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Protocols

Physiotherapy

Application: Punctual technique, on the region fractured or with difficulty of consolidation, surrounding the region by application in points in the long bones. In short bones, few points on the fractured area are sufficient, as long as they cover the respective region, the distance between the points should be 2 to 2.5 cm.

Dosage: 3 to 5 times a week.

Hint: For hard tissues, higher doses are used, between 60 and 120 J/cm², 3 times a week, preferably the infrared laser (808 nm) is used over the fractured region or with difficulty of consolidation. The region is surrounded by points on the long bones. In short bones, only a few points on the fractured area are sufficient, provided they cover the respective region (Luger et al., 2003; Marino et al., 2004; Lirani, 2004).

  • Laser: Infrared
  • Fluency: 60 to 120 J/cm²
  • Dose: 2 to 4 J

Application: Punctual technique, positioning the joint in a way that allows the laser to directly focus on the injured articular cartilage. Perform the circlage, by the punctual technique, throughout the articular region.

Dosage: 3 times a week.

  • Laser: 808 nm
  • Fluency: 35 to 140 J/cm²
  • Dose: 1 to 4 J

Application: Punctual technique, positioning the joint in a way that allows the laser to directly focus on the injured articular cartilage. Perform the circlage, by the punctual technique, throughout the articular region.

Dosage: 3 times a week.

  • Laser: 808 nm
  • Fluency: 35 to 70 J/cm²
  • Dose: 1 to 2 J

Application: Punctual technique, positioning the joint in a way that allows the beam to focus directly on the injured articular cartilage.

Dosage: 3 times a week.

  • Laser: 808 nm
  • Fluency: 35 to 140 J/cm²
  • Dose: 1 to 4 J

Application: Punctual technique, positioning the joint in a way that allows the laser to directly focus on the injured articular cartilage. Perform assisted lateralization or medicalization to expose the area to be treated.

Dosage: 3 times a week.

Suggested dosimetry: Degrees I and II – Lower doses. Degrees III and IV – Higher doses, preferably infrared, should be used, plus visible additives, especially in the early stages. High power densities (P = 100 mW) are suggested to avoid long treatment times (Sandoval, 2001, Guerino et al, 2001).

  • Laser: 808 nm
  • Fluency: 35 to 70 J/cm²
  • Dose: 1 to 2 J

Application: Punctual technique, positioning the joint in a way that allows the laser to directly focus on the injured articular cartilage. Perform the circlage, by the punctual technique, throughout the articular region.

Dosage: 3 times a week.

  • Laser: 808 nm
  • Fluency: 100 to 160 J/cm²
  • Serving Size: 4 to 6 J

Application: Punctual technique, positioning the joint in a way that allows the laser to directly focus on the injured articular cartilage. Perform the circlage, by the punctual technique, throughout the articular region.

Dosage: 3 times a week.

Laser: 808 nm
Fluency: 70 to 110 J/cm²
Dose: 2 to 3 J

  • Photosensitivity history (dermatoses);
  • Client being submitted to treatments with acids synthesized from vitamin A (retinoic acid, Retinol A, Vitanol A, Retin, Tretoinin, Isotretinoin, etc.) and / or tetracycline antibiotics;
  • Personal history of skin cancer in the region;
  • Pregnancy;
  • Glaucoma.

Topical ILIB – Laser Intravascular Blood Irradiation

Action: Originally a Russian Technique that was modified in Brazil (INCOR), which consists of the direct and direct application of red therapeutic laser (660 nm) in the region of the radial artery, which produces a photochemical effect that acts systemically by the production of the metalloenzyme SOD ZnCu , being indicated for acute and chronic inflammatory processes and for combating free radicals.

Applications: With a specific bracelet, low intensity laser is applied in the wrist region, an area with energetic meridians that, when stimulated, optimize the activities of the heart, lungs, circulatory system, libido and others as a kind of Laserpuncture (laser acupuncture and no needles), as well as the stimulation of antioxidant enzymes.

AG mode 15 minutes (Option 1)

5 sessions of 15 MINUTES on alternate days (every other day, not for 10 days).

  • At the end of the 5 initial sessions, one should rest for 20 days and repeat the protocol, then rest another 20 days and repeat the protocol again.
  • Maintenance every 3 months – 5 sessions of 15 minutes only.

