This pilot study will address the immediate effect of Cranial Laser Reflex Technique (CLRT) on the flexibility, strength, and pain pressure threshold of the hamstring muscle in healthy young adults. CLRT is a Complementary and Alternative (CAM) intervention that incorporates principles of laser acupuncture with chiropractic cranial reflexology. Stimulating the reflex with a low-level laser may affect the tonus, pain, and strength of the target muscle and improve muscle function.
This study will address the effect of transcranial photobiomodulation (PBM) on stress physiology as measured by heart rate variability (HRV), electroencephalogram (EEG), and functional magnetic resonance imaging (fMRI) in healthy adults. This study uses low-level laser stimulation on the CLRT chronic stress point, hypothesizing that it will cause a shift towards parasympathetic activity and modification of the acute stress response with reduced frontal asymmetry.
Objective: The objective of the study was to compare the immediate effects of CLRT with a sham treatment on chronic musculoskeletal pain using pressure algometry in a double-blinded randomized controlled trial.
Methods: Fifty-seven (57) volunteers with various musculoskeletal pains gave informed consent and were randomly allocated to either the CLRT treatment or sham group. Painful trigger points and/or tender spinal joints were found in each patient. Using a digital algometer, the pain/pressure threshold (PPT) was determined and a pain rating was given using a numerical pain scale from 0-10. CLRT or a sham treatment was performed with a 50mW, 840nm laser, for a maximum of 20 seconds to the each cranial reflex. The initial pressure (PPT) was immediately delivered to the same spot, and the pain rated again.
Results: There was a statistically significant difference in pain scores between CLRT and sham groups immediately following treatment. Improvement was reported in 95% of the treatment group, with 59% reporting an improvement of 2 points or greater. The average change in pain scores in the treatment group was 2.6 points (p = 0.000) versus negligible change (p = 0.4) for the control group.
Conclusion: The results show that CLRT is effective at immediately reducing chronic musculoskeletal pain.
Cranial Laser Reflex Technique (CLRT) is a novel treatment method that utilizes low level laser therapy (LLLT) stimulation of cranial reflexes discovered by chiropractors. While there are animal studies that prove the pain relieving effects of transcranial laser stimulation4,5, and several studies on transcranial laser therapy for improving neurological deficits after stroke6,7, this is the first study to examine whether laser irradiation of cranial reflexes is effective as a remote control method for reducing musculoskeletal pain.
There are numerous complementary and alternative therapies from around the world that are based on a similar organizing principle: that the information of the whole organism can be found within a smaller circumscribed area. Usually referred to as microsystems or microacupuncture systems, there are many of these therapies in use today: auriculotherapy, Su Jok therapy, foot reflexology, ECIWO (embryo containing the information of the whole organism) therapy, Yamomoto New Scalp Acupuncture (YNSA), Korean Hand Acupuncture, oral (dental/tongue/gum) acupuncture, facial and lip acupuncture, iridodiagnostics, nasal therapy, etc. Although the exact mechanism of how each microsystem is connected to the body’s “macrosystem” may not yet be known, the empirical evidence of the various somatotopic maps has been collected for thousands of years, and the clinical efficacy of microsystem therapies is beyond question.
Cranial Laser Reflex Technique
CLRT is a complementary or alternative intervention that incorporates principles of laser acupuncture with chiropractic cranial reflexology. Instead of points derived from TCM, CLRT involves laser stimulation of two distinct cranial microsystems discovered by chiropractors. The first map of cranial reflex points/pathways (CRP’s) was originally discovered by a doctor named Jack Elvidge using Applied Kinesiology8, and this set corresponds to each major muscle in the body. These soft-tissue CRP’s are either points or directional lines on the skull, and they appear to have a profound influence on the particular muscle’s tonus and strength. It was found that stimulating the linear reflexes with digital pressure in one direction relaxed the muscle’s tone, and stimulating it in the opposite direction increased the tonicity.
The second set of CRP’s used in CLRT were discovered by David Denton, D.C., and consists of points that connect to each vertebra of the spine, rib, each sacroiliac joint, sacrum and coccyx. Dr. Denton found that subtle manipulations of these points affected the position and function of misaligned vertebra in manner similar to adjusting them directly. 9
Dr. Nicholas Wise developed CLRT after postulating that the CRP’s had similar optical properties to the acupuncture meridians.10,11 and would respond to coherent light in a similar manner. Upon clinical experimentation, he found that the cranial reflexes were in fact extremely responsive to low doses of laser light. The major goal of CLRT is to quickly decrease in pain, increase joint range of motion, and achieve lasting functional improvements. CLRT can be performed with any power of laser from 5mW to 500mW with similar results, and wavelengths from 405nm-840nm are used interchangeably.
Theoretical Basis for CLRT
The existence of each of the body’s microsystems is often used to point to deeper level of informational organization, i.e. the holographic12 or fractal nature of the human body13. Holograms are three-dimensional images made from laser light that can store a very large amount of data. Holographic data is stored in interference patterns, appearing as concentric circles which are the summation and negation of the overlapping light waves. The attributes of holograms that are relevant to this discussion are that: they are created with laser light, and the information of the whole is contained within the smallest part. The theoretical framework for CLRT is based on the premise that these cranial reflexes are the holographic storage locations of the information of the target tissue14. It is proposed by Wise  that each of the body’s holograms is formed by interference patterns created by standing waves of biophoton emission15.
