The Effect of Photobiomodulation on Bone Mineral Density, Serum Vitamin D, and Bone Formation Markers in Individuals with Complete Spinal Cord Injuries with Osteoporosis.

Esmaeil Mohammadzadeh, Aref Hosseinian Amiri, Reza Fekrazad, Rainer A Leitgeb, Winfried Mayr, Kamran Ezzati
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Abstract

Study design: A quasi-experimental study utilized a matched-pair design, administering photobiomodulation at four-sites on one side of the body and assigning control to the other side at corresponding sites. Objectives: This study aimed to assess photobiomodulation treatment effects on bone mineral density (BMD) measurement using dual-energy X-ray-absorptiometry in individuals with complete spinal cord injury (C.SCI) and osteoporosis. Methods: Eight patients received treatment at four-sites: forearm-mid-distal (MID), proximal-femur, distal-femur, and proximal-tibia, totaling 32 sites. Using an 830 nm gallium-aluminum-arsenide semiconductor laser irradiation was administered three times weekly for 8 weeks. Different doses (energy density) were determined depending on bone depth from skin surface, as assessed by sonography and adjusted through irradiation time to be 8, 10, and 12 J/cm2 for depths <1 cm, between 1 and 1.5 cm, and >1.5 cm, respectively, using 200 mW power to deliver the optimal isodose of laser at each depth of bone within each therapeutic site. BMD was measured at baseline, week 8 of treatment, and week 15 of follow-up. Serum 25-(OH)-vitamin D and bone formation markers including osteocalcin and bone-alkaline-phosphatase (B-ALP) were also assessed at baseline and week 8 of treatment. Results: Significant increases in BMD were noted in proximal-femur and forearm-MID at both week 8 and week 15. Serum 25-(OH)-vitamin D levels significantly increased after treatment. However, no notable changes were observed in distal-femur and proximal-tibia BMD or in osteocalcin and B-ALP levels. Conclusions: Photobiomodulation (830 nm) laser demonstrated efficacy in improving BMD at proximal-femur and forearm-MID in individuals with C.SCI. Moreover, the observed positive influence on vitamin D levels suggests a potential photobiomodulation role, warranting further investigation.

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光生物调节对完全性脊髓损伤伴骨质疏松症患者的骨矿物质密度、血清维生素 D 和骨形成标志物的影响。
研究设计:准实验研究采用配对设计,在身体一侧的四个部位进行光生物调节,并在另一侧的相应部位进行对照。研究目的本研究旨在评估光生物调节治疗对完全性脊髓损伤(C.SCI)和骨质疏松症患者使用双能 X 射线吸收测量法测量骨矿密度(BMD)的影响。治疗方法八名患者接受了四个部位的治疗:前臂-中远端(MID)、近端-股骨、远端-股骨和近端-胫骨,共 32 个部位。使用 830 纳米镓铝砷化半导体激光器进行照射,每周三次,持续 8 周。根据超声波检查评估的距皮肤表面的骨深度确定不同的剂量(能量密度),并通过照射时间将深度为 1.5 厘米的骨深度分别调整为 8、10 和 12 J/cm2,使用 200 mW 功率在每个治疗部位的每个骨深度提供最佳等剂量激光。在基线、治疗第 8 周和随访第 15 周时测量 BMD。血清 25-(OH)-vitamin D 和骨形成标志物(包括骨钙素和骨碱性磷酸酶 (B-ALP))也在基线和治疗第 8 周时进行了评估。结果显示在治疗第 8 周和第 15 周时,近端-女性和前臂-MID 的 BMD 均有显著增加。治疗后,血清 25-(OH)-vitamin D 水平显著增加。但是,远端-股骨和近端-胫骨的 BMD 以及骨钙素和 B-ALP 水平均未出现明显变化。结论光生物调节(830 nm)激光在改善 C.SCI 患者的近端-股骨和前臂-MID 的 BMD 方面具有疗效。此外,观察到的对维生素 D 水平的积极影响表明,光生物调节具有潜在的作用,值得进一步研究。
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期刊介绍: Photobiomodulation, Photomedicine, and Laser Surgery Editor-in-Chief: Michael R Hamblin, PhD Co-Editor-in-Chief: Heidi Abrahamse, PhD
期刊最新文献
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