1. You did Day 0, its tests, and captured your results with online surveys.

2. You did 10 Days of Intervention with Light.

    

3. Now is Day 11.

You lived this testing process 10 days ago. Let's repeat it as efficiently as possible today.

The goal is to organize this so it's as easy as possible for you, using the summary and links below.

Test 1 - Signs and Symptoms Frequency (5 minutes)

Reminders: 

1. reflecting before answering is more important than getting to the end ASAP.
2. the test is timed so remember to have stopwatch handy, but it's not a race. The duration simply provides additional information.

Here is the link to take TEST 1 now on Day 11.

Test 2 - Trail Making Test (Parts A & B,  2 or 3 minutes)

Reminders:

1. You need a physical sheet of paper before you to do the test.
   1. In your "Day 11" envelope, sent with your light, are copies
   2. other option: Print both TMT Part A and TMT Part B now, using these links
   3. have stopwatch at hand
   4. once done, respond with a few quick entries in this survey for Day 11.

Test 3 - Mental Status Exam (est. 8 minutes)

"Didn't we already do that on Day 0? Do you really think something will have changed?"

Well yes, you did take it Day 0. Your answers now on Day 11, after 10 days of intervention with light, should provide a response to your second question.

Here is the link to the Mental Status Exam - Day 11.

Test 4 - Visual Acuity (est. 4 minutes, once all is set up)

Did 10 days of intervention with light impact on your visual acuity?

Let's repeat it now and see.

Reminders:

1. No online survey for this one. You record the test, spoken out loud, and send in your MP3 or MP4a file.

• Material that's required and its setup (perhaps still there from Day 0).
  • Eye chart (10ft Snellen) placed where light can fall on it
  • Device to confirm distance from chart (a string with 2 knots was provided)
  • A sticker has been provided, to stick on floor or wall, so you can put the string away.
  • Eye obturator (blocks the eye not being tested)
  • Voice recording device (I use iPhone. In the box, if needed, a microphone and a USB adapter to use the microphone with your PC or other recording device).
  • Remember to test both eyes, with and without glasses = 4 sets of results.
• Carrying out the test
  • Get in appropriate position
  • Record your responses (loudly and slowly, saying things like: "Testing Left eye, without glasses."  "E, F, T, O," etc.).
  • Remember to give your eyes a break, blink a bit, between tests.
  • Send response recording via email or messaging
    • can use "Questions@StudyLTCovid.com" or my private address if you have it.
  • Entering responses in a specific database locally
    • we do that when we listen to your recording

Some participants are essentially blind without their glasses or contacts.

To get around this, one person carefully measured half distances (5 feet instead of 10 feet

away from the Snellen eye chart, or even 2.5 feet away). Then she recorded the

result for each eye without glasses. While Snellen (now deceased) might find that

a rather shaky method, I like it. If done the same way on Day 0 and Day 11, any

changes in uncorrected visual acuity might still become apparent.

Test 5  - Attention & Reaction Time Test (est. 5 minutes)

• The video that explains the test, also administers it. The test for Day 11 is found on Youtube at this link. https://youtu.be/ffedNoOBFRk
• If you prefer, it is embedded below for direct use on Day 11 for your convenience.

Test 6  - 6 Minute Walking Test (est. 41 minutes in all)

• Test 6 - 6 Minute Walking Test, (6'WT) with tests before and after.
  • Vital Signs using supplied equipment at rest ("Pre") then at 0, 5, 10, 15 minutes.
    • You may have the required equipment (or better !) but we like the idea that everyone is using the same equipment. Especially, for blood pressure measurements, using the supplied stand keeps things very consistent. 
    • Send in your Vital Signs Results by online survey or a picture of your completed form to Vitals@StudyLTCovid.com
    • One finger stick and preparation of a blood smear at "Pre" (at rest before exercise)
    • One finger stick and preparation of a blood smear at 15 minutes after exercise.
      • Both are sent as soon as possible after their preparation to the address already written on the 'Day 11' envelope supplied in the box. Wrap the glass slides in the 3 "click together" plastic shipping boxes, wrapped as you received them. They're labelled to avoid error.

That's it for the Day 0 to Day 11 comparison by tests.

We'd like to ask you to do just one more ...

You've now lived the Photobiomodulation Experience !

So let's explore a bit more the pluses and minuses that you may have discovered about this intervention with light. Here's a link to the survey with which to do just that. Estimated time to take this: 17 minutes.

"Long-term" COVID-19 & light intervention: PBM at "Day 11."

Thank you for your efforts: when fatigue may still make them seem larger than before LTC.

Hopefully, by "Day 11" there has been some improvement.

As soon as we have feedback to give, we'll give it.

"We" = William O'Neill

Thanks again.

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Voir la vidéo en français au fond de cette page.

This video may help visitors to this site to better understand what these interventions look like, (and why). Just like the interventions, and quite coincidentally, it lasts 10 minutes.

