Laser therapy and it's relative information

Electrotherapy and physical agents

1. Laser therapy Salman Farooqi Lecturer, IPM&R, KMU

2. Question What does the word LASER stands for?

3. Introduction The word laser is an acronym for L ight A mplification by the S timulated E mission of R adiation It refers to a beam of radiation which is differs from the ordinary light.

4. Introduction (cont..) Mono-chromaticity Coherence Collimation The analogy is often made between laser and an army of soldiers marching in steps, in the same direction and wearing the same uniform

5. Types of Laser The Ruby Laser Helium-neon Laser Diode Laser

6. The Ruby Laser

7. Helium-neon Laser

8. Diode Laser

9. Class Power Effects Usage 1 Low None on eye or skin Blackboard pointer 2 Low 1mW Safe on skin eye must be protected Therapeutic Physiotherapy model 3A Low-medium (mid) 5mW Direct intrabeam viewing with optical aids may be hazardous Therapeutic Physiotherapy model 3B Medium 500mW Direct intrabeam viewing may be hazardous Therapeutic Physiotherapy model 4 High 500 mW + Hazardous to skin and eye Destructive Surgical models

10. Effects of Laser Radiation on the tissues The interaction of laser with the tissue is essentially the same as any other radiation in that it can be reflected from the surface or penetrate the tissue. Since the beam of radiation is very narrow treatment can only apply to a small zone of tissue at a time

11. Effects of Laser Radiation on the tissues It is thought that red light is absorbed by cytochromes in the mitochondria of the cell. This in turn possibly affects cell membrane permeability.

12. Therapeutic Uses of Laser The term low-reactive level laser therapy (LLLT) is sometimes used to distinguish this low intensity laser application used in physiotherapy.

13. Tissue Healing The use of radiation of all kinds to accelerate wound healing has a long history but radiation in the red part of the visible spectrum have been particularly employed and found to be effective.

14. Tissue Healing In fact, it is suggested ( Karu , 1987) that the helium-neon laser helps in accelerating tissue healing the observed benefit of laser therapy has been attributed to its coherence.

15. Tissue Healing Laser treatment is recommended for the treatment of tropical ulcers to promote more rapid healing and it is considered that low intensity visible radiation has an effect on accelerating or stimulating cell proliferation.

16. Pain Control Laser therapy is used for the relive of pain in many conditions, both acute and long-term Rheumatoid arthritis, osteoarthritis and bursitis.

17. Pain Control The laser treatment of Rheumatoid arthritis has also been studied and was found to have a significant pain-relieving effect and reduction of joint swelling as well as objective improvement in hand function

18. Pain Control Neurogenic pain (trigeminal neuralgia) has also been found to be relived in some patients by laser applications this was thought to be due to the laser effecting serotonin metabolism

19. Indications Open lesion Decubitus ulcer Diabetic ulcers Laceration Incisions Burns Chronic and acute pain Restricted ROM

20. Contraindications Do not radiate the eye directly Pregnancy Do not use the laser with patients who are naturally photo sensitive or who are photo sensitized by medications.

21. Depth of penetration Direct penetration of the HeNe laser at 1mW is said to be about approximately 0.8mm

22. Dosage Actual dosage with the laser depends on the power factor duration of radiation and tissue resonance

23. Dosage in wound healing In most wound healing application, the prescribed dosage is 90 sec/cm² of open lesion. This may require several minutes of handheld direction of the beam over the surface of the wound so that each square cm is exposed for the same 90 seconds The probe tip is held approximately 2-3 mm from the surface.

24. Dosage in pain control At acupuncture and trigger points nerve roots and pain sites, a dosage of 15 to 30 second for each point is recommended. Unlike in the open wounds technique the probe tip is held in contact with the skin.

25. Treatment Techniques Gridding Technique Divide treatment areas into grids of square centimeters Scanning Technique No contact between laser tip in skin; tip is held 5-10 mm from wound Wanding Technique A grid area is bathed with the laser in an oscillating fashion; distance should be no farther than 1 cm from skin Point Application (Acupuncture point)

26. Modes Current laser equipment offers the clinician two modes Continuous beam Pulsed beam