Acronym for Laser
Light Amplification by Stimulated
Emission of Radiation
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Low level laser therapy ( LLLT): Best and most widely
accepted descriptor of the type of lasers used in
rehabilitation.
Simply another form of energy that can be used to
create physiological changes in tissues.
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Laser devices are classified based on power output
(mW=milliwatts) and on relative risk for causing
biological damage (especially retinal damage when eye
is directly exposed to laser beam).
Class 3b lasers are becoming the standard in the
rehab field.
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A laser is a form of electromagnetic energy that
has a wavelength and frequencies that fall within
the infrared and visible light portions of the
electromagnetic spectrum.
Electromagnetic light energy is transmitted
through space as waves that contain tiny “energy
packets” called Photons. Each photon contains a
definite amount of energy, depending on its
wavelength (color).
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Albert Einstein
provided the basic science and history
Theodore Maiman
First laser (1960)
“Ruby Laser”
Endre Mester
Provided faster healing via laboratory rats experiment
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Decreasing inflammation
Pain reduction
Increasing the tensile strength of a scar
Decreasing scar tissue
Facilitating wound healing
Tissue healing: Soft tissue and bone
Arthritis
Carpal Tunnel Syndrome
Lateral epicondylitis
Chronic back and neck pain
Trigger points
DOME (delayed-onset muscle soreness)
Post Mastectomy Lymphedema
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Cancer (tumors or cancerous area)
Low back or abdomen during Pregnancy
Within 4-6 months after Radiotherapy
Direct irradiation over the thyroid gland
Epiphyseal Plates in children
Direct irradiation of the eyes
Over hemorrhaging regions
When using photosensitizing medications
Symptoms of unknown cause
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Impaired sensation
Impaired cognition
Photophobia or abnormally high sensitivity to
light
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ATP production
Collagen Synthesis
Wound healing
Pain reduction
…..and there is no sensation to the patient except
possibly the sensation of a slight breeze or vibration
Light (photons) applied to tissue
Absorption in Mitochondria
Increase ATP Synthesis
Increases protein synthesis and cell Proliferation
Tissue repair and pain control
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Wavelength (nm)- preset on device; determines depth of
penetration; in rehab 600-1000nm range.
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Power (mW)- rate of energy is produced.
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Duty cycle- Continuous or Pulsed; influences time to deliver
energy, like ultrasound.
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Energy Density (J/cm2) measure of dosimetry, i.e. total power
delivered per treatment session per cm2; influenced by all
parameters above.
Energy density Equation= (Power output X treatment time) divided
by beam area (spot size) J/cm2 = (W X sec) divided by cm2
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Treatment duration ( sec or min)
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Clean face of applicator with a towel sprayed with
0.5% alcoholic chlorhexidine or the antimicrobial
approved for your facility.
Patient and therapist should be wearing protective
goggles
Expose the area to be treated and remove any
shiny jewelry in area
Apply the applicator to the skin with a firm
pressure, keeping the light bean perpendicular to
the skin
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If the treatment area does not have intact skin, is
painful to touch, or does not tolerate for any reason,
treatment may be applied with the applicator slightly
above the tissue, without touching the skin but with
the light beam kept perpendicular to the tissue
surface
Start the light output and keep the applicator in
place throughout the application dose.
If treatment area is larger that the applicator, repeat
the dose to areas approximately 1 inch apart
throughout the treatment area.
The device will automatically stop after the delivery
of the set does (J/cm2)
CLINICAL INDICATIONS
SUGGESTED TREATMENT DOSE
RANGE
Soft tissue healing
1.8-40 J/cm2 (usually 5-24J/cm2)
Bone healing
Up to 120 J/cm2
Arthritis
0.5-2700 J
Lymphedema
1-2 J/cm2
Carpal Tunnel syndrome
3-9 J; >6 and up to 32 J/cm2