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Low Energy Vibration for Fall Prevention and Senior Rehabilitation: What Healthcare Providers Need to Know

Sun, 14 Dec 2025 19:09:47 -0500

Falls remain one of the most significant health risks for adults over the age of 65, contributing to fractures, disability, and decreased independence. As the U.S. population continues to age, healthcare providers are seeking evidence based and accessible interventions that improve balance, neuromuscular control, and overall functional stability. Low energy vibration therapy has emerged as a promising modality that safely delivers mechanical signals to support balance training and postural control in older adults. This blog post reviews how low energy vibration works, the research supporting its use, and how health care providers can incorporate it into clinical practice.

Why Fall Prevention Requires Neuromuscular Stimulation

Falls often occur not because of muscle weakness alone, but due to impaired proprioception, slowed neuromuscular response times, and reduced postural stability. Whole Body Vibration is known to stimulate muscle spindles and mechanoreceptors, helping enhance sensory feedback and neuromuscular activation. Research has shown that targeted mechanical signals delivered through vibration platforms can improve balance and functional performance in older adults by influencing proprioceptive pathways and muscular coordination [1]. Low energy vibration has a direct effect in age declining muscle (sarcopenia) by slowing mitochondrial deterioration [2], preventing neuromuscular junction degeneration by increasing Dok7 and suppressing ERK1/2 phosphorylation [3] and protecting fast firing muscle fibers [4].

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Evidence Supporting Low Energy Vibration for Balance and Stability

Clinical studies have demonstrated encouraging improvements in balance metrics, gait parameters, and functional mobility when low energy vibration is used consistently.

One of the earliest studies examining vibration and balance found that whole body vibration improved neuromuscular performance and balance control in older adults when compared to standard balance training programs [5]. Additional research has confirmed these findings, showing improvements in postural sway, gait speed, and lower-extremity function following low intensity vibration interventions [6].

In an eight week trial, older adults receiving low level vibration demonstrated significant gains in functional performance tests such as the Timed Up and Go (TUG) and chair stand assessments [7]. These findings indicate that low intensity vibration may help compensate for age related declines in neuromuscular responsiveness.

Studies evaluating fall risk have shown that mechanical vibration can improve proprioceptive processing and increase lower limb muscle activation, both of which are essential for preventing loss of balance during daily activities [8].

An important large study in 710 women over 60 years old using low energy vibration 100 minutes per week for 18 months, showed reductions in falls and fractures in the group using the vibration compared to controls using normal exercise. The fall rate in the vibration group was 46% lower than controls. There were significant benefits in leg muscle strength and balance and in the high compliance vibration users 1.4 % hip and 1.12% spine bone density improvements. The study concluded that vibration is effective in reducing falls and associated injuries. This is an important outcome in managing risks associated with the decline in bone and muscle quality with age [9]. A follow up of a subgroup analysis of active and control subjects at 30 months showed the benefits of the vibration on balancing ability, muscle strength and risk of falling were retained after 12 months after cessation of the vibration [10]. The CDC 2022 compendium for effective fall interventions for seniors recommends low energy vibration as an single intervention to be used [11].

Safety Profile in Senior and Medically Fragile Populations

One of the advantages of low energy vibration therapy is its safety in populations that cannot tolerate high mechanical forces. Research has repeatedly shown that low magnitude vibration is well tolerated, with minimal adverse events when proper contraindication screening is followed [12].

Typical contraindications include active deep vein thrombosis, unstable fractures, implanted electronic medical devices, pregnancy, and acute inflammation. However, for older adults with osteopenia, frailty, orthopedic implants, or mobility limitations, low intensity vibration has been shown to be safe when administered under supervision [13].

Integrating Low Energy Vibration into Clinical Practice

Healthcare providers can integrate vibration therapy as an adjunct to traditional balance and mobility training. Sessions typically last ten minutes and can be performed before therapeutic exercise to improve neuromuscular readiness or after exercise to support coordination and sensory processing.

Useful clinical applications include:

• Balance retraining
• Gait initiation drills
• Postural stability exercises
• Fall prevention programs
• Early phase rehabilitation for deconditioned patients

Because low energy vibration platforms are simple to operate, they fit well in multidisciplinary environments including podiatry offices, chiropractic clinics, physical therapy practices, senior wellness centers, and integrative medicine facilities.

Summary

Low energy vibration therapy is supported by multiple peer reviewed studies showing improvement in postural control, gait performance, and neuromuscular activation resulting in fewer falls in older adults. Its safety profile and ease of integration make it an ideal modality for fall prevention and senior rehabilitation programs. As healthcare providers seek effective, low risk interventions for aging populations, low energy vibration therapy represents an evidence informed and clinically practical option.

References

1. Ritzmann R, Kramer A, Gruber M. Effects of whole-body vibration training on postural control in elderly individuals. J Biomech. 2010;43(10):2230–2235.

2. Long YF, Cui C, Wang Q, Xu Z, Chow SKH, Zhang N, Wong RMY, Chui ECS, Schoenmehl R, Brochhausen C, Rubin CT, Li G, Qin L, Yang AZ, Cheung WH, Low-Magnitude High-Frequency Vibration Attenuates Sarcopenia by Modulating Mitochondrial Quality Control via Inhibiting miR-378, Journal of Cachexia, Sarcopenia and Muscle, 2025; 16:e13740

3. Boa Z, Cui C, Liu C, Long YF, Wong RMY, Chai S, Qin L, Rubin CT, Yip BHK, Xu Z, Jiang Q, Chow SKH, Cheung WH, Prevention of age-related neuromuscular junction degeneration in sarcopenia by low-magnitude high-frequency vibration, Aging Cell.2024;00:e14156

4. Mettlach G, Polo-Parada L, Peca L, Rubin CT, Plattner F, Bibb JA, Enhancement of neuromuscular dynamics and strength behavior using extremely low magnitude mechanical signals in mice, Journal of Biomechanics (2013), http://dx.doi.org/10.1016/j.jbiomech.2013.09.024i

5. Rees SS, Murphy AJ, Watsford ML. Effects of whole-body vibration exercise on muscle strength and power in older adults. Age Ageing. 2007;36(3):285–289.

6. Lam FM, Liao LR, Kwok TC, Pang MY. The effect of whole-body vibration on balance, mobility and falls in older adults: a systematic review and meta-analysis. Maturitas. 2012;72(3):206–213.

7. Bogaerts AC, Verschueren SM, Delecluse C, Claessens AL, Boonen S. Effects of whole-body vibration training on postural control in older individuals: a randomized controlled trial. Arch Phys Med Rehabil. 2007;88(3):306–315.

8. Leung KS, Li CY, Tse YK, Choy TK, Leung PC, Hung VWY, Chan SY, Leung AHC, Cheung WH, Effects of 18-month low-magnitude high-frequency vibration on fall rate and fracture risks in 710 community elderly—a cluster-randomized controlled trial, Osteoporosis Int. 2014 Jun;25(6):1785-95.

9. Cheung WH, Li CY, Zhu TY, Leung KS, Improvement in muscle performance after one-year cessation of low-magnitude high-frequency vibration in community elderly. J Musculoskelet Neuronal Interact 2016; 16(1):4-11

10. Rogan S, Taeymans J, Radlinger L, et al. Effects of whole-body vibration on postural control in elderly: a systematic review and meta-analysis. Eur Rev Aging Phys Act. 2012;9(1):41–58.

11. Burns ER, Kakara R, Moreland B. A CDC Compendium of Effective Fall Interventions: What Works for Community-Dwelling Older Adults. 4th ed. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, 2022

12. Mikhael M, Orr R, Amsen F, Greene D, Singh MA. Safety and efficacy of whole-body vibration training in older adults: a systematic review. Aging Clin Exp Res. 2010;22(4):417–431.

13. Marin PJ, Rhea MR. Effects of vibration training on neuromuscular and cardiovascular responses in older adults. Age Ageing. 2010;39(6):647–654.

How Vibration Platforms Support Neuromuscular Re-education: Clinical Applications for Chiropractors, Physical Therapists, and Podiatrists

Sun, 14 Dec 2025 18:42:32 -0500

Neuromuscular re-education is a cornerstone of rehabilitation, supporting the restoration of coordinated movement, balance, and functional strength following injury, neurological insult, or prolonged inactivity. These challenges are especially pronounced in patients with sarcopenia, age-related deconditioning, or chronic disease, where declines in muscle mass are accompanied by impaired motor unit recruitment, diminished proprioceptive input, neuromuscular junction degeneration, and mitochondrial dysfunction.

In these populations, traditional resistance-based exercise alone may be insufficient or poorly tolerated. Low-intensity vibration has emerged as a clinically relevant intervention that delivers mechanical signals capable of stimulating neuromuscular and cellular pathways without excessive joint loading or metabolic demand. Recent evidence demonstrates that low-magnitude, high-frequency vibration attenuates sarcopenia by improving mitochondrial quality control and neuromuscular signaling, even in aging and frail tissue (1). For chiropractors, physical therapists, and podiatrists managing older adults or medically complex patients, vibration platforms offer a practical method to reintroduce meaningful neuromuscular input and support motor re-education when conventional exercise is limited.

How Vibration Stimulates Proprioceptors and Motor Pathways

Effective neuromuscular control depends on continuous afferent feedback from muscle spindles, Golgi tendon organs, joint mechanoreceptors, and cutaneous receptors. Injury, immobilization, neuropathy, and aging blunt this sensory feedback loop, contributing to delayed muscle activation, impaired balance reactions, and inefficient movement strategies. Whole-body vibration (WBV) addresses these deficits through rapid mechanical oscillations that directly stimulate proprioceptive receptors and enhance sensory-motor integration.

