anexa clinica la llt

ANNEX 1

Practical recommendations for laser application proposed by various authors

1. J. COLLS, Spain [40].(laser 632.8 nm C.W. 25 mW; 904nm, 40W pulsed)

A. Analgetic: (2-4) J/cm2 muscular localisation(4-8) J/cm2 articular localisation

B. Anti-inflammatory (1-6) J/cm2 acute and subacute inflammation(4-8) J/cm2 chronic inflammation

C. Eutrophic (3-6) J/cm2.D. Microcirculation improvement (3-6) J/cm2.E. Post-traumatic changes treatment (3-5)J/cm2 per point or average 0.5J/cm2

while scanningF. Rheumatoid arthritis joint lesions (4-5)J/cm2 (first dose less than 3J/cm2

or average 0.25J/cm2 while scanningG. Dermatitis 1J/cm2 H. Wounds, ulcers and burns (3-4)J/cm2

107

2. J. Kert, L. Rose, Denmark [70](laser 830nm, 30mW)

2a. General recommendation

Clinical effect Dose per point [J]mussle relaxationnerve stimulationcontracture relaxationmicrocirculation improvementanti-inflammatory effect (acute infl.)anti-inflammatory effect (chronic infl.)analgetic effectrevascularisationantiviral activityneurone regenerationwound healing improvementacupuncture points stimulation

22

5-71-31-33-61-42-31-22

1-40.1-0.5

2b. Detailed recommendation

Disease entity Therapeutic recommendationDose per point [J] Procedure dose [J]

Traumatic disease:humeral joint sprainthumb joint I sprainknee joint spraintalus dislocationmussle tearing off

(incomplete)nerval injury

22222

2-8

3020

20-3030

20-40

16

108

Disease entity Procedure dose [J]

Productive osteoarthrosisankle jointknee jointhip jointvertebral jointhumeral jointelbow joint and hand joints

Rheumatoid arthritisphalangeal jointselbow jointradio-carpal jointknee joint

Bursal synovitis, advanced arthrosis with pains

phalangeal jointselbow jointradio-carpal jointknee joint

20-3020-4020-4020-501-3020-30

2202030

1151520

109

Advanced osteoarthrosis, contractures, arthral deformation with painsDisease entity Procedure dose Additional recommendationankle joint 10-20knee joint 10-30humeral joint 10-25elbow joint 5-15hand joints 10-20spondylosis 30-60 2-6J per point; 1-2 procedures a week,prolaps of the nucleus 40-50 prolaps projection 1-2J; erector mussle

pulpous of spin projection 2J; 0.8-1J per acupuncture point

Low back pain syndrome 40-50 2J per muscular point; 2-4J per eachmost painful point; 1-2J; 1J per acral point

Superior aperture of the 20 2J per muscular point; 1-2J per thorax syndrome sternocleidomastoid muscle 3-4J

scalenus muscle cleftAncylosing spondylitis 30-50 2J per muscular point; 2-6J affected

joint projection; 1 procedure a weekSupraspinatus muscle 30 5-7J per point; 2-4 procedures a week

myorrhexisSupraspinatus muscle 30 6-7J per point, 2-4 procedures a week

tendinitisSubacrominal bursitis 20-30 5-8J per point; 2-4 procedures a weekLong head of biceps muscle 25-30 6J per point; 2-4 procedures a week

tendinitisEpicondylitis lateralis 30-50 1-2J per muscular point; 4-6J affected

humeri area; epicondylus 8-20J; 2-3 procedures a week

Elbow bursitis 35 6-8J per point; 2-3 procedures a weekCoxarthrosis 25-35 6J per inguinal point; 2J iliotibial band

4-6J gluteal muscleTrochanteric bursitis 25 8J per point; 1-2 procedures a weekChondromalacia of patella 20-30 2J per muscular point;Osgood-Schlater disease 25 10J tubercle of the tibia 5J pateller ligamentAchilles tendinitis 20-30 6-8J per point; 1-2 procedures a weekMarton disease 8-10 4-5J per point

110

3. D. REDUREAU, FRANCE [37] (LASER 904nm, 10W 200ns)

Diagnosis Frequency[Hz]

Number ofprocedures

Efficacy[%]

