Jih-Huah Wu

Carpal Tunnel Syndrome Treated with a Diode Laser: A Controlled Treatment of the Transverse Carpal Ligament

OBJECTIVE The purpose of this placebo-controlled study was to investigate the therapeutic effects of the 830-nm diode laser on carpal tunnel syndrome (CTS). BACKGROUND DATA Many articles in the literature have demonstrated that low-level laser therapy (LLLT) may help to alleviate various types of nerve pain, especially for CTS treatment. We placed an 830-nm laser directly above the transverse carpal ligament, which is between the pisiform and navicular bones of the tested patients, to determine the therapeutic effect of LLLT. MATERIALS AND METHODS Thirty-six patients with mild to moderate degree of CTS were randomly divided into two groups. The laser group received laser treatment (10 Hz, 50% duty cycle, 60 mW, 9.7 J/cm(2), at 830 nm), and the placebo group received sham laser treatment. Both groups received treatment for 2 wk consisting of a 10-min laser irradiation session each day, 5 d a week. The therapeutic effects were assessed on symptoms and functional changes, and with nerve conduction studies (NCS), grip strength assessment, and with a visual analogue scale (VAS), soon after treatment and at 2-wk follow-up. RESULTS Before treatment, there were no significant differences between the two groups for all assessments (p > 0.05). The VAS scores were significantly lower in the laser group than the placebo group after treatment and at follow-up (p < 0.05). After 2 wk of treatment, no significant differences were found in grip strengths or for symptoms and functional assessments (p > 0.05). However, there were statistically significant differences in these variables at 2-wk follow-up (p < 0.05). Regarding the findings of NCS, there was no statistically significant difference between groups after treatment and at 2-wk follow-up. CONCLUSIONS LLLT was effective in alleviating pain and symptoms, and in improving functional ability and finger and hand strength for mild and moderate CTS patients with no side effects.

A Novel Pulse Measurement System by Using Laser Triangulation and a CMOS Image Sensor

This paper presents a novel, non-invasive, non-contact system to measure pulse waveforms of artery via applying laser triangulation method to detect skin surface vibration. The proposed arterial pulsation measurement (APM) system chiefly consists of a laser diode and a low cost complementary metal-oxide semiconductor (CMOS) image sensor. Laser triangulation and centroid method are combined with the Fast Fourier Transform (FFT) in this study. The shape and frequency of the arterial pulsation can be detected rapidly by using our APM system. The relative variation of the pulse at different measurement points near wrist joint is used as a prognostic guide in traditional Chinese medicine (TCM). An extensive series of experiments was conducted to evaluate the performance of the designed APM system. From experimental results, the pulse amplitude and frequency at the Chun point (related to the small intestine) of left hand showed an obvious increase after having food. In these cases, the peak to peak amplitudes and the frequencies of arterial pulsations range from 38 to 48 μm and from 1.27 to 1.35 Hz, respectively. The height of arterial pulsations on the area near wrist joint can be estimated with a resolution of better than 4 μm. This research demonstrates that applying a CMOS image sensor in designing a non-contact, portable, easy-to-use, low cost pulse measurement system is feasible. Also, the designed APM system is well suited for evaluating and pre-diagnosing the health of a human being in TCM clinical practice.

Study of Autonomic Nervous Activity of Night Shift Workers Treated with Laser Acupuncture

OBJECTIVE The aim of this study was to evaluate the impact of laser acupuncture on the autonomic nervous system (ANS) of the night shift worker. BACKGROUND DATA Many articles have demonstrated that levels of affective disorders and stress are high in night shift workers. We applied laser energy to the Neiguan point (PC6) to examine the impact of laser acupuncture on the ANS of 45 healthy young males who were night shift workers and evaluated their heart-rate variability (HRV). MATERIALS AND METHODS The laser group (n = 15) received laser acupuncture (9.7 J/cm(2), 830 nm) for 10 min, and the placebo group (n = 15) received sham laser treatment. The effects before and after this intervention on the HRV of the subjects were assessed, along with those seen after 30 min of lying down. RESULTS After treatment and after the 30-min rest period, the independent-sample t-test showed that both groups exhibited statistically significant differences in high-frequency (HF) HRV, low-frequency (LF) HRV, and the LF:HF ratio of HRV (p < 0.05). Compared with the placebo group, the paired-samples t-test showed that after laser treatment the treatment group had a statistically significant improvement in HF HRV (p = 0.001), LF HRV (p = 0.001), and the LF:HF HRV ratio (p = 0.02). CONCLUSIONS Laser acupuncture stimulation applied to the Neiguan point increased vagal activity and suppression of cardiac sympathetic nerves. This effect was positive and could be used to help patients who have circadian rhythm disorders.