Muscle Spindles: Primary Sensors for Proprioceptive Feedback

Muscle spindles respond strongly to vibratory input, increasing Ia afferent discharge and improving neuromuscular activation.

Neurophysiological studies demonstrate that vibration markedly increases firing rates of muscle spindle Ia afferents, enhancing stretch reflex sensitivity and alpha motor neuron excitability (2). In sarcopenic and deconditioned muscle, where spindle sensitivity and reflex responsiveness are diminished, this mechanism supports earlier and more coordinated muscle activation during rehabilitation.

Golgi Tendon Organs: Modulating Tension and Protective Reflexes

Golgi tendon organs help regulate tension and reflex pathways, and vibration can modulate their responsiveness during rehabilitation.

While Golgi tendon organs typically function as protective inhibitory sensors, controlled vibration appears to recalibrate abnormal tension signaling seen after injury or disuse. This modulation supports more accurate force output during strengthening, gait training, and closed-chain functional activities.

Central Integration and Proprioceptive Pathways

Beyond peripheral receptor activation, vibration enhances sensory input at the spinal and cortical levels. Increased afferent signaling improves motor neuron pool excitability and supports corticomotor plasticity, a critical factor in motor relearning following orthopedic injury or neurological impairment (3,4).

Complementing Therapeutic Exercise in Clinical Practice

Vibration platforms are not intended to replace therapeutic exercise, but to amplify its neuromuscular effects. Studies show that exercises performed with vibration produce greater electromyographic activity and motor unit recruitment compared to identical exercises performed without vibration (5). This enhanced neuromuscular stimulus is particularly valuable for patients with sarcopenia, arthrogenic muscle inhibition, or chronic weakness, where traditional loading strategies may not adequately engage stabilizing musculature.

Improved kinesthetic awareness and sensory feedback also support motor learning, helping patients develop more efficient and durable movement patterns that transfer to functional tasks.

Improvements in Postural Control and Balance

Emerging evidence indicates that low-magnitude, high-frequency vibration exerts clinically meaningful effects on postural control and balance by preserving neuromuscular integrity and enhancing sensory-motor coordination. In aging and sarcopenic populations, degeneration of the neuromuscular junction contributes to delayed muscle activation, impaired balance reactions, and increased fall risk. Research demonstrates that low-intensity vibration can prevent age-related neuromuscular junction degeneration, supporting more effective postural responses and balance control (6).

Mechanistically, vibration increases afferent sensory input and improves neuromuscular signaling efficiency, resulting in better motor unit synchronization and force modulation. Experimental models show that extremely low-magnitude mechanical signals enhance neuromuscular dynamics and strength behavior even in the absence of high mechanical loading (7). Clinically, this heightened sensory demand allows practitioners to safely progress patients through increasingly complex balance and stability programs, particularly in older adults, neurologically impaired individuals, and those recovering from lower-extremity dysfunction.

Supporting Gait Training and Lower-Extremity Rehabilitation

Gait retraining relies on accurate proprioceptive input and coordinated muscle activation across the lower extremity. Vibration platforms can be used as a preparatory intervention or integrated directly into weight-bearing exercises to enhance gait outcomes.

Short bouts of vibration prior to gait training can prime neuromuscular pathways, improving weight acceptance, stance stability, and limb coordination. Weight-shift drills, mini-squats, and closed-chain exercises performed on vibration platforms help restore symmetrical loading patterns, particularly beneficial for patients with foot and ankle pathology, knee dysfunction, peripheral neuropathy, or post-surgical deficits.

In neurological populations, including individuals with stroke or Parkinson’s disease, vibration-assisted interventions have been associated with improvements in stride length, balance, and functional mobility (8,9).

Clinical Recommendations

Use low-magnitude vibration (typically 20–35 Hz) for sarcopenic, frail, or deconditioned patients.
Pair vibration with closed-chain strengthening, balance drills, or gait-preparatory exercises.
Adjust joint angles and stance width to target specific proprioceptive systems.
Monitor fatigue, compensatory strategies, and patient tolerance.

Conclusion

Whole-body vibration platforms provide an evidence-based adjunct to neuromuscular re-education, particularly for patients with sarcopenia, deconditioning, or impaired motor control. By stimulating proprioceptors, preserving neuromuscular junction integrity, enhancing sensory-motor integration, and amplifying the effects of therapeutic exercise and gait training, vibration offers chiropractors, physical therapists, and podiatrists a practical tool to improve functional outcomes across diverse patient populations.

References

Long YF, Cui C, Wang Q, Xu Z, Chow SKH, Zhang N, Wong RMY, Chui ECS, Schoenmehl R, Brochhausen C, Rubin CT, Li G, Qin L, Yang AZ, Cheung WH. Low-magnitude high-frequency vibration attenuates sarcopenia by modulating mitochondrial quality control via inhibiting miR-378. J Cachexia Sarcopenia Muscle. 2025;16:e13740.
Burke D, Hagbarth KE, Löfstedt L, Wallin BG. The responses of human muscle spindle endings to vibration during isometric contraction. J Physiol. 1976;261(3):695–711.
Ritzmann R, Kramer A, Gruber M, Gollhofer A, Taube W. EMG activity during whole-body vibration: motion artifacts or stretch reflexes? Eur J Appl Physiol. 2010;110(1):143–151.
Marín PJ, Rhea MR. Effects of vibration training on muscle power: a meta-analysis. J Strength Cond Res.2010;24(3):871–878.
Di Giminiani R, Masedu F, Tihanyi J, Scrimaglio R, Valenti M. Interaction between body posture and vibration frequency on neuromuscular activation. J Electromyogr Kinesiol. 2013;23(1):245–251.
Boa Z, Cui C, Liu C, Long YF, Wong RMY, Chai S, Qin L, Rubin CT, Yip BHK, Xu Z, Jiang Q, Chow SKH, Cheung WH. Prevention of age-related neuromuscular junction degeneration in sarcopenia by low-magnitude high-frequency vibration. Aging Cell. 2024;00:e14156.
Mettlach G, Polo-Parada L, Peca L, Rubin CT, Plattner F, Bibb JA. Enhancement of neuromuscular dynamics and strength behavior using extremely low-magnitude mechanical signals in mice. J Biomech. 2013;46(15):2467–2474.
Lau RWK, Yip SP, Pang MYC. Whole-body vibration and neuromotor function in chronic stroke. Clin Rehabil.2012;26(9):842–852.
Lam FMH, Lau RWK, Chung RCK, Pang MYC. Effect of whole-body vibration on balance and mobility in older adults: a systematic review and meta-analysis. Maturitas. 2012;72(3):206–213.

Red Light/Infrared Therapy Can Help Your Neck & Shoulders - Here Are the Best Therapy Pads for Fast & Effective Relief From Pain and Stiffness

Sun, 14 Dec 2025 18:42:32 -0500

Did you ever wake up with a stiff neck and could hardly turn your head without pain? Or felt extreme pain from a rotator cuff injury in your shoulder that limited your range of motion, stopping you from moving your arm to do necessary tasks?

Almost everyone has experienced either one or both of these painful scenarios at some point in their lives. But if you had a Red Light/Infrared Therapy system at your disposal, just a simple and easy twenty-minute therapy session would be all that was needed to reduce your pain and stiffness and have you feeling a whole lot better!

Red Light/Infrared Therapy

Rather than taking over-the-counter pain relievers such as Advil, Motrin IB, Aleve or Tylenol, muscle relaxants (or even corticosteroid or lidocaine injections for more acute and chronic cases of neck and shoulder pain) why not try Red Light/Infrared Therapy? Red Light/Infrared Therapy is non-invasive, painless, effective, simple, and very easy to administer by a health practitioner or by the patients themselves in the comfort of their own homes.

Red Light/Infrared Therapy is consistently dependable in its ability to provide fast and effective pain relief. And Red Light/Infrared Therapy also increases circulation, reduces swelling and stiffness, and stimulates, accelerates, and supports the body’s own innate healing processes, eventually regenerating nerves and tissues - something which pain relievers and muscle relaxants cannot possibly do.

Relieves Musculoskeletal Pain

Light therapy has been shown to be an effective treatment for various musculoskeletal disorders, Including”delayed-onset muscle soreness. [1] For more than forty-five years, peer-reviewed scientific studies have found that Red Light/Infrared Therapy, “has been shown to reduce inflammation and edema, induce analgesia, and promote healing in a range of musculoskeletal pathologies. [2] Acute conditions of the neck and shoulder such as whiplash injury or sprains and strains, and chronic conditions such as osteoarthritis (a common cause of neck pain), Rheumatoid arthritis (which can contribute to shoulder problems), and frozen shoulder are amenable [3] to Red Light/Infrared Therapy.

Supports Cartilage, Tendons, and Nerves

Furthermore, medical research has found that “low doses of light have demonstrated the ability to heal skin, nerves, tendons, cartilage and bones. [4] Red Light/Infrared Therapy’s success in supporting the body’s ability to heal cartilage, tendons, and nerves is especially important for those suffering from neck pain, which can be caused by worn joint cartilage and nerve compression; and from shoulder pain, which can come from the tendons surrounding the shoulder joint.

