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# Calculating LLLT Dosage

There has been a lot of discussion about the best method to quantify LLLT dosage.
However, it is my opinion that:
1. There is no agreed method of defining beam area
2. Dosage expressed as J/cm² is inadequate

No agreed method for measuring LLLT dosage
So beam area is hard to define and there is no agreement in our industry for defining it. [I
propose 1/e2 - will explain this soon].

Dosage expressed as J/cm² is inadequate
"Dosage" is usually calculated as Power / Beam Area x Time = J/cm². However, to consider
that dosage should equal J/cm² is, in my opinion, inadequate.
Let me explain:
Assume there is a well-defined beam area and thus a quantifiable dosage.

A 500mW laser with a beam area of 0.25Cm2 used for 20 seconds
delivers 40 J/cm²

A 200mW laser with a beam area of 0.1Cm2 used for 20 seconds
delivers 40 J/cm²

A 30mW laser with a beam area of 0.015Cm2 used for 20 seconds
also delivers 40 J/cm²

Each of these probes apparently apply the same "dosage". However, the total energy
delivered is clearly different [10 Joules, 4 Joules and 0.6 Joules respectively]. While dosage
appears consistent using J/cm², I suggest that the clinical results would be quite diverse. So
I say that J/cm² is an inadequate method of expressing dosage.

Carroll JD BACKGROUND: Dose and beam parameters are critical for successful laser. however. LED.Calculating the area of an laser beam should be simple: But laser beams are rarely round: Area of a circle = Area of a circle = r² And laser beams are rarely of uniform density: r1r2 Some diode laser beams appear very distorted Where is the edge of the beam? What is the beam area? How to Report Low-Level Laser Therapy (LLLT) / Photomedicine Dose and Beam Parameters in Clinical and Laboratory Studies Jenkins PA. and further confounds an already complex subject. in our experience. This makes reproducibility impossible. OBJECTIVE: This article is intended to be a reference document for non-physicist researchers conducting low-level laser therapy (LLLT) laboratory studies and clinical trials to help them design and report the beam and dose aspects of their trials. and no reported verification of beam parameters. researchers frequently make critical errors and omissions when submitting papers for publication. . Journals frequently publish studies with missing data. and other light therapy treatments. mathematical errors.

and the patient gets better more quickly. CONCLUSION: Reviewers should insist that the minimum eight most important beam parameters are included and authors should take care to measure and record these accurately before during and after an experiment or clinical trial. and energy density. this should be checked routinely during an experiment/trial. delivered to the target tissues for an appropriate period of time (typically between 30 . Low Level Laser Therapy (LLLT) of the correct wavelength and density. application technique (contact. Beam power often decreases as the device warms up and as the device ages. irradiation time. and interval between treatments. This competitively displaces oxygen from cytochrome c oxidase consequently reducing ATP (an essential intracellular cellular energy and extracellular signalling molecule) and causing an over production reactive oxygen species (ROS) and leading to oxidative stress. injury or ageing) the mitochondria produces nitric oxide (NO). Pulses can improve tissue repair and anti-inflammatory effect. projection. Once normal mitochondrial function is restored by LLLT then cell metabolism is improves. scanning. The effect depend on the application of the correct wavelength and density of light. pressure). after. as these may also be considered important. Low Level Laser Therapy (LLLT) has a photochemical effect (like photosynthesis in plants). therefore. number of treatments. Power measurements should be taken before. more thorough reporting would include coherence. Oxidative stress is well known to lead to inflammation an cell death via the gene transcription factor NF-Kb. energy. dissociates NO allowing oxygen back in. pulse parameters. . TISSUE REPAIR AND ANTI-INFLAMMATORY EFFECTS The primary effect occurs when light is absorbed in cytochrome c oxidase a protein within the mitochondria. power. One of the main mechanisms of action occurs in the mitochondria (the cellular power plant inside every cell). beam area at the skin or culture surface (this is not necessarily the same as the aperture size).RECOMMENDATIONS: It provides a checklist to help LLLT researchers understand and report all the necessary parameters for a repeatable scientific study. When cells get stressed (perhaps due to disease. analgesia is best achieved with a continuous beam. and spectral width. The three commonly used dose parameters are time. so ATP is restored and oxidative stress reduced. beam profile.60 seconds). It includes the eight most important beam parameters to report. In addition. anatomical location. Measurements of beam area and beam power require special instruments and trained technicians to operate them. which are: wavelength. and at frequent intervals during research trials.