Therapeutic Effects of Low-Level Laser on Lateral Epicondylitis from Differential Interventions of Chinese-Western Medicine: Systematic Review

BACKGROUND Low-level laser therapy (LLLT) is a conservative treatment for lateral epicondylitis (LE), but it is also an alternative intervention between the very different approaches of Chinese and Western medicine. OBJECTIVE The purpose of this study was to systematically review and meta-analyze the therapeutic effects of LLLT on LE. METHODS We searched several electronic databases, including Medline, PubMed, and CINAHL, and explored studies that were randomized controlled trials on the therapeutic effects of LLLT on LE from 1990 to February 2009. These studies were systematically reviewed for the difference in therapeutic effects among various LLLTs on acupuncture points and on tender and myofascial trigger points (MTrPs). The reviewed therapeutic effects included pain, grip strength, range of motion (ROM), and weight tests, and were compared by meta-analysis. RESULTS We selected ten articles, and in seven of them the irradiation was conducted on tender points or MTrPs in the experimental groups. In two other articles, the irradiation was conducted on acupuncture points, and the last one was conducted on both kinds of points. Only three articles provided sufficient data for meta-analysis. The results revealed that applying LLLT on tender points or MTrPs is an effective means to improve the effect size (ES) of pain release after treatment (pooled ES: 0.71, 95% CI: 0.82- approximately 0.60) and follow-up (pooled ES: 1.05, 95% CI: 1.16- approximately 0.94). LLLT application was also able to increase the grip force, ROM, and weight test (p < 0.05). CONCLUSIONS We suggest that using LLLT on tender points or MTrPs of LE could effectively improve therapeutic effects.

Therapeutic Outcomes of Low-Level Laser Therapy for Closed Bone Fracture in the Human Wrist and Hand

OBJECTIVE The therapeutic outcomes of low-level laser therapy (LLLT) on closed bone fractures (CBFs) in the wrist and hand were investigated in this controlled study. BACKGROUND DATA Animal research has confirmed that LLLT increases osteocyte quantity; however, little research has been conducted to determine the effect of LLLT on the treatment of human bone fractures. METHODS In this study, the therapeutic outcomes of administering 830 nm LLLT to treat CBFs in the wrist or hand were examined. Fifty patients with CBFs in the wrist and hand, who had not received surgical treatment, were recruited and randomly assigned to two groups. The laser group underwent a treatment program in which 830 nm LLLT (average power 60 mW, peak power 8 W, 10 Hz, 600 sec, and 9.7 J/cm(2) per fracture site) was administered five times per week for 2 weeks. Participants in a placebo group received sham laser treatment. The pain, functional disability, grip strength, and radiographic parameters of the participants were evaluated before and after treatment and at a 2-week follow-up. RESULTS After treatment and at the follow-up, the laser group exhibited significant changes in all of the parameters compared with the baseline (p<0.05). The results of comparing the two groups after treatment and at the follow-up indicated significant between-group differences among all of the parameters (p<0.05). CONCLUSIONS LLLT can relieve pain and improve the healing process of CBFs in the human wrist and hand.

Effect of Low-Level Laser Stimulation on EEG

Conventional laser stimulation at the acupoint can induce significant brain activation, and the activation is theoretically conveyed by the sensory afferents. Whether the insensible low-level Laser stimulation outside the acupoint could also evoke electroencephalographic (EEG) changes is not known. We designed a low-level laser array stimulator (6 pcs laser diode, wavelength 830 nm, output power 7 mW, and operation frequency 10 Hz) to deliver insensible laser stimulations to the palm. EEG activities before, during, and after the laser stimulation were collected. The amplitude powers of each EEG frequency band were analyzed. We found that the low-level laser stimulation was able to increase the power of alpha rhythms and theta waves, mainly in the posterior head regions. These effects lasted at least 15 minutes after cessation of the laser stimulation. The amplitude power of beta activities in the anterior head regions decreased after laser stimulation. We thought these EEG changes comparable to those in meditation.