Proven to Relieve Neck and Shoulder Pain

Red Light/Infrared Therapy’s ability to effectively reduce pain in conditions affecting both the neck and the shoulders has been scientifically proven. For example:

Neck Pain: A 2009 systematic review and meta-analysis published in Lancet found that Red Light/Infrared Therapy, “reduces pain immediately after treatment in acute neck pain and up to 22 weeks after completion of treatment in patients with chronic neck pain. [5]

Shoulder Pain: A 2014 systematic review focusing on light therapy treatment effects in shoulder tendinopathy concluded that Red Light/Infrared Therapy, can offer clinically relevant pain relief and initiate a more rapid course of improvement, both alone and in combination with physiotherapy interventions. [6]

Best Neck and Shoulder Pads

Whether you suffer from occasional or chronic neck and/or shoulder pain, Energia Medical offersfour pads that are perfect for treating both of these areas: the Small 90 Pad, the Long 180 Pad, the Large 264 Body Pad, and the 96 Shoulder/Knee pad. Here is what each pad offers:

Energia Medical’s Small 90 Diode Pad:

The size and rectangular shape of this pad make it ideal for treating the front or the back of the neck, as well as the shoulder area. At 9.8" X 4.5", this pad offers 90 LED’s: 45 infrared (850nm) and 45 red (660nm), with an output of 3,240 joules per 20 minute treatment. The small size of this 90 pad makes placement extremely easy, allowing it to also be used on practically every other area of the body. Other Uses: the wrist, hand, arm, elbow, stomach, back, calf, thigh, or jaw, making this pad the perfect therapy system for the whole family. For practitioners, this pad is the perfect starter pad for growing your Light Therapy system.

Energia Medical’s Long 180 Diode Pad:

The Long 180 Diode Pad offers 180 LED’s: 60 red (660 nm) and 120 infrared (850 nm), with an output of 6,480 joules per 20 minute treatment. This long and thin pad measures 5" X 16", and is excellent for the neck or up and down the shoulder around the rotator cuff. Other Uses: This pad can also be wrapped around the elbow; the knee; the leg; the foot; the arm; the wrist; and the ankle. Or used vertically down the length of the leg, or horizontally to treat either the front or the back of both legs or both thighs, or the tops or the soles of both feet.

Energia Medical’s Large 264 Diode Pad:

This large rectangular 8" x 15" pad is extremely easy to use to wrap over one entire shoulder, or if placed horizontally across the upper back, can reach both shoulders. It can also be used to treat the neck if the patient leans back upon it and there is a towel or other soft fabric behind the pad to better conform it to the neck. The Large 264 Diode Pad offers 264 LED’s: 120 red (660 nm) and 144 infrared (850 nm), with an output of 10,843 joules per 20 minute treatment. Other Uses: This pad can also treat both hands at once, or the feet by placing one foot or both feet directly on it, or the ankle area, the chest, the entire spine, the knee, or the upper and lower arm.

Energia Medical’s Shoulder, Knee, and Elbow 96 Diode Pad:

The pad features 96 total LED’s with 48 Red (660nm) and 48 Infrared (850nm). This uniquely-shaped pad with a circular cut-out for the joint is flexible and versatile. The two built in straps allow for the best adjustment for the impacted joint. It produces 3,740 joules during the 20 minute treatment.

Therapy Pad Packages Save Time and Money

Energia Medical offers both home users and health practitioners the opportunity to save time and money by purchasing multiple light therapy pads in convenient packages:

Expandable Starter System: A Large 264 Pad and a Long 180 Pad plus a 3-Port Controller
Whole Body Core Package: Two Large 264 Pads plus a 3-Port Controller
Whole Body Enhanced Package: Two Large 264 Pads, a Long 180 Pad, and a 90 Small Pad plus a 6-Port Controller.

Additional Pad Packages are also available. Please contact us for more information.

In Conclusion

Whether you suffer from occasional or chronic neck and/or shoulder pain, Red Light/Infrared Therapy will bring quick and effective relief from pain and stiffness while triggering, accelerating, and supporting your body’s own healing processes. Contact Energia Medical LLC at 860-707-4220 or via email to learn more about how Red Light/Infrared Therapy systems from Energia Medical can help you and/or your patients. Energia Medical provides the best quality, most durable, and most powerful clinical-strength Red Light/Infrared Therapy systems available in today’s marketplace to successfully meet the needs of any individual, family, or health practice.

References

[1] Lin YP, Su YH, Chin SF, Chou YC, Chia WT. Light-emitting diode photobiomodulation therapy for non-specific low back pain in working nurses: A single-center, double-blind, prospective, randomized controlled trial. Medicine (Baltimore). 2020 Aug 7;99(32):e21611. doi: 10.1097/MD.0000000000021611. PMID: 32769919; PMCID: PMC7592994, p. 1.

[2] Cotler, Howard B. et al. The Use of Low Level Laser Therapy (LLLT) For Musculoskeletal Pain. MOJ Orthop Rheumatol. 2015 ; 2(5): . doi:10.15406/mojor.2015.02.00068, p. 1.

[3] Ibid., p. 4.

[4] Ibid.

[5] Chow RT, Johnson MI, Lopes-Martins RA, Bjordal JM. Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials. Lancet. 2009 Dec 5;374(9705):1897-908. doi: 10.1016/S0140-6736(09)61522-1. Epub 2009 Nov 13. Erratum in: Lancet. 2010 Mar 13;375(9718):894. PMID: 19913903, p.1.

[6] Haslerud S, Magnussen LH, Joensen J, Lopes-Martins RA, Bjordal JM. The efficacy of low-level laser therapy for shoulder tendinopathy: a systematic review and meta-analysis of randomized controlled trials. Physiother Res Int. 2015 Jun;20(2):108-25. doi: 10.1002/pri.1606. Epub 2014 Dec 2. PMID: 25450903, p. 1.

Bodily Impact of Red Light Therapy

Sun, 14 Dec 2025 18:42:32 -0500

Photobiomodulation, or altering cellular function using light, is an emerging treatment modality that is increasingly gaining clinical significance. [1] Research shows that light at a specific wavelength is able to penetrate the skin and promote cellular regeneration and tissue repair. [2] The benefits of Light Therapy are now also being explored on dogs, cats, and horses, with positive results. LED devices are being used on animals to address several health concerns such as musculoskeletal pain, osteoarthritis, and chronic back pain.

Is LED Light Effective?

In 1993, NASA sponsored a study to investigate the effects of light-emitting diodes (LEDs) on plant growth. [3] After receiving positive results, NASA decided to see if LEDs could be used for photobiomodulation therapy. In the late 1990s, their Medicine Program created NASA LED, a quasimonochromatic light source with narrow divergence and great power output. This was a handheld LED device that received FDA clearance in 2003.

Research in recent decades has shown photon emitters, like LEDs, to be efficient light sources for photobiomodulation, proving that treatment characteristics like wavelength, irradiance, and fluence, rather than the technical type of light source, are more likely to be responsible for the effects. [4]

How Does Light Therapy Work?

Photobiomodulation, phototherapy, or Red Light Therapy (RLT) is the use of red and/or infrared light to stimulate the body’s regenerative processes by increasing cellular proliferation. [5] Specific wavelengths of light are shown to stimulate fibroblasts, resulting in various health benefits. Mitochondrial photostimulation through LED has been shown to improve cellular functions by up to 200%, decrease wound healing time by up to 40%, and reduce pain by 47%. [6]

The Benefits of LED Light Therapy for Dogs

Since RLT is effective for the management of musculoskeletal pain and tendon and joint problems, it can be beneficial for several canine illnesses. [7] One research project studied the effectiveness of photobiomodulation on chronic wound healing in 21 dogs. [8] After 15 days of usage, the results showed that when compared to the sham group, wound size had significantly reduced in all groups that received LED Light Therapy. The study suggested that photobiomodulation can improve wound healing and reduce treatment duration in dogs.

Osteoarthritis is a common health concern among aging dogs and hounds. A study showed that six weeks of RLT improved lameness, reduced pain, and lowered NSAID requirements in 9 out of 11 dogs with elbow arthritis. [9]

How is Light Therapy Helpful for Horses?

Since Red Light accelerates the healing process, it is found to be very useful in addressing various equine concerns such as soft tissue injuries, back pain, tendon problems, cuts, and wounds. [10] LED Light Therapy also stimulates the production of collagen, inhibiting the formation of scar tissue, finding benefits in equine post-operative care. [11] Photobiomodulation also stimulates the production of Nitric Oxide, and may help address peripheral neuropathies in horses. [12]

Light Therapy can be used not only to address equine health concerns but also to keep your horses fit. Photobiomodulation through LED light can also be an advantage in sports performance for athletic horses. It can be either delivered as a pre-treatment before an event, as a post-treatment to address muscle soreness and other problems, or just to maintain the overall fitness. [13]

Red Light Therapy for Cats

Research shows that red and infrared light radiation can activate cellular signaling pathways in mammals. [14] LED light increases blood circulation, which results in providing more oxygen and nutrients to the hypoxic cells, resulting in accelerated wound healing. [15] Since RLT is able to accelerate the body’s healing process and can enhance cellular activity, it can be used to treat a number of conditions in cats:

Joint or tendon issues
Muscle pain and soreness
Osteoarthritis
Infection
Muscle strain and sprain
Chronic low back pain

Light Therapy is a safe, painless, non-invasive, and side-effect-free treatment modality that can boost the health of your dogs, cats or horses. Energia Medical offers FDA-registered LED pads that can be strapped on or simply placed on your animals. These pads come in various sizes and shapes and can be used anywhere on the body. Our customizable pads have specific wavelengths of light including both red and infrared light. For more information, call us at 860-707-4220 or email Rob.

