Utilization of the 1064 nm Wavelength in Photobiomodulation: A Systematic Review and Meta-Analysis

Abstract

Introduction: Photobiomodulation or low-level laser therapy (LLLT;<0.5 W) has been used as a non-invasive treatment for various medical indications. Short (visible; 635-650 nm) and longer (invisible; 810-850 nm and 915-980 nm) near-infrared wavelengths have been commonly used, but power setting deficiencies or incorrect wavelength settings can cause negative outcomes. The 1064 nm wavelength as the longest wavelength is a relative newcomer in high-powered (>0.5 W) laser photobiomodulation therapy (HPL-PBMT) with unique biophysical characteristics. Methods: A comprehensive search of 2016-2021 PubMed, Google Scholar, and Cochrane databases for "photobiomodulation" restricted to clinical trials for patients with a medical diagnosis was done. "1064 nm" content was identified and restricted to high-powered lasers (>0.5 watt). Cohen’s d was calculated for the effect size and the difference was determined as a measure of relative 1064 nm HPL-PBMT efficacy. Results: The 22 independent studies meeting inclusion criteria focused on knee arthropathies, spine, shoulder/elbow, wound, gynecological, or osteoporosis with evaluation of pain, function, quality of life, range of motion (ROM), and anatomy. Pain was reduced with statistical significance (P<0.05) in 90% of study assessments (n=20) and 100% of studies focused on the knee (n=6). Of 18 studies assessing functional outcome measures, 100% demonstrated statistically significant improvements. Follow-up assessments up to 6 months in 5 knee arthritis studies revealed long-term pain reduction after cessation of treatment. Improvements in wound healing, bone mineral density, and knee cartilage thickness were demonstrated. The largest effect sizes observed were pain reduction in knee arthritis (average Cohen’s d effect size=2.46). Conclusion: These studies have established that 1064 nm HPL-PBMT can effectively reduce pain, increase ROM, increase functional scores, and increase the quality of life for knee osteoarthritis and spinal disorders, with limitations. More studies are needed for clinical validation of single-trial data detecting changes in musculoskeletal conditions, cartilage thickness and bone density.

Effects of Photobiomodulation on Pain and Return to Play of Injured Athletes: A Systematic Review and Meta-analysis

“…According to Tripodi et al (54), there was a positive, substantial effect for reduction in pain in tendinopathy groups that completed PBM with exercise when compared with groups that completed sham PBM with exercise. Penberthy and Vorwaller (45) found a large effect for reduction in pain and improved functional outcome measures when using PBM at 1,064 nm. A systematic review by Vanin et al (56) found a positive, moderate effect of PBM on exercise performance (i.e.,—strength, power, and endurance) and muscular fatigue in healthy individuals during exercise when compared with a placebo group.…”

Clinical Efficiency of High-Intensity Laser Therapy in Patients With Cervical Radiculopathy

“…Because HILT provides more intense energy to deeper tissues than low-intensity laser therapy, its ability to repair damaged tissues and eliminate painful stimuli is more obvious 8 . A comprehensive meta-analysis reported that spinal disorders can be effectively treated with a high-intensity 1064-nm laser 24 . In a study on patients with chronic neck pain, Alayat et al 25 determined that HILT + EX increased the cervical ROM and significantly reduced VAS and the NDI compared with PL + EX.…”

“…8 A comprehensive meta-analysis reported that spinal disorders can be effectively treated with a high-intensity 1064-nm laser. 24 In a study on patients with chronic neck pain, Alayat et al 25 determined that HILT + EX increased the cervical ROM and significantly reduced VAS and the NDI compared with PL + EX. In another study on patients with chronic low back pain, HILT + EX was superior to HILT alone and PL + EX regarding pain and functionality.…”

1064nm Nd:YAG laser promotes chondrocytes regeneration and cartilage reshaping by upregulating local estrogen levels

“…Several hypotheses have been put forward to explain the primary responses following the absorption of laser light, including singlet oxygen hypothesis, redox property alteration hypothesis, nitric oxide hypothesis, transient local heating hypothesis, transient local heating hypothesis, and superoxide anion hypothesis [40,41]. Moreover, laser irradiation can activate components of the mitochondrial respiratory chain, initiate cell signaling, and promote a cascade of cellular proliferation and protective responses [42]. This leads to changes in the synthesis of DNA, RNA, proteins, and enzymes, or alterations in cell membrane properties, ultimately resulting in enhanced proliferation or differentiation of chondrocytes [43,44].…”