Monthly Archives: May 2014

BioFlex Laser Therapy at Meditech

One of the key elements at Meditech clinics is that we are always receptive to patient comments. Unfortunately pain, once it has become established, does not cease on Saturdays, Sundays or Holidays. It is for this reason that our clinics are open 7 days each week, with the exception of the 11 statutory government designated holidays, which dictate that we are not allowed to be open. So much for government intelligence levels and regulations. Most important of all, patients are always greeted in a positive manner and are not required to apologize for being late or other insignificant matters.

Pain, although characterized in many ways by the pharmaceutical industry, is a symptom that is generally unrelenting. For purposes of advertising, drugs are prescribed for breakthrough pain, night pain and other descriptive terms. This is erroneous as pain is simply just that – “pain”.

Moreover, it is even more important to understand that pain is only a symptom, not a disease. At our clinics we therefore focus on curing the pathology or the clinical condition that causes the pain, rather than masking the symptoms, which is a significant aspect of this equation. We are less concerned with pain management than eradicating the cause responsible for the symptoms. With Laser Therapy this can be accomplished sometimes after 1 or 2 but generally over a course of 8 -30 treatment sessions.

The administration of Laser Therapy also requires determining the correct dosage or therapeutic protocol that will produce the optimal effect in that particular individual. This includes the appropriate combination of LEDs and laser diodes applied for each specific condition.

The parameters that must be considered in order to develop specific protocols include the frequency of the pulse, duty cycle, wave form, wave length, duration and other modulations of the laser light source. The guidelines to that endeavor are dictated by the patient’s response to symptoms, based on the genetic makeup of the patient’s cells, the sensitivity to light of the individual cells, etc. These factors are all of considerable importance. Unlike drugs where one dose appears to fit all, Laser Therapy is adjusted for the individual patient, taking into account the many factors involved; these include the patient’s dermal pigmentation, adipose tissue content, chronicity of the disease, etc. Again, unlike drugs, one size does not fit all but must be carefully and creatively calculated for each individual patient and those not responding to standard protocol settings.

The subtleties of in this therapeutic approach are guided by observation, clinical change, both subjective and objective, and the general and specific effects produced. The resulting outcome is dependent on and correlated with careful attention to these details.

Simply shining laser light on to the tissues will bring benefit calculated from 20-60% but giving proper attention to the many factors involved, can potentially achieve a 100% cure rate. This approach may not be as simple as writing a prescription, which although in many instances can be effective, generally does not provide a permanent solution. Laser Therapy on the other hand is able to achieve a relatively complete resolution of medical conditions where its use is correctly applied, in over 90% of all cases treated.

NOTES RE CLASS IV LASERS:

Although these devices are currently highly touted by individual manufacturers and their paid proponents, they need to be regarded with a critical eye.

First of all, these systems operate at high energy levels and may therefore be bioinhibitory and I quote the Arndt Shultz Law which states that a small dosage of light may have no biological effect, a moderate dosage may have a biostimulatory effect, and a large dosage may have a bioinhibitory or even cytotoxic effect. Moreover, Class IV devices do not reduce the severity of the inflammatory process so essential to therapy and do not accelerate the regeneration of individual cells. Indeed in review, they have proven to slow wound healing and accordingly their advertising hype never mentions the healing of wounds. It should be observed that the healing of wounds does not differ from the healing of other tissues, notwithstanding the existing degree of pathology. The generation of the heat imposed also detracts from the effectiveness of therapy.

Wavelengths from the 900-1000 level are primarily absorbed by lipids and water and therefore have minimal effect on the cells involved in the pathological process. Once again, it should be noted that Class IV Lasers are not applied directly to the tissues because to do so would cause burns using the high powered settings recommended. The 980 nm diodes incorporated in Class IV Lasers do not increase penetration, as much of the light energy is absorbed superficially and more rapidly, leading to heat generation. This diminishes the physiological benefits so essential to cellular activity.

It should be noted that Tuner and Hode, who have a good grasp of the physics of laser light, do not recommend Class IV Lasers and state that Class IIIB devices, properly engineered, are most appropriate for cellular healing (excerpted from an article, “No Cure from LiteCure” by Jan Tuner).