Citations

[1]Chung H, Dai T, Sharma SK, Huang YY, Carroll JD, Hamblin MR. The nuts and bolts of low-level laser (light) therapy. Ann Biomed Eng. 2012 Feb;40(2):516-33. doi: 10.1007/s10439-011-0454-7. Epub 2011 Nov 2. PMID: 22045511; PMCID: PMC3288797.

[2]Calderhead, R. G. (2007). The photobiological basics behind light-emitting diode (LED) phototherapy.Laser Therapy,16(2), 97-108.

[3]NASA. (2008).LED device illuminates new path to healing | NASA spinoff. NASA Spinoff.https://spinoff.nasa.gov/Spinoff2008/hm_3.htmlNASA Spinoff.https://spinoff.nasa.gov/Spinoff2008/hm_3.html

[4]Smith KC. Laser (and LED) therapy is phototherapy. Photomed Laser Surg. 2005 Feb;23(1):78-80. doi: 10.1089/pho.2005.23.78. PMID: 15782040.Laser (and LED) therapy is phototherapy. Photomed Laser Surg. 2005 Feb;23(1):78-80. doi: 10.1089/pho.2005.23.78. PMID: 15782040.

[5]Rohringer S, Holnthoner W, Chaudary S, Slezak P, Priglinger E, Strassl M, Pill K, MÃ¼hleder S, Redl H, Dungel P. The impact of wavelengths of LED light-therapy on endothelial cells. Sci Rep. 2017 Sep 6;7(1):10700. doi: 10.1038/s41598-017-11061-y. PMID: 28878330; PMCID: PMC5587748.

[6]Whelan HT, Smits RL Jr, Buchman EV, Whelan NT, Turner SG, Margolis DA, Cevenini V, Stinson H, Ignatius R, Martin T, Cwiklinski J, Philippi AF, Graf WR, Hodgson B, Gould L, Kane M, Chen G, Caviness J. Effect of NASA light-emitting diode irradiation on wound healing. J Clin Laser Med Surg. 2001 Dec;19(6):305-14. doi: 10.1089/104454701753342758. PMID: 11776448.

[7]Anders, J.J., Ketz, A.K. and Wu, X. (2017). Basic Principles of Photobiomodulation and Its Effects at the Cellular, Tissue, and System Levels. In Laser Therapy in Veterinary Medicine (eds R.J. Riegel and J.C. Godbold).https://doi.org/10.1002/9781119220190.ch5

[8]Hoisang S, Kampa N, Seesupa S, Jitpean S. Assessment of wound area reduction on chronic wounds in dogs with photobiomodulation therapy: A randomized controlled clinical trial. Vet World. 2021 Aug;14(8):2251-2259. doi: 10.14202/vetworld.2021.2251-2259. Epub 2021 Aug 28. PMID: 34566346; PMCID: PMC8448658.

[9]Looney AL, Huntingford JL, Blaeser LL, Mann S. A randomized blind placebo-controlled trial investigating the effects of photobiomodulation therapy (PBMT) on canine elbow osteoarthritis. Can Vet J. 2018 Sep;59(9):959-966. PMID: 30197438; PMCID: PMC6091142.

[10]Douris P, Southard V, Ferrigi R, Grauer J, Katz D, Nascimento C, Podbielski P. Effect of phototherapy on delayed onset muscle soreness. Photomed Laser Surg. 2006 Jun;24(3):377-82. doi: 10.1089/pho.2006.24.377. PMID: 16875447.

[11]Wunsch A, Matuschka K. A controlled trial to determine the efficacy of red and near-infrared light treatment in patient satisfaction, reduction of fine lines, wrinkles, skin roughness, and intradermal collagen density increase. Photomed Laser Surg. 2014 Feb;32(2):93-100. doi: 10.1089/pho.2013.3616. Epub 2013 Nov 28. PMID: 24286286; PMCID: PMC3926176.

[12]Keszler A, Lindemer B, Weihrauch D, Jones D, Hogg N, Lohr NL. Red/near infrared light stimulates release of an endothelium dependent vasodilator and rescues vascular dysfunction in a diabetes model. Free Radic Biol Med. 2017 Dec;113:157-164. doi: 10.1016/j.freeradbiomed.2017.09.012. Epub 2017 Sep 19. Erratum in: Free Radic Biol Med. 2019 Feb 1;131:443. PMID: 28935419; PMCID: PMC5699925.

[13]Ferraresi C, Huang YY, Hamblin MR. Photobiomodulation in human muscle tissue: an advantage in sports performance? J Biophotonics. 2016 Dec;9(11-12):1273-1299. doi: 10.1002/jbio.201600176. Epub 2016 Nov 22. PMID: 27874264; PMCID: PMC5167494.

[14]Karu TI. Mitochondrial signaling in mammalian cells activated by red and near-IR radiation. Photochem Photobiol. 2008 Sep-Oct;84(5):1091-9. doi: 10.1111/j.1751-1097.2008.00394.x. Epub 2008 Jul 18. PMID: 18651871.

[15]Frangez I, Cankar K, Ban Frangez H, Smrke DM. The effect of LED on blood microcirculation during chronic wound healing in diabetic and non-diabetic patients-a prospective, double-blind randomized study. Lasers Med Sci. 2017 May;32(4):887-894. doi: 10.1007/s10103-017-2189-7. Epub 2017 Mar 25. PMID: 28342007.

Whole Body Vibration (WBV) Therapy

Sun, 14 Dec 2025 14:34:59 -0500

The user of the device stands upon a platform that delivers acceleration (mechanical energy) to the user through their feet and up through their body to their head These signals transfer energy to muscles, bones, and connective tissues through direct contact with the feet, hands, or torso. At the cellular level, vibration acts as a mechanical stimulus that triggers biochemical responses within tissues, a process known as mechanotransduction. These signals influence muscle activation patterns, circulation, inflammatory signaling, and bone remodeling pathways [1].

High vs Low Energy Vibration Therapy: Clinical Differences Healthcare Providers Must Know

WBV therapy has gained increasing attention in rehabilitation, sports medicine, geriatrics, and integrative care settings. Clinicians are now faced with two main categories of devices when evaluating this modality for patient use: high energy vibration platforms (acceleration in excess of 1.0g) and low energy vibration platforms (acceleration below 1.0g). The biological effects, clinical applications, and safety profiles differ significantly between the two modalities. Understanding these differences allows healthcare providers to select the most appropriate technology for specific patient populations and clinical goals while minimizing possible risk.

Key Technical Differences

High energy vibration platforms typically operate at higher amplitudes and produce greater acceleration forces from 1.0g to 15.0g. The standing surface of the platforms move in various planes; vertically, side to side alternating or triplane and are measured in millimeters. They are often marketed for athleticism, physical conditioning, and performance enhancement. These devices strongly stimulate muscle spindles and motor neurons, producing visible contractions and reflex muscle activation [2]. This creates loading patterns closer to resistance-based exercise than to purely therapeutic stimulation.

Low energy vibration platforms deliver much smaller mechanical forces and operate at lower acceleration outputs in the range 0.2g to 0.4g. The surface platforms only displace vertically and are measured in microns with frequencies between 30 and 40 cycles per second (Hz). These systems aim to stimulate cellular signaling pathways and neuromuscular communication rather than generate force production. Research has shown that low energy vibration can influence bone and muscle physiology even at very low signal intensity levels [3].

In practice, high energy platforms place higher mechanical load on joints and soft tissues. Low energy platforms are designed to deliver subtle but biologically meaningful signals while maintaining a higher margin of safety for fragile or post operative populations.

Clinical Applications for Each Platform Type

High energy vibration therapy is best suited for physically capable patients who can tolerate mechanical loading. It has demonstrated benefit in athletic conditioning, neuromuscular training, and strength conditioning programs [4]. In sports medicine settings, high energy platforms are commonly used to enhance muscle recruitment and coordination. At lower frequencies they are well suited for neuromuscular rehabilitation following stroke or motor decline conditions such as Parkinsons Disease.

Low energy vibration therapy has shown utility in populations for whom traditional exercise presents a risk. This includes older adults, individuals with mobility impairments, and patients with reduced bone mass. Researchers have demonstrated that low energy vibration can stimulate osteoblast activity and inhibit bone resorption signaling [5]. In addition, they protect fast firing fiber activity in sarcopenic muscles [6]. This has led to its use in osteoporosis research and frailty prevention programs.

Low energy vibration has also demonstrated benefit in improving postural stability and neuromuscular coordination in older adults [7]. Because the intensity is lower, these systems are also applied in early-stage rehabilitation, neurological recovery, and patients with chronic illness who are not candidates for aggressive mechanical loading.

Safety and Contraindications

High energy vibration carries a higher risk profile. User stance is generally bent knees to suppress acceleration. Excessive mechanical force may exacerbate joint degeneration, provoke pain, or lead to musculoskeletal injury if improperly administered. Case reports and safety reviews recommend careful screening for patients with recent surgery, herniated discs, severe osteoporosis, or advanced arthritis [8].

Low energy vibration platforms generally demonstrate a better tolerance profile. Users stand upright on the device. Clinical research has shown they can be safely administered even to elderly populations when proper protocols are followed [9]. Low energy vibration can be used by patients with orthopedic implants in situ [10]. However, precautions still exist and include pregnancy, active deep vein thrombosis and implanted electronic medical devices.

Both device types require standardized protocols, patient screening, and provider education. More force does not equate to better outcomes, and higher energy levels simply change the biological target.

