The Effect of Therapeutic Laser on the Performance of ...

The Effect of Therapeutic Laser on the Performance of Vertical Jump

Research Advisor:

Dr. Jane Wibbenmeyer

Authors:

Kevin Boyd Joel Inman

Brian Jennings Kyle Peacock

11/21/12

Vertical Jump Performance

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Abstract

Objective: Many passive modalities are used today for treatment of acute and chronic conditions, along with performance-based improvements. In this study the Class IV Laser ‘LightCure’ was utilized and examined to study its overall validity and effect with measured performance improvement. Methods: The trial was done on 64 participants, 38 men and 26 women, which were unknowingly divided into a treatment and placebo group. Participants performed a series of measurd vertical jumps, underwent treatment by the laser on the gastrocnemii and jumped again. Data was analyzed and as a result of completing the above procedure it was found that the LightCure Results: Laser increased overall performance. The average post-treatment numbers nearly doubled the pre-treatment numbers for those participants who received treatment. The placebo group slightly improved as well due to possible psychological effects. The data was analyzed per gender as well and showed noticeable improvement in performance between men and women. Conclusion:This trial lends to the conclusion that the LightCure Laser is beneficial in increasing performance starting at the cellular level.


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Introduction

Using phototherapy or biostimulation, instead of thermal (heat), sound, or

vibration, a variety of musculoskeletal problems can be addressed with laser

therapy. “Indications include carpal tunnel syndrome, joint disorders and

tendinopathies, lateral and medial epicondylitis, osteoarthritis, low back pain, ankle

sprains, venous ulcers, and decubitus ulcers” (Wang, 2004). Joint disorders included

in studies were low back joints and osteoarthritis. Superficial wounds such as ulcers

were also treated with low-level laser therapy (LLLT). Laser phototherapy is a very

effective tool for therapeutic treatment in encouraging tissue repair and offering

pain relief (Enwemeka, 2004).

According to studies done on rats, bone healing has also been noted with

laser use. Bone repair and remodeling were improved in the studies of rats treated

with laser therapy versus the ones who were not (Blaya, 2008). Lasers are

implemented any many disciplinary practices to improve healing, rehabilitation and

training of musculoskeletal problems. Disciplines include Chiropractic, Dental,

Medical, and Physical Therapy.

Class IV lasers affect the body to speed up the healing process of muscle

tissues at the cellular level. The physics behind the laser therapy is focused on using

red and near-infrared light. The laser therapy is applied over the injured tissue to

provide soft tissue healing and alleviate both chronic and acute pain (Parr, Larkin, &


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Borsa, 2010). This is achieved through the biological process of light energy utilized

at the cellular level. The light energy is in the form of photons, and these photons

produce the biostimulative effects without the negative effects of damage or trauma.

The biostimulative effects involved in using light therapy occur when an area of the

skin’s surface is treated with the laser, the photons of the laser light will penetrate

the tissue cells. Then they are absorbed by photo-acceptor molecules within the cell

membrane as well as the cytosolic organelles found inside the tissue cells exposed,

such as mitochondria. Once inside the mitochondria, the light energy is absorbed by

chromophores, such as cytochrome c oxidase. This is where light energy is

converted to biochemical energy. This results in the increased production of ATP,

which will speed up the healing process through tissue healing and cellular

regeneration.

Another aspect of using class IV laser therapy would be to help reduce pain

by decreasing the inflammatory response as well as its effects on the nociceptors

found in the tissue being treated. When the target tissue is treated with laser

therapy, there is an inhibition in the release of pro-inflammatory cytokines that

occur during the acute inflammatory response (Parr, Larkin, & Borsa, 2010). This

also creates a modulation effect on peripheral nociceptors, which alleviates the

sensation of pain, and “effects include slowing nerve conduction velocity, altering

neural membrane depolarization potential, and decreasing muscle spasm and

edema” (Parr, Larkin, & Borsa, 2010).

Standing vertical jump is an important field test for capable performance in

athletes, especially those in soccer, football, basketball, and volleyball. The vertical


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jump is accomplished by a series of explosive muscle contractions from coordinated

muscle groups around the ankle, knee and hip joints. A vertical jump also involves

many stabilizing muscle groups such as the hamstrings, abdominals and lower back.

To accomplish a vertical leap, the glutei, quadriceps and gastrocnemii muscles must

eccentrically contract to prepare the individual to jump. This means that the

extensor muscles lengthen lowering the individual into a squat position. These

muscles must then concentrically contract in an explosive manner, which will propel

the participant into the air. The abdominals, hamstrings and lower back muscles

work to stabilize these joints as the other muscles act on them. The hamstrings

become the most important in strength of the muscles in the lower extremities and

is the most important determinant of vertical jump performance (Vanezis & Lees,

2005).

