Photobiomodulation Therapy - Laser Dosing & Delivery

Photobiomodulation Therapy and Therapy lasers by LightForce Medical Lasers
www.lightforcemedical.com/
In this video, learn how the success of photobiomodulation therapy (also commonly known as laser therapy) is largely determined by appropriate dosing and delivery methods.
The key to achieving success when tweeting with laser therapy, more appropriately termed photobiomodulation therapy, is to modulate the energy of a sufficiently large number of aging injured or malfunctioning cells to produce a measurable, clinically meaningful response.
To adequately discuss photobiomodulation dosing it's best to start by describing a few terms involved in its definition, most importantly, energy.
Lights total energy striking a target is the addition of all the individual
energies of small packets of light called photons reaching such target over a predefined period.
The international system of radiometric units uses the Joule J as the unit of energy measure and the watt W, or J per sec, as the unit of power.
At any specific wavelength of light, every photon contains exactly the same amount of energy. The intensity of the light, its brilliance, or irradiance, is given in watts per centimeter squared. It describes the density of photons striking a given surface area per unit of time.
Power density - this factor irradiance is critically important in achieving a therapeutic dose of light to target tissue.
There are three key parameters to consider to achieve adequate irradiance and safely deliver an effective dose of light energy to target tissue.
1) the condition being treated
2) the absorption characteristics of any intervening tissues between the light source and the target tissue and
3) the mechanism of delivery
Consideration of the condition being treated requires an understanding of the location of the target tissues.
Taking into consideration how far the site of injury is below the skin surface and what types of tissue the lights energy must travel through to reach it
Research of lights losses as it travels through the various tissue layers of skin fat and muscle has shown that light intensity at depth is proportional to the intensity applied at the skin surface.
This is because as light energy travels through tissue, photons will either be reflected scattered, absorbed, or transmitted at proportions that depend on the tissues optical characteristics.
Primarily, the tissues absorption and scattering coefficients which are wavelength dependent. In order to achieve a clinically significant response, a sufficiently large number of photons must reach the target tissue and be absorbed by target tissue chromophores.
Therefore deeper target tissues require greater or radiances be applied at the skin's surface. For a fixed set of treatment parameters condition being
treated tissue type and mechanism of delivery, the photobiomodulation dose can be described in terms of the energy density expressed as joules per centimeter squared.
Dose relates to the energy delivered at the skin surface needed to appropriately saturate a defined volume of the target tissue with light.
For any given treatment area, the treatment time can be determined with a relation to the treatment power W and the total joules to be delivered, as joules equals power times time in seconds.
Regarding the power setting, users should choose the optimal irradiance or power density that minimizes surface heat yet produces the desired treatment effect.
For therapeutic dose of energy to safely and efficiently reach deep target tissues, the absorption characteristics of intervening tissue layers such as hair skin fat and muscle must be considered.
Wavelengths of light in the near-infrared spectrum between 700 to 1300 nanometer are commonly used for photobiomodulation therapy and are within what is termed the therapeutic window.
So-called because these wavelengths not only penetrate through the appropriate tissue layers to varying degrees but are also absorbed by the chromophore of interest in the mitochondrial membrane cytochrome C oxidase, which mediates the photobiomodulation response
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