Choosing the Right Technology for Your Practice

Clinical goals should guide platform selection. If the objective is athletic performance and muscular conditioning, higher energy may be appropriate under supervision. If the focus is fall prevention, bone health support, post operative rehabilitation, low energy platforms often present a safer and more appropriate option.

Providers should also consider patient age, comorbidities, physical capacity, and long-term safety. Vibration therapy should never replace comprehensive rehabilitation or exercise programs. It should be viewed as an adjunct modality that enhances clinical outcomes when used judiciously.

As research continues to evolve, clearer frameworks are emerging for strain-specific dosing and patient selection. The growing evidence base supports vibration therapy as a meaningful tool when matched correctly to patient needs rather than applied uniformly across all populations.

Summary

High energy and low energy vibration therapy devices may appear similar, but they serve very different clinical roles. High energy platforms operate as strength and neuromuscular conditioning tools, while low energy platforms function as biological signaling devices. For the healthcare provider, understanding these differences is essential to safe implementation, appropriate patient selection, and optimal clinical outcomes. When used thoughtfully and supported by evidence based practice, vibration therapy can offer measurable benefits across a wide range of patient populations.

References

Rubin C, Recker R, Cullen DM, Ryaby J, McCabe J, McLeod K. Prevention of bone loss in the hip and spine of postmenopausal women using low-level whole body vibration. J Bone Miner Res. 2004;19(3):343–351.
Cardinale M, Bosco C. The use of vibration as an exercise intervention. Exerc Sport Sci Rev. 2003;31(1):3–7.
Turner F, DeMers MS, Fox HR, Reed JL. Low-level whole body vibration can increase muscular strength and bone density in postmenopausal women. J Musculoskelet Neuronal Interact. 2011;11(4):370–376.
Delecluse C, Roelants M, Verschueren S. Strength increase after whole-body vibration compared with resistance training. Med Sci Sports Exerc. 2003;35(6):1033–1041.
Lau E, Al-Delaimy WK. Mechanobiology of bone adaptation to mechanical loading. Clin Orthop Relat Res. 2016;474(8):1880–1893.
Boa Z, Cui C, Liu C, Long YF, Wong RMY, Chai S, Qin L, Rubin CT, Yip BHK, Xu Z, Jiang Q, Chow SKH, Cheung WH, Prevention of age-related neuromuscular junction degeneration in sarcopenia by low-magnitude high-frequency vibration, Aging Cell. 2024;00:e14156.
Rees SS, Murphy AJ, Watsford ML. Effects of whole-body vibration exercise on neuromuscular and functional performance in older adults. Age Ageing. 2007;36(3):285–289.
Rittweger J. Vibration as an exercise modality: how it may work and what its potential might be. Eur J Appl Physiol. 2010;108(5):877–904.
Lau E, Al-Delaimy WK. Low-level vibration improves neuromuscular function in elderly adults. J Aging Phys Act. 2013;21(3):331–346.
Wong RMY, Wong PY, Liu C, Chui CS, Liu WH, Tang N, Griffith J, Zhang N, Cheung WH, Vibration therapy as an intervention for trochanteric hip fractures – _A randomized double-blinded, placebo-controlled trial, Journal of Orthopaedic Translation 51 (2025) 51-56 https://doi.org/10.1016/j.jot.2025.01.002

Is Red Light Therapy (RLT) Effective for Animals?

Tue, 02 Apr 2024 13:00:00 -0400

Red Light Therapy, often known as Low-Level Light Therapy, photobiomodulation, or LED therapy, has been studied and investigated for many years and is gaining popularity among the medical community for its wide range of health benefits. Its practical applications are not confined to humans only; veterinarians have been using red light therapy for years to treat a variety of problems in dogs, cats, horses, and other animals.

Does RLT Work?

Despite the fact that there were alternative light sources accessible during the first 40 years of PBM (photobiomodulation) research, lasers remained by far the most often used treatment modality. Collimated, coherent, highly monochromatic beams with potential for high power densities were considered effective. However, non-coherent light sources like broad-band lights and light-emitting diodes (LEDs) have proliferated in recent years. Today, the use of LEDs, commonly called Red Light, in photobiomodulation and other healthcare applications is well-established.

How is Light Therapy Beneficial?

The mechanism of Light Therapy involves mitochondrial photostimulation: increased cellular energy. This results in a wide range of health benefits, including improved blood circulation, Nitric Oxide production, and overall cellular activity, resulting in accelerated healing and tissue regeneration. Studies have demonstrated that LED can improve cellular function by up to 200%.

What Conditions can be Treated with RLT?

Most animals have been shown to respond well to photobiomodulation in the same way as humans. Studies suggest that Red Light Therapy can be used not only to treat a variety of health conditions but also to maintain the general health and performance of animals. The effects of Red Light Therapy are well-documented. It has been shown to accelerate wound healing, help with musculoskeletal disorders, and assist in relief from pain and inflammation. Following is a collection of studies that provide evidence of the benefits of RLT in animals.

Wound Healing

Low-level light treatment with LEDs (LED-LLLT) is becoming popular in the field of wound healing because it can speed up wound recovery while also controlling sequelae. A study investigated the effects of RLT on five wounds, including a wound with an ulcer, excoriation wounds, and edema of the lips. All patients experienced complete wound healing, infection control, and discomfort management. Although this study was done on humans, we can deduce similar outcomes in animals.

Chronic Back Pain

Red Light Therapy can be used to treat chronic back pain in several animals, including horses, dogs, cows, goats, and sheep. For competitive horses, back sprains and injuries are relatively common. Traditional medicine may find it exceedingly difficult to precisely identify the source of the pain in certain injuries, making treatment difficult. Studies suggest that Red Light Therapy can help with chronic low back pain due to its analgesic effects

Arthritis

Arthritis is a prevalent health issue in older animals. However, some breeds, like hounds and bulldogs, are more prone to joint issues than others, even at earlier ages. Red light therapy is becoming a more widely used treatment for these kinds of problems as a result of the mounting clinical data. One study observed the effects of LED therapy in the treatment of joint pain caused by osteoarthritis in white New Zealand rabbits. The results revealed decreased inflammation levels and preservation of the articular surface after 5 weeks of treatment.

Post-Operative Recovery and Increased Activity

A study observed the effects of RLT on dogs that had herniated discs repaired surgically. The results showed that the treatment group healed 4 times faster than the control group. One study conducted two experiments to investigate if red light could be beneficial in promoting growth and activity in broiler chickens. The results concluded that bright red light not only increased activity in chickens but also reduced locomotive disorders.

For Stronger Immunity

Red Light can help strengthen the body’s immune system due to increased cellular activity. Regular treatment can protect animals from bacteria and viruses by strengthening the body’s defense system. One study revealed that regular LED therapy increased platelet counts in mice with immune thrombocytopenia. Studies also suggest that PBM has the potential to change thymic involution, enhance immunological function in the elderly, and has the potential to increase lifespan.

Since evidence suggests that Light Therapy is increasingly becoming a revolutionizing, holistic treatment, it can be used to treat animals, and various studies have suggested positive results. Moreover, RLT is not only effective, but it is also a safe, non-invasive, side-effect-free treatment modality that doesn’t require one to use any medicines.

Looking for a quick and effective treatment method for your pets, cattle, or poultry? Check out Energia Medical’s collection of lightweight and portable Red Light Therapy pads. These are easily maneuverable and come in a variety of sizes and shapes to suit all areas of the body. Call Rob at 860-707-4220 or email Rob.

Citations

Calderhead, R. G. (2007). The photobiological basics behind light-emitting diode (LED) phototherapy. Laser Therapy, 16(2), 97-108.

Heiskanen V, Hamblin MR. Photobiomodulation: lasers vs. light emitting diodes? Photochem Photobiol Sci. 2018 Aug 8;17(8):1003-1017. doi: 10.1039/c8pp90049c. Erratum in: Photochem Photobiol Sci. 2018 Oct 31;18(1):259-259. PMID: 30044464; PMCID: PMC6091542.

Kim WS, Calderhead RG. Is light-emitting diode phototherapy (LED-LLLT) really effective? Laser Ther. 2011;20(3):205-15. doi: 10.5978/islsm.20.205. PMID: 24155530; PMCID: PMC3799034.

Tafur J, Mills PJ. Low-intensity light therapy: exploring the role of redox mechanisms. Photomed Laser Surg. 2008 Aug;26(4):323-8. doi: 10.1089/pho.2007.2184. PMID: 18665762; PMCID: PMC2996814.

NT, Turner SG, Margolis DA, Cevenini V, Stinson H, Ignatius R, Martin T, Cwiklinski J, Philippi AF, Graf WR, Hodgson B, Gould L, Kane M, Chen G, Caviness J. Effect of NASA light-emitting diode irradiation on wound healing. J Clin Laser Med Surg. 2001 Dec;19(6):305-14. doi: 10.1089/104454701753342758. PMID: 11776448.

Zhang WW, Wang XY, Chu YX, Wang YQ. Light-emitting diode phototherapy: pain relief and underlying mechanisms. Lasers Med Sci. 2022 Jul;37(5):2343-2352. doi: 10.1007/s10103-022-03540-0. Epub 2022 Apr 11. PMID: 35404002.

Opel DR, Hagstrom E, Pace AK, Sisto K, Hirano-Ali SA, Desai S, Swan J. Light-emitting Diodes: A Brief Review and Clinical Experience. J Clin Aesthet Dermatol. 2015 Jun;8(6):36-44. PMID: 26155326; PMCID: PMC4479368.

