Lateral Epicondyle Tendinopathy Toolkit: Section G - LASER Dosage Calculation: Difference between revisions

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'''Toolkit Navigation'''
*[[Lateral Epicondyle Tendinopathy (Tennis Elbow) Toolkit|''Contents Page'']]
*[[Lateral Epicondyle Tendinopathy Toolkit: Summary of the Evidence|''Summary of the Evidence'']]
*[[Lateral_Epicondyle_Tendinopathy_Toolkit:_Treatment_Algorithm|''Treatment Algorithm'']]
*[[Lateral Epicondyle Tendinopathy Toolkit: Appendix A|''Appendix A: Details of the Articles'']]
*[[Lateral Epicondyle Tendinopathy Toolkit: Appendix B|''Appendix B: Manual Therapy'']]
*[[Lateral Epicondyle Tendinopathy Toolkit: Appendix C|''Appendix C: Details of Exercise Prescription'']]
*[[Lateral Epicondyle Tendinopathy Toolkit: Appendix D|''Appendix D: LASER Dosage Calculation'']]
*[[Lateral Epicondyle Tendinopathy Toolkit: Appendix E|''Appendix E: Braces, Splints, and Taping'']]
*[[Lateral Epicondyle Tendinopathy Toolkit: Appendix F|''Appendix F: Outcome Measures'']]
*[[Lateral Epicondyle Tendinopathy Toolkit: Appendix G|''Appendix G: Medical and Surgical Interventions'']]
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== LASER Dosage Calculation  ==
== LASER Dosage Calculation  ==


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The World Association of Laser Therapy (WALT) provides dosage guidelines using Joules for various conditions. These<br>dosage guidelines are based upon the best evidence from the literature in conjunction with expert opinion.  
The World Association of Laser Therapy (WALT) provides dosage guidelines using Joules for various conditions. These<br>dosage guidelines are based upon the best evidence from the literature in conjunction with expert opinion.  


Physical Therapists are encouraged to set LLLT dose according to the WALT guidelines found at:&nbsp;[http://waltza.co.za/documentation-links/recommendations/dosage-recommendations/ http://waltza.co.za/documentation-links/recommendations/dosage-recommendations/]&nbsp;(''Note that the WALT guidelines are given for surface exposure.'')<br>
Physical Therapists are encouraged to set LLLT dose according to the WALT guidelines found at:&nbsp;[http://waltza.co.za/documentation-links/recommendations/dosage-recommendations/ http://waltza.co.za/documentation-links/recommendations/dosage-recommendations/]&nbsp;(''Note that the WALT guidelines are given for surface exposure.'')<br>  


== Download Lateral Epicondyle Tendinopathy Toolkit: Appendix D - LASER Dosage Calculation ==
== Download Lateral Epicondyle Tendinopathy Toolkit: Appendix D - LASER Dosage Calculation ==


http://physicaltherapy.med.ubc.ca/files/2013/07/Appendix-D.-Lateral-Epicondyle-Tendinopathy-LASER-Dosage-Calculation-June-2013.pdf  
http://physicaltherapy.med.ubc.ca/files/2013/07/Appendix-D.-Lateral-Epicondyle-Tendinopathy-LASER-Dosage-Calculation-June-2013.pdf  


<br>
<br>  


== Acknowledgements  ==
== Acknowledgements  ==
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A Physical Therapy Knowledge Broker project supported by: UBC Department of Physical Therapy, Physiotherapy Association of BC, Vancouver Coastal Research Institute and Providence Healthcare Research Institute.  
A Physical Therapy Knowledge Broker project supported by: UBC Department of Physical Therapy, Physiotherapy Association of BC, Vancouver Coastal Research Institute and Providence Healthcare Research Institute.  


