NEW LIFE PERSPECTIVES Research Project
Research project abstract
Light therapy is used all over the world by well-known organisation including NASA, military personnel, doctors, physiotherapists, chiropractors and wellness centres simply to aid and encourage the body in recovery. Light influences the body in a number of ways and different types of light stimulate different reactions, from the simple production of vitamin D, activation of ATP (adenosine triphosphate), serotonin and the encouragement of cell growth and collagen rejuvenation. Using light at specific frequencies triggers a reaction within the body to stimulate receptors in the brain. It simply assists the body to do what it does naturally.
The results of the pilot study will lead into a larger scale investigative case study to commence later in 2014. This study differed from others in this area as we investigated the effects of light therapy (660-1250 bandwidths) on depressive symptoms (optimism, immune function, interpersonal relationships and sleep patterns). We also sought to gain an understanding of other beneficial effects that occurred from the light exposure.
Methodology: Four participants (three females, one male (ages 49m, 50f, 58f, 65f,)) were exposed to 20 minutes of light therapy using the RX6 machine at varying weekly frequencies for a period of 10 weeks. Psychological assessment and biological markers were taken before commencing the treatments.
All participants experienced results specifically in the optimism scales and feelings of well-being. Two chronic pain sufferers had decreased or no pain and felt they had better coping skills. To access and identify causation larger samples sizes are needed to identify generalisability. Data analysis was based upon self-reported diaries, surveys and interviews as well as naturalistic observation and biochemical markers. At time of writing this proposal the biochemical results were still pending. An important component of this research program is the inclusion of both qualitative and quantitative sections.
The larger scale ‘light therapy and depression’ research proposal will be conducted as a controlled case study. It would include an in-depth analysis of a group of 100 participants as they are exposed to the light therapy for ten weeks, two times per week. It will assess cause and effect of light therapy on specific symptoms of depression and/or anxiety as the independent variable (RX6 machine) is introduced. Markers used to establish causation and outcome include measuring sleep patterns (sleep diary), immune function (biochemical tests), optimism (questionnaire) and pain level (pain diary) and structured interviews.
Collagen Clinique is providing the researchers access to the RX6 machine which delivers “15 different wavelengths (from 590nm – 1250nm wavelengths) of red light (wavelengths between 630 – 660 nanometres) infra- red (from 770 – 900nm) and far infra-red (from 900 -1200nm). The Collagentex RX-6 full body scanner has the latest in Plasma Arc lamp technology and delivers no UV emissions and is safety certified by spectral radiometer testing and is underpinned by over 20 years of testing data.
‘Light therapy and depression’ report
A study assessing how light therapy affects specific symptoms (optimism, sleep, immune function) of depression.
OBJECTIVE: This study aims to build on current research supporting beneficial results of light therapy by examining the effects of light therapy at a specified range (630-1250nm) for people living with mental ill health specifically depression. The purpose of this pilot study was to assess the associated problems with coordinating a larger scale research project assessing the efficacy of light therapy in treating depression. METHOD: The author systematically searched medical journals to identify methodology used in trials of light therapy for treating depression. These articles were reviewed and a literature review and project brief was written which guided the pilot program processes. Five subjects were sourced to participate in a 10 week program of red light treatment, one to three times per week. RESULTS: All five subjects reported positive results including pain eradication, management, sleep quality, mental health and wellbeing, self-esteem, skin benefits and stress management. CONCLUSIONS: The literature review analysis of red light therapy on depression symptoms suggests it is efficacious, with effect sizes equivalent to those in most antidepressant pharmacotherapy trials. This small pilot study supports those findings in the literature review, however adopting standard approaches to light therapy’s specific issues (e.g., defining parameters of active versus placebo conditions) and incorporating rigorous designs (e.g., adequate group sizes, randomized assignment) are necessary to evaluate light therapy for depression in the future.
