Introduction
The guidelines listed here are very general guidelines. Many factors affect the selection of the appropriate dosage and treatment frequency for each condition and patient.
The healthcare practitioner must take into account the body mass of the patient, their age and general health, the depth of the injury, the tissue type, skin color, etc.
Approaches to Treatment
1. Treat the site of the injury and / or pain
2. Treat using an anatomical perspective
3. Treat using an acupuncture perspective
Additional Treatment Approaches
1. Treat the pathway of the involved nerves
2. Treat the involved spinal level; often the cervical spine area from C1 to C4
3. Treat the auricular point(s) related to the condition.
General Treatment Guidelines
Ø Follow all Safety guidelines
Ø Treatment must be administered directly to exposed skin.
IMPORTANT :Do not treat through clothing or bandages(the treatment will not be effective)
Ø Patient feedback is important to avoid any discomfort or pain.
Patients may report a number of sensations, such as localized feelings of “soothing warmth”, tingling, or an increase or decrease in symptoms during the laser therapy treatment or within a 24 hour period immediately following the treatment.
Ask the patient to immediately report any discomfort or pain (“feels too warm or hot”) during the laser therapy treatment.
Treatment Method Two Options
Option One: NON – CONTACT METHOD:
The Handpiece or Probe is held ½” away from the skin
Option Two: CONTACT METHOD:
The Handpiece or Probe is held directly on the skin
Position of the Handpiece or Probe
Position the handpiece perpendicular to the skin
Do not angle the handpiece to the skin, but follow the contour of the body and skin treatment area
Treatment Techniques for Using the Handpiece
The area to be treated should be performed in a “painting” manner, with a constant slow movement of approximately 1-2 inches per second. 50% of the treatment should be delivered along a vertical plane and 50% in a horizontal plane.
When performing treatment with the Class IV Therapeutic Laser, different techniques can be used. Most healthcare providers use variations of a scanning technique, requiring the wand to be moved at a consistent speed over a specified pattern. Te pattern that the operator follows is not as important as maintaining a consistent speed while delivering the therapeutic laser treatment.
Note: overlapping patterns do result in increased thermal perception by the patient. Variances in probe to skin distance alter power density and consequently dosage delivered to the injured tissue.
Using the Handpiece Spacer
The wand should be placed directly on the skin for most musculoskeletal conditions. If you are treating a deep injury (i.e: to the back or hip joint), and at higher power the wand spacer can be used and should be placed on the skin to achieve maximum power density and penetration.
For treatment over skin lesions, small peripheral joints, or bony prominences, the wand can be held as far as 1-2 inches of the body. This will effectively increase the treatment surface area and decrease the power density.
Size of Treatment Area
A single treatment area is the size of the palm of your hand. We recommend treating a wide area that includes at least 1-2 inches of healthy tissue outside of the targeted area. This helps to establish proper circulation to the affected tissues. The majority of energy should be delivered over the area of pathology.
Thermal Discomfort
If the patient experiences thermal sensitivity, make the following adjustments:
First try increasing the rate of wand movement (greater than 1 inch per second) without changing the treatment probe to skin distance or decreasing the output power of the laser. (This method will not affect energy density of the treatment beam).Increase the distance between the treatment probe and the skin.
(This method will affect energy density of the treatment beam). Decrease the power (wattage).(This method will affect energy density and dosage of the treatment beam.)
Summary of Treatment Techniques
Wand Position: Perpendicular to treatment area, usually directly on the skin.
Treatment Area: Area that includes at least 1-2 inches of healthy tissue outside the targeted area.
Treatment Rate: Move wand at a rate of 1” per second. You may increase rate if patient experiences thermal sensitivity.
Treatment Frequency: Acute: daily. Chronic: every other day: 3 times/week.
Treatment Duration: Refer to treatment protocol chart.
Dosage: Refer to treatment protocol chart.
Areas Requiring Deeper Penetration
Wand Position: Perpendicular to treatment area, place wand on the skin.
Areas Requiring Superficial Penetration
Wand Position: Perpendicular to treatment area, 1-2 inches from the skin.
Regions: Fingers, Toes and over open wounds.
Pulsed application is used to custom tailor beam quality to fit the patient’s condition, (acute/chronic), comfort level, as well as technique of application. Cryo-therapy is strongly advised for continuous laser applications above 35 watts and for all pulsed applications over 25 watts
donna@gigaalaser.com
