The recommended dosage (WALT) for anti inflammatory effect
Laser classes 3 or 3 B, 780 -860nm GaAlAs Lasers. Continuous or pulse output less than 0.5 Watt Energy dose delivered to the skin over the target tendon or synovia
| Tendinopathies |
Points
or cm2 |
Joules
780 -820nm |
Notes |
| Carpal-tunnel |
2-3 |
12 |
Minimum
6 Joules per point |
| Lateral
epicondylitis |
1-2 |
4 |
Maximum
100mW/cm2 |
| Biceps
humeri c.l. |
1-2 |
8 |
|
| Supraspinatus |
2-3 |
10 |
Minimum
5 Joules per point |
| Infraspinatus |
2-3 |
10 |
Minimum
5 Joules per point |
| Trochanter major |
2-4 |
10 |
|
| Patellartendon |
2-3 |
6 |
|
| Tract.
Iliotibialis |
2-3 |
3 |
Maximum
100mW/cm2 |
| Achilles
tendon |
2-3 |
8 |
Maximum
100mW/cm2 |
| Plantar
fasciitis |
2-3 |
12 |
Minimum
6 Joules per point |
|
|
|
|
| Arthritis |
Points
or cm2 |
Joules |
|
| Finger
PIP or MCP |
1-2 |
6 |
|
| Wrist |
2-4 |
10 |
|
| Humeroradial joint |
1-2 |
4 |
|
| Elbow |
2.4 |
10 |
|
| Glenohumeral joint |
2-4 |
15 |
Minimum
6 Joules per point |
| Acromioclavicular |
1-2 |
4 |
|
| Temporomandibular |
1-2 |
6 |
|
| Cervical
spine |
2-4 |
15 |
Minimum
6 Joules per point |
| Lumbar
spine |
2-4 |
40 |
Minimum
8 Joules per point |
| Hip |
2-4 |
40 |
Minimum
8 Joules per point |
| Knee
medial |
3-6 |
20 |
Minimum
5 Joules per point |
| Ankle |
2-4 |
15 |
|
Laser classes 3 or 3B, 904 nm GaAs Lasers (Peak pulse output more than 1 Watt) Energy dose delivered to the skin over the target tendon or synovia
| Tendinopathies |
Points or cm2 |
Joules 904nm |
Notes |
| Carpal-tunnel |
2-3 |
4 |
Minimum 2 Joules per point |
| Lateral epicondylitis |
1-2 |
1 |
Maximum 100mW/cm2 |
| Biceps humeri cap.long. |
1-2 |
2 |
|
| Supraspinatus |
2-3 |
3 |
Minimum 2 Joules per point |
| Infraspinatus |
2-3 |
3 |
Minimum 2 Joules per point |
| Trochanter major |
2-3 |
2 |
|
| Patellartendon |
2-3 |
2 |
|
| Tract. Iliotibialis |
2-3 |
2 |
Maximum 100mW/cm2 |
| Achilles tendon |
2-3 |
2 |
Maximum 100mW/cm2 |
| Plantar fasciitis |
2-3 |
3 |
Minimum 2 Joules per point |
|
|
|
|
| Arthritis |
Points or cm2 |
Joules 904nm |
|
| Finger PIP or MCP |
1-2 |
2 |
|
| Wrist |
2-3 |
3 |
|
| Humeroradial joint |
1-2 |
2 |
|
| Elbow |
2-3 |
3 |
|
| Glenohumeral joint |
2-3 |
6 |
Minimum 2 Joules per point |
| Acromioclavicular |
1-2 |
2 |
|
| Temporomandibular |
1-2 |
2 |
|
| Cervical spine |
2-3 |
6 |
Minimum 2 Joules per point |
| Lumbar spine |
2-3 |
10 |
Minimum 4 Joules per point |
| Hip |
2-3 |
10 |
Minimum 4 Joules per point |
| Knee anteromedial |
2-4 |
6 |
Minmum 2 Joules per point |
| Ankle |
2-4 |
6 |
Daily treatment for 2 weeks or treatment every other day for 3-4 weeks is recommended Irradiation should cover most of the pathological tissue in the tendon/synovia.
Tendons
Start with energy dose in table, then reduce by 30% when inflammation is under control (Does not apply for carpal tunnel tendo synovitis)
Therapeutic windows range from typically +/-50% of given values Recommended doses are based on ultrasonographic measurements of depths from skin surface and typical volume of pathological tissue and estimated optical penetration for the different laser types in caucasians.
Disclaimer: The list may be subject to change at any time when more research trials are being published. World Association of Laser Therapy is not responsible for the application of laser therapy in patients, which should be performed at the therapist/doctor`s discretion and responsibility
Revised August 2005
Comparative Study Using
685-nm and 830-nm Lasers in the Tissue Repair of Tenotomized
Tendons in the Mouse
PATRICIA M. CARRINHO, M.S., 1
ANA CLAUDIA MUNIZ RENNO, Ph.D.,1
PAULO KOEKE, Ph.D., 1
ANA CLAUDIA BONOGNE SALATE, M.S.,1
NIVALDO ANTONIO PARIZOTTO,
Ph.D., 1
and BENEDITO CAMPOS VIDAL, Ph.D.2
ABSTRACT
Objective:
The objective
of this study was to evaluate the effects of 685- and 830-nm
laser irradiations, at different fluences on the healing
process of Achilles tendon (Tendon calcaneo) of mice
after tenotomy.
Background
Data: Some authors have shown that low-level laser
therapy (LLLT) is able to accelerate the healing process of
tendinuos tissue after an injury, increasing fibroblast cell
proliferation and collagen synthesis.
However, the mechanism by
which LLLT acts on healing process is not fully understood.
Methods: Forty-eight male mice were divided into six
experimental groups: group A, tenomized animals, treated
with 685 nm laser, at the dosage of 3 J/cm2; group B,
tenomized animals, treated with 685-nm laser, at the dosage
of 10 J/cm2; group C, tenomized animals, treated with 830-nm
laser, at dosage of 3 J/cm2; group D, tenomized animals,
treated with 830-nm laser, at the dosage of 10 J/cm2; group
E, injured control (placebo treatment); and group F,
non-injured standard control. Animals were killed on day 13
post-tenotomy, and their tendons were surgically removed for
a quantitative analysis using polarization microscopy, with
the purpose of measuring collagen fibers organization trough
the birefringence (optical retardation [OR]). Results:
All treated groups showed higher values of OR when
compared to injured control group. The best organization and
aggregation of the collagen bundles were shown by the
animals of group A (685 nm, 3 J/cm2), followed by the
animals of group C and B, and finally, the animals of group
D. Conclusion: All wavelengths and fluences used in
this study were efficient at accelerating the healing
process of Achilles tendon post-tenotomy, particularly after
the 685-nm laser irradiation, at 3 J/cm2. It suggests the
existence of wavelength tissue specificity and dose
dependency.
Further studies are
required to investigate the physiological mechanisms
responsible for the effects of laser on tendinuos repair.
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