The implications and benefits of light therapy for treating depression is gaining some much needed attention, both in the scientific community and mental health settings. Numerous worldwide researchers have conducted successful clinical trials with results now supporting the use of this experimental treatment in treating conditions such as non-seasonal mood disorders, Alzheimer’s disease, circadian-related sleep disorders and jet lag, skin and eating disorders, and other behavioural syndromes. Data collected during this trial supports red light therapy and its positive effect on stress levels (cortisol) and immune function (white blood cells). Despite twenty-seven years of clinical data and research support for red light therapy, the mental health treatment community fails to recognise it is a standalone or adjunct treatment option. At this time no Australian insurer offers reimbursement for this type of treatment, yet its efficacy is scientifically proven in a number of overseas studies. It is the aim of the pilot program to lead into a larger scale study to provide scientific data to address this concern.
The small pilot study was funded by the researcher. Thus participants were limited to 5 physically healthy adults who met criterion-based mood disorder diagnosis specifically depressive symptoms. The age ranged from 50–66 years in an effort to define a standard for adequate treatment procedures. It was also recognised that at each end of the age spectrum, the requirements for light therapy dosing may differ and this is a confounding factor that could bias future outcomes as there is no data to correlate specific wave lengths and age related factors. For example, children and adolescents may differ from adults in the needed dose of light therapy, while elderly subjects may require a higher dose or frequency.
All subjects were required to participate in a psychological assessment process using the Hamilton Depression Rating Scale, SF36 and Quality of Life surveys along with a GP clearance and biochemical markers taken pre and post-trial.
Light Therapy Overview
Visible red light, at wavelengths from 630 to 700 nm penetrates tissue to a depth of about 10 mm. Light at this wavelength is very beneficial in treating problems close to the surface such as wounds, cuts, scars, trigger and acupuncture points, and is particularly effective in treating infections. Infrared light (800 to 1000nm) penetrates to a depth of about 40mm and deeper which makes it more effective for treating organs and provide relief for ailments of bones, joints, deep muscle tissue. Near-infrared light therapy, utilizes the near infrared light to increase blood perfusion, oxygen partial pressure and tissue temperature. It also hastens cell repair process by directly stimulating the mitochondria. Near-infrared light is also known for its great anti-inflammatory agent and in relieving pain. It relieves pain caused by Lou Gehrig’s disease, arthritis, joint aches, Parkinson’s disease and pain due to injury. It stimulates the production of energy in the cell eliciting growth and restoration of tissues.
The small, investigator-initiated pilot project was conducted from February – May 2014 with 2 female participants (50yo and 65yo). Both participants initially attended a medical assessment with their local GP’s. Blood test were taken the week before and the week after the program and assessed for serum chemistry, thyroid and liver function, cholesterol, full blood examination, cortisol and hormone levels. Participants were then exposed to 10 weeks of red light therapy using the RX6 machine for 20 minutes 3 times per week.
Late February 3 more subjects joined the study, 2 females (57yo & 66yo) and 1 male (50yo). These 3new participants were also exposed to red light therapy using the RX6 machine at varying frequencies. These participants specifically the 50 year old male and the 58 year old female were exposed to the machine once per week for 20 minutes, this limitation was due to lifestyle factors, and the 66 year old to three times a week for 8 weeks.
All these late participants were asked to fill in the SF 36 and the Quality of life surveys however no biochemical markers were recorded due to late start. All participants were required to meet with the researcher at end of week 5 to discuss results, problems and concerns, as well as complete the 8 question quality of life survey.
At the completion of the program, week 11, participants attended a forum to discuss subjective experience, results and expectations. The 2 initial participants were required to visit their GP for physical assessment and end of project blood test as well as completing Hamilton Depression Rating Scale, SF36 and Quality of Life surveys for comparative study.
Subjective data was analysed using three questionnaires, a daily diary recording pain, sleep, medication and mood was used to access quality of life changes. Objective data was monitored using biochemical markers through a blood test pre and post program. Blood test included serum chemistry, full blood examination, cortisol, thyroid function and hormones.
A thematic style of analysis was used to code and compare patterns and clusters between surveys to enhance reliability of study. Triangulation of responses from interview and survey data along with biochemical markers tested consistency across responses. However the statistical significance cannot be established due to the small number of participants. The effect size was too small and no homogeneity analyses or comparisons were conducted limiting generalisability of outcomes. Also the odds ratios for the likelihood of symptom remission were unable to be established due to timeframes and limited resourcing.
