Author and graduation date: Justin D. WHITEHOUSE, February, 2002

Committee members: Denise L. Wiksten (Chair), Roger Simmons, Paul T. Kolen

Thesis title: The Efficacy of Low Level Laser Therapy on Iliotibial Band Syndrome in Marine Recruits

This paper examines the efficacy of an experimental device on an inflammatory musculoskeletal condition of the knee commonly found in Marine Corps recruits during recruit training. Low Level Laser Therapy (LLLT) is a new technology gaining popularity in the treatment of soft tissue inflammation usually associated with strains and sprains. The Food and Drug Administration has determined LLLT devices to be no-risk devices but has yet to acknowledge benefits of treatment. Previous studies have shown that under certain conditions, photons delivered into cells during LLLT help to stimulate the release of chemicals associated with the healing response to injury. Iliotibial Band Syndrome (ITB) was chosen for this study for its prevalence in the military population due to the friction caused by repetitive running, marching, and hiking.

Forty-two male subjects were included after referral from physicians at the base medical clinic. Upon meeting inclusion criteria, subjects were randomly selected to either the "active" or "placebo" groups and asked to complete a Visual Analog Scale (VAS) questionnaire for baseline pain measurements. VAS data were given a numerical value of 1 to 10 for analysis. A Galium Aluminum Arsenide diode laser at 830 nm with 120 W of energy was used to treat five sites along the ITB for the active group (n = 21). Placebo group (n = 21) subjects were treated with a "sham" laser. Over 2 weeks, with baseline measurements and follow-up measurements, six treatments occurred and seven VAS reports of pain were recorded. Subjects were given a standardized course of treatment in addition to LLLT or placebo, consisting of a daily regimen of ice, stretching, rest, and antiinflammatory medication.

Data analysis using a one-way repeated measures ANOVA revealed that there was no significant difference between group means over time (alpha = .05). While there was no statistically significant difference between groups, there was a trend for the LLLT group to have a lower reporting of pain as compared to the placebo group. It is thought that these mean differences might reveal clinical significance. Post hoc analysis showed that when groups were combined, significant differences (p = .001) were found between baseline and the second treatment.

Subjects were found to be motivated toward following treatment guidelines, yet outside circumstances may have altered the reporting of pain. Subject bias and study design effects were considered equal across groups. Largest differences of group means were found during the first few days of treatment when the healing response is most active. Therefore, LLLT may show the most benefit to injuries in their first days of healing. Given the trend with the active group reporting slightly better reductions of pain, a larger sample size may provide insight on the effectiveness of LLLT for musculoskeletal pain.

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