Laser Flashcards
indications for laser therapy
carpal tunnel syndrome
neck and shoulder musculoskeletal pain
wound healing
musculoskeletal conditions
trigger points
inflammatory conditions
acute and chronic pain
chronic joint disorders
neuralgia
diabetic neuropathy
benefits of laser therapy
increase circulation
relief of minor muscle and joint aches
relief of pain and stiffness (associated with arthritis)
muscle spasms
contraindications for LLLT
no significant adverse effects
cancer
direct irradiation to eyes
photophobia (sensitivity to light)
photosensitizing medication
direct irradiation over fetus or uterus during pregnancy
direct irradiation over thyroid gland
symptoms of unknown cause
over hemorrhaging lesions or epiphyseal plates
transplant or autoimmune suppressed pts
LASER acronym
light (photons)
amplification by
stimulated
emission of
radiation
physiological effects of LLLT
light absorption
absorption in mitochondria
increased ATP synthesis
increased protein synthesis and cell proliferation
tissue repair and pain control
classification of lasers
class 1
class 2
class 3a
class 3b
class 4
class 1
power very low <0.5 mW
later printers
CD players
class 2
low <1 mW
diffuse output
grocery scanner
laser pointer
class 3a
power <5 mW (low)
laser pointer
very low power LLLT devices
class 3b
power <500 mW (medium power)
LLLT
class 4
high power >500 mW
surgical lasers
industrial lasers
LCT 1000 laser therapy
which laser classification is visible
3b
history maiman
used ruby crystal as the amplifying medium w/in lasing
ruby emits red light (visible)
history endre mester
used ruby laser to destroy tumors in lab rats
believed to be high power tissue destroying laser
healed surgical incisions faster
mester’s early work
changed his research agenda to tissue healing applications of laser
showed fast healing of…
experimental skin defects
diabetic skin ulcers
venous insufficiency
bedsores
production of therapeutic light
pumping of atoms inside a tube causes electrons causing them
laser radiation characteristics
monochromatic
coherent
collimated
monochromatic
one color
one frequency
one wavelength
coherent
all waves are in phase
light waves match identically in timing and spacing
collimated
light (photons) is focused w/ almost no divergence
remains well focused as it moves thru tissue
parameters
wavelength
power
continuous of pulsed
energy density
treatment duration
wavelength
measured in nanometers
distance b/w 2 peaks of a wave
lambda is the symbol
what wavelengths are used in rehab
600-1000
what wavelengths penetrate deeper
longer
which is longer, infrared or red wavelengths
infrared
short wavelengths
visible red
superficial target tissue
approx short wave lengths
620-695 nm
HeNe short wavelength
633 nm
ruby short wavelength
695 nm
penetration of short wavelength
3-4 nm
when is short wavelengths used
skin wounds
trigger points
LED
longer wavelengths (infrared)
gallium aluminum arsenide (GaAIAs)
classified as diode lasers
infrared wavelength
760-1000 nm
ratio of gallium and aluminum
varies to create devices of different wavelengths
deeper penetration of infrared
30-40 nm
examples of infrared
SLD
laser
depth of penetration from low to high
LED –> .5 cm
SLD –> 2.5 nm
Laser –> 5 cm
light sources
low level laser therapy
super luminous diode
light emitting diode
cluster probes (combos)
low level laser therapy
laser diode
collimated light (very focused)
monochromatic
coherent
approx wavelength for low level laser therapy
760-1000 nm
penetrate deeper
super luminous diode (SLD)
non-coherent
indicated for treatment of superficial tissue
how do SLDs resemble laser
produce monochromatic collimated light
less focused
approx wavelength for SLD
660-880 nm
depth of penetration is less diode but typically greater than LEDs
light emitting diode (LED)
non-collimated (significantly less focused)
non-coherent
indicated for treatment of very superficial tissue
approx wavelength for LED
620-690 nm
minimal penetration (several mm)
cluster proves (combos)
laser diodes can be combined w/ SLDs and LEDs to form a diode cluster
important to know what the cluster is compromised of
when are cluster probes indicated
treating larger areas
power
measured in milliwatts (mW)
usually preset in the device
LLLT uses power…
less than 500 mW
higher power levels
in new generation devices decrease necessary time
enhance penetration
how can power decrease
by pulsing
power density
measured in W/cm2 or mW/cm2
described the average power per unit area of the beam
area of the beat is fixed
unit or measurement used in ultrasound therapy
energy
measured in joules (J)
1J = 1 Watt x sec
when you increase power (mW)
decrease treatment time
50 mW
80 sec
4 joules delivered
100 mW
40 sec
40 joules delivered
500 mW
8 sec
4 joules delivered
energy density
measure in joules/cm2
describes energy delivered per unit area
“amount of energy falling on a surface”
optimal dose of energy
response relationships for different tissues and conditions continues to be studied
acceleration of healing energy density
doses in the range of 1.0-6.0 J/cm2
consideration for increasing depth of penetration
longer wavelengths
highly collimated beam (laser not SLD/LED)
increase power
clinical implications LLLT devices w/ longer wavelengths w/ higher power (mW)
deeper muscles
tendons
ligaments
clinical implications –> depth of penetration can be enhanced using
longer wavelengths (infrared)
greater power (mW)
collimated beam (laser not SLD/LED)
application technique
clean skin w/ alc prior to treatment
no coupling media is used
stationary technique
maintaining firm direct contact w/ intact skin to increase depth of penetration
protective eyewear
delivering the treatment
choose a dosage (J/cm) based on best available evidence
device will automatically calculate the treatment time
choose either to leave the device on continuous or select a specific pulse frequency (Hz) if available
press start
delivering treatment pt 2
place applicator in firm contact w/ pts skin and press button on applicator to administer treatment
treat area under with probe with the number of seconds/minutes indicated
repeat procedure for every area being treated
depending on the size of the target area, multiple applications may be necessary to cover all the symptomatic area