Option 2

  • 1 session per week of 30 minutes, at least 8 sessions.
  • Maintenance every 30, 60 or 90 days, depending on each systemic condition.

Topical ILIB – Laser Intravascular Blood Irradiation

Action: Originally a Russian Technique that was modified in Brazil (INCOR), which consists of the direct and direct application of red therapeutic laser (660Nm) in the radial artery region, which produces a photochemical effect that acts systemically by the production of the metalloenzyme SOD ZnCu, with indication for acute and chronic inflammatory processes and fight against free radicals.

Applications: With a specific bracelet, low intensity laser is applied in the wrist region, an area with energetic meridians that, when stimulated, optimize the activities of the heart, lungs, circulatory system, libido and others as a kind of Laserpuncture ( laser acupuncture and no needles), as well as the stimulation of antioxidant enzymes.

Autoimmune Diseases (IL Mode 30 minutes)

  • 10 sessions of 30 MINUTES for 10 consecutive days.
  • At the end of the initial 10 days, one should rest for 20 days and repeat the protocol, then rest another 20 days and repeat the protocol again.
  • Maintenance every 30, 60 or 90 days, depending on each systemic condition.

Cardiovascular / Lung Diseases and Diabetes (IN Mode 60 minutes)

  • 5 consecutive days, rest 20 days, repeat the cycle 3 times.
  • Maintenance every 30, 60 or 90 days, depending on each systemic condition.

Application: Point technique, around the ulcer in the integral tissue, about 1 cm from the border, the distance between the points should be from 2 to 2.5 cm.

  • Laser: Red
  • Fluency: 35 to 70 J/cm²
  • Dose: 1 to 2 J

Application: Point technique, around the ulcer in the integral tissue, about 1 cm from the border, the distance between the points should be from 2 to 2.5 cm. In the presence of infarcted or compromised oedemas or lymph nodes, irradiate in the ganglion region relative to the affected territory.

Dosage: 2 to 3 times a week.

Tip: Doses between 2 and 4 J/cm 2 are recommended, with visible laser, 2 to 3 times a week, respecting the fact that in regions with no skin, the dose should be reduced to ¼ or 1q3 of the dose used on the epithelium (Schindl et al, 1999).

  • Laser: Red
  • Fluency: Up to 4 J/cm²
  • Serving Size: 1 J

Application: Timely technique, about the area of surgery.

Dosage: 3 to 5 times per week.

  • Laser: Infrared
  • Fluency: 35 to 140 J/cm²
  • Dose: 1 to 4 J

Application: Point technique, around the ulcer in the integral tissue, about 1 cm from the border, the distance between the points should be from 2 to 2.5 cm. Usually, lower doses can be used in the earlier or acute stages, and higher doses in the more advanced stages of the disease.

Dosage: 2 to 3 times a week.

Tip: Differentiated doses should be used for superficial or deep burns and depending on: the area to be treated with or without epithelial cover and the dimensions of the burned area. Usually, lower doses in the earlier or acute stages and higher doses in the more advanced stages of the disease.

  • Laser: Red
  • Fluency: 4 to 40 J/cm²
  • Serving Size: 1 J

Application: Point technique, around the ulcer in the integral tissue about 1 cm from the border, the distance between the points should be 2 to 2.5 cm, in the internal region of the ulcer should be used doses between 3 and 4 times smaller .

Dosage: 2 to 4 times per week.

Tip: Phases I and II – Treat with visible laser, 2 times a week.

Phases III and IV – Treat with visible laser, 2 to 3 times per week, depending on the observed repair response.

On the internal face of the wound, where there is no skin presence, doses 3 to 4 times smaller than those used at the edges of the ulceration should be used (Mester et al., 1995).

Note: For this type of application, high energy densities should be avoided, since they could cause hemolysis (Cen & Chen, 2004).

  • Laser: Red
  • Fluency: 35 to 70 J/cm²
  • Dose: 1 to 2 J

Application: Point technique, around the ulcer in the integral tissue, about 1 cm from the border, the distance between the points should be from 2 to 2.5 cm. In the internal region of the ulcer doses of 3 to 4 times smaller should be used. The intrinsic venous and arterial pathway should also be irradiated to the lesion region with the infrared laser 808 nm.