Researchers for this project were interested in gaining a rich and complex understanding of people’s experience, as well as physiological changes which can be generalised for predication for other larger group studies.
Biochemical markers from the pre and post blood test results were analysed and compared using statistical analysis. Results demonstrated an overall increase in white and red cell counts a decrease in stress hormones- cortisol, an increase in liver protective markers.
All participants were asked to attend a face to face interview with the researcher. A meeting was held on the 17th May 2014, eight people attended. Four people from the pilot program and four people who had been using the RX6 machine regularly for the same period of time were interviewed to gather subjective data.
The 65 year old participant completed 30 treatments over 11 weeks. Self-reported outcomes include:
- No pain and more movement in her arthritic hands.
- She also reported she is off her Zoloft primarily as she ‘forget to take it’ she feels quite confident and is not feeling overwhelmed, no thoughts of devastation or doom as previously reported. “I am coping well even though I have a lot of stress in my life right now’ her pet is terminally ill.
- She stated she didn’t know if she wanted to stop the therapy as she now enjoys it.
- She did find that attending sessions 3 times a week was ‘a bit of a drag’.
All of which subjectively supports the scientific research demonstrating red light therapy:
Increased production of endorphins and enkephalins from the brain – promoting pain reduction and mood elevation.
Stimulates production of adrenals— which facilitate long term pain relief and resilience to stress.
Reduces inflammation and swelling in chronic conditions of arthritis, bursitis, and tendonitis.
Increases blood capillary circulation and vascular activity by promoting improvement in the metabolism of nitric oxide (NO). This facilitates improved regulation of vasodilation and leads to the formation of new capillaries – this in turn provides additional oxygen and nutrients to accelerate natural tissue healing processes and eventually evokes a cascade of beneficial biochemical processes.
The youngest participant 50 year old completed 30 treatments over 10 weeks and reports:
- She is no longer taking any form of hormone supplication and has not experienced any menopausal symptoms.
- She stated she has not been sick even though people in her close proximity have had severe flu like symptoms.
She is sleeping better, averaging 7/8.5 hours per night whereas previously she would not sleep through the night, she regularly reported she would wake and not be able to return to sleep so would get up at 3 or 4 in the morning and work. It appears this habit has been broken as she is sleeping uninterrupted and waking up more refreshed, if woken she states she can easily go back to sleep.
- She also reported that she is able to concentrate better, feels more active and optimistic, is more focused and her quality of work has improved.
- She stated, “I feel confident and calm even though life is busy, I am not fighting or being short with my partner actually we are getting on better.”
- She believes her brain is a lot more active at the right time of day, not at 3 in the morning.
- She feels less stressed going into her exams and her memory recall was better.
- She experiences no physical discomfort from weight training and believes her running and recovery is better.
All of which subjectively supports the scientific research demonstrating red light therapy:
Relaxes muscles, reduces nerve excitability and stimulates nerve transmission
Reduces scar tissue and stimulates wound healing
Relaxes muscles, reduces nerve excitability and stimulates nerve transmission
Stimulates production of collagen—the most important component of wound healing
Increases lymphatic system activity and relieves edema and discomfort associated with swelling
Stimulates acupuncture points and immune response
Increases phagocytosis – the body’s natural process to scavenge dead and degenerated cells and is important to the infection control process required for healing
Stimulates fibroblastic activity – promoting repair of connective tissue and formation of collagen fibers
Stimulates tissue granulation and connective tissue formation – an important process in the healing of wounds, ulcers and inflamed tissues
The 58 year old (13 treatments, 3 in quick succession then 1 per week), stated that she has felt overall better and more able to cope with her life (she works away mon-fri) her moods still fluctuates, however she too has gone off her hormone supplementation and feels that her hot flashes are not as frequent but they are just as harsh. She stated that she is sleeping better and has more energy and less joint pain. People have commented on how good her skin looks and she reports that her ‘liver spots’ and stretch marks have faded substantially. She has also suffered with knee pain and swelling for the last ten years and she reported that she now has no pain. She felt that doing 1 treatment a week was probably beneficial however she would like to be able to do more but is impeded by her job location (Warwick)
The fifty-year-old male shift worker (8 treatments, infrequent attendance due to work restrictions at least one treatment per week) reported no chronic episodes of back pain and his overall pain was less intense (chronic back injury from brick laying accident). He believes his quality of life is better due to the pain decrease, making him sleep better, happier, and able to move more freely.