Arnold’s neuralgyTennis elbowPost-zosteral intercostal

neuralgiaNeck-shoulder syndromeAnkle joint sprainSpondyloarthrosis of the neck

segmentLong head of biceps muscle

tendinitisScapular pain syndromeLumbalgiaPost-operative lumbalgiaTrigeminal neuralgiaSciatic neuralgiaPubal neuralgiaCoxarthrosis Knee joint sprainQuadriceps muscle of tight

tearing off (incompletely)Status post arthroscopy of knee

jointHerpes I

1010+400010+4000

10+400010+4000+200

2000

10+4000

4040+1000

400010+40

10+20004000

1010+2000+400

200

10+400

4000+100

61012

8812

10

661010610101010

4

3

8010075

809070

60

808080508090308080

100

100

111

4. J. MOLINA, S. MOLLER, SPAIN [48] (904nm pulsed, 20W, 200ns; 632.8nm C.W. 30mW)

4A. General recommendation:A1. Visible radiation

Analgetic (2-10)J/cm2

Anti-inflammatory (4-12)J/cm2 Regenerative (4-8)J/cm2; (5-15)J/cm2 – extra arthrial application

Scanning:Analgetic (1-3)J/cm2

Anti-inflammatory (2-4)J/cm2 Number of procedures: 3 times a week, less than 30 in series

A2. Infrared radiationAnalgetic (3-10)J/cm2, 500-5000HzAnti-inflammatory (4-13)J/cm2, 5000HzRegenerative (4-13)J/cm2; 5000HzNumber of procedures: 3-5 a week, less than 15 in series

4B. Particular recommendationB1. Vertebral diseases:

Neck part:1. Discopathy: (5-10)J/cm2, 8-10 procedures (acute) IR

(5-10)J/cm2, red light irradiation (chronic)2. Arnold’s neuralgy (4-13)J/cm2, 8 procedures IR

Thoracical part:1. Scoliosis (4-10)J/cm2, 15-20 procedures2. Intercostal neuralgy (4-11)J/cm2, 7-20 procedures (acute)

(4-10)J/cm2, 15-20 procedures (chronic)Lumbal part:

1. Spondylosis (4-10)J/cm2, 10-15 procedures (acute)(4-10)J/cm2, 20-25 procedures (chronic)

2. ScoliosisAnalgetic (4-10)J/cm2, 20-25 procedures

3. Sacroilitis (5-13)J/cm2, 7-12 procedures (acute)(6-12)J/cm2, 20-25 procedures (chronic)

112

B2. Upper limbs diseases:1. Supraspinous tendinitis or Long head of biceps muscle tendinitis

(5-14)J/cm2, 5-8 procedures (acute)(4-12)J/cm2, 10-15 procedures (chronic)

2. Shoulder pains syndrome(4-13)J/cm2, 7-10 procedures (acute)(5-15)J/cm2, 15-20 procedures (chronic)

3. Subacrominal bursitis(4-8)J/cm2, 5-8 procedures (acute)(4-12)J/cm2, 10-15 procedures (chronic)

4. Algodystrophy(4-13)J/cm2, 15-20 procedures (oedemal stage)(5-15)J/cm2, 5-15 procedures (atrophic stage)

5. Epicondylitis lateralis humeri(4-10)J/cm2, 5-7 procedures (acute)(4-12)J/cm2, 10-13 procedures (chronic)

6. Olecranon bursitis(4-8)J/cm2, 8 procedures (acute)(4-8)J/cm2, 15 procedures (chronic)

7. Inflammation of hand joints(4-8)J/cm2, 8 procedures (acute)(4-8)J/cm2, 15-20 procedures (chronic)

8. Tendinities(4-8)J/cm2, 8 procedures (acute)(4-8)J/cm2, 15 procedures (chronic)

9. De quervain disease(4-6)J/cm2, 8 procedures (acute)(4-6)J/cm2, 15 procedures (chronic)

10. Dupuytren disease(4-6)J/cm2, 15 procedures

11. Carpal tunnel syndrome(4-6)J/cm2, 10-15 procedures (acute)(4-6)J/cm2, 15 procedures (chronic)

113

B3. Lower limbs diseases1. Coxarthritis analgetic activity

(6-10)J/cm2, 7-12 procedures (acute)(6-10)J/cm2, 20-25 procedures (chronic)

2. Perthes disease(12-15)J/cm2, 20-30 procedures

3. Trochanteric bursitis(4-8)J/cm2, 5-7 procedures (acute)(4-8)J/cm2, 15-20 procedures (chronic)

4. Periarthritis coxae(4-8)J/cm2, 7-10 procedures (acute)(4-8)J/cm2, 15-20 procedures (chronic)

5. Gonarthrosis analgetic activity(3-10)J/cm2, 5-8 procedures (acute)(3-10)J/cm2, 20-25 procedures (chronic)(4-10)J/cm2, 5-10 procedures regenerative activity