Dosage: 2 to 3 times a week.

Tip: For stasis ulcers, the visible laser is indicated on the edge of the wound and the use of ¼ of the energy inside the wound. In this type of ulcer the infrared laser must be used in the venous and arterial path of the affected region, thus improving the blood flow to this region.

  • Laser: Red
  • Fluency: 35 to 70 J/cm²
  • Dose: 1 to 2 J

Application: Point technique, around the ulcer in the integral tissue, about 1 cm from the border, the distance between the points should be from 2 to 2.5 cm. Usually, lower doses may be used for more superficial nerves and may be elevated depending on the depth and characteristics of the skin to be treated.

Dosage: 3 times a week.

Hint: Suggested doses are between 80 and 150 J/cm², lower doses are recommended for more superficial nerves and higher doses, depending on the nerve depth and the patient’s skin color. The visible laser was more efficient, but the infrared (808 nm) showed greater depth of penetration (gigo-Benato et al, 2005).

  • Laser: Infrared
  • Fluency: 10 to 150 J/cm²
  • Dose: 1 to 4 J

Application: Punctual technique along the path of the affected nervous branch and on the “trigger points”.

Dosage: 3 times a week.

Tip: The treatment consists of about 10 applications with intervals of 72 hours to 96 hours between them. Ideally, doses in the first 2 doses should be lower (between 40 and 50 J/cm² per 1 J point) and these doses increase gradually until the fifth or sixth session reaches 100 and 130 J/cm² per point .

  • Laser: Infrared
  • Fluency: 70 to 140 J/cm²
  • Dose: 2 to 4 J

Application: Punctual technique, along the path of the affected nervous branch, on the emergency points of the facial nerve (anterior to the auricular pavilion) following its path in the different branches: temporal, zygomatic, buccal, cervical and marginal of the mandible, the distance between the points should be 2 to 2.5 cm.

Dosage: 3 times a week.

Tip: Infrared laser, on the emergency points of the facial nerve (anterior to the auricular pavilion), following its path in the different branches: parotid, zygomatic, buccal and marginal of the mandible. It is suggested to apply points along all branches of the facial.

  • Laser: Infrared
  • Fluency: 60 to 150 J/cm²
  • Dose: 2 to 4 J

Application: Point technique, around the ulcer in the integral tissue, about 1 cm from the border, the distance between the points should be from 2 to 2.5 cm. Usually, lower doses may be used for more superficial nerves, and may be elevated, depending on the depth and characteristics of the skin being treated.

Dosage: 3 times a week.

  • Laser: Infrared
  • Fluency: 60 to 150 J/cm²
  • Dose: 2 to 4 J

Application: Point technique, around the ulcer in the integral tissue, about 1 cm from the border, the distance between the points should be from 2 to 2.5 cm. Usually, lower doses may be used for more superficial nerves, and may be elevated, depending on the depth and characteristics of the skin being treated.

Dosage: Daily applications.

  • Laser: Infrared
  • Fluency: 60 to 150 J/cm²
  • Dose: 2 to 4 J

Application: Punctual technique, throughout the area of the carpal region and along the path of the nervous branch in the region of the middle third of the ankle to the palmar region.

Dosage: 3 to 5 times per week.

  • Laser: Infrared
  • Fluency: 60 to 150 J/cm²
  • Dose: 2 to 4 J

 

Application: Along the nervous path and at the trigger points.

Dosage: Daily.

Tip: Application per point along the paravertebrais in 12 points equidistant, being 6 of one side and 6 of another. The protocol is applied 10 days and then, the table should be reassessed to know if there is a need for more applications (Özdemir et al, 2001).

  • Laser: 808 nm
  • Fluency: 100 to 160 J/cm²
  • Serving Size: 4 to 6 J

Application: Along the nervous path and at the trigger points (follow the trigger point map more active).

Dosage: Daily.

Tip: Apply on tight bands, at painful points, to facilitate unlocking. Application with the technique of contact (infrared laser of 808 nm).

  • Laser: 808 nm
  • Fluency: 100 to 160 J/cm²
  • Serving Size: 4 to 6 J

Application: In the region of pain and trigger points.

Dosage: Daily.

