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πŸ”΄ Electrotherapy πŸ”΄ > Low Level Laser Therapy LLLT > Flashcards

Low Level Laser Therapy LLLT Flashcards

1
Q

What is LLLT

A

Therapeutic application of low output laser for the treatment of disease and injury

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2
Q

Laser light is a form of what energy ?

A

Electromagnetic energy

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3
Q

Where can I find laser light on the electromagnetic spectrum

A

Between Infrared and visible spectra

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4
Q

Is laser superficial/deep? Thermal/nonthermal?

A

Laser is a superficial and nonthermal agent ( too low to produce heat)

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5
Q

The term laser is an acronym for :

A

Light Amplification by Stimulated Emission of Radiation

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6
Q

What is light

A

Emission of electromagnetic waves made of photons traveling in space

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7
Q

Compared to other forms of light, what characteristics/properties make lasers different ?

A

Monochromatic
Collimated
Coherent

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8
Q

What is phototherapy

A

The use of lights, or photons for therapeutic purposes οΏΌ

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9
Q

Common lights used for therapy are:

A

IR and UV

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10
Q

Are lasers in the infrared band visible to the human eye?

A

No

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11
Q

Lasers are classified into 4 major classes:

What are they?
What were they classified based on ?

A

Class 1
Class 2
Class 3a
Class 3b
Class 4

(Based on power output + exposure time)

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12
Q

What is meant by hazards

A

The potential risk of the lasers causing biological damage to the skin or eye (retina)

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13
Q

Class 1, 2, and 3a lasers

A

They have low power outputs ( < 5 mW)
Are not used for therapeutic purposes

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14
Q

Class 3b

A

Power output ranging from 5 to 500 mW

Can cause eye damage but doesn’t affect skin

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15
Q

Class 4 lasers

A

Power output > 500 mW

Can cause eye AND skin damage

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16
Q

History (just read)

A
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17
Q

What are the two laser categories

  • what do they require
  • what is the power output
  • what is it used for
A
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18
Q

What is meant by monochromaticity?
What is the therapeutic advantage?

A

all photons accounting for the laser light have a single wave length and thus a single color

Advantage: absorption can be targeted at specific wavelength-dependent photoreceptor molecules called chromophores, varied within soft tissue

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19
Q

What is collimation?
What is the therapeutic advantage?

A

The ability of a laser beam not to diverge or spread with distance (the photons move in a parallel fashion, concentrating the beam of light)

Advantage : ability to be focused on a very small target area.

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20
Q

What is coherence?
What are the types of coherence?
How is coherence lost?
What is the therapeutic advantage?

A

Photons that make up a laser light travel in phase in both time and space with one another.

Temporal and spatial coherence

Coherence is lost immediately after the light gets absorbed by the skin, due to scattering and refraction.

No therapeutic advantage

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21
Q

Properties of light compared to laser light

A
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22
Q

Laser devices have 3 basic physical components

A
  1. Lasing medium (active medium)
  2. Resonance chamber
  3. Power supply
23
Q

What is a lasing medium?
Provide examples

A

The material used to emit a laser light for which the laser is named

It is gas, liquid, or solid with excitable atoms

Examples:
HeNe
GaAlAs (diode)

24
Q

What is a resonance chamber?
What is it made up of?
Which side is the beam of laser light emitted through ?

A

The cavity within the laser device that contains the active medium, which is activated or lased leading to the production of a beam of laser light.

It is made up of a sealed glass tube , housing the active medium and has a fully-reflective mirror at one end, and a semi-reflective mirror at the other end.

The beam of laser light is emitted through the semi-reflective mirror

25
Q

What is power supply used in laser devices?

A

An electrical current passing through the residence chamber that powers the laser and stimulates the active medium.

26
Q

What is spontaneous emission of radiation?

A

When atoms get excited, their electrons jump to higher orbitals and are now unstable and will go back to their original orbital by releasing energy in the form of light

27
Q

What are the laser types that are used?

  • wavelength
  • penetration depth
A

Red light laser (HeNe)
- gaseous laser
- visible red band ( 600 - 750 nm)
- penetration depth: 0.5 cm

Infrared-light laser (GaAs / GaAlAs)
- diode lasers
- IR band ( 750 nm to 1000 nm) or (750 nm to 1 mm)
- GaAs: 904 nm
- GaAlAs: 820 nm
- penetration depth: 1 cm

28
Q

Process of laser light emission

A

First: activation of active medium by electrical current.
The process of moving atoms from their resting ground state to their excited state

Second: population inversion
The majority of atoms are in their excited state

Third: spontaneous emission
Emission of photon caused by spontaneous drop of an electron from its excited state to its ground state.