The four other participants ranged in ages from 38- 68, (Sheryl, Rosemary, Kim and Shelley) all had attended one session per week under the RX6 machine for ten weeks. Three of these participants had commenced with a condensed three times per week for a period of four weeks followed by two sessions per week for another four weeks and now one day per week for the ten week period of the trial.
Results from interview included:
Kim was very sick when started using the machine with a rare disease picked up in Thailand.
- Skin clearance, decrease in lesions
- Skin elasticity and plumpness
- More energy
- No more back pain (previous injury leading to medication for pain management)
- Feeling of being less stressed and able to cope with life
Shelley has lost 60 kg over the last 24 months and was concerned about loose skin
- Skin tightening with no stretch marks and no loose skin present
- Increased collagen
- No pain in her back (she fractured her cervical vertebrae including severe nerve damage, previously in intense chronic pain visiting a chiropractor weekly for treatments) – no need to visit chiropractor anymore
Sheryl suffered from depression and asthma and was heavily medicated for both ailments. She suffered with debilitating stress and was unable to function appropriately in life and work.
- No longer on any medication (Zoloft and Seretide)
- Happy and healthy
- Sleeping, eating and managing life positively
- Stated ‘it was like the machine plugged my battery back in’
- Now engaged and in a happy relationship, she feels she is coping and loves life now.
Rosemary doesn’t sleep well and suffers with a lack of energy.
- More energy and is sleeping better.
During the pilot program the RX6 machine boosted immune function, decreased stress levels, eliminated pain, increased quality and time of sleep and increased coping mechanisms and energy for all participants in the study.
Longer term results (from 4 other machine users) include weight loss, increases in skin elasticity and collagen production, pain decrease, more energy and depression and stress management.
First, there are inherent challenges in creating an acceptable placebo (or even an active control) condition for red light therapy. While it is relatively easy to create a placebo pill or capsule that is identical in appearance to an active medication formulation, it is more difficult to “blind” a subject when broad-spectrum red light is the active experimental intervention. The pharmaceutical industry, which has considerable resources devoted to research and development activities, funds much of the clinical trial research for potential new antidepressant pharmacotherapies. In contrast, there has not been a similarly endowed industry nor as sizable a market in place to support the development and testing of light therapy treatments.
Several side effects of bright light therapy have been described in the literature including headache, eye strain, nausea, and agitation. No reports to date showed adverse effects. However, some psychotropic medications may increase photosensitivity. Light therapy, like other antidepressants, may be associated with a switch to hypomania or mania in vulnerable bipolar patients. Other potential side effects from may emerge only after the treatment has become more widely applied. Another limitation is that we restricted our analyses to studies of a relatively homogeneous, clearly defined population. Population age separation and exposure frequency merits a larger evidence base and further study. This pilot study suggests that the RX6 machine is effective in the treatment of depression however the most outstanding results are in pain management. Larger controlled trials with appropriate numbers of subjects are needed to confirm efficacy, safety, optimum dose, and the proper place of light therapy in the mental health professional’s toolbox. However the question remains has this type of treatment enough scientific data to support Australian insurer to offer health care consumers with reimbursement for this type of holistic treatment option.
Modifications to research program
Program participants reported the daily diary was a ‘drag’. After careful examination of the data recorded, it is proposed that printed questionnaires be left at Collagen Clinique in a locked filing cabinet. Each participant will be allocated a number and have their own de-identified folder. Each participant will be required to complete a weigh in using the fat measuring scales at the clinic. After they have completed their treatment they will be required to complete the questionnaire. Questions will include:
- Week, day, time, weight, BMI.
- Alcohol and coffee consumption
- Emotions and moods Stressful situations
- Sleep quality and time
- Pain levels
Quality of life questionnaires will be completed pre, week 5 and post treatments and will be conducted by participant.
Participants will be required to attend psychological assessments pre and post treatment regime. A report will be provided by practitioner to researchers to enable data to be coding and correlated.