Evaluating Different Low-level Laser Therapies to Treat Neck Pain in Air Force Pilots and Flight Crew

Evaluating Different Low-level Laser Therapies to Treat Neck Pain in Air Force Pilots and Flight Crew

Evaluating Different Low-level Laser Therapies to Treat Neck Pain in Air Force Pilots and Flight Crew

The purpose of this study is to identify what are the most effective low level laser therapy (LLLT) dosimetry parameters when treating pilots and navigators complaining of flight related neck pain.

Utilizing the Pinnacle Series Laser by Aspen Laser Systems, investigators will apply 635-780nm, 10 mW cw, ~ 5-105 J/cm2 at the following time and mW intervals. The beam will be applied at 12 application patterns equidistant and parallel to each other. Each application point will be treated for the timeframes referenced below: Subgroup 1: 10 minutes at 5 mW Subgroup 2: 10 minutes at 15 mW Subgroup 3: 10 minutes at 32 mW Subgroup 4: 15 minutes at 5 mW Subgroup 5: 15 minutes at 15 mW Subgroup 6: 15 minutes at 32 mW

Utilizing the Pinnacle Series Laser by Aspen Laser Systems, we will apply 830nm, 30- 50mW cw, ~ 1-20 J/cm2 at the following time and mW intervals. The beam will be applied at 12 application patterns equidistant and parallel to each other. Each application point will be treated for the timeframes referenced below: Subgroup 1: 10 minutes at 5 mW Subgroup 2: 10 minutes at 15 mW Subgroup 3: 10 minutes at 32 mW Subgroup 4: 15 minutes at 5 mW Subgroup 5: 15 minutes at 15 mW Subgroup 6: 15 minutes at 32 mW

Utilizing the Phoenix Thera-Lase by Phoenix Thera-Lase Systems, we will apply 904nm, 40mW (pulsed) @10000Hz, ~ 4-18 J/cm2 at the following time and mW intervals. The beam will be applied at 12 application patterns equidistant and parallel to each other. Each application point will be treated for the timeframes referenced below: Subgroup 1: 10 minutes at 5 mW Subgroup 2: 10 minutes at 15 mW Subgroup 3: 10 minutes at 32 mW Subgroup 4: 15 minutes at 5 mW Subgroup 5: 15 minutes at 15 mW Subgroup 6: 15 minutes at 32 mW

The NDI assessing functional capacity, has 10 parts, which evaluate pain intensity, personal care, lifting objects, reading, headache, concentration, work, driving, sleeping, and recreation. NDI scores, ranging from 0-50, may be doubled and also expressed as a percentage of function on a scale of 0-100%; thereby allowing the measure to be treated as an interval variable. It has also been categorized into 5 ordinal measurements, which are shown below with corresponding score and percentage measurements: NDI Score 0-4 (0-8%) is total capacity (no disability) NDI Score 5-14 (10-28%) is mild incapacity (mild disability) NDI Score 15-24 (30-48%) is mild incapacity (moderate disability) NDI Score 25-34 (50-64%) is serious capacity (severe disability) NDI Score 35-50 (70-100%) is severe incapacity (complete disability)

The Defense and Veterans Pain Rating Scale is an assessment tool that utilizes a numerical rating scale, enhanced by functional word descriptors, color coding, and graphical facial expressions to evaluate a patient's self-reported pain levels. The DVPRS consists of an 11-point numerical rating scale with 0 indicating no pain and 10 indicating severe pain. It has been confirmed for reliability and validity in measuring both acute and chronic pain, and is currently the standard for pain measurement throughout DoD and VA health systems. The DVPRS has demonstrated linear scale qualities allowing parametric methods to be used.

Phlebotomists will draw 750 uL into 3 separate cryovials on two separate occasions. Interleukin 2 Receptor (CD25) Soluble Standard curve range: 4.25-17400 pg/mL

Phlebotomists will draw 750 uL into 3 separate cryovials on two separate occasions. Interleukin 12 Standard curve range: 1.56-6400 pg/mL

Phlebotomists will draw 750 uL into 3 separate cryovials on two separate occasions. Interleukin 4 Standard curve range: 9.35-38300 pg/mL

Phlebotomists will draw 750 uL into 3 separate cryovials on two separate occasions. Interleukin 5 Standard curve range: 6.52-26700 pg/mL

Phlebotomists will draw 750 uL into 3 separate cryovials on two separate occasions. Interleukin 10 Standard curve range: 2.49-10200 pg/mL

Phlebotomists will draw 750 uL into 3 separate cryovials on two separate occasions. Interleukin 13 Standard curve range: 3.27-13400 pg/mL

Phlebotomists will draw 750 uL into 3 separate cryovials on two separate occasions. Interleukin 1 beta Standard curve range: 2.39-9800 pg/mL

Phlebotomists will draw 750 uL into 3 separate cryovials on two separate occasions. Interleukin 6 Standard curve range: 6.74-27600 pg/mL

Phlebotomists will draw 750 uL into 3 separate cryovials on two separate occasions. Interleukin 8 Standard curve range: 2.38-9750 pg/mL

Phlebotomists will draw 750 uL into 3 separate cryovials on two separate occasions. Tumor Necrosis Factor - alpha Standard curve range: 6.42-26300 pg/mL

Phlebotomists will draw 750 uL into 3 separate cryovials on two separate occasions. Interleukin 2 Standard curve range: 4.25-17400 pg/mL

Phlebotomists will draw 750 uL into 3 separate cryovials on two separate occasions. Interleukin 17 Standard curve range: 2.22-9100 pg/mL

Phlebotomists will draw 750 uL into 3 separate cryovials on two separate occasions. cyclooxygenase (COX-2) Standard curve range: 7.5 U/ml - 60 U/ml

Phlebotomists will draw 750 uL into 3 separate cryovials on two separate occasions. cortisol Standard curve range: cortisol will be compared to normal reference range for the time the blood is drawn, which is noted on lab report 8AM sample using the new assays is 10 to 50 picograms per milliliter (pg/ml); levels are usually less than 20 pg/ml at 4 PM and less than 5-10 pg/ml at midnight.

Phlebotomists will draw 750 uL into 3 separate cryovials on two separate occasions. substance P Standard curve range: N/A, values from day 0 time will be compared with day 10 values

Phlebotomists will draw 750 uL into 3 separate cryovials on two separate occasions. C-reactive protein Standard curve range: 3 mg/L-10 mg/L

Phlebotomists will draw 750 uL into 3 separate cryovials on two separate occasions. alpha-1 antitrypsin Standard curve range: 100-300 mg/dL

**Patients must be able to get care at Nellis Air Force Base (a military installation) in order to participate in this study** Inclusion Criteria: Active Duty US Air Force pilots or onboard navigators, aged 18- 62 years of age maintain operational flight status at enrollment or within the last 6 months History of neck pain for a period of more than two months Score on the Neck Disability Index ranging from 15-24 No physiotherapy or local injection in 3 months before starting the study Exclusion Criteria: pregnant major surgery or trauma in the previous 3 months unstable cervical spine cervical radiculopathy rheumatoid arthritis open wound over neck pace-maker or defibrillator implantation overt neuropathic pain or radiation pain inability to express pain or quality of life. history of neurological disorders medical diagnosis of fibromyalgia; systemic disease

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