Fourth: stimulated emission

Fifth: amplification
The back-and-forth movements of incident and newly emitted photons through the active medium amplifies the process of stimulated emission .

Sixth: laser beam emission

29
Q

Effects of LLLT

A

photo-biomodulation effect
Photo chemical mechanisms

30
Q

What is Photo-biomodulation effect?

  • photo-biostimulation
  • photo-bioinhibition
  • what does the photo-biomodulation effect depend on? Which law does it follow? What does the law state?
A

Biomodulation is the process of modulating the biochemical responses or functions of a cell (simulating or inhibiting)

Photo-biostimulation :
Increases the cellular function (increases cell metabolism)

Photo-bioinhibition:
Decrease the cellular function (decreases cell metabolism)

Photo-biomodulation is DOSAGE DEPENDENT

Arndt-Schultz Law :
- lower dosages = photo-biostimulation
- higher dosages = photo-bioinhibition

31
Q

How does LLLT stimulate cell metabolism?

  • photochemical effects
A

Photonic absorption
- Grotthus-Draper Law: for photobiostimulation to occur, photonic energy must first be absorbed by the exposed soft tissue.

Chromophores :
Transfer of energy from a photon to a photon except your molecules within the cells called chromophores (color loving)
Ex: melanin, hemoglobin, retinal rhodopsin

Penetration depth
- absorption
- scattering

32
Q

Penetration depth of laser light depends on:

A

Absorption:
- Greater in superficial tissue
- inversely related to penetration depth
- HeNe (red laser light) is more superficial than IR

Scattering :
- Wavelength dependent
( short wavelength = more scattering)
( longer wavelength = less scattering)

33
Q

Which laser light has higher absorption and less scattering

A

Infrared laser (904-820 nm) > Red laser (632-694)

Due to having longer wavelength

34
Q

Penetration depth value

A
35
Q

Physiological effects of LLLT

A
36
Q

Therapeutic benefits

A
37
Q

What is power output (P) ?

Unit ?

How to convert units ?

A

Rate of energy delivered

Watts or Joule/sec
( 1 watt = 1 J/sec)

Commonly expressed in mw

(She says to go from Watt to mW , multiply Watt by 0.001, but that looks wrong)

38
Q

What is power density (Pd) ?

Unit?

A

The power delivered per diode’s beam area measured in cmΒ²

Unit: mW/cmΒ²

39
Q

What is energy density or dosage (Ed)

Unit?

Formula?

A

The energy delivered per diodes beam area, multiplied by the time of radiation

J/cmΒ²

Pd x Time of irradiation

Power/area x time

40
Q

What is dose per diode (Dd)?

Units ?

Formula ?

A

The amount of laser energy delivered to the tissue by each diode

Joules

Power of diode (J/s) x Time of irradiation (sec)

41
Q

What is dose tissue (Dt) ?

Units?

Formula

A

The total amount of laser energy delivered to the exposed tissue

Joules

The sum of all the doses per diode (Dd) x number of points of application during a single treatment session

42
Q

Formula to calculate time of irradiation (sec)

A

Time = (Ed x Area)/ Power

43
Q

Pulse repetition rate

A

Expressed in hertz Hz

2-10 thousand Hz

44
Q

Modes of emission of laser

A

Continuous mode

Pulsed mode

45
Q

Dosage protocol for biostimulation

A

1 - 4 J/cm Β²

Stimulates growth and healing

46
Q

Dosage protocol for bioinhibition

A

5 - 8 J/cmΒ²

Inhibits excessive scar tissue and destroys bacteria

47
Q

Energy density for ACUTE and CHRONIC conditions

A

Lower energy density ( 0.05 to 0.5 J/cmΒ² ) - ACUTE

Higher dosage (0.5 to 3 J/cmΒ² ) - CHRONIC

48
Q

Types of applicators of LLLT

A

Single diode
Multiple diode (cluster)

49
Q

Class 3B lasers require both the therapist and patient to wear what protective gear

A

Eye protection goggles

(Filter wavelength must match photonics wavelength generated by laser device)

50
Q

Application methods

A
  1. Point by point.
    - Contact
    - Noncontact (2 - 4 mm)
    - Grid application : mapping the treated surface area with 1cmΒ² squares
  2. Scanning technique.
    - Wound treatment
51
Q

General contraindications

A
52
Q

Local contraindications

A
53
Q

Adverse side effects

A

Transient tingling
Mild erythema
Burning sensation
Eye damage
Skin rash
Increased pain and numbness

54
Q

Which modality is more effective with LLLT: hot pack, or cold pack?

A

Hot pack is more effective due to increase circulation and increase hemoglobin

πŸ”΄ Electrotherapy πŸ”΄ (6 decks)

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