6. Chondromalacia patellae(4-8)J/cm2, 7-10 procedures

7. Osgood-schletter disease(3-10)J/cm2, 6-9 procedures

8. Knee joint sprain(4-10)J/cm2, 8-10 procedures

9. Kohler I, II disease and Haglund-Sever disease(4-8)J/cm2, 8 procedures

10.Calcaneal tendinitis(4-10)J/cm2, 8-10 procedures(4-10)J/cm2, 10-15 procedures

11.Tendosynovitis(4-8)J/cm2, 5-8 procedures (acute)(4-8)J/cm2, 8-13 procedures (chronic)

12.Sudeck syndrome(4-10)J/cm2, 4-8 procedures (oedermal stage)(4-10)J/cm2, 8 procedures (atrophic stage)

114

B4. Skin diseases1. Contact dermatitis – Scanning J/cm2 2. Infectious dermatitis, eczema, dermatitis herpetiformis

2J/cm2, 10-15 procedures3. Acne –supportive treatment (1-3)J/cm2 4. Post-operative wounds treatment 4J/cm2 5. Ulcers – supportive treatment

(2-4)J/cm2, central part of ulcer4J/cm2, marginal part of ulcer

6. Burns – supportive treatment (2-4)J/cm2

5. G. Danhof, Holand [101] (laser 632.8nm, C.W.; 904nm pulsed)

Muscle incompletely tearing offPainful area 0.5J/cm2 Pain releasing points (3-5)J/cm2

Scars (4-6)J/cm2 per pointRheumatoid arthritis

prolonged activity (4-5)J/cm2

exacerbation of disease (2-3)J/cm2

scanning irradiation 0.25J/cm2

Carpal tunnel syndrome (3-6)J/cm2

Styloiditis radii (2-6)J/cm2

Tendinopathy (3-8)J/cm2 per pointOlecranon bursitis (2-3)J/cm2 per central point of bursa

0.5J/cm2 scanningPeriarthritis humero-scapularis

(4-5)J/cm2 per point0.5J/cm2 scanning (surface 5-10cm2)

Degenerative shoulder joint disease (4-5)J/cm2

Frozen shoulder syndromeminimal dose (2-3)J/cm2, number of procedures: 12-16scanning: 0.5 (surface 4-5cm2)

Subacromial bursitis (2-8)J/cm2

115

Discopathy(2-3)J/cm2 (acute)(5-6)J/cm2 (chronic)

Spondyloarthrosis neck partbilateral irradiation at 4 points (C3-C4 and C4-C5) – (2-3)J/cm2

scanning 0.5 (surface 3-5cm2)Coxarthrosis 4J/cm2

Calcaneal tendinitis and bursitis (2-8)J/cm2

Chondromalacia patellae and others knee joint diseases(3-5)J/cm2 per point0.5J/cm2 scanning

Talalgy (2-3)J/cm2

Trigeminal neuralgiatrigger points (2-3)J/cm2

number of procedures: 12-15 every other dayProstatitis treatment combines with antibiotics

endorectal probe (4-5)J/cm2, number of procedures 12Haemorrhoids

endorectal probe 3J/cm2

external irradiation 3J/cm2

6. G. Kostyrka, H. Kostyrka, Austria (laser 670nm C.W.; F1500Hz 904nm, 15W pulsed)

Spondyloarthrosis (1-2)J/cm2

Scanning 10min. and 2-3min. per point, therapy duration 3 weeks, 3 times a week, 10 procedures in seriesefficacy: 60% very good results

30% good results10% without improvement

Coxarthrosis 2J/cm2


20% good results

116

Gonarthrosis (1.5-2)J/cm2


25% good results

Periarthritis humero-scapularisScanning 15min. and 3-4min. per point, therapy duration 3 weeks, 3 times a week, 10 procedures in seriesefficacy: 35% very good results

65% good results

Degenerative changes of hands and feet joints 2J/cm2


40% good results

Trigeminal neuralgia 3J/cm2


50% good results

Other neuralgies 2J/cm2


35% good results

Zoster 2J/cm2


35% good results

117

Contusions 2J/cm2

Scanning 10min. and 2-3min. per point, therapy duration 3 weeks, 3 times a week, 10 procedures in series

Degenerative changes of temporo-mandibular joint 2J/cm2

Scanning 10min. and 2-3min. per point, therapy duration 3 weeks, 3 times a week, 10 procedures in series

118

ANNEX 2 LASER THERAPY APPLICATION - PRACTICAL INDICATIONS1. Diagnosis: discopathy, spondylosis

1A. General recommendations:Complementary treatment in therapy of "sacralgia school" type, preference for using the laser emitting infrared radiation.- dosage: (6-12) J/cm2- procedures numbers: (3-5) a week, in series of 10-20,- in-contact irradiation of the painful points with pressure on tissues is preferred.

