Photobiomodulation 101

Photobiomodulation 101: Taught by Ian McVay, PTA from IPA Physio Portland
Photobiomodulation is the use of non-thermal, non-invasive red and infra-red light to modulate the inflammatory process in the body, improve cell function and accelerate healing. Photobiomodulation is known by many other names, including; Low Level Laser Therapy (LLLT), Cold laser therapy, Laser Biostimulation, Laser Phototherapy, Low-Power Laser Irradiation, Low-Power Laser Therapy
At IPA Physio Portland, photobiomodulation is often prescribed to patients who have underlying inflammatory or degenerative conditions. Learn about the big picture of what over 5,000 scientific studies have discovered.
Topics covered will be the following:
-Brief history of photobiomodulation and how it has evolved into it's current state in the medical field
-The cellular mechanisms resulting from exposure to red and infra-red wavelengths of light
-Considerations if you choose to purchase a photobiomodulation unit for personal use to self-treat
-Common treatments performed at IPA Physio including muscle strain, nerve regeneration, brain, ligament, tendon, spine, inflammation, and platelet-rich plasma
Articles/ Blogs:
Mechanisms and applications of the anti-inflammatory effects of photobiomodulation
www.ncbi.nlm.nih.gov/pmc/arti...
Systematic Review of Photobiomodulation Therapy (PBMT) on the Experimental Calcaneal Tendon Injury in Rats
onlinelibrary.wiley.com/doi/e...
Photobiomodulation Therapy (PBMT) in Peripheral Nerve Regeneration: A Systematic Review
www.ncbi.nlm.nih.gov/pmc/arti...
Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials
www.thelancet.com/journals/la...
Photobiomodulation in the Treatment of Muscle Injury: A Systematic Review
www.researchgate.net/publicat...
Brain Photobiomodulation Therapy: A Narrative Review
www.ncbi.nlm.nih.gov/pmc/arti...
Evaluation of low-level laser therapy, platelet-rich plasma, and their combination on the healing of Achilles tendon in rabbits
link.springer.com/article/10....
Isolated and combined effects of photobiomodulation therapy, topical nonsteroidal anti-inflammatory drugs, and physical activity in the treatment of osteoarthritis induced by papain
pubmed.ncbi.nlm.nih.gov/27752...
Comparison between cryotherapy and photobiomodulation in muscle recovery: a systematic review and meta-analysis
pubmed.ncbi.nlm.nih.gov/34669...
ipa.physio/photobiomodulation...
ipa.physio/photobiomodulation...
bioflexlaser.com/personal-the...

[@jamesgordon8867]

When you listen to this, then go learn about insulin resistance. When photobiomodulation is wed to insulin resistance, all that metabolic damage is greatly improved 😊

[@Shirley-nt9sz]

Clear and well-paced presentation. Thank you

[@smarzig]

one of the best presentations! Easy to follow/hear/understand.

[@metalguru5226]

Amazing! Thank you for this very important information.

[@charlescottrell8377]

Great video. I appreciate all the links also.

[@eliakimjosephsophia4542]

Great presentation, thank you.

[@kennyrayj]

Excellent presentation.

[@vishalvermaphysio]

excellent information on photobiomodulation .

[@firstlast-lr4jt]

nice lecture, thank you for the infomation

[@marionharris5952]

Thank you.

[@asoopalany1528]

Well done i love the presentation ❤

[@haroldparker5768]

Very good program

[@jw6180]

Thanks for this informative video! 👍

[@redlightglassesonthischannel]

wow, what an amazing lecture, thank you 👍👍

[@onetime7408]

This was very interesting and well presented. I learned a great deal. I understand that photobiomodulation is the new name for this therapy, there is a great deal of interest in "red light" at present....I wonder if you also put red light in the title (along with the official name for it)....many more people would benefit from the information you so generously provided.

[@NurseJacqueline]

I wholeheartedly agree! By simply adding “red light” to the title it would definitely increase the number of views exponentially I seriously believe!

[@micaonyx5301]

​@@NurseJacquelineI totally agree, because for the longest I didn't know they were the same thing and a lot of people probably don't know that either.

[@robgronbeck8862]

well done!!

[@jamellelangfordiii3586]

So interesting. I am an RT and am very interested in photobiomodulation in the treatment of lung disease. I am trying to figure out how to involve myself into research on the subject, but I don't even know where to start.

[@jamesgordon8867]

If they ever figure out how to incorporate hyperbaric oxygen into the photobiomodulation process, an entire new healing process could occur 😊

[@shersmith5700]

Very informative!

[@IPAPhysio]

Glad it was helpful!

[@UlySambrano]

Thanks for the video it was good stuff! What do you recommend for at home unit?

[@IPAPhysio]

We like any of the home units from Bioflexlaser.

[@donflamingo795]

Is this a university class session? Holy shit we can get this information on youtube.