Min PK, Goo BL. 830 nm light-emitting diode low level light therapy (LED-LLLT) enhances wound healing: a preliminary study. Laser Ther. 2013;22(1):43-9. doi: 10.5978/islsm.13-or-06. PMID: 24155549; PMCID: PMC3799047.

Gale GD, Rothbart PJ, Li Y. Infrared therapy for chronic low back pain: a randomized, controlled trial. Pain Res Manag. 2006 Autumn;11(3):193-6. doi: 10.1155/2006/876920. PMID: 16960636; PMCID: PMC2539004.

Oshima Y, Coutts RD, Badlani NM, Healey RM, Kubo T, Amiel D. Effect of light-emitting diode (LED) therapy on the development of osteoarthritis (OA) in a rabbit model. Biomed Pharmacother. 2011 Jun;65(3):224-9. doi: 10.1016/j.biopha.2011.02.011. Epub 2011 May 20. PMID: 21658899.

Draper WE, Schubert TA, Clemmons RM, Miles SA. Low-level laser therapy reduces time to ambulation in dogs after hemilaminectomy: a preliminary study. J Small Anim Pract. 2012 Aug;53(8):465-9. doi: 10.1111/j.1748-5827.2012.01242.x. Epub 2012 Jul 11. PMID: 22783835.

Prayitno DS, Phillips CJ, Stokes DK. The effects of color and intensity of light on behavior and leg disorders in broiler chickens. Poult Sci. 1997 Dec;76(12):1674-81. doi: 10.1093/ps/76.12.1674. PMID: 9438281.

Yang, J., Zhang, Q., Li, P. et al. Low-level light treatment ameliorates immune thrombocytopenia. Sci Rep 6, 38238 (2016). https://doi.org/10.1038/srep38238

Odinokov D, Hamblin MR. Aging of lymphoid organs: Can photobiomodulation reverse age-associated thymic involution via stimulation of extrapineal melatonin synthesis and bone marrow stem cells? J Biophotonics. 2018 Aug;11(8):e201700282. doi: 10.1002/jbio.201700282. Epub 2018 Feb 12. PMID: 29227581; PMCID: PMC5995606.

Image Credit: Freepik

Why Use Red Light And Blue Light In The Same Pad?

Tue, 05 Mar 2024 13:00:00 -0500

Normally, red, blue, or both color lights are used for skincare treatment. As different colors have varied specifications and benefits, we have written this article to help you understand what skin concern each color treats to help you make a wise decision.

Due to continuous advances in research that demonstrate the efficacy of Light Therapy, it is increasingly being adopted. It is an FDA-cleared cosmetic procedure where different wavelengths of light are used to treat several skin disorders. Light Therapy pads present a compact, cheap, and quick alternative to surgical or pharmaceutical intervention.

What is Light Therapy?

Light Therapy, also called photobiomodulation or low-level light therapy (LLLT), is a treatment method where different wavelengths of light, including, red, blue, and infrared, are used to stimulate cells. It has been proven to enhance ATP production, stimulate angiogenesis, and increase blood flow.

Light Therapy and Skincare Treatment

Light therapy is a highly flexible, affordable, and adaptable treatment that can be used to address various skin disorders.

It has found its way into dermatology as research shows its efficacy in treating psoriasis, rosacea, and wrinkle reduction. The biological efficacy of Light Therapy doesn’t only depend on the procedure but also on specific light parameters. The right wavelength of light is needed to achieve optimal results. As shown in Figure 1, different wavelengths target different tissues, and finding the right balance is important for effective treatment. The right wavelength of light is needed to achieve optimal results. As shown in Figure 1, different wavelengths target different tissues, and finding the right balance is important for effective treatment. The right wavelength of light is needed to achieve optimal results. As shown in Figure 1, different wavelengths target different tissues, and finding the right balance is important for effective treatment.

Red Light

Red light can reach the dermis and can activate fibroblasts, cells that contribute to collagen synthesis. It also stimulates the production of elastin, assisting in rapid cellular regeneration. Red light penetrates deep in the tissue and improves the overall skin texture by reducing inflammation, blemishes, wrinkles, and age spots.

Blue Light

Blue light, when compared to red light, doesn’t penetrate deep into the tissue and can be useful for addressing skin concerns in the epidermis. Research has revealed blue light to be effective for treating acne. Blue light also has antimicrobial properties, which can help eliminate a wide variety of pathogens. Therefore, it is effective in the treatment of skin disorders that involve microbial agents. Blue light’s antimicrobial properties also point out its potential in modifying the skin microbiome.

Combination of Red and Blue Light for Skin Conditions

Since red light can reach the dermis and blue light can reach the epidermis, a treatment modality where both are used is found to be effective in addressing skincare concerns.

Treatment of Acne Vulgaris

This is a chronic skin disorder where acne is present on the face and sometimes on the back and chest. In this condition, pilosebaceous units are either inflamed or blocked, resulting in acne as inflammatory and/or non-inflammatory lesions. The current treatments for this condition aren’t much effective and involve drugs that pose adverse side effects and dependence. Several studies have suggested that a combination of red and blue light can be effective in the treatment of acne vulgaris. Red light is shown to have an inhibitory effect on sebum production, while blue light can reduce sebocyte proliferation. Moreover, blue light’s antimicrobial properties further assist in treating the condition as it can alter the skin’s microbiome. A 38% reduction in inflammatory and noninflammatory acne lesions was observed when a combination of red and blue light was used.

Wrinkle Reduction And Other Skin Concerns

Light Therapy has found its practical application in not just treating acne, but also in other cosmetic procedures such as skin rejuvenation and anti-aging. Red light at the wavelength of 660nm has been found effective in addressing aged skin by reducing wrinkles. Red light can reduce fine lines and wrinkles, increase collagen density, and improve complexion, by energizing cells, leading to accelerated healing and a more youthful, healthier skin. Blue light has shown to improve the overall texture, skin elasticity, and complexion. It also promotes surface healing and together with red light can result in a radiant skin and powerful antiaging effects. Research shows that a combination of different wavelengths, especially red and blue light, can demonstrate higher efficacy in addressing these concerns.

The Right Light Therapy Pad for Acne Treatment and Wrinkle Reduction!

Research shows that using red and blue light together can be more helpful in combating acne, wrinkles, and other issues, as compared to when used separately. They offer a perfect combination as red light carries out cellular regeneration and accelerates healing, while blue light addresses the issues on the surface of the skin by destroying microbes. Optimal results can be gained from using a light pad that has both red and blue light wavelengths. It is important to use FDA-cleared pads too to ensure your safety.

Light Therapy is truly revolutionizing healthcare as it is safe, easy, and affordable. It doesn’t require surgery or medication and has no known side effects. Research suggests that both red and blue light are best suited to treat skincare concerns, such as acne. If you are looking for a system where you get the best of both worlds in one product, without buying two separate ones, we recommend our collection.

Feel free to contact us or call Rob at 860-707-4220 and we would be happy to address your queries or provide more information.

Citations

Calderhead RG. The photobiological basics behind light-emitting diode (LED) phototherapy. Laser Therapy. 2007;16:97–108.

Whelan HT, Smits RL Jr, Buchman EV, Whelan NT, Turner SG, Margolis DA, Cevenini V, Stinson H, Ignatius R, Martin T, Cwiklinski J, Philippi AF, Graf WR, Hodgson B, Gould L, Kane M, Chen G, Caviness J. Effect of NASA light-emitting diode irradiation on wound healing. J Clin Laser Med Surg. 2001 Dec;19(6):305-14. doi: 10.1089/104454701753342758. PMID: 11776448.

Kleinpenning MM, Otero ME, van Erp PE, Gerritsen MJ, van de Kerkhof PC. Efficacy of blue light vs. red light in the treatment of psoriasis: a double-blind, randomized comparative study. J Eur Acad Dermatol Venereol. 2012 Feb;26(2):219-25. doi: 10.1111/j.1468-3083.2011.04039.x. Epub 2011 Mar 24. PMID: 21435024.

Wilson BC, Patterson MS (2008 May 7) The physics, biophysics and technology of photodynamic therapy. Phys Med Biol 53:R61–R109.

Wunsch A, Matuschka K. A controlled trial to determine the efficacy of red and near-infrared light treatment in patient satisfaction, reduction of fine lines, wrinkles, skin roughness, and intradermal collagen density increase. Photomed Laser Surg. 2014 Feb;32(2):93-100. doi: 10.1089/pho.2013.3616. Epub 2013 Nov 28. PMID: 24286286; PMCID: PMC3926176.

Ash C, Harrison A, Drew S, Whittall R. A randomized controlled study for the treatment of acne vulgaris using high-intensity 414 nm solid state diode arrays. J Cosmet Laser Ther. 2015;17(4):170–176.

Dai T. The antimicrobial effect of blue light: what are behind? Virulence. 2017;8(6):649–652.

Williams HC, Dellavalle RP, Garner S. Acne vulgaris. Lancet. 2012 Jan 28;379(9813):361-72. doi: 10.1016/S0140-6736(11)60321-8. Epub 2011 Aug 29. Erratum in: Lancet. 2012 Jan 28;379(9813):314. PMID: 21880356.

Bhardwaj SS, Rohrer TE, Arndt K. Lasers and light therapy for acne vulgaris. Semin Cutan Med Surg. 2005 Jun;24(2):107-12. doi: 10.1016/j.sder.2005.04.001. PMID: 16092799.

