Photobiomodulation for Fatigue, Depression and Pain in Youth with Inflammatory Bowel Disease

Photobiomodulation therapy (PBMt) is the use of photonic (light) energy to modulate cellular activity. PBMt has a significant evidence base for modulating not only physiological markers across a range of conditions, but more recently it has been shown to have early promise in influencing neuropsychiatric/neuropsychological effects in a range of conditions that may have similar non-intestinal symptomology to IBD. For physiological effects, as pre-conditioning to an exercise protocol, PBMt has been shown to have moderate evidence for improving markers of physical performance (e.g., exercise capacity and time to exhaustion; and peak muscle torque) and low to moderate evidence for reducing signs of muscle fatigue in healthy subjects but more recently also in people with chronic obstructive pulmonary disease. Research on the effects of PBM on physical performance has found that PBM significantly reduced muscle fatigue across a range of indicators, with significant differences between PBM and placebo. Taken together, these results suggest that fatigue in chronic disease can be mitigated by using PBM. Preliminary evidence also exists for the use of PBM in treatment of depression and other psychiatric and neurological conditions. For example, in a review of the literature, Cassano et al identified evidence that PBM was well tolerated by people with depression, and that depressive symptoms could be significantly reduced in people with major depressive disorder. Anti-anxiety and anti-depressive effects have also been demonstrated in a mouse model. In people with Parkinson’s disease, PBMt has been shown to improve sleep-wake cycles. This study hypothesis is that PBM will reduce fatigue, depression, abdominal and joint pain, and inflammatory burden in youth with IBD. Hypothesis specific to the pilot nature of the study is that the PBM intervention and study procedures will be feasible and acceptable. PBMt will be delivered by using the ProSeries device (SYMBYX, Australia) multi-diode 904nm array. PBMt will be applied for approximately 1.5-2 minutes per site, on 9 abdominal sites and 6 anterior thigh sites (3 on each thigh), with the whole PBMt session lasting about 30 minutes. PBMt will be delivered in weekly one-on-one face-to-face consultations for ten weeks. PBMt will be administered by an experienced physiotherapist-study co-investigator. Strategies used to monitor adherence to the intervention will include sessions attendance sheet (for PBMt sessions attendance), and participant diary of their weekly exercise (type and duration).