According to Fritz-Albert Popp, all living systems emit light. This is an intrinsic result of the metabolic processes of a living system, which is a dissipative system far from thermal equilibrium. Also called ultra-weak photon emission, this light emission is not a random process, as it would be if it were purely thermal in nature. Instead the experimental results indicate that biophotons originate from a coherent photon field within the living organism, its function being intra and intercellular regulation and communication. It has been studied extensively, and certain properties have been enumerated, among them: biophotons are in the visible part of the electromagnetic spectrum (380-780 nm), and the intensity and spatial aspect of light emission is dependent upon state of health and state of mind. [Popp, 1999.]
Biophotons are thought to be encoded with vibrational information across a wide range of frequencies, including visible and near-visible light, and that they are likely to serve as “signals that integrate processes, such as growth, injury repair, defense, and the functioning of the organism as a whole.16” Every cell in the body emits and is highly sensitive to these “laser-like photons” 17 and in a holographic model, coherent light is capable not only of carrying and storing large amounts of information, but modulating it as well.
According to Curtis and Hurtak , there is a biophysical basis for a “Medicine of Light,”18 that incorporates the way biophysical light interacts with the human self-organization of information. This may be achieved by means of “biomolecular, metabolic, or neural communication. These systems may merge as mobile energy relay systems similar to what is seen as qi processes in acupuncture science, suggesting a 'holomovement' that seeks to confirm itself and increasingly retrieves and uses only the information that serves its exchanges with the environment.”
Therefore it is proposed that the effect of the therapeutic laser (coherent) light in CLRT is less of the biostimulation effect seen in LLLT, but acting on an energetic and informational level on the cranial hologram.
One or more painful trigger points or spinal joints were located in each patient using manual palpation. Two distinct painful areas were found in 76% (n=22) of the CLRT group participants, and 79% (n=22) of the control group. Once the painful areas were located, they were evaluated for the cardinal signs of a trigger point19 or spinal joint tenderness.
The pain/pressure threshold (PPT) was determined using a Wagner FPX digital algometer (Wagner Instruments, Post Office Box 1217, Greenwich, CT 06836-1217). The instrument consists of a rubber disc with a surface of exactly 1 cm2 that is attached to a digital force (pressure) gauge. Pressure algometry has been shown to be a reliable, valid form of pain measurement20, as well as an effective indicator of the immediate efficacy of a therapeutic intervention.
After its use was explained to the participant, the instrument was used on the location of the trigger point to assess the amount of pressure the participant could sustain before they registered it as being painful. The participant’s perceived pain levels were assessed via a numerical rating scale (NRS). The NRS has been shown to be simple to administer and still produce a consistent measure of clinical pain intensity21. On the basis of a review of the literature on pain measures prepared for the IMMPACT-II consensus meeting (Jensen, 2003) the 11-point (i.e. 0–10) NRS measure of pain intensity is recommended as a core outcome measure in clinical trials of chronic pain treatments22.
Participants were asked to score the intensity of their pain on an 11-poi nt scale from 0-10, with zero (0) being “no pain” and ten (10) being the “worst pain you can imagine.” These assessments were performed before and immediately after the intervention.
The experiment was performed with a focus-adjustable, handheld 50mW, 840nm laser. The laser’s treatment spot size is 3.14cm2. To satisfy the requirements of a double-blinded experiment, it was important that neither the examiner nor the participant be able to determine if the laser was actually functioning during the session. This was accomplished by obscuring the power switch and indicator light by an application of black vinyl tape beforehand and keeping the laser in its defocused setting. When defocused, the beam of this wavelength is invisible in normal daylight condition
Once the participant was in position for treatment, the participants underwent the CLRT protocol as outlined by Wise . To assess an immediate difference in pain intensity, the initial amount of pressure that elicited a painful response was delivered to the same spot in the trigger point of the muscle. The tip of the algometer was placed in the exact spot as before as indicated by the residual pressure mark. The participant was then asked to rate their pain level again with the NRS.
The patient was instructed to breathe deeply and slowly, and each CRP was lasered for the duration of three (3) full respiration cycles, or approximately 20 seconds each, delivering approximately 1J of energy to each reflex. For the point reflexes, the laser was held still. For those reflexes that are represented as lines rather than points, a bidirectional scanning method was used for the duration of three (3) full respiration cycles.
A feedback technique (muscle test) for determining the optimal direction of reflex stimulation is usually part of the protocol, but was left out of this study as it was thought it might compromise the blinding or influence the patient in some way towards a particular outcome.
The primary limitation of the study was that it focused on a single outcome measurement: the immediate effect of CLRT on pain levels. Future studies will be needed to examine the long-term effects, the duration of relief, the effect on quality of life, and effects on medication usage. Furthermore, the physiological mechanisms need to be investigated as well, with EMG measurements and, ideally, fMRI and biophoton measurements. Such future studies will undoubtedly contribute to a better understanding of this treatment.
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