FROM BASIC SCIENCE. to ADVANCED TECHNOLOGY

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Ronald Watts
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1 FROM BASIC SCIENCE to ADVANCED TECHNOLOGY

CONTENTS INTRODUCTION TO LASER THERAPY 1 PHYSIOLOGICAL EFFECTS OF LASER THERAPY 2-3 INFLAMMATION PATHWAY 4-5 CLINICAL EFFECTS OF LASER THERAPY 6-7 PAIN PATHWAY &

2 CONTENTS INTRODUCTION TO LASER THERAPY 1 PHYSIOLOGICAL EFFECTS OF LASER THERAPY 2-3 INFLAMMATION PATHWAY 4-5 CLINICAL EFFECTS OF LASER THERAPY 6-7 PAIN PATHWAY & THERAPY TARGETS 8-9 CLASS III VS. CLASS IV LASERS THE BIOFLEX ADVANTAGE CONDITIONS TREATED 14 COPYRIGHT Meditech International Inc. ALL RIGHTS RESERVED.

INTRODUCTION TO LASER THERAPY WHAT IS LASER THERAPY The technology utilizes superluminous and laser diodes to irradiate diseased or traumatized tissue with photons.

the restoration of normal cell structure and function. The process is curative and therefore results in the elimination of symptoms including pain.

Compared to traditional treatment, patients recover from musculoskeletal and peripheral nerve injuries with less scar tissue, accelerated cell regeneration and improved function.

3 INTRODUCTION TO LASER THERAPY WHAT IS LASER THERAPY The technology utilizes superluminous and laser diodes to irradiate diseased or traumatized tissue with photons. These particles of energy are selectively absorbed by the cell membrane and intracellular molecules, resulting in the initiation of a cascade of complex physiological reactions, leading to the restoration of normal cell structure and function. The process is curative and therefore results in the elimination of symptoms including pain. In addition, it enhances the body s immune system response and facilitates natural healing. Compared to traditional treatment, patients recover from musculoskeletal and peripheral nerve injuries with less scar tissue, accelerated cell regeneration and improved function. ADVANTAGES OF LASER THERAPY Non-invasive Non-toxic Easily applied Highly effective No adverse effects The technology is highly effective in the treatment of musculoskeletal conditions, arthritis, sports injuries, wound healing and a wide range of dermatological conditions. Studies are ongoing with regard to a number of additional challenging medical problems. 1

(600 900 nm) penetrate 5-10 cm deep into

BONE MITOCHONDRIA ELECTRON TRANSPORT CHAIN

4 PHYSIOLOGICAL EFFECTS OF LASER THERAPY Photon particles of red and infrared light ( nm) penetrate 5-10 cm deep into tissue and are absorbed by the mitochondria inside of cells TISSUE PENETRATION EPIDERMIS DERMIS FAT EUKARYOTE CELL MUSCLE BONE MITOCHONDRIA ELECTRON TRANSPORT CHAIN PHOTONS Cytochrome C Oxidase in damaged tissue absorbs these photons leading to increased ATP production Cytochrome C Oxidase ATP Synthase ADP ATP 2

5 ATP ATP plays a role in energy metabolism and intracellular signaling CELL PROLIFERATION INFLAMMATORY MEDIATORS FIBROBLASTS OSTEOCYTES MACROPHAGES LYMPHOCYTES CHONDROCYTES NEUTROPHILS Collagen, Cartilage and Bone Regeneration Inflammation and Edema Tissue and Nerve Regeneration Resolution of Inflammation and Pain 3

INFLAMMATION PATHWAY target cells and clinical effects of laser

cellular injury that is marked by capillary dilatation,

6 INFLAMMATION PATHWAY target cells and clinical effects of laser therapy Inflammation Pathway Inflammation is a local response to cellular injury that is marked by capillary dilatation, leukocytic infiltration, erythema, edema, pain and often loss of function. It also serves as a mechanism to initiate tissue repair and eliminate damaged tissue. Injury Site Neutrophils 1 Macrophages Blood Vessel 4 PGE Cytokines Oxidative Stress Nociceptor Pain Signalling Tissue Repair Cellular Damage Collagen Cartilage Myofibers 4

