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4. Increased fibroblast proliferation. Light therapy stimulation increases fibroblast numbers and fibroblast-mediated collagen production.viii 5. Keratinocyte proliferation. The beneficial synthesis activities and growth factor ability of keratinocytes are enhanced by proliferation secondary to light therapy.ix 6. Early epithelialization. Laser-stimulated acceleration of epithelial cell regeneration speeds up wound healing, minimizes scarring, and reduces infection opportunities. 7. Growth factor increases. Two to five fold increases in growth-phase-specific DNA synthesis in normal fibroblasts, muscle cells, osteoblasts and mucosal epithelial cells irradiated with IR light are reported. Increases in vascular endothelial growth factor (VEGF) and fibroblast growth factor (FGF-2) secondary to infrared light irradiation have also been reported. 8. Enhanced cell proliferation and differentiation. Infrared-induced increases in Nitric Oxide, ATP and other compounds that stimulate higher activity in cell proliferation and differentiation into mature cells. Increased numbers of myofibroblasts, myofibrils, myotubules etc., as well as bone cell proliferation, have been clinically documented after light therapy. Satellite cells, the precursor cells in the process of muscle regeneration, show significant increase in proliferation when irradiated with light therapy.x,xi,xii 9. Greater healed wound tensile strength. In both soft tissue and connective tissue injuries, light therapy can increase the final tensile strength of the healed tissue. By increasing the amount of collagen production/synthesis and by increasing the intra and inter-molecular hydrogen bonding in the collagen molecules, laser therapy contributes to improved tensile strength.xiii,xiv,xv,xvi The preceding effects combine to achieve an accelerated healing rate. The time from onset of injury to mature healed wound is reduced.xvii Light Therapies and Soft Tissue Healing Numerous studies have been conducted which demonstrate the effectiveness of infrared light on soft tissue healing. LED produced in vitro increases of cell growth of 140-200% in mouse- derived fibroblasts, rat-derived osteoblasts, and rat-derived skeletal muscle cells, and increases in growth of 155-171% of normal human epithelial cells. Wound size decreased up to 36% in conjunction with HBO in ischemic rat models.xviii A clinical study was performed on 74 patients with injuries to the following anatomic locations: ankle and knee, bilaterally, Achilles tendon; epicondylus; shoulder; wrist; interphalangeal joints of hands, unilaterally. All patients had had surgical procedure prior to infrared light. Comparison of the healing process between two groups of patients obtained the following results: wound healing was significantly accelerated (25%-35%) in the group of patients treated with infrared light.xix In another study, forty-seven soccer players with second degree ankle sprains were selected at random and divided into three groups: treatment with the conventional initial treatment (RICE, rest, ice, compression, and elevation), treatment with the RICE method plus placebo laser, and the third group treated with the RICE method plus an 820-nm GaA1As diode laser. The laser + RICE group showed statistically significantly edema reduction compared to controls at 24, 48 and72 hours.xx Finally, a review of 9 separate placebo controlled trials measuring pain and range of motion scores in tendinopathies showed an average 32% improvement in treated over untreated.xxi Light Therapies and Bone Healing Studies of bone healing response to infrared light show acceleration of osteoblast formation as well as calcium salt deposition under the influence of infrared light.xxii,xxiii Studies have demonstrated that bone growth factors are stimulated by IR light. Osteoglycin is a small leucine-rich proteoglycan (SLRP) of the extracellular matrix which was previously called the osteoinductive factor. SLRP are abundantly contained in the bone matrix, cartilage cells and connective tissues, and are thought to regulate cell proliferation, differentiation and adhesion in close association with collagen and many other growth factors. In osteoblastic cells the osteoglycin/mimecan gene was upregulated 2.3-fold at 2 h after exposure to infrared light.xxivPDF Image | Mechanisms of Action for Infrared Light on Tissue Healing
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