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Background: Carpal tunnel release (CTR) is widely accepted as an effective treatment for carpal tunnel syndrome. However, the recovery is often delayed and incomplete. Photobiomodulation therapy (PBMT) produces a nonthermal effect on living tissues; it promotes healing, remodels and reduces inflammation of an injured nerve. The purpose of this study was to compare the outcome of CTR between patients who underwent postoperative PBMT and without PBMT. Materials and methods: We recruited 105 patients who had open CTR from January 2019 to January 2021. Fifty-six patients fulfilled the study criteria and were randomized into two groups: with PBMT ( n  = 28) and without PBMT ( n  = 28). Demographic and clinical data were obtained preoperatively. The PBMT group had ten 3-min sessions over 3 weeks using 808 nm, 50 mW PBMT to deliver 9 J per session to the CTR incision scar. Clinical outcomes were assessed at 1, 3, and 6 months postoperatively. Data analysis was performed with SPSS software. Results: There were significant improvements in the Functional Status Scale in the Boston Carpal Tunnel Questionnaire ( p  = 0.018) and pain (visual analogue scales) in the morning ( p  = 0.019) at 1 month postoperatively in the PBMT group compared with the non-PBMT group. Improvement of tip pinch strength at 3 months ( p  = 0.022) and 6 months ( p  = 0.024), lateral pinch strength at 1 month ( p  = 0.042) and 3 months ( p  = 0.05), and tripod pinch strength at 3 months ( p  = 0.005) was significantly better in the PBMT group. Thumb 2-point discrimination (2PD) at 3 months ( p  = 0.018) and 6 months ( p  = 0.016) and index finger 2PD at 3 months ( p  = 0.039) were also significantly improved in the PBMT group. There were no side effects of PBMT reported. Conclusions: Patients who underwent PBMT post-CTR had better outcomes. PBMT may be a valuable adjunct to post-CTR care.

Objective: To investigate effect of photobiomodulation (PBM) on nerve regeneration after neurotization with the Oberlin Procedure (ulnar fascicle to motor branch to biceps) to restore elbow flexion in patients with brachial plexus injury. Materials and methods: This prospective randomized controlled trial was conducted with 14 patients with high brachial plexus injury who underwent neurotization with the Oberlin Procedure to restore elbow flexion. The patients were randomly allocated to two groups of equal numbers: control group and PBM group. In this study, the PBM used has a wavelength of 808 nm, 50 mW power, continuous mode emission, 4 J/cm 2 dosimetry, administered daily for 10 consecutive days, with an interval of 2 days (weekends). The outcome of surgery was assessed after 1, 2, 3, and 6 months. The nonparametric Mann-Whitney U -test and chi-square test were utilized to compare the results between both groups. Results: After 3 months postoperatively, more patients in the PBM group had demonstrated signs of reinnervation and the mean muscle power was significantly higher in the PBM group. No adverse effects resulted from the administration of PBM. Conclusions: PBM is a treatment modality that can improve nerve regeneration after neurotization with the Oberlin Procedure.

Objectives: The study aims to assess, evaluate, and compare the efficacy of acupressure and hypnotherapy in the management of pain in patients presenting with chronic brachial neuralgia (CBN). Design: Randomized controlled trial. Settings/location: Department of Orthopaedic Surgery, University Malaya Medical Centre, Kuala Lumpur, Malaysia. Subjects: Forty patients with CBN following traumatic brachial plexus injury from 2012 to 2017. Intervention: Therapy for a duration of 1 month in two groups; subjects in the hypnotherapy group received a weekly session of clinical hypnotherapy (total of four times) using a standardized protocol, while subjects in the acupressure group were guided by an acupuncturist during the initial session, received 2 month take home supply of acupressure patches, and were reviewed fortnightly. Outcome measures: The Visual Analog Scale, the Brief Pain Inventory, and the SF-36v2 ® Health Survey were recorded at different time points; 1 month pretreatment (week 0), pretreatment (week 4), post-treatment (week 8), and 4 months post-treatment (week 20). Results: There was a statistically significant improvement in the average pain intensity from pretreatment to post-treatment score in both groups. The pain intensity increased 4 months later; however, the pain intensity was still significantly reduced in comparison with pretreatment scores. The study suggests that both treatment outcomes are effective in terms of alleviating pain and improving quality of life in subjects with CBN, to a different degree. Conclusion: Overall, both therapies were able to improve the pain intensity and quality of life significantly during the treatment period. Hypnotherapy was observed to have a better carryover effect compared to acupressure, especially in terms of improving quality of life and the mental component score.