June 2013  
June 2013
 
<br>
 
== Toolkit Navigation  ==
 
*''Click to return to the ''[[Lateral Epicondyle Tendinopathy (Tennis Elbow) Toolkit|''Contents Page'']]
*''Click to return to the ''[[Lateral Epicondyle Tendinopathy Toolkit: Summary of the Evidence|''Summary of the Evidence'']]
*''Click to return to the ''[[Lateral Epicondyle Tendinopathy Toolkit: Treatment Algorithm|''Treatment Algorithm'']]
*''Click to return to&nbsp;''[[Lateral Epicondyle Tendinopathy Toolkit: Appendix A|''Appendix A: Details of the Articles'']]
*''Click to return to ''[[Lateral Epicondyle Tendinopathy Toolkit: Appendix B|''Appendix B: Manual Therapy'']]
*''Click to return to ''[[Lateral Epicondyle Tendinopathy Toolkit: Appendix C|''Appendix C: Details of Exercise Prescription'']]
*''Click to continue to ''[[Lateral Epicondyle Tendinopathy Toolkit: Appendix E|''Appendix E: Braces, Splints, and Taping'']]
*''Click to skip to ''[[Lateral Epicondyle Tendinopathy Toolkit: Appendix F|''Appendix F: Outcome Measures'']]
*''Click to skip to ''[[Lateral Epicondyle Tendinopathy Toolkit: Appendix G|''Appendix G: Medical and Surgical Interventions'']]
 
<br>

Revision as of 04:42, 24 August 2013

LASER Dosage Calculation[edit | edit source]

Current recommendations specify that LLLT dosage be provided in Joules (J, total energy), rather than the previous
recommended Joules/cm2 (J/cm2, energy density). Use Joules rather than Joules/cm2 to specify how much energy is
delivered in a treatment.

In Laser devices that do not calculate Joules automatically, dose can be determined in seconds of exposure required to give
the desired Joules by using the following calculation:

  • Joules = watts.seconds
  • hence, Seconds = Joules/watts

For example:

  • For a 50 mW Laser (= 0.050 Watts), with a required dose = 2 J per point…
  • Seconds exposure = 2 / 0.05 = 40 secs

This change is very important clinically as the use of the previously recommended Joules/cm2 resulted in confusion when
comparing dosages between protocols. The resultant dose in Joules/cm2 could be the consequence of a number of
different treatment options.

For example, 4 J/cm2 can be delivered by:

Option #1

  • a 20 mW Laser with a beam cross section of 0.5 cm2 in 100 seconds
  • i.e. 4 = (0.02/0.5 x 100)

Option #2

  • a 10 mW laser with a beam cross‐section of 0.25 cm2 in 100 seconds
  • i.e. 4 = (0.01/0.25 x 100)


In Option #1, the total energy delivered would be 2 J

In Option #2, the total energy would be 1 J


This example illustrates that using Joules/cm2 resulted in one patient receiving twice the total amount of energy that is
received by the other patient!

Therefore, all physical therapists using LLLT should be delivering dosages based on Joules rather than Joules/cm2.

Using Joules rather than Joules/cm2 will enable better standardization of dosage and permit comparison across different
treatment regimes.

The World Association of Laser Therapy (WALT) provides dosage guidelines using Joules for various conditions. These
dosage guidelines are based upon the best evidence from the literature in conjunction with expert opinion.

Physical Therapists are encouraged to set LLLT dose according to the WALT guidelines found at: http://waltza.co.za/documentation-links/recommendations/dosage-recommendations/ (Note that the WALT guidelines are given for surface exposure.)

Download Lateral Epicondyle Tendinopathy Toolkit: Appendix D - LASER Dosage Calculation[edit | edit source]

http://physicaltherapy.med.ubc.ca/files/2013/07/Appendix-D.-Lateral-Epicondyle-Tendinopathy-LASER-Dosage-Calculation-June-2013.pdf


Acknowledgements[edit | edit source]

Developed by the BC Physical Therapy Tendinopathy Task Force: Dr. Joseph Anthony, Dr. Angela Fearon, Diana Hughes, Carol Kennedy, Dr. Alex Scott, Michael Yates, & Alison Hoens.

A Physical Therapy Knowledge Broker project supported by: UBC Department of Physical Therapy, Physiotherapy Association of BC, Vancouver Coastal Research Institute and Providence Healthcare Research Institute.

June 2013