Tip: Application per point along the paravertebrais in 12 points equidistant, being 6 of one side and 6 of another. The protocol is applied 10 days and then, the table should be reassessed to know if there is a need for more applications (Özdemir et al, 2001).

  • Laser: 808 nm
  • Fluency: 100 to 160 J/cm²
  • Serving Size: 4 to 6 J

Application: On the triggers points.

Dosage: Daily.

Tip: Applies on the trigger points with the punctual technique, using the infrared laser of 808 Nm.

  • Laser: 808 nm
  • Fluency: 35 to 70 J/cm²
  • Dose: 1 to 2 J

Application: Along the muscle path and around the lesion area. In the acute phases, with active inflammatory process, use the laser in the visible (red laser 660 nm) and infrared (808 nm) range in the regions of origin and insertion of the target muscle.

Dosage: Daily.

  • Laser: 660 nm + 808 nm
  • Fluency: 35 to 70 J/cm²
  • Dose: 1 to 2 J

Application: On the trigger points and areas of allergy.

Dosage: Daily.

  • Laser: 808 nm
  • Fluency: 10 to 160 J/cm²
  • Serving Size: 4 to 6 J

Application: 35 J/cm² – 1 J in the acute phase, progressing to 70 J/cm² – 2 J in the sub-acute phase.

Dosage: 3 to 5 times per week.

  • Laser: 808 nm
  • Fluency: 35 to 70 J/cm²
  • Dose: 1 to 2 J

Application: Punctual technique, positioning the joint in a way that allows the laser to directly focus on the injured joint. Perform the circlage, by the technique punctual, throughout the articular region.

Dosage: Daily

  • Laser: Infrared
  • Fluency: 35 to 70 J/cm²
  • Dose: 1 to 2 J

Application: Punctual technique around the joint and on the epicondyle; in the presence of pain, use higher doses and, in chronic cases, lower doses.

Dosage: 3 to 5 times per week.

  • Laser: Infrared
  • Fluency: 100 to 160 J/cm²
  • Serving Size: 4 to 6 J

Application: Punctual technique, on the path of the fascia. In the presence of active inflammatory processes, reduce the doses used.

Dosage: 3 to 5 times per week.

Tip: High power density (P = 100 mW), infrared laser (808 Nm). Doses for chronic cases range from 30 to 60 J/cm² (Bradley et al, 2003).

  • Laser: Red + Infrared
  • Fluency: 70 to 140 J/cm²
  • Dose: 3 to 6 J

Application: Punctual technique, on the path of the fascia. In the presence of active inflammatory processes, reduce the doses used.

Dosage: 3 to 5 times per week.

Tip: 12 to 16 J/cm², infrared laser (808 Nm). In the more chronic and deep lesions, doses of 30 J/cm² are suggested.

  • Laser: Red + Infrared
  • Fluency: 70 to 140 J/cm²
  • Dose: 2 to 4 J

Application: Punctual technique around the structures of the cuff. In the presence of pain, higher doses should be used.

Dosage: 3 to 5 times per week.

Tip: Visible laser if there are tendinous ruptures (seen in the ultrasonography). Using the technique of contact, the tip should be pressed on the region to be treated for best results. If there are no partial ruptures but only an inflammatory process and if it has occurred abruptly and acutely (recent), the doses suggested above may be used. If only pain is the limiting factor, the same doses should be used with infrared laser.

  • Laser: Infrared
  • Fluency: 100 to 160 J/cm²
  • Serving Size: 4 to 6 J

Application: Punctual technique, on the path of the fascia. In the presence of active inflammatory processes, reduce the doses used.

Dosage: 3 to 5 times per week.

Tip: Doses between 4 and 12 J/cm² by direct contact with the technique, aiming to irradiate the insertion regions of the patellar tendon in the tuberosity of the tibia and in the inferior border of the patella. The infrared laser is the suggestion for better results, but red can be used in the same doses.

  • Laser: Red + Infrared
  • Fluency: 70 to 140 J/cm²
  • Dose: 2 to 4 J

Application: Punctual technique, on the path of the tendon, in the presence of active inflammatory processes, reduce the doses used. In deep tendon structures, increase the doses used, to allow energy to reach the target tissue.

Dosage: 3 to 5 times per week

  • Laser: Red + Infrared
  • Fluency: 35 to 70 J/cm²
  • Dose: 1 to 2 J