As it says in the description of the video:

"A demonstration of practice and principles of photobiomodulation applied to frontal and lateral aspects of the head. For details, visit LTCOVID.com for background, and StudyLTCOVID.com for current work."

If needed for sharing, the link to the above video is:  https://youtu.be/M9vma2JtZ4Y

-----------

Voici ce même sujet, mais présenté en français.

Le lien vers cette vidéo    https://youtu.be/Friz9f4HJL8

Nous ne prévoyons pas de faire 40 exemplaires de ce stand !

Mais pour ceux où l'accès local est possible, cela semble réduire la variabilité associée au fait de tenir la lumière dans les mains. Bien que cela soit certainement faisable, le stand semble rendre cette intervention plus facile et plus efficace.

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Presenting the interventions of red and near-infrared light as applied in the present study's protocol will quickly beg answers to questions, which is as it should be.

The output from these lights will be directed at two regions of an enrollee's body: the head, and for some, the lower region of the chest in back as well.

Here are at least some of those questions which can be anticipated.

We'll take advantage of a "sister" site to respond to most, using links to information already offered elsewhere. 

• • • Is it safe?
    • Has it ever been done before? Is this brand new and untested?
    • Has it ever proven to be effective?
    • What specific scientific characteristics of these lights are applied in this study?
    • Have these lights been used with COVID-19 patients?
    • Exactly how is an 'intervention' carried out?

For most of those questions, this Selected Bibliography is the right place to start.

A quick summary based on the peer-reviewed literature is that such intervention is safe, has been in use for about 40 years, has proven effective across a variety of medical domains, best summarized as healing and repair, and has been used in the present COVID-19 setting. In all of this, no undesirable side effects have been reported or described.

For some, shining a light on one's elbow might meet with less resistance than shining a light on one's head. While understandable, it is underscored here that when exactly that was done with helmets of red lights worn on and surrounding the head, these were carried out, and are still carried out, without reports of harmful sequelae.

This is also an appropriate place to address concerns about possible detrimental effects on vision. While similar devices are at times sold with black or obturating eyewear for "protection," this may be guided by thoughts that are more administrative and legal than scientific. A part of the present study includes assessment of visual acuity. On that page attention is drawn to numerous studies where red light in these wavelengths is used for retinal and optic nerve protection and repair. As an aside, blue, ultraviolet and even white light are concerning with respect to known potential eye damage. 

A more detailed response to appropraite questions is available as introduced through links on this site's landing page. But to provide that detail again here will only delay presentation of the specifics of our present interventions. These are clearly based in the prior art.

Useful specifics will next be presented.

• A light in its supplied holder will be hand-held by enrollees, and moved around the head in a specific pattern, at a distance from the scalp of 1.25cm, and for specifically 10 minutes each day during days 1 to 20 of the study. The pattern of movement is shown in the gallery below, and will be demonstrated in a video (soon to be placed on this page).

The light is started above and behind the right ear (point 1), moves towards the front to reach and touch the right eyebrow (pt 6), is passed to the middle of the forehead (pt 7), moves straight back towards the back of the head (pt 12), is passed towards the left side in back (pt 13), then forwards until reaching the left eyebrow (pt 18). The left hand then passes the device to the right hand (pts 19 & 20) to reach pt 1 and repeating continuously the same path once again. An audio file is provided to help time and keep track of these movements during the 10 minutes. The lamp and its holder do not become hot.

Each light has been equipped with a central "bump" which serves as a distance reminder.

It measures 1.25cm in thickness. While 'massaging' one's head with this is not the idea, it serves as a frequent reminder of the distance between scalp and light to be maintained during this intervention. Why 1.25cm? Because for the specific and measured irradiance of these devices, over a 10 minute period they will supply an energy density of 40 Jouls/cm² which is the desired field strength. This value has often been reported in studies for indications as varied as traumatic brain injury to wound healing to retinal repair and orthopedic fracture healing.

For those enrollees randomized to the "Intervention +" subgroup in each arm of the study, a similar exposure will be carried out for 10 minutes, again at 1.25cm, but over the surface of the lower posterior thorax. (back of the chest, above the lower ribs, from left, to middle, to right side and back again). This, in addition to the cephalic (head) intervention. This determines a total of 20 minutes of light intervention per day for those in the "Intervention +" subgroup, during the 20 intervention days of the study.

This posterior thoracic intervention is represented in the gallery of images below, and will soon have both a video and an audio recording to assist participants. It has been selected as a region for the intervention, based on symptoms and findings commonly associated with COVID-19 infections and the "long-term" COVID-19 variant.

The images show the device supplied to enrollees, clamped to a simple chair back, a supplied pad on the chair designed to simplify left-to-right rotation, and a subject at the correct distance from the light.

So an enrollee's involvement is essentially divided in half. One part being the intervention for 20 days, and the second being subjective and objective measurements made to assess the effectiveness of the intervention. Neither activity will be of use for the study, unless measurements that have been made are transmitted for safekeeping and analysis. So that would represent a third vital category of enrollee activity.

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