Laser

Question 1

LASER- acronym

Answer 1

LASER means light amplification by stimulated emission radiation​

Question 2

Laser use

Answer 2

used to promote tissue healing , decrease pain and inflammation via NON-THERMAL mechanisms​

Question 3

Light definition

Answer 3

Light is defined as the emission of electromagnetic waves, made of photons traveling in space, in or close to the visible range of the spectrum

Question 4

Laser (3 characteristics)

Answer 4

Invisible light energy in the visible red and near-	infra red band of the electromagnetic spectrum ​
                           ​
Monochromatic – 1 frequency only​
Collimated/directional-non-divergent​
Coherent - all waves in sync​

Question 5

How laser delivers energy

Answer 5

Lasers deliver energy in the form of electromagnetic radiation at specific frequencies and wavelength

Question 6

The intensity of energy reaching the body is greatest when

Answer 6

the energy output is high​
radiation source is close to the client​
the beam is perpendicular to the skin surface

Question 7

Monochromatic Light Therapeutic Advantage

Answer 7

absorption targeted to specific , wavelength dependent photoacceptor molecules, called chromophores, buried within soft tissue​

Question 8

Wavelength values

Answer 8

Visible light: ~400-650 nm​
Infrared light: >650-1300 nm​
Longer wavelength penetrates deeper​

Question 9

Photo Diodes

Answer 9

LEDs- light emitting diodes​
SLDs-superluminous diodes​
Laser diodes

Question 10

Light emitting diodes-LED’s

Answer 10

produce low intensity light,​
is not coherent or monochromatic​
spreads widely​
increases application time required​

Question 11

​Supraluminous diodes-SLD’s

Answer 11

-produce high intensity,​
almost monochromatic light, not coherent​
spreads minimally​
requires shorter application times than LED’s ​
delivers energy to wider area than laser diodes​

Question 12

Laser diodes

Answer 12

produce monochromatic, coherent and directional light​

deliver energy to small specific area​

Question 13

LEDs

Answer 13

Most diffuse light ​
Widest frequency range​
Low power individually​
Best suited for treating large, superficial areas

Question 14

SLDs

Answer 14

Less diffuse light​
Narrower wavelength​
Emit >power than LED’s​
Best suited for superficial, moderately deep areas, based on wavelength

Question 15

Laser Diodes

Answer 15

Provide single wavelength light​
Very concentrated​
Best suited to treat small areas​
Delivers the most, deepest light to a single area of tissue

Question 16

Power

Answer 16

The amt. of electromagnetic energy per unit time​
Laser applicator power is measured in milliwatts ​
1mW=1/1000 of a watt ​
Preset on each applicator​
Some units: Continuous vs. Pulsed

Question 17

Laser diodes Power

Answer 17

5mW to 500mW​

Question 18

Energy

Answer 18

total amt. of electromagnetic energy delivered over entire treatment time.​
Energy = power x time​
1J = 1 W x 1 sec​
The higher the power of the applicator, the shorter the treatment time​

Question 19

Energy Density

Answer 19

= power per unit area =J/cm2*​

* Preferred clinical measure 2-30 J/cm2​

Question 20

Energy density for acute conditions

Answer 20

Acute and superficial conditions - use lower​

energy doses

Question 21

Energy Density for chronic conditions

Answer 21

Chronic and deeper conditions - use higher energy doses

Question 22

Energy Density Parameters for soft tissue healing

Answer 22

5-16 J/cm2

Question 23

Energy Density for Fracture Healing

Answer 23

5-16 J/cm2

Question 24

Energy Density for acute arthrits

Answer 24

2-4 J/cm2

Question 25

Energy Density for chronic arthritis

Answer 25

4-8 J/cm2

Question 26

Energy density for lymphedema

Answer 26

1.5 J/cm2

Question 27

Energy density for Neuropathy

Answer 27

10-12 J/cm2

Question 28

Energy Density for acute soft tissue inflammation

Answer 28

2-8 J/cm2

Question 29

Energy density for chronic soft tissue inflammation

Answer 29

10-20 J/cm2

Question 30

Photobiomodulation

Answer 30

photochemical interactions between photons and healthy cells within and surrounding the soft tissue pathology light unbinds nitric oxide, releases ATP, improves cell functions

Question 31

chromophores

Answer 31

the light absorbing part of molecule that gives it color

Question 32

best known chromophores

Answer 32

Hemoglobin (red blood)​ Melanin (skin darkening)​ Retinal rhodopsin (color vision)

Question 33

light stimulates chromophores in mitochondria triggering..

Answer 33

Mitochondrial cytochromes which triggers the process of photobiomodulation and increases the oxidative metabolism of mitochondria​

Question 34

Clinical Indications for Lasers and Light

Answer 34

``` Soft tissue and bone healing​ ​ Arthritis​ ​ Lymphedema​ ​ Neurological conditions​ ​ Pain management ``` promotes use of LLLT for wound management, tendinopathies and pain​

Question 35

Effects of Laser and Light

Answer 35

``` Promote ATP production by mitochondria​ ​ Promote collagen production by fibroblasts​ ​ Modulate inflammation​ ​ Inhibit bacterial growth ```

Question 36

Wavelength LLT

Answer 36

600-904 nm

Question 37

Contraindications

Answer 37

``` Malignancy​ ​ Direct irradiation of the eyes​ Should always wear goggles opaque to the wavelength of the LASER​ ​ Within 4 to 6 months after radiotherapy​ Radiotherapy increases tissue susceptibility to malignancy and burns​ ​ Hemorrhaging regions​ May cause vasodilation and increase bleeding​ ​ Over the endocrine glands​ May alter function of endocrine glands ```

Question 38

Precautions

Answer 38

``` Low back or abdomen during pregnancy​ ​ Epiphyseal plates in children​ ​ Impaired sensation​ ​ Impaired mentation​ ​ Photophobia/light sensitivity​ ​ Pretreatment with photosensitizer​ Acne medications ```

Question 39

Adverse Effects

Answer 39

``` Transient tingling​ Mild erythema​ Rash​ Burning sensation​ Increased pain/numbness​ Burns from warm diode​ Fatigue ```

Question 40

Implications of Laser

Answer 40

Laser is non-thermal = OK for acute conditions​ ​ Laser can be used for patients with metal implants and pacemakers

Question 41

Modalities used before Laser

Answer 41

Ice | vasoconstriction decreases blood flow, improving light penetration

Question 42

Modalities used After Laser

Answer 42

Massage, US, Estim | vasodilation increases blood flow, diminishing penetration of light

Question 43

``` LLT Review (definition, purpose, use) ```

Answer 43

the application of low power light energy in the ​visible red and near-infra red band of the electromagnetic spectrum ​ ​ for the purpose of photoactivating cellular mechanisms via process called photobiomodulation​ ​ leading to soft tissue repair and pain modulation​ ​