[@Frederer59]

If you use older probes where the aperture plate is flush with the cone, make sure you have them tested to be sure that contaminants such as lotion does leak into and contaminate the aperture. This can dramatically effect the function. The newer probes have the aperture countersunk into the cone so the aperture does not contact the skin with pressure. I may be possible to have an older property be refitted with the modification the new ones have. I'm referring to the bioflex probes.

[@IPAPhysio]

Thanks for the information!

[@Frederer59]

I'm an RMT and sadly learned this from experience. My IR probe was affected and it's power output was seriously affected. I may have played a part in the modification, who knows. Btw, I like the old portable units the best. So easy to use. I have two (wish I had four) and the and 2 probes R/IR. Bought a Weber IR helmet too.

[@SarkisKlinik]

What are the cheapest effective machines that one can still get these effects? Thanks

[@Roberto-cg2gr]

Any research of PBM and CKD?

[@colfaxschuyler3675]

The thing about light absorption... "Hemoglobin absorbs a lot of red light". Does it absorb it, or reflect it? O don't know what color hemoglobin is. If it appears red, then it's reflecting that wavelength. If it is absorbing it, I would think that the hemoglobin is benefiting from that wavelength, and as it's in the blood, that is circulating the benefit through the body. Not a "Bad" thing, it's just grabbing the photons first for its own benefit. Hemoglobin with oxygen in it is used in the production of ATP. That's the same goal of using PBM. In one case, you want to focus on local tissues, in the other, the result of the PBM is spread throughout the body.

[@ICONICFREEDOM]

wonder what the recommendation is for specific areas of the body/brain when setting up a daily protocol.

[@IPAPhysio]

Depending on your specific unit, I would reach out the manufacturer for their recommendations on their equipment, as the power output and unit parameters might differ from the unit we have in our clinic. Hope that helps!

[@renita9424]

From another PBM researcher, she found that for stroke patients you must only apply the PBM to the side of the brain with the injury. If you apply it to the entire head, you will do more damage than good.

[@IPAPhysio]

Thanks for sharing. Can you link the study information in the comments section? Thank you!

[@saichandinisandeep5636]

Any article on oral and extra oral applications of PBM with parameters

[@IPAPhysio]

Here is one article published in the Archives of Oral Biology in 2020: Effect of Low- Level Laser Therapy on Bone Regeneration of Critical-Size Bone Defects: A Systematic Review of In Vivo Studies and Meta-Analysis. They provide some parameters as guidance as well, however often the parameters used vary by PBM system used in your practice.

[@dani9114]

you mentioned wavelength but you didn't say anything about the laser device's peak power, average power, duration of impulse and effective dose.. in my opinion they are fundamental parameters to know

[@IPAPhysio]

Great question! Unfortunately every manufacture of photobiomodulation equipment uses different power settings which makes it difficult for us practitioners to standardize our protocols. Additionally, the parameters would differ slightly if the instrument was an LED light bar vs class 3b laser. Some key parameters that have been proposed by researchers are the joules of energy per point or per treatment area. For more information on this subject, I recommend reviewing the guidelines by WALT (world association for photobiomodulation therapy) here: waltpbm.org/documentation-links/recommendations/. Hope that helps!

[@bradojacko8247]

Do you have any thoughts on red light panels? What characteristics would be required to make them useful? It seems much more useful than a want or probe that works on small areas at a time only.

[@IPAPhysio]

Also great question! Bioflex recently released some interesting new devices that include panels. They reference research that suggests that panels are meant for general wellness by treating the skin/ surface level blood vessels. Professional equipment is best used in rehab and medical settings as they are far more targeted and effective for specific areas of the body. Hope that helps!

[@bradojacko8247]

@@IPAPhysio my concern with small tools like the bioflexs is that, while pain may manifest in one area of the body, it may be caused by problems elsewhere in the body that aren't being treated and arent known. So, a full body device (like a panel or a full body mat would be even better) would be necessary to produce longterm effective results. But I don't know of any full body device that you can lay on that produces the appropriate wavelengths and energy output other than something insane like the Thor bed that normal people could never afford. Do you know of such a device? Is there any reason why this would be a bad idea?

[@Arrasel]

​@@bradojacko8247I'm thinking of buying a Mitolight panel. They are quite expensive.

[@bradojacko8247]

If you use it on the spine which is experiencing back and sciatic pain and heel numbness, is it just a pain reliever or does it actually heal anything longterm?

[@IPAPhysio]

Great question! Photobiomodulation is used with the intention of healing injured tissue through the interaction with the dysfunctional cells that are being targeted. As a result, the symptoms will improve as the source of the injury repairs, usually in conjunction with other therapeutic interventions.

[@Noticias-de-Israel-Hamas]

I know this post is over 2 years old. I am going to ask anyway. Are there any success studies when using PBM for treating kidney failure?