1B. Additional recommendation:- repetition of procedure series,- precise diagnosis and possible surgical treatment in cases of intervertebral disc

nucleus pulposus hernia.

119

2. Diagnosis: spondylosis, forming changes

2A. General recommendations:- analgetic treatment, application of lasers emitting the infrared radiation (830 nm or

904 nm) is preferred,- dosage: (8-14)J/cm2- number of procedures: (2-3) a week, in series of 6-10,- in-contact irradiation of the painful points using the pressure on tissues is preferred. It is recommended to use scanning irradiation for the tissue area affected by pathology, including automatic scanning and in-contact irradiation of painful points.

2B. Additional recommendations:- precise diagnosis,- using the laser therapy together with magnetotherapy, electrotherapy, ultra sound

therapy,- therapy repetition (2-3) times a year.

120

3. Diagnosis: Ankylosing spondylitis

3A. General recommendations:Supplementary treatment. It is recommended to irradiate using simultaneously the infrared radiation (830 nm or 904 nm) and the visible radiation (632.8 nm or 670/690 nm),- dosage: (6-12) J/cm2.Radiation dosage in automatic scanning should not exceed 150 J per procedure.- number of procedures: (2-3) a week, in series of 6-10.

3B. Additional recommendations:- repetition of therapy series,- combination with other physiotherapeutic treatments, as for example: magnetic

field, electrotherapy. It is recommended to perform scanning of the tissue area affected by pathology using automatic scanning and additional in-contact irradiation of painful points.

121

4. Diagnosis: Sacroilitis

4A. General recommendations:Supplementary, analgetic treatment. It is recommended to use simultaneously the infrared radiation (830 nm or 904 nm) and visible radiation (632.8/670/690 nm).- dosage: (4-8) J/cm2- number of procedures: (2-3) a week, in series of 8-12.

4B. Additional recommendations:- precise diagnosis,- repetition of therapy series,- it is recommended to apply laser therapy together with magnetotherapy,

electrotherapy, ultrasound therapy,- it is recommended to perform scanning of the tissue area affected by pathology

using automatic scanning and additional in-contact irradiation of painful points.

122

5. Diagnosis: Intercostal neuralgia (e.g. after past zoster)

5A. General recommendation:Analgetic treatment. It is recommended to use lasers emitting the infrared radiation e.g. 830 nm or 904 nm.- dosage: (2-6)J/cm2,- number of procedures: (2-3) a week in series of 8-12.

5B. Additional recommendations:- repetition of procedures series,- in-contact irradiation using the point or superficial treatment probe, without pressure on tissues.

123

6. Diagnosis: Tendinitis and vaginitis of biceps muscle long head

6A. General recommendations:- dosage: (4-8) J/cm2, infrared radiation (830 or 904 nm), it is recommended to use

simultaneously visible radiation (670/690 nm and infrared radiation,- number of procedures: (2-5) a week, in series of 8-12.

6B. Additional recommendations:- repetition of procedure series 2-3 times a year (in case of need),- precise diagnosis and surgical treatment in cases of not diagnosed earlier tendon

rupture,- scanning of the tissue area affected by pathology using disfocused radiation of the

CO2 laser, c.w. 7W,- combination with other physiotherapy procedures, e.g. magnetotherapy, ultra

sounds, iontophoresis, electrotherapy,- application of automatic scanning technique or irradiation using the hand-held

probe with in-contact irradiation of painful points without pressure.

124

7. Diagnosis: Supraspinous muscle syndrome

7A. General recommendations:- dosage: (4-8) J/cm2, infrared radiation (830 or 904 nm), it is recommended to use

simultaneously visible radiation (670/690 nm or 632.8 nm) and infrared radiation,- number of procedures: 2-5 a week, in series of 8-12.

7B. Additional recommendations:- repetition of procedure series in case of recurrence,- precise diagnosis and surgical treatment in case of tendon rupture that was not

diagnosed earlier,- scanning of tissue area affected by pathology using disfocused radiation of the CO2

laser, c.w. 7W- combination with mangetotherapy, ultra sound therapy, electrotherapy,- using automatic scanning or irradiation with the treatment probe using manual in-

contact technique.

