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Introduction to New High Power High Dose Class IV Laser Therapy. Bruce R. Coren , DVM , MS Founder Class IV Laser Therapy. HDLT-HPLT High Dose – High Power L aser Therapy.
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Introduction to NewHigh PowerHigh Dose Class IV Laser Therapy Bruce R. Coren, DVM, MSFounder Class IV Laser Therapy
HDLT-HPLT High Dose – High Power Laser Therapy • HPLTwas first introduced to the medical field in 2002 by then CEO of Avicenna Laser Technology, Inc, Bruce R. Coren, DVM, MS. • The company invented and developed the first High Power Therapeutic Laser to receive FDA clearance in 2003.
TMA– Technological Medical Advancements is a spin off from Avicenna and was founded not only to advance the field of Laser Medicine but also to bring other innovative medical devices to the market place. • TMAoffers the most powerful laser platforms in the world and thus allowing physician's of all medical disciplines the capability to heal injuries previously refractive to traditional medical care.
Design of the TMA Laser • The TMA laser was designed from the ground up to be a therapeutic medical laser.
It was developed using researchby our own biomedical engineers and clinicians as well as collaboration with a major medical school and university optics department.
We investigated important criteria such as wavelength, power and power density, optics and beam deliveryin order to afford the greatest penetration and delivery of a therapeutic dose capable of stimulating tissue healing in deep seated pathologies.
LASER— an acronym for: Light Amplification by Stimulated Emission of Radiation
LASER It could well stand for – Latest Advance For Surgeon to Enhance Revenue
Surgical Lasers in Medicine Are used to cut, coagulate, and evaporate tissues. This type of laser replaces the scalpel blade.
The TMA Laser is the only laser available on the market that was designed to accomplishboth surgical and therapeutic procedures.
Lasers in Medicine • Therapeutic Lasers are used for the stimulation of cell function. • The biological effect is photochemical not thermal, as is the case with surgical lasers.
Comparison of “Class IV” Surgical and Therapeutic Lasers • Surgical lasers collimate high amounts of laser energy into a beam of high intensity resulting in tissue destruction
High Power Therapeutic Lasers take a high amount of laser energy but instead of beam collimation you get beam divergence resulting in tissue stimulation
Who is using Diowave • Veterinarians • - Equine and Small Animal • Human • - Physical Medicine and Rehab • - Pain Management • - Orthopedists, Neurologists, • - Family Practice
Chiropractors and Physical Therapists • Podiatrists, Naturopaths and DOM’s • MLB, NBA, NFL • College Sports Teams • Medical and Veterinary Colleges • United States Military • VA Hospitals
Biological Effects of Therapeutic Lasers • Laser therapy aims to bio-stimulate injured and dysfunctional tissues. • Clinical studies and trials of Class III & IV laser technology indicate the following beneficial effects of light therapy on tissues and cells.
Cellular Effects of Laser Energy • Chromophores are components of molecules which absorb light.
The stimulation of chromophoreson mitochondrial membranes incites the production of ATP. • Leading to a biological cascade of events.
Increased Growth factor response within cells and tissue as a result of increased ATP and protein synthesis. • Accelerated cell reproduction and growth leading to faster repair of damaged tissues.
Increased metabolic activity- via increase in enzyme outputs, oxygen and nutrient availability. • Stem cell activation
Wound Healing Effects of Laser Therapy • Faster Wound Healing - Laser significantly increases fibroblast and collagen production which are essential for tissue repair. • Improved Vascular Activity - Increased capillary production leads to faster wound closure. • .
Greater Tensile Strength - Surgical repaired wounds heal with greater tensile strength, including skin, tendon, ligament and fascia. • Scar Tissue Reduction - Wounds heal with less scar tissue formation.
Wound Healing - Vet WOUND DAY 1 WOUND DAY 7 SID TX 4 WATTS-3000 JOULES
Wound Healing- Human PRE-LASER AND AFTER TWO MONTHS OF TRADITIONAL THERAPY AFTER TWO 5 MINUTE LASER THERAPY TREATMENTS AT 7.5 WATTS
Immune System Effects of Laser Therapy • Strengthening the immune system response via increasing levels of lymphocyte activity and through a newly researched mechanism termed photo-modulation of blood.
