Gbox Diode Laser Using Method

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Summary of Laser Therapy Treatment Techniques

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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 PenetrationWand Position: Perpendicular to treatment area, place wand on the skin.Areas Requiring Superfcial PenetrationWand 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 ft 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

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Efect of Laser Spot Size on Tissue Distribution of Light Energy

A beam of light incident on tissue may be:

• Refected

• Absorbed

• Scattered

Scattering in tissue broadens the incident beam, decreasing the efective fuence in the intended target area.For efective penetration, light needs to avoid scattering and surface absorption.Doubling the spot size will increase the efective volume by a factor of eight.A larger spot size usually enables faster and more efective treatment in dermatologic applications such as treatment of vascular lesions, laser hair removal, etc.However, more photons must be supplied by more complex and expensive power supplies, components, and delivery devices. As a general rule, doubling the spot size and halving the fuence will yield an equivalent efective fuence at a given depth. Tis efect becomes more pronounced with increasing depth.

Indication for laser therapy

Infammatory Conditions
Bursitis
Carpal Tunnel Syndrome
Edema
Efusion
Epicondylitis
Infammation 
Muscle Spasms
Myofasciitis
Paresthesia  
Plantar Fasciitis
Primary Diagnosis Pain
Radicular Pain 
Restricted Rom / Stifness
Rheumatoid Arthritis

Pain Management
Bursitis
Cervical/Neck Pain
Edema
Efusion
Fasciitis
Fibromyalgia
Infammation
Low Back Pain
Muscle Spasms
Myofascial Pain
Myofasciitis
Primary Diagnosis Pain
Restricted ROM / Stifness


Connective Tissue Injury / Disorders
Edema
Efusion
Infammation
Muscle Spasms
Myofasciitis
Primary Diagnosis Pain
Radicular Pain
Restricted Rom / Stifness
Sprains
Strains
Tendon Ruptures
Tendonitis

Muscle Injury / Disorders
Edema
Infammation
Muscle Bruises, Contusions
Muscle Contractures
Muscle Ruptures
Muscle Spasms
Myofasciitis
Myositis
Primary Diagnosis Pain In Joint
Restricted ROM / Stifness

Joint Injuries / Disorders
Dislocations
Edema
Efusion Of Joint
Infammation
Ligament Injury
Osteoarthritis
Primary Diagnosis Pain In Joint
Restricted Rom / Stifness
TM Disorders

Neurological Injury / Disorders
Crush Injuries
Decreased Rom / Stifness
Edema
Efusion
Infammation
Muscle Spasms
Myofasciitis
Neuritis
Paresthesia
Primary Diagnosis
Prolapsed Disk
Radicular Pain
Ruptured Disk

Skin Injuries / Conditions
Burns
Edema
Infammation
Primary Diagnosis Pain In Joint
Restricted Rom / Stifness
Skin Grafs
Skin Ulcers
Surgical Incisions

Calculating Laser Treatment Parameters

Power

Power and energy are closely related. Power is the rate at which energy is delivered, not an amount of energy itself.

Formula:

Power = Energy / Time     1 Watt = 1 Joule / Second

Terapeutic Energy = Power (Watts) or Joules/sec x Time (sec)

Power Density

Power density or Irradiance refers to the amount of power delivered per unit area.

Power density indicates the degree of concentration of the laser output

It is expressed in Watts per square centimeter (W/cm2),or miliWatts per square centimeter (mW/cm2)

Some studies have concluded that the power density may be of even greater signifcance than the dose.

Example:  A laser’s output is 4 Watts, and it is illuminating a circle of 3 centimeter diameter

                First fnd the area of the circle, 3.14 x 1.5 x 1.5 = 7 cm2

                Then divide the power by the area, 4W / 7cm2 = 0.6 W/cm2

Formula: Irradiance (PD) =W/cm2

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donna@gigaalaser.com

Laser Physical Therapy Treatment Protocol Guidelines

Introduction

The guidelines listed here are very general guidelines. Many factors afect the selection of the appropriate dosage and treatment frequency for each condition and patient. 

Te 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; ofen the Cervical spine area from C1 to C4 

3. Treat the auricular point(s) related to the condition.

General Treatment Guidelines

Follow all Safety guidelinesT

reatment must be administered directly to exposed skin.  

IMPORTANT: Do not treat through clothing or bandages (the treatment will not be efective)

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 OptionsOption

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

EVLA treatment picture

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Ultrasound  image showing  the catheter and  the  laser fber inserted in the Saphenous vein




Duplex ultrasound  is performed  in  the upright posi-tion  to map  incompetent  sources of venous  refux and  then  to mark  the  skin  overlying the  incompetent  portion  of  the  great saphenous vein starting at the saphenofemoral junction




Duplex  control  is  used  to  guide  injection  of  7-  to 8-mL  aliquots of  the  following  solution: 10 mL  lidocaine 1% with epinephrine and 10 mL lidocaine 1% without epinephrine and additional 60 mL physiologic serum



To reduce the amount of blood inside the vein, patients are placed in a 15–20° head-down position (Trendelenburg position)



During  laser  irradiation,  the withdrawal of  the  laser fber is controlled to apply a constant linear endovenous energy density (in this case, a metric ruler)



At  the end of  the surgical procedure, venous com-pression  was  applied  for  24  h  by  irremovable  compression bandage