QUESTIONS
1. One of the following statements is not correct. Indicate the incorrect statement:
(a) Low level laser therapy (LLLT) has analgesic, vasodilatory and anti-inflammatory properties.
(b) An infra-red laser, emitting at a wavelength of 904 nM, would be classed as an infra-red laser.
(c) LLLT greatly enhances the healing of wounds and burns.
(d) LLLT gives adverse effects in periostitis.
(e) LLLT is very effective in treating superficial Trigger Points (TPs)
2. One of the following statements is not correct. Indicate the incorrect statement:
(a) LLLT gave excellent long term results in severe equine tendon strain
(b) LLLT reduced joint pain in humans but did not significantly reduce arthritic swelling of human finger joints.
(c) When combined with a knowledge of the acupuncture (AP) system, LLLT was value in the treatment of myofascial syndromes in dogs and humans.
(d) LLLT was about 10% less successful than AP in treating equine myofascial problems.
(e) LLLT gave poor results in serious spinal pathology
3. One of the following statements is not correct. Indicate the incorrect statement:
(a) The history, theoretical uses and physics of laser are discussed in detail in Pontinen's textbook (1995).
(b) LLLT is gaining acceptance in conventional veterinary practice as a therapy for tissue trauma, wounds, granuloma, myositis, tendinitis etc.
(c) Cold (soft) lasers are available as robust, portable instruments, operated by batteries or by mains electricity.
(d) Russian and German workers have used LLLT at the human AP points for many years.
(e) LLLT is clinically far superior to needles in veterinary acupuncture (AP)
4. One of the following statements is not correct. Indicate the incorrect statement:
(a) Though laser light is emitted in a continuous wave (cw) beam, it can be interrupted (modulated) at variable frequencies and intervals by mechanical or electronic means. Interruption of the light beam at fixed intervals is called pulsing.
(b) Lasers with MOP = 50 mW need 5 times less irradiation time/session that those with MOP = 5 mW
(c) Pulsed lasers, especially those interrupted 2000-10000 times/second (Hz), penetrate deeper in tissue than unpulsed lasers.
(d) In LLLT, total treatment time/session depends on mean output power (MOP) and the depth of the point.
(e) Superficial points need less irradiation time than deeper points.
5. In relation to advantages of LLLT over needling or point injection in AP or TP therapy, one of the following statements is not correct. Indicate the incorrect statement:
(a) LLLT is aseptic, non-invasive, painless and, if used properly, has no reported side-effects.
(b) LLLT is ideal for use on painful (AhShi) points or in nervous or difficult animals. Children and cats tolerate LLLT very well.
(c) LLLT may be used safely on dangerous points in large animals (such as points below the carpus and tarsus of cattle and horses).
(d) LLLT is ideal for treatment of superficial AP points, such as those on the ear.
(e) Paravertebral AP points which give no clinical response to needling frequently respond to LLLT
6. One of the following statements is not correct. Indicate the incorrect statement:
(a) LLLT is usually given on 2-8 occasions, at intervals of 1-3 days in acute cases.
(b) LLLT is usually given on 2-8 occasions, at intervals of 3-7 days in chronic cases.
(c) At each session, the laser is applied over or around the rim of the lesion and to each of the APs or TPs selected for the case.
(d) In a busy clinical practice, lasers with MOP = 1-3 mW are preferable to those with MOP = 30-60 mW.
(e) As it can be used for deep massage also, the ideal veterinary laser for LLLT has a strong metallic probe, with the diode- shield set back about 0.5 cm from the probe-tip.
7. One of the following statements is not correct. Indicate the incorrect statement:
(a) LLLT can be used alone, or in combination with other therapy.
(b) If systemic signs are present, the relevant APs were treated also, for example in a case of chicken-pox, LLLT was applied to points GV14; LI04,11; ST36 (for their effect on fever and the immune system), as well as to the pruritic lesions.
(c) LLLT has no clinical value in localised dermatitis or lick-granuloma.
(d) LLLT had marked clinical effect in equine, human and canine muscle pain/lameness, especially paravertebral pain (cervical, thoracic, lumbar or sacral) and pain of limb muscles (scapula, arm, forearm, thigh, gluteals, gastrocnemius).
(e) In dogs and people, results of LLLT were similar to those using simple AP, electro-AP or point injection in similar cases over the previous few years.
8. One of the following statements is not correct. Indicate the incorrect statement:
(a) LLLT in horses, in which TPs can be 7-12 cm deep, took 1-3 sessions more to attain clinical success than with earlier AP methods.
(b) Human Grade 1 and canine Grades 1-3 "thoracolumbar disc disease" are good indications for LLLT, possibly combined with AP at TPs plus BL23, GB34 bilateral, plus GV03.
(c) Injury to the equine flexor tendon sheath (but with the tendon intact) is a very poor indication for LLLT.
(d) When used 3-6 times in 1-4 weeks on about 8 points along each surface of the tendon (lateral, posterior and medial), concentrating especially on the bowed or swollen area, and on LI04,11 and Thoresen's Ting points (PC09, LU11, HT09), LLLT often reduced the bow in chronic bowed tendons within 2-4 weeks.
(e) Superficial swellings on flexor tendons, treated by LLLT, can regress sufficiently to pass a standard veterinary inspection within 2 weeks
9. One of the following statements is not correct. Indicate the incorrect statement:
(a) In the acute (hot, painful) stage of equine and human periostitis (splint, spavin, bucked shins etc), LLLT (locally and on the Ting Points) every 1-2 days took more than 14 days to resolve the pain.
(b) LLLT is very useful in human shin splint and epicondylitis
(c) LLLT was useful in abrasions, cuts, burns, wounds, pruritic lesions (chicken-pox), facial herpes, retro- and para-scrotal wet eczema
(d) LLLT was useful in resolving postsurgical suture-line infection
(e) Clinical results in acute cases in humans were dramatic, with relief of pain or pruritus and marked anti-inflammatory effect within 1-3 days and excellent healing within 7-14 days. In chronic cases, healing was slower but was markedly enhanced.
10. Trelles et al 1987 reviewed the use of LLLT. The stimulus was applied mainly to local lesions. One of the following statements is not correct. Indicate the incorrect statement:
(a) LLLT had biostimulatory effects (reparative effects in ulcers, granulomas, burns, septic wounds and trauma to superficial tissues (tendon, bursa, sheath, joint and muscle)
(b) LLLT had no analgesic, antiexudative or anti-haemorrhagic effect
(c) LLLT stimulated local cell metabolism in damaged tissues in vivo and in vitro (mitosis, local DNA and protein synthesis, local phagocytosis, antibody formation and activity of local tissue enzymes (succinyl- and lactate- dehydrogenase, acid phosphatase, non-specific esterase).
(d) LLLT enhanced scar formation and tissue regeneration (wounds, ulcers of skin and portio uteri), enhanced mitogenic activity (cell proliferation), enhanced osteogenic activity (in bone fractures, arthritis, osteomyelitis),
(e) LLLT had anti-inflammatory effect (in herpes lesions, urethritis, haemorrhoids, sinusitis etc); it had anti-neuralgic, anti-oedematous, antiseptic, anti-spasmodic (in muscle injury) and vasodilatory effect (in local disorders, organic disorders and alopecia areata).