7 Laser Therapy Effects on the Inflammation Pathway Laser Therapy s modulation of inflammatory mediators allows for an accelerated resolution of the inflammatory process and enhanced tissue repair. Target Cells Clinical Effects 1 Macrophages Removes foreign bodies and damaged cells in preparation for the tissue repair process Neutrophils Limits the production of pro-inflammatory cytokines which breaks the cycle of chronic inflammation Oxidative Stress 2 Oxidative Stress Oxidative Stress Promotes cell survival and reduces damage to cellular membranes, thereby promoting tissue repair 3 Anti-inflammatory Cytokines Pro-inflammatory Cytokines Stimulates tissue repair including collagen, myofibers and cartilage Prevents stalling in the inflammatory phase which can lead to chronic inflammation 4 Prostaglandin (PGE 2 ) levels Decreases sensitivity to pain preventing hyperalgesia common in chronic inflammatory conditions Decreases vasodilation thereby reducing inflammation characterized by edema 5

CLINICAL EFFECTS OF LASER THERAPY Angiogenesis &

the injured tissue accelerates tissue healing.

of collagen reduces internal scar formation and

Muscle Regeneration & Muscle Atrophy Repair of

8 CLINICAL EFFECTS OF LASER THERAPY Angiogenesis & Neovascularization An increase in oxygenated blood to the injured tissue accelerates tissue healing. Collagen Production Proper alignment and remodeling of collagen reduces internal scar formation and enhances tissue elasticity. Muscle Regeneration & Muscle Atrophy Repair of damaged muscle fibers and activation of myogenic satellite cells leads to regeneration of muscle tissue. 6

Inflammation & Edema Increase in inflammatory

lymphocytes accelerates and resolves the inflammatory

Nerve Regeneration Proliferation of growth factors

collagen production allows for improved cartilage

9 Inflammation & Edema Increase in inflammatory mediators such as macrophages, neutrophils and lymphocytes accelerates and resolves the inflammatory process. Nerve Regeneration Proliferation of growth factors promotes neuronal sprouting and myelin formation for optimal nerve recovery. Cartilage Production Increase in chondrocyte and collagen production allows for improved cartilage deposition and joint function. Bone Formation Proliferation of osteocytes and remodeling of bone extracellular matrix results in accelerated bone repair. 7

10 Th Las er er ap y TE NS Ul Th tras er ou ap nd y Sh Th ock er wa ap ve y IF C TE NS Ul Th tras er ou ap nd y Sh Th ock er wa ap ve y IF C Mechanisms of Action Th Las er er ap y COMPARISON OF THERAPEUTIC MODALITIES Increased ATP Production Inhibition of Nociceptor (Pain) Signaling Endorphin Release Angiogenesis Tissue Regeneration Resolution of Inflammation Thermal Effect Indications Pain Muscle Tears, Sprains or Spasms Tendon Injuries Arthritis Peripheral Nerve Injuries Microcirculation Edema and Inflammation Wounds & Dermatological Conditions 8

11 Contraindications Over Uterus in Pregnancy Laser Therapy TENS Ultrasound Therapy Shockwave Therapy IFC Directly over Malignancies Impaired Skin Sensation Pacemakers Risk of Hemorrhage or Thrombosis Bone Fractures Epilepsy Cardiovascular Disease Metal Implants Evidence-Based Research Laser Therapy TENS Ultrasound Therapy Shockwave Therapy IFC Indications include commonly used applications of each therapeutic modality Evidence-Based Research graph is based on a Pubmed search of the following keywords LLLT, transcutaneous electrical nerve stimulation, ultrasound therapy OR therapeutic ultrasound, shockwave therapy, interferential current 9

12 CL A SS I II VS. CL A SS IV L A SERS CLASS IV Contact with skin ensures that photons penetrate deep into the target tissue. Up to 80% of light is reflected away. CLASS III CLASS III CLASS IV Deeper Penetration of Photons Optimal Power for Tissue Regeneration Tissue Regeneration CLASS III CLASS IV Stimulates Inhibits Power (mw) & Temperature (ºC) Too little power has no effect and too much power can cause tissue damage through heating (Arndt-Schultz Law) 10

13 Best Wavelengths for ATP Production CLASS III CLASS IV Blood Cell Absorption Water Cytochrome C Oxidase Wavelength (nm) Avoiding photon absorption by blood and water ensures maximum ATP production through Cytochrome C Oxidase absorption Published Research Articles Number of Articles >2000 <20 CLASS III CLASS IV Over 50 years of evidence-based peer-reviewed research supporting Class III lasers CLASS III LASERS ARE SAFE & EFFECTIVE WITH PROVEN CLINICAL RESULTS 11

