken at T0, T2 and T3 time points. Data on semi quantitative scale have been analysed using the Mann-Whitney non parametric test. Data on cervical interference have been analysed using the parametric Paired Samples T Test. With regards to the non parametric data, no significant variations between the two groups have emerged. However, both sets of data showed significant variations in the trend over time of the various parameters, within each group, with a more rapid improvement, in terms of pain and functional limitation, in those subjects undergoing a combined kinesistherapy and Hilterapia® treatment. With respect to the cervical interference index, a significant variation between T0 and T3 has been observed only in the combined treatment group. Hilterapia® has been found to be an effective help to produce faster subjective improvements with kinesistherapy and more importantly, it has been demonstrated to improve proprioceptive balance disorders.

Treatment of chronic low back pain: back school versus Hilterapia®.

Abstract:: Chronic low back pain can be treated with the use of back school, drugs, physical therapy with therapeutic medical equipment, psychological therapy, life style improvement and surgery. The aim of this study was to compare the efficacy of back school treatment with a combination of back school and treatment by pulsed Nd:YAG laser (Hilterapia®). Patients have been divided in two groups similar for age and sex: the first group was treated exclusively with back school exercises; conversely, the second group received a combined therapy of back school and Hilterapia®. Results obtained with the two therapy regimens have been evaluated measuring pain control and disability. Although an improvement has been observed in both groups, this was more evident in patients treated with the combined therapy.

Effects of Hilterapia® vs. Viscosupplementation in knee osteoarthritis patients: a randomized controlled clinical trial.

Abstract:: Therapeutic approach in Knee Osteoarthritis (KO), a long lasting disease with both epidemiological and social implications, may consider local interventions which are useful along the course of the pathology. Viscosupplementation has got efficacy with little side effects. Lasertherapy (Low Level Laser Therapy-LLLT-) is widely used but we don’t still have sure demonstrations on its efficacy. High Intensity Laser Therapy (HILT, Hilterapia®) seems to be more effective than LLLT, due to its higher intensity and to the compare the efficacy of Hilterapia® to viscosupplementation in patients with symptomatic KO. 41 out-patients with symptomatic KO (II-IIIII Kellgren-Lowrence Scale stage) were enrolled and evaluated by WO MAC and Lequesne Scales, before treatment (t0), after treatment (t1) and after 4 months (t2). After randomization, the treatment consisted in viscosupplementation (4 Hyaluronic acid infiltrations 1/week) for Group A, or Hilterapia® (antalgic treatment, 10 sessions, three time a week) for Group B. Both the groups (A and B) showed a highly statistically significant improvement between t0 and t1 in WO MAC and Lequesne Scales. The improvement was maintained at followup (t2) either by Group A or Group B. No side effect was found, neither in Group A nor in Group B. Hilterapia® showed analogous results to viscosupplementation. We conclude that Hilterapia® seems a good medical instrument for pain control and for improvement of patient’s quality of life.

Hilterapia® efficiency in handling the post surgical pain after the release of the carpal tunnel.

Abstract:: A descriptive observational study was made to evaluate the efficiency of a new option of treatment, the high power laser therapy (Hilterapia®) in handling a frequent pathology as the pain in the palm of the hand after the open release of the carpal tunnel (pillar pin). Pillar pain is a painful condition present in early stages in up to 41% of the patients after the transverse ligament release. This percentage diminishes with time, but has not yet had a therapeutic, efficient and non invasive treatment. Thirteen patients were evaluated after being operated by three different surgeons with a standard open carpal release technique. After six months of surgery, they still presented a persistent and incapacitating pain that could be attributed to a pillar pain. All patients were summated to eight sessions of Hilterapia® treatment with the HIRO 3 equipment (ASA S.r.l., Vicenza, Italy). The energy applied in the painful area of the hand was 600 Joules. Two different parameters were evaluated: pain scale and grip strength, both affected by the pathology of pillar pain. The study shows a tendency to diminish the pain and to improve the grip strength and the hand functioning. This can be attributed to the use of Hilterapia®, which opens a therapeutic way to its use in this type of condition.

Muscle lesions in athletes: case comparison between Hilterapia® and traditional therapy.

Abstract:: Muscle pathologies during sport activities are very frequent. The most serious event is the muscle strain that needs specific treatment based upon functional rehabilitation associated with physiotherapeutic medical equipments. This clinical study compared the results obtained in two groups of 15 patients, homogeneous for pathology (1st degree strain), sex and age, treated with either Hilterapia® or with traditional therapy (CO 2 laser therapy and ultrasound therapy). Results have been evaluated by using VAS pain score, ultrasound scan, number of therapy sessions, time before sport activity can be resumed and satisfaction index of patients. Based on this study, Hilterapia® proved to be effective in reducing pain and time before sport activity can be resumed, with statistically better results when compared to conventional therapy, according to all evaluation parameters.

Effects of pulsed Nd: YAG laser at molecular and cellular level. A study on the basis of Hilterapia®.

Abstract:: Lasers have been widely applied in many different fields of medicine, proving their effectiveness in the treatment of a wide range of diseases. In spite of the great amount of literature, it is difficult to understand the molecular and cellular mechanisms at the basis of the systemic effects induced by laser irradiation because of different kinds of laser used, operative conditions, variety of biological targets and responses. The application of high power lasers in physiotherapy is quite recent. It is due to the development of instruments which allow the control of photothermal and photomechanical processes so as to obtain therapeutic effects without tissue damage. In particular, pulsed Nd:YAG laser has proved hisversatility and efficacy in the treatment of many different musculoskeletal diseases and it is believed to have anti-inflammatory, anti-oedema, analgesic and also reparative effects. The aim of the studies here presented was to contribute in understanding the molecular mechanisms and cellular processes at the basis of the systemic effects produced by pulsed Nd:YAG laser irradiation. Owing to the lack of chromophores efficiently absorbing Nd:YAG radiation (wavelength 1064 nm) in cells and tissues, we hypothesized that, rather than photochemical processes, aspecific mechanisms probably due to combined photothermal and photomechanical interactions could be responsible for the above mentioned effects of pulsed Nd:YAG laser. The finding suggest that cells “sense” pulsed ND:YAG laser irradiation and respond to it through mechanotransduction machinery. We hypothesize that the interaction between tissue and laser radiation alters the mechanics of cell microenvironment, thus acting on the cells as a mechanical stress.