However Lasers may be classified, whether Class II, III or IV, it is an extensive combination of factors that are essential to promote cellular healing and the production of optimal clinical outcomes. These include malleable parameters such as pulse frequency, duty cycle, waveform, wavelength, energy density, duration, etc. The diodes utilized must be minimally degradable and applied directly to tissue to achieve maximum benefit. The benefits derived from Class IV Lasers generally, removed some distance from the tissues and covered by either a plastic or glass protective barrier, are negatively affected by the refraction of light as it transverses the atmosphere and reflection as it strikes the epidermal surface.

While curtailing the so-called benefits of higher powered lasers, the degree of power cannot be accurately determined and effects on tissue will therefore be random, unpredictable and potentially produce serious adverse effects.

LASER THERAPY – AN INNOVATIVE TREATMENT FOR CERVICAL SPINE AND TRAUMATIC BRAIN INJURIES

LASER THERAPY – AN INNOVATIVE TREATMENT FOR CERVICAL SPINE AND TRAUMATIC BRAIN INJURIES

CLINICAL EFFECTS OF MOTOR VEHICLE ACCIDENTS

Patients who have been involved in a motor vehicle accident (MVA) will probably experience symptoms secondary to intracranial and cervical trauma immediately or at some point subsequent to the episode.  Injuries relating to the thoraco-lumbar spine and the joints in the lower regions of the body are generally less common in this type of trauma. Most frequently, MVAs are responsible for injuries to the cerebral hemispheres, cerebellum, brainstem and cervical spine.

In cases where the vehicle is struck from the rear, the accident victim may experience a whiplash-type injury as the neck is abruptly moved forward at the time of collision and then rapidly moves posteriorly, the brain striking the cranium during the process.  All the soft tissues in the neck and upper body, including muscles, ligaments and nerves, etc. may also be damaged during this event.

Along with the invariable soft tissue injuries, concussions of varying degrees are a common result of motor vehicle accidents. The latter can cause multiple symptoms to occur at the time of, or long after the accident, often unrelated to the severity of the degree of trauma, even when the patient may not have lost consciousness.

In summary, whenever an external force injures the brain through direct impact or via the acceleration/deceleration forces, symptoms invariably result at some point in time.

In addition to the initial damage at the moment of impact, brain trauma may be accompanied by secondary injuries in which a series of events take place immediately following the event or many weeks or months subsequent to the initial trauma.  Reduction of cerebral perfusion, with decreased oxygenation of the hemispheres, edema and elevated intracranial pressure – all contribute substantially to the damage resulting from these episodes.

Symptoms of TBI are both diverse and complex. They vary with the degree of injury and can be termed mild, moderate or severe.  Again, delayed onset is not uncommon.  Complaints frequently noted include  headaches, pain and stiffness of the cervical spine, dizziness, nausea, vertigo, fatigue, light and sound sensitivity, visual disturbances, general apathy,  amnesia, emotional lability (crying, talkative), cognitive impairment (slow reaction time, memory loss) and most significantly, loss of mental focus and concentration.

LASER THERAPY IN THE TREATMENT OF MUSCULOSKELETAL AND NEUROLOGICAL CONDITIONS

Over the past 40 years, Laser Therapy has been increasingly and effectively utilized in the treatment of both acute and chronic musculoskeletal conditions, including degenerative disc disease, repetitive stress injuries, ligament and muscle strains, tears, etc. The technology is a non-invasive, light-based therapy that uses a combination of red and infrared light in the form of superluminous light-emitting and laser diodes.

The power output of these devices is significantly below the level of ablative high-intensity laser devices. Particles of energy, known as “photons”, are emitted from the diodes and absorbed by the cell membrane, numerous molecular components within the cell, the mitochondria, etc. Ultimately this process stimulates cellular metabolism in the damaged tissues.  Moreover, it resolves inflammation and accelerates the healing process, resulting in the elimination of pain.

In instances where trauma is the dominant factor, injuries of the brain and cervical spine are frequently overlooked.  As the brain stem transits the atlanto-occipital junction providing neurological connectors between the cerebral hemispheres and cerebellum to the peripheral areas of the body, the inflammation and compression which may be produced, results in symptoms.

The central nervous system is pivotal in maintaining consciousness and regulating involuntary functions such as the sleep cycle, heart rate, breathing and metabolism, which are affected when trauma occurs.