Charakida A, Seaton ED, Charakida M, Mouser P, Avgerinos A, Chu AC. Phototherapy in the treatment of acne vulgaris: what is its role? Am J Clin Dermatol. 2004;5(4):211-6. doi: 10.2165/00128071-200405040-00001. PMID: 15301568.

Barolet D, Boucher A. Radiant near infrared light emitting Diode exposure as skin preparation to enhance photodynamic therapy inflammatory type acne treatment outcome. Lasers Surg Med. 2010 Feb;42(2):171-8. doi: 10.1002/lsm.20886. PMID: 20166163.

Barolet D, Roberge CJ, Auger FA, Boucher A, Germain L. Regulation of skin collagen metabolism in vitro using a pulsed 660 nm LED light source: clinical correlation with a single-blinded study. J Invest Dermatol. 2009 Dec;129(12):2751-9. doi: 10.1038/jid.2009.186. Epub 2009 Jul 9. PMID: 19587693.

Touma D, Yaar M, Whitehead S, Konnikov N, Gilchrest BA. A trial of short incubation, broad-area photodynamic therapy for facial actinic keratoses and diffuse photodamage. Arch Dermatol. 2004 Jan;140(1):33-40. doi: 10.1001/archderm.140.1.33. PMID: 14732657.

Jagdeo J, Austin E, Mamalis A, Wong C, Ho D, Siegel DM. Light-emitting diodes in dermatology: A systematic review of randomized controlled trials. Lasers Surg Med. 2018 Jan 22;50(6):613–28. doi: 10.1002/lsm.22791. Epub ahead of print. PMID: 29356026; PMCID: PMC6099480.

Sadowska M, Narbutt J, Lesiak A. Blue Light in Dermatology. Life (Basel). 2021 Jul 8;11(7):670. doi: 10.3390/life11070670. PMID: 34357042; PMCID: PMC8307003.

Image Credit:https://sites.google.com/a/coe.edu/principles-of-structural-chemistry/relationship-between-light-and-matter/electromagnetic-spectrum

Don’t Limit Or Lose Mobility! Here Are The Best Pads For Leg And Knee Pain

Tue, 20 Feb 2024 13:00:00 -0500

Suffering from pain in the knees and/or legs can lead to serious consequences. In addition to making it hard to get a good night’s sleep, pain can also negatively impact knee and leg function and therefore, mobility — making even simple everyday tasks more difficult to accomplish. And pain and difficulty with walking may also impact one’s ability to drive, which in turn, may reduce personal freedom and one’s quality of life.

Drugs Only Mask Pain

If you suffer from pain in the leg(s) and/or knee(s) (or have patients who do) why be locked into a constant routine of temporary relief from over-the-counter pain medications, or face the risks of potentially addictive prescription drugs? Taking these medications, especially opioids, only masks the pain while never addressing its root cause, and can come with a distressing amount of side effects. So what is a much better approach?

Try Red Light/Infrared Therapy

Red Light/Infrared Therapy is a safe, dependable, non-invasive, and painless healing modality that can not only provide fast and effective pain relief without the side effects and risks of pharmaceuticals, but also healing support to help alleviate the cause of the pain —potentially leading to permanent relief.

Whether the pain is caused by injury, infection, or inflammation (as in the case of osteoarthritis in the knee), studies have found that Red Light and Infrared Therapy can help relieve pain, reduce swelling and stiffness, and stimulate and accelerate healing in a wide range of knee and leg issues. Red Light and Infrared Light Therapy can be depended upon to increase circulation and reduce pain and inflammation in the local area where the light therapy pads are placed. Red Light/Infrared Therapy is extremely easy and simple to administer, and has “an almost complete lack of reported adverse effects...”

Best Pads for Knee and/or Leg Therapy

With all the many shapes and sizes of Light Therapy pads now available, you may wonder what pads are best for treating the knee and/or leg. As a general rule, Light Therapy pads should cover the entire area where pain relief and healing support are needed. Energia Medical offers three pads that are perfect for treating the knee and/or leg: the Large 264 Body Pad; the Long 180 Pad; and the 96 Knee/ Shoulder/Elbow Pad. Here is what each pad offers:

Light Therapy Pad Features	Energia Medical’s Large 264 Body Pad	Energia Medical’s Long 180 Pad	Energia Medical’s 96 Knee, Shoulder and Elbow Pad
Number of Diodes	264	180	96
Red Diodes	120	80	48
Infrared Diodes	144	100	48
Standard Wavelengths of Red (660nm) and Infrared (850nm)	Yes	Yes	Yes
Pad Output Per 20 Minutes	10,483 joules	6,480 joules	3,740 joules
Measurements	8” x 15”	5” x 16”	12.6” X 11.7”
Designed For:	Perfect for placing over or under, or wrapping around the knee, and can also be wrapped around the calf, thigh, or ankle. (Can also treat hands, chest, entire back, shoulder, hip, and upper and lower arm.)	Great for wrapping around a knee, a leg, or a thigh. Can be used vertically from the knee and down the leg, or from the knee up to the thigh. When used horizontally, can treat both legs or both thighs at front or back simultaneously. (Can also be wrapped around elbows; feet; arms; wrists; and ankles to treat all sides at once.)	Specifically designed to wrap around the knee, shoulder or elbow. Built in straps. .
Warranty	Two year	Two year	Two years

In Conclusion

Knee and leg pain do not have to affect your mobility and limit your quality of life. For effective pain relief, look no further than Red Light/Infrared Therapy. Whether you yourself are tired of suffering from knee or leg pain, or if you want to provide quick and dependable pain relief to your patients, Energia Medical provides the best quality, most durable, and most powerful clinical-strength LED-powered Red Light Therapy systems available in today’s marketplace. Their wide range of Red Light and Infrared Light Therapy systems will successfully meet the needs of any individual or family, or any size health practice. Contact Energia Medical, LLC at 860-707-4220 or by email.

Citations

Hamblin, Michael R. “Mechanisms and applications of the anti-inflammatory effects of photobiomodulation.” AIMS biophysics vol. 4,3 (2017): 337-361. doi:10.3934/biophy.2017.3.337, p. 14.

Foot Pain? Red Light Therapy Can Help! Here Are The Best Pads To Use For Fast Foot Pain Relief

Tue, 09 Jan 2024 13:00:00 -0500

With all the walking, running, hiking, exercising, dancing, stair climbing, and jumping that you may do throughout your life, is it any wonder that at some point you may experience foot pain? According to a 2014 survey conducted for the American Podiatric Medical Association (APMA), “…almost 8 in 10 Americans have experienced a foot problem, and half say it has impacted their quality of life.” In fact, “Half of all adults say that foot pain has restricted their activities—like walking, exercising, working, or playing with grandchildren—in some way. For those with chronic foot pain, that number jumps to 83 percent.”

Red Light Therapy Can Help

Foot pain should be addressed as soon as possible, as pain in one or both feet can potentially lead to impairment of foot function, which in turn may increase the risk of falling. But foot pain does not have to restrict daily life.

If you or a loved one suffers from any type of foot pain, or if your patients do, rather than treating foot pain with over-the-counter pain and anti-inflammatory medications such as ibuprofen, or prescription nonsteroidal anti-inflammatory drugs (NSAIDs), or corticosteroid injections for chronic foot pain, why not try Red Light Therapy?

Red Light Therapy is non-invasive, painless, effective, dependable, and very easy to administer. And unlike many pain medications and surgery, there are no potential risks. Red Light Therapy has been proven to have “…an almost complete lack of reported adverse effects...”

Pain Relief PLUS Healing Support

Red Light Therapy can not only help relieve all types of foot pain quickly and effectively, but due to the beneficial chemical processes released within the cells during treatment, Red Light Therapy may also accelerate healing.

Scientific studies prove that “Radiation of tissue with light causes an increase in mitochondrial products such as ATP, NADH, protein, and RNA…” And its release of nitric oxide increases circulation, so that blood high in oxygen and nutrients can flow more freely into the local area, reducing pain and supporting the body’s natural healing.

It may seem amazing but it is true that “…low doses of light have demonstrated the ability to heal skin, nerves, tendons, cartilage and bones.” And over time, as nerves heal, numbness decreases and feeling in the foot returns. Studies show that pain in any part of the foot, from the toes to the Achilles tendon and up to the ankle, will respond well to Red Light Therapy.

Best Pads for the Feet

If you are looking to alleviate foot pain, why not give Red Light Therapy a try? Many manufacturers of Red Light Therapy systems, such as Energia Medical, make pads especially designed for treating the foot.

Here are four neoprene therapy pads made by Energia Medical that are excellent for treating foot issues. All four are medical grade:

Energia Medical’s Foot and Ankle 122 Diode Pad:

This uniquely-shaped 3-section pad is flexible and versatile, allowing it to be used in two ways: extended or folded over.

1. When extended, the pad can cover the bottom of the foot from the toes to the back of the heel, continuing up over the calf area.

2. When folded over, this pad can cover the toes and foot like a boot, including the top of the foot, sole, heel, and both ankles.

The 122 Foot and Ankle Pad features 122 LED’s - 61 Infrared and 61 Red diodes. Its standard wavelengths are red (660nm) and infrared (850nm). The top section measures 8” wide x 5” long, the middle section is 12” long x 4” wide, and the bottom section is 7” long x 6” wide. This pad makes an excellent home unit, for its length and unique top and bottom also allow the pad to be wrapped around the hand with the forearm resting on the pad, down the spine or the thigh and leg, or over a shoulder. Hands can be placed on the top and bottom sections.