Objective: The purpose of this study was to review studies of photodynamic therapy (PDT) on wound healing and cells in vitro, to assess the effects of such therapy., Background Data: PDT is used to treat tumors. When activated by light of a specific wavelength, the photosensitizer produces reactive oxygen species (ROS) that kill tumor cells. Low levels of ROS may induce cellular proliferation., Methods: Research articles investigating PDT on wound healing and cells in vitro published up to August 2010 were retrieved from library sources, PubMed and Medline databases, reference lists of articles, and searches of relevant journals., Results: The studies indicated that use of various photosensitizers combined with laser irradiation led to improved wound outcomes. For most in vitro studies, there was a decrease in cell growth or viability., Conclusions: PDT improved healing outcomes in several animal wound models, but mainly had an inhibitory effect on cells in vitro. These findings strongly support PDT for wound healing.

Aim: The aim of this paper was to review experimental studies of laser irradiation of human and animal cells in culture to assess the photobiomodulatory effects of such irradiation on gene expression and release of growth factors and CYTOKINES., Background: Previous studies have reported that the release of certain growth factors and cytokines by various types of cells can be modulated by laser irradiation. A review of recent studies may provide further insight into the clinical effects brought about by laser irradiation of cells and tissues, including changes in inflammation and cellular proliferation., Methods: A systematic review was completed of original research papers investigating the effects of laser phototherapy on gene expression and release of these mediators from human and animal cells in culture (January 2002 to September 2009). Relevant papers were retrieved primarily from PubMed and Medline databases. The search terms were "growth factors", "cytokines", "laser therapy", "laser irradiation", "laser phototherapy," and "phototherapy"., Results: A total of 17 relevant papers were included in the review, comprising studies on a variety of cell types. Considerable variation occurred in research design, methodology, and irradiation parameters employed, limiting comparison of research findings between studies. Results demonstrated that laser irradiation at green, red, or infrared wavelengths at a range of dosage parameters can cause significant changes in the cellular gene expression and release of these mediators, and that such effects depend upon wavelength and radiant exposure., Conclusion: Findings from the reviewed studies clearly demonstrate the ability of laser irradiation to modulate gene expression and the release of growth factors and cytokines from cells in culture. Further work is indicated at the clinical level to elucidate the putative clinical relevance of these cellular-level effects.

Objective: To develop a suitable method for dressing skin wounds in BKS.Cg-m(+)/(+)Lepr(db) mice for subsequent use in laser irradiation of wounds. The healing of nonirradiated wounds (controls) was examined histologically to provide essential reference data., Background Data: Dressing excisional skin wounds in mice has many advantages. However, previous studies using dressings such as Tegaderm W or OpSite, with or without adhesives, have shown that this is not easily achieved., Materials and Methods: In a pilot study, a full-thickness wound was made on the left flank in six diabetic and six nondiabetic mice, and five different methods were tried for dressing the wounds with Tegaderm HP to develop an optimized procedure. The optimized procedure was used in subsequent studies, with a total of 23 diabetic and 13 nondiabetic mice being controls for laser-irradiated mice. Measurements of healing outcomes from histologic sections of controls were statistically analyzed., Results: The optimized procedure used Tegaderm HP with Cavilon and Fixomull Stretch strips for the first dressing, and with Mastisol for subsequent dressings. Wound closure by contraction was retarded in a large proportion of diabetic mice (approximately 80%) and a small proportion of nondiabetic mice. These wounds, described as "splinted," healed mainly by epithelial regeneration and granulation tissue formation., Conclusion: A simple, easy-to-perform procedure was developed for dressing wounds in diabetic and nondiabetic mice. It was found to cause splinting with wound healing mimicking that in human patients. This model is suitable for examining the effects of different therapies on wound healing, including lasers.