125

8. Diagnosis: Torticollis, muscle derivate

8A. General recommendations:- dosage: (3-6) J/cm2, preferred radiation of 632.8 nm or 670/690 nm (the better

results can be obtained when using simultaneously two treatment probes – the second one generates the infrared radiation),

- number of procedures: (2-5) a week, in series of 8-10.8B. Additional recommendations:

- it is preferred to use the hand-held treatment probe, in-contact technique without pressure on tissues,

- taking extreme care when irradiating areas adjacent to thyroid gland,- scanning of the tissue area affected by pathology using disfocused radiation of the

CO2 laser, c.w. 7 W,- repetition of procedure series.

126

9. Diagnosis: Syndrome of painful elbow (enthesopathy of extensor muscle aponeurosis)

9A. General recommendations:- dosage: (4-10) J/cm2 of IR radiation (830 or 904 nm), synergistic action obtained

using visible radiation (70/690 nm or 632.8 nm),- number of procedures: (2-5) a week, in series of 8-10.

9B. Additional recommendations:- repetition of procedure series in case of recurrence,- scanning of the tissue area affected by pathology using disfocused radiation of the

CO2 laser, c.w. 7W,- combination with other therapeutic procedures, such as magnetic field, ultra

sounds, iontophoresis, electrotherapy,- using automatic scanning or irradiation using the hand-held treatment probe, in-

contact technique without pressure.

127

10. Diagnosis: De Quervain disease

10A. General recommendations- dosage: (4-8) J/cm2- number of procedures: (2-5) a week, in series of 8-10.

10B. Additional recommendations:- repetition of procedure series,- strengthening of the therapeutic effect through combining with other therapy

methods, e.g. magnetic field, electrotherapy,- irradiation using the manual treatment probe, in-contact technique with pressure

on tissues.

128

11. Diagnosis: Carpal tunnel syndrome

11A. General recommendations:- dosage: (2-6) J/cm2,- number of procedures: (5-6) a week, in series of 8-10.

11B. Additional recommendations:- precise diagnosis and surgical treatment,- irradiation using the manual treatment probe, in-contact technique without pressure

on tissues,- strengthening of the therapeutic effect through combination with other therapy

methods.

129

12. Diagnosis: Guyon canal isthimus syndrome

12A. General recommendations:- dosage: (2-6)Jcm2,- number of procedures: (5-6) a week, in series of 8-10.

12B. Additional recommendations:- precise diagnosis and surgical treatment,- it is preferred to irradiate using the manual treatment probe, in-contact technique

without pressure on tissues,- strengthening of the therapeutic effect through combining laser therapy with other

available therapy methods, e.g. magnetic field.

130

13. Diagnosis: Coxarthrosis

13A. General recommendations:Adjunctive, analgetic treatment,.- dosage: (4-6)J/cm2 of IR radiation (830 or 904 nm), it is recommended to use

simultaneously visible radiation (670/690 nm or 632.8 nm) and infrared radiation,- number of procedures: (2-3) a week, in series of 6-10

13B. Additional recommendations:- precise diagnosis and surgical treatment dependent upon the indications,- repetition of procedure series,- strengthening of the therapeutic effect through combination with other

physiotherapy methods, e.g. mangetotherapy, electrotherapy,- irradiation of painful points, using in-contact technique with pressure on tissues,- using automatic scanning technique of area affected by pathology,- irradiation of painful points mainly,

131

14. Diagnosis: Gonarthrosis

14A. General recommendations:Adjunctive treatment.- dosage: (4-12) J/cm2 of IR radiation (830 or 904 nm), it is advisable to irradiate

using simultaneously visible radiation (670/690 nm or 632.8 nm) and IR radiation.


- precise differential diagnosis,- repetition of procedure series,- strengthening of the therapeutic effect through combing with other therapy

methods, e.g. magnetotherapy, electrotherapy,- in-contact irradiation of points in articular space projection,- using automatic scanning of area affected by pathology.

132

15. Diagnosis: Morton disease

15A. General recommendations:- dosage: (2-8) J/cm2- number of procedures: (2-5) a week, in series of 8-10.

15B. Additional recommendations:- strengthening of the therapeutic effect applying other therapeutic procedures, e.g.

magnetotherapy, electrotherapy,- it is preferred to irradiate using the manual treatment probe, in-contact technique

without pressure on tissues.

