UNDERSTANDING LASER THERAPY TERMINOLOGY
Even with this declaration from the laser therapy organisations, a variety of terms continue to be used and confusion remains. The key point is that laser therapy, no matter the terminology used, affects the body through a process called photobiomodulation (PBM). “PBM is the mechanism by which nonionizing optical radiation in the visible and near-infrared spectral range is absorbed by endogenous chromophores to elicit photophysical and photochemical events at various biological scales without eliciting thermal damage.” 3 It is a mechanism that leads to “physiological changes and therapeutic benefits.” 3 While both high and low power lasers can deliver photobiomodulation therapy, it is important to note that high power lasers are differentiating themselves from their low power counterparts. Higher power lasers can deliver more light energy to deeper target tissues, and recent studies demonstrate that these devices can give patients better results than those treated with a low power laser for certain conditions. 3,4,5 Make sure you are optimising your patient outcomes. Unfortunately, these terms do not comprehensively describe the mechanisms related to therapy lasers, nor do they adequately distinguish them from other light-based therapies. This lack of clarity has led to significant confusion about the laser modality and a need for better nomenclature. 1 In September 2014, the North American Association for Light Therapy (NAALT) and the World Association for Laser Therapy (WALT) convened and agreed upon the term “Photobiomodulation Therapy” as the preferred nomenclature. Photobiomodulation Therapy (PBM) was added to the MeSH database in November 2015 and is the preferred name for researchers and key opinion leaders in the field because it more clearly characterises the modality. 1 More recently, based on a consensus in the field, the term photobiomodulation therapy (PBMT) was added to the National Library of Medicine MeSH database as an entry term to the existing record of laser therapy. 1 In general, all these terms refer to “treatment using irradiation with certain wavelengths of light which create biochemical changes in tissues once absorbed.” With the recent advancement of laser technology producing higher power devices (>0.5 W), this therapy can create warmth on the surface of the skin during treatment but the main mechanism of action is biochemical effects from light rather than heat. 2 “Cold Laser”, “Low-Level Laser Therapy (LLLT)” and “Low-intensity Laser Therapy (LILT)” are all terms previously used in the laser therapy field. Photobiomodulation Therapy (PBM) was added to the meSH database in November 2015 and is the preferred name for researchers and key opinion leaders in the field because it clearly characterises the modality. While both high power and low power lasers can deliver photobiomodulation therapy, it is important to note that high power lasers are differentiating themselves from their low power counterparts.
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