14 THE BIOFLEX ADVANTAGE The BioFlex Professional Laser Therapy System offers clinicians the highest clinical success rates with predictable, reliable and reproducible results. LCD Monitor Infrared Laser Probe Shuttle Computer Main Controller Unit (MCU) Treatment Array Keyboard & Mouse Custom Designed Ergonomic Cart w/ Treatment Array/ Probe Holder 12

Large Flexible Arrays Contours to anatomical configuration permitting accurate and reliable dosage delivery Allows for hands-free treatment Covers a large area of tissue 11.

rate 660 nm, 830 nm and 840 nm (peaks of cytochrome C oxidase absorption) Software Scientifically researched and clinically developed over 30 treatment protocols for a wide range of medical

buttons offer information and clinical advice for protocol applications Software can be updated based on new clinical findings and research Anatomical and Pathology Tutor Provides detailed

15 Large Flexible Arrays Contours to anatomical configuration permitting accurate and reliable dosage delivery Allows for hands-free treatment Covers a large area of tissue 11.6 in 2 (75 cm 2 ) 179 superluminous diodes per array ( mw) Laser Probe LD-I 200 Class 3B Laser (200 mw) LD-R 100 Class 3B Laser (100 mw) 3 Different Wavelengths Heals tissue at an optimum rate 660 nm, 830 nm and 840 nm (peaks of cytochrome C oxidase absorption) Software Scientifically researched and clinically developed over 30 treatment protocols for a wide range of medical conditions Capacity to deliver an infinite range of protocols through the customization of parameters including frequency, duty cycle, waveform, energy density and duration Menu-Driven Info and Help buttons offer information and clinical advice for protocol applications Software can be updated based on new clinical findings and research Anatomical and Pathology Tutor Provides detailed illustrations of pathologies and anatomy for therapist Educates patients thereby improving patient compliance Portable and Stationary Mode All BioFlex Systems are portable and can be used in stand-alone configuration Patient Factors Treatment protocols modified according to variables such as age, skin colour and body type ensuring predictable and effective treatments Electronic Patient Software Permanent database includes patient info, history, diagnosis and prescribed treatments 13

A12233 ISO 13485 Meditech International Inc. BIOFLEX LASER THERAPY CLINICALLY PROVEN HIGHLY EFFECTIVE www.bioflexlaser.

Sports Injuries (Trauma) Ligament & Tendon Tears, Muscle Strains, Tendonitis, Contusions Arthritic Conditions Degenerative Osteoarthritis, Rheumatoid Arthritis, Vertebral Radiculopathy, Chronic

Sympathetic Dystrophy, Post Herpetic Neuralgia Wound Healing Traumatic Lesions (burns, etc.

16 A12233 ISO Meditech International Inc. BIOFLEX LASER THERAPY CLINICALLY PROVEN HIGHLY EFFECTIVE Accelerates Healing Anti-inflammatory Eliminates Pain Carpal Tunnel Syndrome Tennis Elbow Cervical Pain Rotator Cuff Injury Health Canada Medical Device License CONDITIONS TREATED Soft Tissue & Sports Injuries (Trauma) Ligament & Tendon Tears, Muscle Strains, Tendonitis, Contusions Arthritic Conditions Degenerative Osteoarthritis, Rheumatoid Arthritis, Vertebral Radiculopathy, Chronic Spinal Problems Repetitive Motion Injuries Carpal Tunnel Syndrome, Rotator Cuff Injuries, Tennis Elbow General Problems Herniated Disc, Fibromyalgia, Tempero-Mandibular Joint Syndrome, Reflex Sympathetic Dystrophy, Post Herpetic Neuralgia Wound Healing Traumatic Lesions (burns, etc.), Dermal Ulcers Venous Stasis Ulcers or Venous Ulcers Other Minor Muscle Pain, Minor Joint Pain, Arthritis-Related Pain and Stiffness, Muscle Spasm, Rotator Cuff Tendonitis Related Pain Achilles Tendonitis Osteoarthritis Spinal Stenosis Disc Herniation Muscle / Ligament Tears Osteoarthritis Plantar Fasciitis Call today to learn more about Laser Therapy or visit MT-MKT-LB HOW CAN I GET STARTED WITH LASER THERAPY? Clinic Visit Webinar Training Tour Meditech Laser Therapy Clinic

LASER THERAPY FOR PHYSIOTHERAPISTS

BioFlex Laser Therapy presents LASER THERAPY FOR PHYSIOTHERAPISTS Expand your knowledge. Build your practice. Did you know? Laser Therapy is one of the strongest evidence-based therapies according to Clinical