EFFECT OF INFRARED LED ARRAY STIMULATION ON EEG

Affecting the brainwave by radiating the palm of the tester with a low-level laser array has been proposed in our previous study. The power of alpha rhythms has been increased mainly in the posterior head regions. The effect lasted at least 15 minutes after cessation of the laser stimulation. However, the effect of non-coherent light (Light Emitting Diode, LED) in similar conditions hasn’t been investigated. In this study, a LED array stimulator (6 pcs LEDs, central wavelength 850nm, output power 30mW, operation frequency: 10 Hz) was designed to be the light source. An eyes-open EEG data were recorded during and after stimulation. The experimental results reveal the power of the alpha band has been enhanced with this LED array which operated in 10Hz. Significant activations were found in the parietal lobe、 the occipital lobe and the temporal lobe (p<0.05). The experimental result reveals that LED almost has the same effect obtained from the laser.

The application of laser triangulation method on the blind guidance

A new apparatus for blind-guide is proposed in this paper. Optical triangulation method was used to realize the system. The main components comprise a notebook computer, a camera and two laser modules. One laser module emits a light line beam on the vertical axis. Another laser module emits a light line beam on the tilt horizontal axis. The track of the light line beam on the ground or on the object is captured by the camera, and the image is sent to the notebook computer for calculation. The system can calculate the object width and the distance between the object and the blind in terms of the light line positions on the image. Based on the experiment, the distance between the test object and the blind can be measured with a standard deviation of less than 3% within the range of 60 to 150 cm. The test object width can be measured with a standard deviation of less than 1% within the range of 60 to 150 cm. For saving the power consumption, the laser modules are switched on/off with a trigger pulse. And for reducing the complex computation, the two laser modules are switched on alternately. Besides this, a band pass filter is used to filter out the signal except the specific laser light, which can increase the signal to noise ratio.

An improved arterial pulsation measurement system based on optical triangulation and its application in the traditional Chinese medicine

An improved arterial pulsation measurement (APM) system that uses three LED light sources and a CCD image sensor to measure pulse waveforms of artery is presented. The relative variations of the pulses at three measurement points near wrist joints can be determined by the APM system simultaneously. The height of the arterial pulsations measured by the APM system achieves a resolution of better than 2 μm. These pulsations contain useful information that can be used as diagnostic references in the traditional Chinese medicine (TCM) in the future.

Clinical Effects of Laser Acupuncture plus Chinese Cupping on the Pain and Plasma Cortisol Levels in Patients with Chronic Nonspecific Lower Back Pain: A Randomized Controlled Trial

Objectives Chronic nonspecific lower back pain (LBP) is a common disease. Insufficient data is currently available to conclusively confirm the analgesic effects of laser acupuncture on LBP. This study evaluated the effectiveness of laser acupuncture plus Chinese cupping in LBP treatment. Methods Patients with chronic nonspecific LBP were enrolled for a randomized controlled trial and assigned to the laser acupuncture group (laser acupuncture plus Chinese cupping) and control group (sham laser plus Chinese cupping). Laser acupuncture (808 nm; 40 mW; 20 Hz; 15 J/cm2) and Chinese cupping were applied on the Weizhong (BL40) and Ashi acupoints for 5 consecutive days. Plasma cortisol levels were assessed before and after the 5-day treatment session. The visual analog scale (VAS) scores were recorded at baseline and throughout the 5-day treatment session. Results After the treatment session, the plasma cortisol levels and VAS scores decreased significantly in both groups. In the laser acupuncture group, the VAS scores decreased significantly on days 4 and 5, and an enhanced reduction in VAS scores was observed. Conclusion Laser acupuncture plus Chinese cupping at the Weizhong (BL40) and Ashi acupoints effectively reduced pain and inflammation in chronic nonspecific LBP. This therapy could be a suitable option for LBP treatment in clinical settings.