Material and Methods

The research project consisted of recording participants vertical jump with a

vertical jump tester. A series of three pre-treatment vertical jumps were averaged

and recorded. Participants were then blinded to treatment. All participants were

under the assumption that each participant underwent laser therapy. After

treatment, or sham treatment, the participants again were ordered to perform three

more vertical jumps. These calculations were recorded and averaged with the use of

a vertical jump tester. The data sets were averaged, and equations were utilized to

obtain a standard deviation for both the treatment and placebo data sets. If any data


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points fell outside two standard deviations from the average point, then these data

points were thrown out as anomalies to the study.

The class IV laser used was identified as LightCure. Class IV lasers affect the

body to speed up the healing process of muscle tissues at the cellular level. The

physics behind the laser therapy is focused on using red and near-infrared light. The

laser therapy is applied over the injured tissue to provide soft tissue healing and

alleviate both chronic and acute pain (Parr, Larkin, & Borsa, 2010). This is achieved

through the biological process of light energy utilized at the cellular level. The light

energy is in the form of photons, and these photons produce the biostimulative

effects without the negative effects of damage or trauma. The biostimulative effects

involved in using light therapy occur when an area of the skin’s surface is treated

with the laser, the photons of the laser light will penetrate the tissue cells. Then they

are absorbed by photoacceptor molecules within the cell membrane as well as the

cytosolic organelles found inside the tissue cells exposed, such as mitochondria.

Once inside the mitochondria, the light energy is absorbed by chromophores, such

as cytochrome c oxidase. This is where light energy is converted to biochemical

energy. This results in the increased production of ATP, which will speed up the

healing process through tissue healing and cellular regeneration. Half of the

participants underwent three minutes of laser therapy on each of their

gastrocnemii. The settings were 15 amps for three minutes. The sham group also

received three minutes of contact time with the laser probe but with no treatment

delivered.


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Participants were initially measured for their standing reach to accurately

determine their vertical jump. Participants were instructed to abduct there arm to

180° and then these heights were used to compare to their vertical leap. The vertical

jump was tested using a vertical jump tester that was acquired from Logan College

of Chiropractic Wellness Center. Participants would perform a vertical jump with

their shoes off pre and post treatment. Data was obtained and recorded.

Results

The data collection demonstrated a significant trend between the two groups

of participants, treated and untreated. There were a total of 64 participants, 38 men

and 26 women. The following data represents the distribution of all participants’

average improvement between their initial jumps and their post-treatment jumps.

Figure 1 includes the participants who did not receive the laser treatment and

received the placebo.


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Figure 1. Untreated participant jump improvement average.

The data shows that most participants improved their vertical jumps without

treatment. The entire group of participants who did not receive treatment improved

their vertical jump by an average of 0.1867 inches. Figure 2 includes the

participants who received the laser treatment.


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Figure 2.Treated participant jump improvement average.

The data shows that most participants improved their vertical jumps with the

LightCure Laser treatment. The entire group of participants who received treatment

improved their vertical jump by an average of 0.36 inches. Figure 3 demonstrates

the difference between the total groups of participants’ average improvement.


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Figure 3. Average improvement between groups.

This figure shows a significant difference of improvement in vertical jump between

the different treatment groups. There is a 0.1733-inch improvement with the

vertical jump after receiving laser treatment as opposed to the untreated group.

Included in these results were some data anomalies that did not follow the

trend and were outliers compared to the rest of the data field. After establishing a

standard deviation of 0.7025 for the treatment group and 0.8095 for the placebo

group, any data outside 2 standard deviations from the average were removed.

These data were removed in the following figures to demonstrate a new average

improvement between series of jumps. Figure 4 shows the participants who did not

receive the laser treatment and received the placebo with the outliers removed.


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Figure 4. Untreated participant jump improvement averages without the outlying data.

There were 3 data averages removed out of this treatment group, both above and

below the averages. Figure 5 includes the participants who received the laser

treatment, but the data anomalies were removed.

Figure 5. Treated participant jump improvement averages without the outlying data.


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There were 3 data averages removed out of this treatment group as well, including

data points above and below the normal averages. The average improvement and

difference between treatment groups becomes even more solidified after removing

the data anomalies. Figure 6 demonstrates the new treatment group average

improvement between series of jumps.

Figure 6. Average improvement between treatment groups without the outlying data.

Figure 6 also shows a statistical difference between treatment groups. The treated

group’s average jumps were improved by 0.577-inches between series of jumps.

The untreated group’s average jumps were also improved but only by 0.361 inches

between series of jumps. The treated group had a 0.216-inch improvement over the

untreated.

As mentioned before, there were 64 participants in this study, 38 men and 26

women. The data collection was separated into men and women, and the following


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data shows the gender specific results of the study. Figure 7 shows the average

improvement between treatment groups of the men in this study.