Traumatic brain injuries and cervical dysfunction often produce concomitant pathologies. Many articles have been published describing the benefits of Laser Therapy in the treatment of acute and chronic cervical pain.  Laser Therapy applied to the cervical spine and other associated structures which may be affected, brings significant benefit. The mechanism of action involves irradiation of the cerebrospinal fluid, increasing arterial perfusion of the cerebral hemispheres and provides a potent anti-inflammatory effect, all of which reduce the symptoms caused by both the initial and delayed effects of the injury.

CASE PROFILE:

CHRONIC POST-CONCUSSION SYNDROME

A 64-year-old woman presented with post-concussion syndrome 10 years subsequent to an MVA.  She experienced a number of symptoms following the accident, including cognitive impairment, visual disturbances, headaches, dizziness, fatigue, irritability, numbness/tingling, emotional instability and sensory deficits.   She was also experiencing severe pain in the cervical and lumbar spine, including right-sided sciatic pain which she described as “knife-like”.

A course of Laser Therapy was administered over a period of eight weeks over both areas.  During this period, no other therapy was being administered.

The patient’s pain levels steadily decreased over the course of this period from an initial score of nine out of ten down to a three out of ten. A number of neurological symptoms that she had initially rated in the severe category were reduced to mild or non-existent levels.  These included dizziness, fatigue, emotional lability, feeling mentally foggy and having difficulty concentrating.

CONCLUSIONS

Laser Therapy is a proven, highly effective treatment for an extensive range of musculoskeletal and neurological conditions. Whereas ongoing research continues to increase our ability to develop appropriate treatment protocols, we have observed that significant benefit can result in individuals who have sustained an MVA. We feel that this approach has unlimited potential in treating these disease entities and are carrying on extensive research in this area.  To date, our experience has produced positive results beyond our expectations.

MEMO WITH REGARD TO LASER THERAPY EQUIPMENT

All diodes have a finite lifespan, as do all devices whether medical, automotive or other products. This directly relates to the hours of utilization, much as in human bodies where excessive activities, particularly in athletes, leads to early arthritic degeneration.

Fortunately at this time we have been able to find a diode manufacturer who has been able to design custom diodes to meet our specifications. These have been installed in all new equipment since November 2013 and will be the standard for all new devices manufactured at Meditech. For this reason arrays built subsequent to November 2013 will no longer require calibration. The diodes that we are currently installing in all our BioFlex Systems typically exhibit minimal degradation.

In older equipment with 5 years of heavy use or 8-10 years of moderate use, consideration should be given to replacing arrays in order to provide optimal patient outcomes. Again, with the new arrays, minimal degradation occurs and the lifespan of the diodes has been extended to 10 years plus, even with heavy utilization.

Fred Kahn, MD

President

Meditech International Inc.

FK/km

Laser Therapy – A New Dimension in Medical Practice

Lasers in Medicine
The focused power of Laser light has been utilized in the field of medicine since the 1960s. Traditionally used for its precision in surgery and its ability to cauterize blood vessels, high-powered Lasers are now routinely used in most hospitals around the world. Dialing down the power of Lasers provides a whole new range of possibilities and clinical applications that can stimulate healing in human tissue. With over 50 years of scientific and clinical research, Low Intensity Laser Therapy has been used to resolve inflammation, repair injured tissue and eliminate pain.

What does Laser Therapy do?
Laser Therapy has been shown to regenerate muscle, bone, cartilage and neurological tissue. All tissue consists of cells, therefore it may be described as healing by restoring the normal structure and function of the cells. Many experiments have demonstrated that Laser expedites and resolves the inflammatory process, which is often arrested in chronic pain conditions, particularly in situations of arthritis, degenerative disc disease, etc. Laser Therapy has no adverse effects and can be safely applied in patients with implants, prosthesis, pacemakers and other medical problems.

What Conditions Can Benefit from Laser Therapy?
Both acute and chronic conditions can benefit significantly from the utilization of Laser Therapy. Acute injuries including soft tissue and sports injuries, trauma and dermatological conditions can generally be resolved in ten treatments or less. The earlier in the course of the disease process that Laser Therapy is instituted, the more likely it is that optimal results can be achieved. Ideally, a patient should initiate treatment within the first 24 hours post-diagnosis.
Chronic conditions including degenerative osteoarthritis, repetitive stress injuries and dermatological wounds may require a more prolonged course of treatment to resolve completely. Compared to the alternatives, including the use of pharmaceuticals and surgery which may offer limited benefit, Laser Therapy is preferable as it produces no side effects or complications from its application.
Recalcitrant, complex wounds, including ulcers secondary to atherosclerosis, diabetes, venous stasis, trauma, etc., along with post-surgical contact ulcers, can all be resolved rapidly with a course of Laser Therapy. Often these wounds have not responded to conventional therapy that may result in life changing outcomes for the patients, including amputation. Even the most stubborn or recalcitrant wounds have responded favorably to Laser Therapy with complete healing over a period of time.