Aim: The aim of this article was to review experimental studies of laser irradiation of human and animal cells in culture to assess the photobiomodulatory effects of such irradiation., Background: Previous studies have shown that various types of cells respond differently to laser irradiation, depending on irradiation parameters. Cellular outcomes measured or examined include cell numbers, cell viability, and ultrastructural features. A review of these studies may provide a further insight into the clinical effects brought about by laser light on cells and tissues, including laser effects in wound healing and repair of nerves and skeletal muscle after injury., Methods: A systematic review was completed of original research articles investigating the effects of laser therapy on human and animal cells in culture (January 2002 to September 2009). Relevant articles were primarily sourced from PubMed and Medline by using EndNote X1, and from secondary searches. Search terms were "cell proliferation," "laser therapy," "laser irradiation," "laser phototherapy," and "phototherapy.", Results: In total, 46 relevant articles were included in the review, comprising work completed on a variety of cell types. Although results consistently demonstrated the potential of laser irradiation to affect cellular proliferation in a wavelength- and dosage-dependent manner, the relevance of other key irradiation parameters, such as irradiance, to such effects remained unclear., Conclusions: Findings from studies of cells in culture clearly demonstrate the ability of laser irradiation to modulate (typically stimulate) cellular proliferation. The relevance of some irradiation parameters remains occult and represents an important area for further research.

Objectives: This investigation reviewed experimental studies of laser irradiation of wound healing in mice and rats published from 2003 to August 2008, respectively, to assess putative stimulatory effects of this treatment., Background: Animal models, including rodents, attempt to reflect human wound healing and associated problems such as dehiscence, ischemia, ulceration, infection, and scarring. They have played a key role in furthering understanding of underlying mechanisms involved in impaired wound healing, and in testing new therapeutic strategies including laser irradiation., Method: Original research papers investigating effects of laser or monochromatic light therapy on wound healing in mice and rats and published from January 2003 to August 2008 were retrieved from library sources, PubMed and Medline databases, reference lists from retrieved papers, and hand searches of relevant journals. Papers were selected for this review with regard to specific inclusion and exclusion criteria. Studies were critically reviewed in terms of study design, methodology, and appropriateness of laser irradiation parameters., Results: The literature search identified eight studies in mice and 39 in rats. A variety of wound models were investigated, including acute-wound, impaired-healing, and chronic-wound models. Considerable variation was observed in research design, methodology, and irradiation parameters employed, limiting comparison of research findings between studies. Inadequate reporting of key experimental details, or errors in specification and/or calculation of key irradiation parameters was also found. Evidence from the studies reviewed suggested that use of red or infrared wavelength at a range of dosage parameters (median 4.2 J cm(-2)) results in significant benefits in measured parameters of wound healing. Interestingly, coherence does not seem essential to the photobiomodulatory effects of 'laser' phototherapy., Conclusion: Studies reviewed consistently demonstrated the ability of laser or monochromatic light to photobiomodulate wound healing processes in experimental wounds in rats and mice, and strongly support the case for further controlled research in humans.

Objective: The aim of this investigation was to compare the healing of laser-irradiated and non-irradiated wounds covered by an occlusive dressing in mice., Background Data: Many previous studies of the effects of laser irradiation of experimental wounds in mice and rats did not cover the wounds so that healing occurred mainly by contraction. Healing of covered wounds is slower and mimics more closely wound healing in humans., Materials and Methods: Forty-seven diabetic and twenty non-diabetic mice were used. A single wound (5 mm diameter) was created on the left flank of each animal and covered by Tegaderm HP dressing (Day 1). Wounds were irradiated (660 nm) for 20 s using a lower power (18 mW) or higher power (80 mW) laser starting immediately post-wounding for seven consecutive days (0.36 or 1.6 J/day); untreated wounds served as controls. Animals were euthanized on Day 8, 10, or 14. Wound specimens were cut and stained using haematoxylin and eosin, and picrosirius red, and examined by microscopy., Results: Results confirmed that wound healing was impaired in diabetic mice. Analysis of the data demonstrated that Tegaderm HP dressing had retarded contraction (splinted the wounds) in a large proportion of diabetic mice and, to a lesser extent, in non-diabetic mice. Healing of splinted wounds was delayed compared to unsplinted wounds, but laser irradiation (1.6 J/day, 7 days) stimulated healing by re-epithelization and granulation tissue formation., Conclusion: These are the first findings of laser-mediated stimulation of healing in splinted wounds. Further studies are needed to assess the effects of different constellation sets of laser parameters in this wound model.