Acute Inflammation Reduction Stabilization of cellular membrane Lubart R, Friedman H, and Lavie R. Photobiostimulation as a function of different wavelengths. The Journal of Laser Therapy. Vol12. World Association of Laser Therapy. 2000. Karu T. et al. Changes in absorbance on monolayer of living cells induced by laser irradiation. IEEE Journal of Selected Topics in Quantum Electronics. IEEE Lasers and Electro-Optical Society. December 2001. 7(6):982. De Castro E Silva Jr. O, et al. Laser enhancement in hepatic regeneration for partially hepatectomized rats. Lasers in Surgery and Medicine. 2001. 29(1):73-77
Acute Inflammation Reduction • Acceleration of leukocyticactivity • Increased Prostaglandin synthesis • Reduction in Interleukin 1(IL-1). • Enhanced lymphocyte response • Increased angiogenesis • Temperature modulation
Acute Inflammation Reduction Laser Therapy Cytochrome Activation Ros Production Ca, Na, K Ion Changes Cell Membrane Changes Proton Gradient Change ATP Increase Vasodilation PG Synthesis IL-1 Decrease Increased Leukocyte Activity Enhanced Lymphocyte Response Temperature Modulation Angiogenesis SOD Production
Summary of LT Biological Effects • Accelerated Tissue Repair • Accelerated Cell Growth • Faster wound Healing • Reduced Scar Tissue Formation • Anti-Inflammation • Anti-Pain (Analgesia)
Summary of LT Biological Effects contd.. • Improved Vascular Activity • Increased Metabolic Activity • Improved Nerve Function • Immunoregulation • Trigger Point Resolution • Acupuncture Pt. Stimulation
Summary of LT Biological Effects contd.. • Improved Vascular Activity • Increased Metabolic Activity • Improved Nerve Function • Immunoregulation • Trigger Point Resolution • Acupuncture Pt. Stimulation
High Power - High Dose Laser Therapyas it Pertains to the Spine • Decreased inflammation of disc, nerve roots and the caudaequine • Increase microcirculation of spinal structures • Accelerate healing of annular defects • Decreased formation of abnormal/non • functional scar tissue
Decreased scar tissue and non-osseous hypertrophic changes • Reduce pain associated with PRP –prolotherapyinjection • Decrease or even eliminate • need for epidurals
High Power – High Dose Laser Therapyas it Pertains to the Lower Extremities • Decreased inflammation of nerve tissue • Accelerated Reinervation of nerve fibers • Increase blood flow and microcirculation of tissue structures
Accelerate healing of open wounds • Decreased formation of abnormal non-functional scar tissue • Increase synovial fluid and cartilage production
Increase collagen and fibroblast production • Increase osteoblastic activity and fracture healing • Decreased bony edema – osteochondral bone bruise
Laser Safety Overview • Safety Training begins with YOU! • Class IV Laser Beams can cause damage to the eyes • Safety Glasses must be worn by everyone in the treatment area AKA Nominal Hazard Zone (NHZ)
Laser Safety • Safety protocols must ensure sufficient precautions are taken to protect the health and safety of employees and patients. Use of safety goggles to prevent retinal exposure is paramount.
Laser Safety • Laser safety eyewear is not a primary mode of protection • They do not replace proper laser safety education, training, and careful clinical practice.
Laser Safety Lesion Fluorescein angiography of retina after laser irradiation
Laser Safety • Training • Equipment Purchase, Service, Quality Assurance • Room Design • Protective Equipment / Optical
Laser Safety • Hazards • Routine Procedures • Administrative Controls/Management • Electrical Hazards
Laser Safety-Reflective Surfaces • Medical Instruments (Reflex Hammers, Stethoscope) • Jewelry (Rings, Watches, Earrings) • Treatment Table • Mirrors, Door Knobs and other Fixtures
Optical Hazards Reflect Absorb Transmit Scatter
Laser Classifications Class 1 Lasers Compact Disc Players Laser Printers
Laser Classifications Class 2 Lasers