CLASS IV LASER

CLASS IV LASER. UJJWAL VERMA MPT - 1st sem 06/MPT-SM/DPSRU/SOP/2023.

Introduction. LASER means Light Amplification from Stimulated Emission of Radiation. Laser is created by specific process within the laser device to cause the controlled emission of radiation in form of light. Laser usually comes in one color and it comes in a thin beam. Lasers were first invented by physicist Gordon Gould in 1958 and first working model was built in 1960. They have been used in Europe and America for more than forty years and have been used in fields of dermatology, surgery. ophthalmology and physical medicine and rehabilitation. Laser is used by physiotherapists for relief of pain, to accelerate healing and decrease inflammation..

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Class IV laser. This new class of therapeutic lasers of laser therapy delivers high-power penetrating infrared energy to deeper target tissues. These lasers always shorten the therapy time for a wider area of use. These are also called Hot lasers (as they produce heat) The major difference between class IV & class 3 diode laser is that it is able to produce a primary biostimulation effect on deeper tissues..

PRODUCTION OF LASER Laser device is made up of an optical cavity or chamber that contains active medium for which laser is named. The chamber has mirrors on either end that are perfectly parallel to each other within a single wavelength of light. One of the mirror is partially open. Electricity or energy is added to the medium which excites it. The active medium atoms are reflected back and forth across the mirrors within the chambers. This cause more excitation of atoms within the medium. Laser light is then emitted through the partially reflective end of mirror. The light production occurs in the following steps : Electron is pumped to higher energy level. Pumping level is unstable so the electron quickly jumps to a slightly lower energy level. Electron relaxes to a lower energy state and releases a photon. Light and an electron in an excited energy level produces two photons of same wavelength and phase. Mirror reflects the photons or laser light emitted. CHARACTERISTICS OF LASER Due to specific nature of laser production, it also has specific characteristics ; Monochromaticity - ‘mono’ means single. ‘Chromaticity’ means color. Laser when emitted produces single pure color because it has one specific wavelength. Coherence - laser rays are synchronous to each other. The crest and trough of individual rays matches each other. Collimation - it is also termed as non-divergence. Laser rays travel parallel to each other..

HOW DOES LASER WORK ? When the light source is placed against the skin, the photons penetrates several centimetres and gets absorbed by the mitochondria. The energy fuels many positive physiological responses resulting in restoration of normal cell morphology and function but at enhanced rate. Targeted in haemoglobin and cytochrome oxidase, the high power diode laser could help in respiration and then in result have a good performance therapy..

EFFECTS OF LASER THERAPY ON TISSUES PRIMARY EFFECT Photons incident on tissue will reflect, absorb, transmit or scatter. The primary response is elicited when photons emitted by the laser reach the mitochondria and cell membranes of low lying cell such as fibroblast where energy absorbed by chromophore and is converted into chemical kinetic energy within the cell. SECONDARY EFFECT This step is basically amplification of the primary effect and goes as ; Cell membrane permeability Cell migration, RNA & DNA synthesis Cell mitosis, proliferation and protein secretion TERTIARY EFFECT Energized cells communicate with each other and with non-irradiated cells through increased levels of cytokines or growth factors. This intercellular communication results in an increase in the immune response with the activation of T-lymphocytes, macrophages, and number of mast cells. An increase in the synthesis of endorphins and a decrease in bradykinin results in pain relief..

How therapy is done ?. During a Class IV laser treatment, the treatment wand is kept in motion during the continuous wave phase, and is pressed into the tissues for several seconds during laser pulsation. Patients feel a mild warmth and relaxation. Since tissue warming occurs from the outside-in, Class IV therapy lasers are safe to use over metal implants. After treatment, a clear majority of patients feel some change in their condition, be it pain reduction, improved range of motion, or some other benefit. Use of the accessories mentioned will make the treatment easy and effective..

Indications. Physiotherapists use HPLT basically on the presumption that energized cells from the laser increase the rate of healing. Class IV hot laser therapy (high intensity laser therapy) can treat a variety of conditions, such as:.

[image]. Pins, L. (2017). Use of Class IV, High Intensity Laser Therapy as an Adjunct in Treating a Patient with an Acute Shoulder injury: A Case Report..

CONTRAINDICATIONS Pregnancy Tumor Hemorrhage Pacemaker Thrombosis.

PRECAUTIONS •Should wear laser‐protective glasses or goggles •Inappropriate use of the goggles is more dangerous than their non‐use, as they may provide a false sense of security. •Laser equipment should be placed in a controlled area with minimal access to avoid inadvertent exposure •Avoid laser reflection from mirrored surfaces •Avoid – exposure of eyes, unclosed fontanels of children..

Citations. Song HJ, Seo HJ, Lee Y, Kim SK. Effectiveness of high-intensity laser therapy in the treatment of musculoskeletal disorders: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). 2018 Dec;97(51):e13126. doi: 10.1097/MD.0000000000013126. Erratum in: Medicine (Baltimore). 2019 Jan;98(4):e14274. PMID: 30572425; PMCID: PMC6319951. Babatunde OO, Jordan JL, Van der Windt DA, Hill JC, Foster NE, Protheroe J. Effective treatment options for musculoskeletal pain in primary care: A systematic overview of current evidence. PLoS One. 2017 Jun 22;12(6):e0178621. doi: 10.1371/journal.pone.0178621. PMID: 28640822; PMCID: PMC5480856. Karlekar A, Bharati S, Saxena R, Mehta K. Assessment of feasibility and efficacy of Class IV laser therapy for postoperative pain relief in off-pump coronary artery bypass surgery patients: A pilot study. Ann Card Anaesth. 2015 Jul-Sep;18(3):317-22. doi: 10.4103/0971-9784.159800. PMID: 26139735; PMCID: PMC4881709. Larkin KA, Martin JS, Zeanah EH, True JM, Braith RW, Borsa PA. Limb blood flow after class 4 laser therapy. J Athl Train. 2012 Mar-Apr;47(2):178-83. doi: 10.4085/1062-6050-47.2.178. PMID: 22488283; PMCID: PMC3418129..

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