Laser Therapy Or

PhotoBioModulation For

Medical and Veterinary Practitioners

ENHANCE CELLULAR METABOLISM - PAIN - INFLAMMATION - TISSUE HEALING

970nm

Increase

lood Flow

905nm

Boost Cells

Oxygenation

800nm

Enhance

ATP Production

660nm

Assist

Tissue Healing

Understand the technology used for 20 years in the USA and Europe
to reduce pain & inflammation and optimise wound healing.

Cellular Health Is Key To Healing

" Cellular health is important because it is what determines the health of each organ, which is made up of cells. The organ is sort of the unit of health, " explains Leonard Guarente, Ph.D., the Novartis Professor of Biology at Massachusetts Institute of Technology.

We believe that focusing on health at the micro level is an important step to recovery as cells are the base of living beings.

Achieving cellular health through PhotoBioModulation Therapy

K-LASER utilises visible and near-infrared wavelengths targeting specific chromophores in the tissues in order to reduce pain, inflammation, and promote tissue healing. The photobiomodulation (PBM) process was discovered in the 70's and was first called "Low Level Laser Therapy" (LLLT) or "Cold Laser Therapy" as technology could only offer very low powered lasers at that time.

Since 2002, K-Laser started developing high power lasers to allow health professionals to use PBM for faster, deeper and more efficient treatments."High Intensity Laser Therapy" (HILT) was born. Of course a K-Laser devices can also output low power when needed for specific applications.

By accelerating the normal biochemical process the K-Laser is able to increase blood flow, boost cells oxygenation, and enhance ATP production. The aim is to improve healing as well as reduce pain and swelling.

What Is A Laser Therapy Treatment?

A laser therapy treatment is composed with the following parameters, each of them needs to be finely tuned to optimise efficiency:

1- A given power (Average power and peak power)

2- A delivery mode and frequency ( Continuous Wave (CW), Pulsed Wave (PW), SuperPulse (SP), IntenseSuperPulse (ISP) )

3- Wavelengths (one or several simultaneously)

4- A duration of treatment

Multi-Phase

Laser Treatment

All K-Laser units are Multi-phase capable.

This means that a typical 3-5 minutes K-Laser treatment session is divided into up to 12 successive phases.

Each phase holds a different configuration of the laser in order to optimise energy absorption at desired depth by cells and target the different tissues types present in a specific part of the body.

As the practitioner enters specific characteristics about the patient and targeted area each different phases of the treatment will be automatically configured.

Understanding Laser Therapy Parameters

Power: Class IIIa, Class IIIb, Class IV, LLLT, HILT - Understanding Laser Outputs

A- Average Power

IMPORTANT:

Laser classification has been created to classify the potential damage to the eye.

It is a safety classification.

Classification has nothing to do with laser therapy itself.

This classification is only based on the AVERAGE POWER a laser unit is able to output WHEN USED TO ITS MAXIMUM POWER:

  • Class IIIa: < 0.005W
  • Class IIIb: < 0.5W
  • Class IV: > 0.5W

The maximum average power gives the real maximum power of a laser unit.Of course a Class IV laser can also be used at low power as well when needed according to the area targeted and the depth of treatment required.

The examples below show a 15W K-LASER CUBE-4-PLUS used at full power in Continuous Wave Mode (CW) and in Pulsed Wave Mode (PW).As you can see the average power is high (when used at maximum power) which means a higher quantity of beneficial energy is sent to cells.

K-Laser-Continuous-Wave-Mode
K-Laser-Pulsed-Mode

B- Peak Power (With SuperPulse Mode - SP)

This mode is used on low power lasers which are unable to achieve high average power.

It is important to note that a higher power than the maximum average power of a laser unit can be achieved for a very short period of time (nano-seconds). The "trick" is to release the energy during extremely short peaks instead of continuously or pulsing.

This technique is called "SuperPulse".

The example below features a low power laser diode (1W) outputting 15W peak power during a very short time (T-ON). T-OFF is the period where nothing is emitted. In this case the duty cycle is 6.7% (1/15). Although the peak power is 15W the average power is still only 1W so the targeted tissue does not receive a large quantity of energy.

SuperPulse-Low-Power-Laser

Advantages of SuperPulse Mode

The SuperPulse mode offers the ability to:

  • Achieve deeper penetration of tissues
  • Have lower interaction with melanin in the skin

Disadvantage of SuperPulse Mode

Although the SuperPulse mode offers a higher peak power, the average power is still unchanged so no more energy is sent to the tissue.

In our example above, even if the 1W laser emits 15W peak the average power is still only 1W so the quantity of energy received is still unchanged (low).

In many cases the required dosage cannot be reached as the average power is far too low.