Energia Medical’s Foot and Calf 131 Diode Pad:

This uniquely-shaped 3-section pad is flexible and versatile, allowing it to be used in two ways: extended or folded over:

2. When folded in half the pad will treat the top and bottom of the foot.

The 131 Foot and Calf features 131 LED’s – 83 Infrared and 48 Red diodes. Top Section is 7” X 10.75”. Mid to Bottom Section is 4.5” X 13.7”

Energia Medical’s Long Painbuster 180 Diode Pad:

At 16”x 5”, the double length of this highly flexible long and narrow pad allows it to be used in several ways:

1. Place the pad over the top of the foot and wrap it under the sole.

2. Place the pad under the sole of the foot and let the rest of the pad travel up the heel and into the calf area.

3. Place the pad horizontally, putting both feet on top to allow the toes or the heels to be treated simultaneously.

This pad contains a total of 180 LEDs: 120 infrared (850nm) and 60 red (660nm) diodes. It can also be used to treat other areas: its length makes it easy to wrap around the elbow or knee, the jaw, and the forehead, or flat down the back or across the shoulders, calf, stomach, or hip.

Energia Medical’s Small 90 Diode Pad:

The size and rectangular shape of this pad make it ideal for foot treatment. Just place the foot on top of the pad, or put the pad over the toes or strap across the ankle with Velcro. At 9.8” x 4.5”, this pad should easily cover the toes, sole, heel, or ankle area. This pad contains 90 total LEDs: 45 infrared and 45 red, with an output of 3,240 joules per 20 minute treatment. Its standard wavelengths are red (660nm) and infrared (850nm). The 90 pad can also be used on practically every other area of the body: the wrist, hand, neck, arm, elbow, shoulder, stomach, back, calf, thigh, or jaw, making this one pad the perfect therapy system for the entire family.

Summing Up – Kick Foot Pain Out!

Foot pain does not have to limit the quality of life for you or for your patients. Red Light Therapy can make a big difference in being able to maintain a comfortable, mobile, and active lifestyle.

Contact Rob Berman at Energia Medical at 860-707-4220 or via email to learn more about how Red Light Therapy can help you or your patients.

Citations

APMA. Public Opinion Research on Foot Health and Care: Findings from a Survey of 1000 US Adults. 2014 March, p. 3.

Day, B. New Survey Reveals Majority of Americans Suffer from Foot Pain: Ailments widespread, yet few people address issues. American Podiatric Medical Association. PRNewswire-USNewswire. 2014 May 19, p. 1.

Hamblin, Michael R. “Mechanisms and applications of the anti-inflammatory effects of photobiomodulation.” AIMS biophysics vol. 4,3 (2017): 337-361. doi:10.3934/biophy.2017.3.337, p. 14.

Chung, Hoon, et al. The Nuts and Bolts of Low-level Laser (Light) Therapy. Ann Biomed Eng. 2012 February; 40(2): 516–533. doi:10.1007/s10439-011-0454-7, p. 5 of NIH Public Access version.

Cotler, Howard B. et al. The Use of Low Level Laser Therapy (LLLT) For Musculoskeletal Pain. MOJ Orthop Rheumatol. 2015 ; 2(5): . doi:10.15406/mojor.2015.02.00068, p. 4.

Acupuncture Pairs Perfectly With Red Light/Infrared Therapy For Better Patient Outcomes!

Sun, 24 Dec 2023 13:00:00 -0500

Acupuncturists, did you know that adding Red Light and Infrared Therapy to your treatment menu can bring a whole new dimension to your practice, opening the door to greater benefits for your patients that result in better patient outcomes? That’s because the ancient traditional healing art of acupuncture and the modern day healing modality of Red Light/Infrared Therapy pair perfectly. And used together, they become a dynamic, winning treatment team that can be relied upon to deliver consistently outstanding results and bring a new flow of energy into your practice! Here are the reasons why.

Needles and Light Waves Produce Similar Results

While acupuncture utilizes fine needles to penetrate the body in order to trigger specific meridians to relieve both acute and chronic pain and stimulate healing, Red Light and Infrared Light Therapy achieves the same beneficial results by employing light waves that are absorbed by the body. This is because applying light “to tissues and organisms can elicit both stimulatory and inhibitory responses, depending upon the light parameters used.”

And, like the benefits produced by acupuncture, science has discovered that Red Light/Infrared Therapy “…results in beneficial therapeutic outcomes including but not limited to the alleviation of pain or inflammation, immunomodulation, and promotion of wound healing and tissue regeneration.” Red Light and Near Infrared Therapy uses light-emitting diodes (LEDs) in specific wavelengths in the visible and infrared spectrum that penetrate the skin and are absorbed by tissues, nerves, tendons, ligaments, organs, and even bones, to achieve fast acting pain relief and healing support.

More Similarities

Red Light/Infrared Therapy, like acupuncture, not only relieves pain and discomfort, but increases blood flow and circulation, boosts tissue oxygenation, relaxes muscles and the nervous system, and stimulates and accelerates the body’s own innate healing processes through the release of nitric oxide (NO), ATP, NADH, RNA, and other highly beneficial chemicals.

And like acupuncture, Red Light and Near Infrared Light Therapy can be used on every part of the body, helping the body regain and maintain health and wellness. Red Light/Infrared Therapy also matches acupuncture in being an all-natural, highly dependable, and cost-effective alternative to the potential risks, negative side effects, and sky-rocketing costs of pharmaceutical drugs and surgery.

Red Light/Infrared Therapy Adds Value

Red Light Therapy can add value to your treatment sessions for the simple reason that one Red Light Therapy pad can enhance circulation and relieve pain and stiffness over a large area of the body. Also, Infrared Light Therapy may possibly enhance and augment the benefits of your needling work. Red Light/Infrared Therapy has been described by patients as being gentle, soothing, and comforting, and can help your patients to reach a deeper level of relaxation during their acupuncture treatments.

Non-Invasive, Safe, and Risk-Free

Since Red Light and Infrared Therapy is non-invasive, it generates additional value by being a treatment option for patients who are afraid of needles. Also, since the skin is never penetrated, there is no risk of bleeding, bruising, or infection. And, most importantly, Red Light/Infrared Therapy is completely safe and risk-free, as clinical studies have found that Red Light and Infrared Light Therapy “has a wide range of benefits on various patient populations, different medical indications and conditions without any serious risk of adverse effects.”

How to Administer

No matter your style of acupuncture, Red Light/Infrared Therapy is extremely easy to incorporate into your treatment sessions in several ways:

Pre-Needling: Light Therapy pads may be used on areas requiring greater chi and circulation for at least ten minutes before needling. The pads will increase blood flow and relieve pain quickly. The warmth of the therapy pads will cause the patient’s body to relax, and then insertion and manipulation of the needles may actually be easier.
During Needling: Most acupuncturists utilize Light Therapy pads at the same time as needling, usually as soon as treatment begins. Wherever the pads are placed, chi and blood circulation will increase in that local area. Light Therapy pads soothe tissues and ease the buildup of muscle tension, deepening the patient’s relaxation and enhancing stress reduction. Light Therapy pads can then be moved around the body, working on different problem areas as the session progresses. Most Light Therapy pads are flexible enough to be versatile, allowing the same pad to be used on different areas to treat a range of conditions.
Post-Needling: Give your patient a complete twenty-minute Light Therapy session immediately after needling. Light Therapy pads can be placed where the needling was administered, or on other acupoints throughout the body where support is needed. Red Light/Infrared Therapy will enhance relaxation, and trigger cellular processes that accelerate the body’s own innate healing ability.
Stand-Alone Treatment: Red Light/Infrared Therapy can be administered by itself as a standalone treatment option, which may appeal to patients who have a fear of needles. During this time, the patient may be left unattended, allowing you to treat other patients.

Red Light/Infrared Therapy Can Boost Your Revenue:

Adding Red Light/Infrared Therapy to your treatment menu can boost the revenue of your acupuncture practice in four distinct ways:

As an add-on to needling for an extra fee.
As a stand-alone treatment option for patients afraid of needles, or for those who discover that they enjoy and benefit from Red Light/Infrared Therapy.
Through the sales of Red Light/Infrared Therapy systems to patients for their home use.
By broadening your treatment menu and making your practice more unique, helping it to stand far above the ever-growing competition — potentially increasing your client base.

The Bottom Line

Used together, acupuncture and Red Light/Infrared Therapy make a great treatment team! By adding Light Therapy to your treatment menu, you can energize your practice, boost your revenue, and bring greater benefits to your patients that result in better patient outcomes and increased patient satisfaction. Red Light and Infrared Light Therapy is easy to integrate and easy to administer. Plus, Red Light/Infrared Therapy systems offer a fast ROI and are surprisingly affordable, with a wide range of systems available to meet the needs of any acupuncture practice.

For more information, contact Rob Berman at 860-707-4220 or via email.

Anders JJ, Lanzafame RJ, Arany PR. Low-level light/laser therapy versus photobiomodulation therapy. Photomed Laser Surg. 2015 Apr;33(4):183-4. doi: 10.1089/pho.2015.9848. PMID: 25844681; PMCID: PMC4390214, p. 183.

Ibid., p. 184.

Tsai SR, Hamblin MR. Biological effects and medical applications of infrared radiation. J Photochem Photobiol B. 2017 May;170:197-207. doi: 10.1016/j.jphotobiol.2017.04.014. Epub 2017 Apr 13. PMID: 28441605; PMCID: PMC5505738, p. 3.

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