[@IPAPhysio]

Good question! Here are 2 articles I found that might help: www.ncbi.nlm.nih.gov/pmc/articles/PMC8558702/ www.ncbi.nlm.nih.gov/pmc/articles/PMC9320354/

[@benjaminperks7534]

Question with time lapse 20min:20-28; When nitic oxide leaves the mitochondria for enhanced used of oxygen, in lament terms are we kicking out the nitric oxide in making "space" for more oxygen, or are we splitting the nitrogen from the oxygen and the nitrogen becomes a waste product removed by the body and more oxygen for the body?

[@IPAPhysio]

Good question! Think of it as making space for more oxygen.

[@Iamandthatiam]

can you comment on frequencies that are most potent to use? major LED panels are 660 and 850 but there are other like 630,660,810,830,850.. so maybe one or two potent frequencies will be more useful ?

[@IPAPhysio]

Great question! in the article in the description section titled "Brain Photobiomodulation Therapy: A Narrative Review" there is a breakdown of some of the benefits of various wavelengths. They each have their pros and cons, but will all benefit the proposed effects of PBMT on our cells.

[@haroldparker5768]

How do we test for results with use of photo bio modulation therapy

[@IPAPhysio]

Great question! Ultrasound imaging and other forms of diagnostic imaging are capable of identifying the status of the tissue being treated. Outside of imaging, we often rely on functional tests and stress tests that challenge the integrity of ligaments, joints or other structures to quantify progress, as well as the patient's subjective reports.

[@sharmilelliott2414]

Thank you for this presentation! I am wondering if/how this might help pain & healing from old injures & surgeries with lots of scar tissue?

[@chrisvecchione7138]

and all the units are pretty insanely priced... 4k for a home unit

[@dbz5808]

There are cheap 10W 850-660nm caps on eBay for around $60. 30-45W panels and lamps in the $30-$40 range. My dad uses one for his macular degeneration. It isn't a cure, but it has helped. According to his VA doctor, there's been no disease progression in the two years since Dad's been using it (which surprised his doctor) and subjectively some very slight improvement in actual vision according to Dad.

[@Arrasel]

​@dbz5808 what device is your dad using?

[@user-bb8bt3mn9o]

Is it good for autism patient ??

[@alanturnham.9939]

please STOP using split screens on presentations- because one cannot actually READ graphics- as print is TOO SMALL ! Thanks much

[@Thestonedavidthrows]

Nir infrared only penetrates up to 2 mm into the body? How are you affecting cells?

[@IPAPhysio]

Good question! I have read dozens of research papers (however I am sure there are tons more) that show IR light can penetrate various tissues up to about 2.5 inches, which is more than enough to target some of the deepest tissues in our body. Depressing the probe or light array into the tissue can also displace some blood to allow deeper penetration in a shorter time. I recommend performing a deep dive of the available research on PBM, as there are thousands of papers published, at least 6,000 that I am aware of, from the time of this comment.

[@Thestonedavidthrows]

@IPAPhysio it's not true. The scientific data suggests that nir only penetrates 2 mm deep unless it is a Lazer, which is concentrated and focused light. I'm in the industry, and only Far Infrared penetrates 1 3/4 to 2 inches into the skin.

[@Thestonedavidthrows]

@@IPAPhysio You erased my reply? Nir infrared can only go 2 mm deep unless structured in the form of a Lazer. Far Infrared can go 1 3/4 to 2 inches deep. This is the official science.

[@IPAPhysio]

@@Thestonedavidthrows Thanks for sharing! Here is the first article I pulled up that discusses 808NM penetration of about 40mm through cadaver head tissue. onlinelibrary.wiley.com/doi/10.1002/lsm.22343 Again, with pressure the light can reach much greater depths and is mostly dependent on the wavelength vs the instrument that delivers the light.

[@hngi26]

Can PBM reduce BPH.

[@IPAPhysio]

Great question. We haven't seen any research to support this yet, however photobiomodulation research has seen a significant increase in the last few years and wouldn't be surprised to see this researched soon.

[@stefanallard3084]

Toughts on LED vs laser? I have both and its said to be the same but LED takes longer time, wich i feel is not correct. Hitting my balls with laser makes them MUCH bigger and MUCH faster then LED

[@stefanallard3084]

I now combine, hitting laser on heart and testicles and LED on cns/front/legs

[@Strength-Honor-Courage]

You can get yourself an infrared lizard light lamp for $30 and it will do the same trick...no need to buy expensive red light machines for $200..

[@IPAPhysio]

Thanks for sharing!

[@getstarted7168]

Red Light Therapy

[@roncarlson2530]

cancer, if present; would this not be a problem?

[@IPAPhysio]

Great question! We consider treatment over known malignant lesions to be contraindicated.

[@larryscriven7500]

You didn’t talk about Parkinson’s in detail. (PBM on brain)

[@IPAPhysio]

This article might be helpful: www.ncbi.nlm.nih.gov/pmc/articles/PMC7225948/

[@jamesgordon8867]

Maybe they will catch up with Ukraine and learn to use a light inside the vein 😊