133

16. Diagnosis: Osgood-Schlatter syndrome

16A. General recommendations (after past Osgood-Schlater disease):- dosage: (4-10) J/cm2 using simultaneously lasers emitting IR and red radiation,- number of procedures: (2-5) a week, in series of 8-10.

16B. Additional recommendations: - repetition of procedure series,- strengthening of the therapeutic effect applying other therapeutic procedures, e.g.

magnetotherapy, electrotherapy,- it is preferred to use automatic scanning or irradiation of painful points using the

manual treatment probe, in-contact technique without pressure.

134

17. Diagnosis: Straight distortion of knee joint collateral ligaments

17A. General recommendations:- dosage: (2-8) J/cm2, of IR radiation (830 or 904 nm), it is advisable to irradiate

using simultaneously visible radiation (670/690 nm or 632.8 nm) and infrared radiation,


- repetition of procedure series,- strengthening of the therapeutic effect through other therapeutic procedures, e.g.

mangentotherapy, electrotherapy,- it is preferred to use the area automatic scanning and irradiation using the manual

treatment probe, in-contact technique without pressure on tissues.

135

18. Diagnosis: Achillotendovaginitis

18A. General recommendations:- dosage: (3-10) J/cm2- number of procedures: (2-5) a week, in series of 8-12.

18B. Additional recommendations:- repetition of procedure series,- precise diagnosis and surgical treatment, - scanning of the tissue area affected by pathology using disfocused radiation of the

CO2 laser, c.w. 7W,- strengthening of the therapeutic effect applying other therapeutic procedures, e.g.

magnetotherapy, electrotherapy,- it is preferred to use area automatic scanning and in-contact irradiating using the

manual treatment probe without pressure on tissues.

136

19. Distorsion of ankle joint

19A. General recommendations:- dosage: (1-6) J/cm2, infrared irradiation (it is recommended to irradiate using

additionally red radiation),- number of procedures: (2-5) a week, in series of 8-10.

19B. Additional recommendations:- repetition of procedure series,- strengthening of the therapeutic effect applying other therapeutic procedures, e.g.

magnetotherapy, electrotherapy,- it is preferred to use automatic area scanning and irradiation using the manual

treatment probe, in-contact technique, without pressure on tissues.

137

20. Diagnosis: Anterior tibial tendonitis

20A. General recommendations- dosage: (4-8) J/cm2- number of procedures: (2-5) a week, in series of 8-12.It is advisable to use lasers emitting two different wavelengths (in the visible and

infrared spectrum).20B. Additional recommendations:

- scanning of tissue area affected by pathology using disfocused radiation of the CO2 laser, c.w. 7W,

- strengthening of the therapeutic effect applying other therapeutic procedures, e.g. magnetotherapy, electrotherapy,

- it is preferred to use area automatic scanning and irradiation using the manual treatment probe, in-contact technique, without pressure on tissues, along a tendon.

138

21. Diagnosis: Posterior tibial tendinitis

21A. General recommendations:- dosage: (4-8) J/cm2,- number of procedures: (2-5) a week, in series of 8-12.

21B. Additional recommendations:- repetition of therapy series,- precise diagnosis and surgical treatment,- scanning of the tissue area affected by pathology using disfocused radiation of the

CO2 laser c.w. 7W,- strengthening of the therapeutic effect applying other therapeutic procedures, e.g.

magnetotherapy, electrotherapy,- it is preferred to use area automatic scanning and irradiation using the manual

treatment probe, in-contact technique, without pressure on tissues along a tendon.

139

22. Diagnosis: Plantar aponeurositis

22A. General recommendations:- dosage: (4-12) J/cm2 (it is preferred to use IR radiation of 830 nm or 904 nm),- number of procedures: (2-5) a week, in series of 8-10.

22B. Additional recommendations:- strengthening of the therapeutic effect applying other therapeutic procedures, e.g.

ultra sound therapy,- it is preferred to irradiate using the manual treatment probe, in-contact technique,

with pressure on tissue or "pecking" technique.

140

23. Diagnosis: Calcanean spur

23A. General recommendations:- dosage: (8-16) J/cm2 (it is preferred to use IR radiation of 830 nm or 904 nm),- number of procedures: (2-5) a week, in series of 8-10.

23B. Additional recommendations:- precise diagnosis and surgical treatment,- strengthening of the therapeutic effect applying other therapeutic procedures, e.g.

ultra sound therapy,- it is preferred to irradiate using the manual treatment probe, in-contact technique

with pressure on tissues or "pecking" technique.

141

anexa clinica la llt

Documents