Figure 7. Average improvement of the men between treatment groups.

Figure 7 shows a significant increase in the average improvement in the men,

especially in the treatment group. The treatment group showed an average

improvement of 0.587-inches, and the untreated group showed an average

improvement of 0.2549-inches. The group treated with the LightCure Laser showed

a 0.3321-inch improvement compared to the control. Figure 8 shows the average

improvement between treatment groups of the women in this study.


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Figure 8. Average improvement of the women between treatment groups.

Figure 8 does not show a large difference between the treatment groups. The

treated group improved the most by 0.472-inches, and the control group was not far

behind with an improvement of 0.321-inches. This is only a difference of 0.151-

inches.

Discussion

The data collected show a significant trend in both the treated and non-

treated groups. Figures 1 and 2 both show that most participants improved their

vertical jump after treatment. This trend has a serious impact on the study. The

hypothesis stated that the LightCure Laser treatment would improve the

participants’ vertical jump in their second series of jumps but not the placebo group

of participants. While the treatment group improved, the placebo group also

improved their vertical jump. In Figure 3, the improvement averages are shown


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with the treatment group improving 0.36 inches and the placebo group improving

0.1867 inches. This is a difference of 0.1733 inches in favor of the treatment group.

When Figures 4 and 5 are considered, the average improvement increases in both

groups. The data that was outside the normal sets of data were excluded in Figures

4 and 5. This eliminated the participants who either improved or worsened

significantly after treatment. Compared to the rest of the data, these data collections

were abnormal and did not follow the majority of the data. Figure 6 represents the

average improvements with the outliers removed, and the improvement is greater.

Removing these outliers cleaned up the data, and the improvement trends in both

groups still exist.

The LightCure Laser is used to act upon the mitochondria, generating a

photobiostimulation process. One of the primary roles of mitochondria is to produce

adenosine triphosphate (ATP). ATP fulfills the energy requirement of the cell, and

the mitochondria meet the demand (Ali, 2011). When the body is placed under

strenuous exercise, the mitochondria must produce more ATP to ensure the cell

continues to function. The data support the hypothesis, and the LightCure Laser,

treating the gastrocnemii, improves the vertical jump. However, the improvement

seen in the placebo group must be explained.

The difference between the average improvements can be explained by the

LightCure Laser treatment. The study created a question of how and why the

placebo group improved. There are a couple of explanations to these sets of data:

the participants received a placebo and initiated a psychological response for


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improvement or the participants were able to successfully recruit their muscles

more efficiently after having 3 jumps.

Athletes often perform stretches and techniques in order to improve

efficiency in their muscles. According to Young and Behm, when an athlete performs

a run through with increasing intensities, the joint and therefore muscles are taken

to a new range of motion limit dynamically, which can result in greater performance

(2002). This type of warm-up serves to activate or recruit the specific muscle fibers

and neural pathways required to achieve optimum neuromuscular performance

(Young & Behm, 2002). If one views the 3 jumps before the treatment as a warm-up

and increasing the dynamic motion, then Young and Behm’s principles can be

applied to this study. Furthermore, according to Fredrick and Szymanski,

performing dynamic flexibility exercises raise core body and deep muscle

temperatures, elongates active muscles (elasticity), decreases the inhibition of

antagonist muscles, and stimulates the nervous system (Fredrick & Szmanski,

2001). All of these processes result in greater performance when warming up before

performing the activity. Therefore, it can be reasonably expected that a portion of

the improvement, in both the treatment and placebo group, be from dynamically

warming up the muscles, thereby making them operate more efficiently (Janssen,

Heymsfield, Wangssen & Ross, 2000).

The placebo affect has mixed results. According to one study, a supervised

10-week exercise program was performed to determine whether a placebo effect is

involved within the exercise-psychological enhancement connection, one-half of the

subjects were led to believe that their program was specifically designed to improve


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psychological well-being (experimental condition) whereas no such intervention

was made with the second half (control condition). Self-esteem, used as the main

indicator of psychological well-being, was measured on four specific occasions

during the workout protocol: at the beginning, after the fourth and seventh weeks,

and upon completion of the training program. The results showed similar significant

increases in fitness levels in both conditions. Moreover, self-esteem was

significantly improved over time in the experimental but not in the control

condition. These findings provide evidence to support the notion that exercise may

enhance psychological well-being via a strong placebo effect. (Desharnai, Jobin, Cote,

Levesque & Gaston, 1995). Another study conducted by Sawkins revealed that real

and placebo ankle taping influenced participants’ perceptions of stability,

confidence and reassurance when performing functional tests for stability in the

ankle (2007). This helps to further confirm the role of the placebo effect with ankle

taping in individuals with ankle instability especially when focusing on maximizing

the patient’s belief in the efficacy of ankle taping. In this study, its application

reassured participants and improved perceived stability and confidence (Sawkins,

2007).