The Potential Role of Laser Therapy in Mainstream Medicine

While Laser Therapy is not yet commonly used in hospital and clinical practices, it is becoming available in a growing number of health care clinics, rehabilitation centres and in institutions that specialize in wound care.
An increasing number of health care associations and institutions are integrating Laser Therapy into their therapeutic programs as a growing body of evidence-based research papers support and validate the technology. It is the hope that in the future Laser Therapy can be considered the treatment of choice in dealing with musculoskeletal conditions, dermal ulcers and many other challenging medical problems.
“Primum non nocere” the Latin phrase that means “first, do no harm” is taught to all physicians and is a fundamental principle of medical practice around the world. With Laser Therapy, there is no concern with regard to harming the patient, only indications that it will significantly improve clinical outcomes.

CONCUSSION – A NEW THERAPEUTIC PARADIGM

Since the ancient Egyptians learned how to trephine the cranium, there has been only minimal progress with regard to the treatment of neurological problems. Concussion particularly has persisted throughout the centuries without a viable therapeutic solution regardless of activities, environmental factors and the coexistence of other disease entities.

Recently, this problem has achieved a greater profile as it affects highly paid professional athletes and is often responsible for cognitive disabilities, disruptive behavior patterns and other problems resulting from impacts sustained during athletic activities, particularly in contact sports.

There are many variations of this problem, from minimal to severe and symptoms can negatively impact activity levels, mentation and destroy the quality of life. The effects of this trauma include progressive dysfunctional behavior patterns, many other symptoms, sometimes in unusual combinations and may even lead to suicide. Post-Traumatic Stress Disorder, which not infrequently includes a history of concussion, should also be added to the list of these pathologies.

Although diagnostic techniques have advanced through the introduction and refinements in interpretation of EEGs, MRIs, PET scans, etc. along with improvement in medical education, therapeutic solutions remain elusive or largely ineffective. The need to find effective therapies for these problems has stimulated our interest and efforts in order to provide viable solutions. The therapeutic aspect of dealing with these diseases clearly must improve and can only be achieved through the process of innovation.

At Meditech, over the past decade particularly, we have been acutely aware of this problem and more recently, supported by a number of neuroscientists, we are in the process of developing effective therapeutic techniques, delivered without adverse components.

At this time we feel that we have made significant progress in this area and continue our research in the effort to improve the development of protocols that relieve symptoms without creating negative effects. To date we are encouraged with the significant symptomatic improvement in patients utilizing Laser Therapy that either had no solutions offered to them previously or had been treated with conventional approaches for many years without any viable benefit.
Meditech International was founded in 1989 and early on the principals directing research recognized these problems. Its products therefore are always designed to have an almost unlimited range of flexibility in applying effective therapy. Parameters can be configured in an infinite number of permutations and combinations to produce protocols that are disease specific. At the same time, Meditech devices permit the extensive customization of protocols for each individual patient. This is of extreme importance and unfortunately is not well recognized within the industry.

In the past year or two, increasingly we see Class IV and higher powered lasers in general being aggressively marketed. In the majority of these devices, the light sources are removed some distance from the tissues in order to avoid damaging the latter. This raises the problem of refraction, as light encounters the epidermis. It should be noted that the light source in Class IV Lasers is invariably covered by plastic or glass in order to avoid burning or otherwise damaging the tissues. Whereas the light source in these systems may be powerful, an indeterminate photon stream arrives at the dermis and the joules of energy penetrating to the deeper tissues cannot be calculated and therefore produce an uncontrollable, random effect. If these arrays were placed directly on the skin, thermal damage and denaturing of the intracellular proteins would result.

Conversely, the BioFlex Laser Therapy Systems regulate the photon stream precisely without any intervention between the light source and the tissues and can therefore produce dosages with total accuracy and optimal healing effect.