LASER. Prof.Dr.Gehan Mosaad. At the end of the lecture the student should be able to. Define laser and know its physical properties Discuss the mechanism of LASER production Identify different classification of LASER Understand the therapeutic effects of LASER
Laser has three main effects:
I- Effect on tissue healing (wound and bone healing):
a- wound healing:
a- Bone healing:
II- Analgesic effect:
III- Effect on tissue inflammation:
It was reported that laser irradiation leads to:-
1- Non infected and infected skin wound and ulcers
Such as, open wounds, decubitus ulcer (Bed sores), diabetic ulcer, lacerations, incisions, burns.
2- Acute and chronic inflammation of musculoskeletal system as
- Osteoarthritis and rheumatoid arthritis
- Acute and chronic soft tissues injuries(tendon, ligament, muscle)
- Acute and chronic sprain and strain.
3- Pain management:
-Acute and chronic pain of different cases:
Spondylosis, arthritis, tennis elbow, epicondylitis, tendinitis, sprain, supraspinatus tendinitis).
- Neurogenic pain such as, carpal tunnel syndrome, trigeminal neuralgia, post-herpetic neuralgia.
4- Non-united fracture.
5- Trigger point and acupuncture point stimulation.
1- Direct irradiation of the eye
Laser may damage the retina, Thus, care must be taken when treating the head area. The patient & therapist should wear protective glasses.
2- Pregnant uterus
Laser may have a mobilizing effects on steroids in the human system.
3- Patients who are naturally photosensitive
6- Treatment of the thyroid gland and other sensitive organs.
7- Hemorrhaging regions
8- Within 4 to 6 months after radiotherapy
A variety of therapeutic laser devices currently available for clinical applications in the field of physical therapy
1- Helium neon laserwas the first laser system to be used in clinical and research applications.
2-Semiconductor diode lasers (Infrared LASER)based upon the gallium arsenide (Ga-As) or gallium aluminum arsenide (Ga-Al-As).
There are two main techniques:
I- Contact technique
Methods of application of contact technique:
l- Spot methods where only isolated points are irradiated.
2- Lineal methods where laser is irradiated linearly along the neural route related to the painful area.
3- Combined methods (Spot and Lineal), where laser irradiation started by lineal methods and shifted to spot one.
2- Non – contact technique
Methods of application of non contact technique:
1- Scanning application:
2- Manual scanning :
alternative to manual scanning
a grid work of square measuring 1 x 1 cm (1 cm2).
square using a single diode applicator from
a distance of no more than 0.5-1 cm.
Non -contact technique wound bed application
Contact technique linear application on scar tissue
I- The techniques used in treatment of wounds
2-Non- contact technique:
the laser unit available.
II- Laser type:
Both types of laser (He Ne & IR Laser) are effective.
III- Duration and frequency of treatment:
The duration of treatment is detected according to the power of laser unit.
Laser treatment is given once daily or at alternate days.
Case study: A case of ligament strain.
• Relevant joint is appropriately positioned.
• Laser applied using a single probe with firm but comfortable pressure.
• Energy densities of at least 1 J/point or 8 J/cm².
• In the early stage, daily treatment is recommended.
• In the latter stages, the frequency of treatment should be decreased.
Case study: Tendnitis /tenosynovitis
• Laser irradiation should usually be applied to the most sensitive areas of the tendon on palpation as well as to the area of tendon immediately above and below the site of tenderness or pain.
• Single diode probe and energy densities of at least 0.5 J/point or 4 J/cm² is used.
• During treatment, the tendon must be placed on a slight stretch but with pain free, and all aspects of the tendon are irradiated by directing the laser at a range of angles for treatment.