Dr. Ali states that a skeletal muscle cell contains up to 10,000 mitochondria

(Ali, 2011). Therefore, one can expect to see men having an extra 2000 – 4000 more

mitochondria working in there skeletal muscle as compared to women. When taking

the gastrocnemius into effect and applying the same principle of 20 – 40% more

muscle mass, this indicates that the men will be able to generate more power and

energy at the mitochondrial level compared to women. Thus, the increased


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performance in men can be explained. Men carry more mitochondria, and the

LightCure Laser is acting primarily on the mitochondria. Figure 7 shows that men

improved 0.5873 inches in the treatment group compared to 0.2549 inches in the

placebo group. This is a difference of 0.3324 inches of improvement in the men who

received LightCure Laser treatment. However, in women, the differences were less

significant. Figure 8 demonstrates that the women in the treatment group improved

by an average of 0.4722 inches and the placebo group by an average of 0.3214

inches. This is a difference of 0.1508 inches, favoring the women of the treatment

group. Therefore, the effects of the LightCure Laser are shown to be amplified in

men compared to the effects in women.

Conclusion

Effectiveness of lasers and performance enhancing treatments have always

been scrutinized based on validity and overall accurateness. In this study it was

hypothesized that the LightCure Laser would improve overall performance, tested

with a series of vertical jumps. The hypothesis was supported to be accurate with

treatment of 64 patients, of whom some were placebo participants. Data was

collected and analyzed, revealing that the LightCure Laser treatments added over

0.5 inches in vertical jump performance for those jumpers who received the actual

treatment. Once broken down into gender, the Laser showed greater improvement

in performance for men than in women. This backed up the notion that men have

more mitochondria in their body and in essence can be greater effected by Laser

treatments on their gatrocnemii than women can.


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One unexpected result of the study was that the placebo group also showed

improvement in performance. Due to the hypotheses that their were physiological

implications and/or recruitment of more muscle fibers from warming up the first

three jumps, this group of participants improved their jumping average; however,

not near the rate and amount that the control group did. This study helps to validate

the effectiveness of the LightCure Laser. Its use can be multifaceted with

implications in acute and chronic cases of pain or ailments, along with performance

enhancement procedures as was evidenced here.

Controlling ATP and mitochondrial activity at the cellular level is the key to

this process. In the study above, the LightCure effectively generated a

photobiostimulation process that allowed the mitochondria to produce more ATP,

after the treatment, to assist with increased cellular energy and performance. This

explains the improvement between the men and women in the procedure. Overall

the LightCure is a valuable modality that can be used passively to objectively

improve performance and increase statistical numbers as was seen in this vertical

jump experiment.


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http://www.majidali.com/the.htm. Baechle, T. R., & Earle, R. W. (2008). Essentials of strength and conditioning. (3rd ed.,

pp. 141-157). Champaign, IL: Human Kinetics. Blaya, D. e. (2008, September). Histologic Study of the Effect of laser therapy on

bone repair. The Journal of Contemporary Dental Practice. , 6. Desharnai, R., Jobin, J., Cote, C., Levesque, L., & Gaston, G. (1995). Aerobic exercise

and the placebo effect: A controlled study . Psychosomatic Medicine, 55(2), 149-154.

Enwemeka, C. S. (2004, August). The Efficacy of Low-Power Lasers in Tissue Repair

and Pain Control: A Meta-Analysis Study. Photomedicine and Laser Surgery , 323-329.

Fredrick, G., & Szmanski, D. J. (2001). Basebal (part i): Dynamic flexibility. Strength

and Conditioning Journal, 23(1), 21-30. Janssen, I., Heymsfield, S. B., Wangssen, J., & Ross, R. (2000). Skeletal muscle mass

and distribution in 468 men and women aged 18 -88 yr. Journal of Applied Physiology, 89, 81-88.

Parr, J. J., Larkin, K. A., & Borsa, P. A. (2010). Effects of Class IV Laser Therapy on

Exercise-Induced Muscle Injury. Athletic Training and Sports Health Care , 2 (6), 267-276.

Sawkins, K. (2007). The placebo effect of ankle taping on ankle instability. (39 ed.,

Vol. 5, pp. 781-787). Lippincott Williams & Wilkins. Vanezis, A., & Lees, A. (2005, November). A Biomechanical Analysis of Good and

Poor Performers of the Vertical Jump. Ergonomics , 1594 – 1603. Wang, G. (2004, May). Low Level Laser Therapy. Technology Assessment , 1. Young, W. B., & Behm, D. G. (2002). Should static stretching be used during a warm-

up for strength and power activities? . Strength and Conditioning Journal, 24(6), 33-37.

http://www.majidali.com/the.htm

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