Important note on SuperPulse mode

Although our example above shows a 1W average power laser diode outputing 15W peak power, most manufacturers using the SuperPulse method actually operate extremely low average power diodes (usually from 0.005W to 0.1W) and advertise output of 15W or 25W peak!

In addition most of the time only the peak power is advertised for marketing reasons.

C- Peak Power (With IntenseSuperPulse Mode - ISP)

The IntenseSuperPulse mode (ISP) is a high power version of the SuperPulse mode reviewed above.

ISP is one of the modes available with a K-Laser.

The aim of the ISP mode is to use the SP mode's advantages without the disadvantages.

The ISP mode allows higher power than the average power of the laser unit but with a high average power.

The example below shows a K-LASER CUBE-4-PLUS used at full power in ISP mode (15W unit outputting 20W ISP with a 12W average power.K-Laser Cube Series is the laser technically able to achieve such a performance.

K-Laser-IntenseSuperPulse-Mode

Higher power Laser for correct dose, faster treatment, and deeper penetration

Getting the correct laser dose

According to applications and areas of the body, the right dose for PhotoBioModulation ranges between 0.5 - 12 joules/cm2.

For example if we consider the treatment of a painful lower back:

Area to be treated: 20 cm x 15 cm = 300 cm2

Dose for this type of area: 8 joules/cm2

Total energy needed: 300 x 8 = 2,400 joules

The quantity of energy received is calculated according to the AVERAGE POWER only.

Treatment time with a 0.005W laser: 2400J / 0.005W = 480,000s = over 133 hours

Treatment time with a 0.5W laser: 2400J / 0.5W = 4800s = 80 minutes

Treatment time with a 5W laser: 2400J / 5W = 480s = 8 minutes

Treatment time with a 10W laser: 2400J / 10W = 240s = 4 minutes

Treatment time with a 15W laser: 2400J / 15W = 160s = 2.6 minutes

Continuous Wave (CW) vs Pulsed Wave (PW)

The calculations above have been made considering a laser used in CW mode (=Average Power).However in real-life treatments are usually done with in Pulsed Wave (PW) mode (see graph above) with a duty cycle of 50% (T-ON / T-OFF).

Therefore twice more time will be needed than the calculations above as PW mode outputs half the energy than CW mode.

Therefore using a higher power laser makes much more sense for professional usage!

Faster treatment and deeper penetration

Higher power K-Laser units allow practitioners to work faster and reach deeper tissues.

When treating Musculoskeletal cases with a K-Laser we also consider the volume of tissue below the treatment area, not just a point (acupuncture) or a surface (wound treatment). A K-Laser treatment is about saturating all the cells within the targeted zone with the appropriate quantity of energy.

Depending on many parameters (example: wavelengths used, frequency used, area targeted, darkness of the skin,...) the power remaining after 7 cm of depth in tissue varies from 5% to 15% of the power applied at the surface as the laser light has been scattered and absorbed by tissue along the way.

Remaining-power-laser

Wavelengths used for specific effects

The wavelength of a light is measured in nanometer (nm) and is perceived by the human eye as a color. For example in the visible range 445nm is blue, 530nm is green, and 660nm is red.

Infrared lights (above 700nm) are not visible to the human eye but will interact differently with specific entities (chromophores) in the targeted tissues in order to trigger specific effects in the body.

As it penetrates the tissues the laser light can be either scattered or absorbed gradually. The wavelength acts as a carrier for the energy.

Certain wavelengths will be able to go through given type of tissues while being absorbed and interacting better with others. The aim is to be able to go through the skin and interact with hemoglobin in order to accelerated oxygen release and mitochondria in order to increase ATP production.

Wavelength_definition2

Which wavelengths should be used for laser therapy?

800nm => ATP

The primary process that we want to increase is the production of ATP in the mitochondria to accelerate cell healing. Therefore we use 800nm which targets Cytochrome c oxydase and enhances the use of oxygen to generate ATP.

905nm => Oxygenation

As we are using the oxygen in an accelerated way due to the action of 800nm we need to bring more oxygen to feed the process. Therefore we use 905nm which targets hemoglobin and forces oxygen release.

970nm => Vasodilation

The oxygen is being extracted due to the action of 905nm but if we want to maintain the efficiency of the process we need to bring new blood. Therefore we use 970nm as a vasodilator as it will create a temperature gradient into the tissue by targeting water specifically.

660nm => Skin/Wound healing

660nm is visible red light, it does not penetrate tissue very deeply but is very efficient at healing wounds and healing skin conditions.

As we described above wavelengths have to be selected accordingly to the effects required.

The K-Laser will use different wavelengths SIMULTANEOUSLY.

K-Laser-Wavelenghts-Absorption

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PhotoBioModulation

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Presenter:

Dr. Laurence ONER