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Laser 5000
User manual
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BTL Laser 5000 User manual

BTL-5000 Laser
USER'S GUIDE
112IE08/08/2008CZ
OBSAH
1.3.1 Source......................................................................................................................................................6
1.3.2 Wavelength (primarily semi-conductor lasers) .........................................................................................6
1.3.3 Beam Operation Mode .............................................................................................................................7
1.3.4 Type of Beam...........................................................................................................................................7
1.3.5 Laser Class (defined by the output)..........................................................................................................7
1.3.6 Use...........................................................................................................................................................8
1.6.1 Frequencies for Laser Acupuncture According to Dr.Nogier ..................................................................10
1.6.2 Frequencies for Laser Acupuncture According to Dr.Voll (EAV) ............................................................11
2.2.1 Dose.......................................................................................................................................................12
2.2.2 Frequency ..............................................................................................................................................13
2.2.3 Output (laser probe) ...............................................................................................................................13
2.2.4 Output (laser cluster)..............................................................................................................................13
2.2.5 Area........................................................................................................................................................14
2.2.6 Distance between the Probe/Cluster and the Irradiated Surface............................................................15
2.2.7 Time of Therapy .....................................................................................................................................15
2.2.8 Course of Signal – Duty Factor (DF) ......................................................................................................15
2.2.9 Physiological Effects .............................................................................................................................17
2.2.10 Laser Sequences ...................................................................................................................................17
2.3.1 Door Activity ...........................................................................................................................................17
2.3.2 Acupuncture ...........................................................................................................................................18
2.3.3 Self-calibration of the Laser Probe .........................................................................................................18
2.4.1 COM IN/OUT connector .........................................................................................................................19
2.6.1 Dental Attachment..................................................................................................................................21
2.6.2 Gynaecological Attachment....................................................................................................................21
2.6.3 ENT Attachment.....................................................................................................................................21
2.6.4 How to Connect the Attachment.............................................................................................................22
STRANA 2 Z 25
3.1.1 Label placed on the case of the device, warning about occurrence of visible and invisible radiation of
class 3B..................................................................................................................................................24
3.1.2 Label placed on the probe, warning about proximity of aperture of laser of the stated wavelength, power
and laser class .......................................................................................................................................24
3.1.3 Label placed on the laser cluster, warning about proximity of aperture of laser of the stated wavelength,
power and laser class.............................................................................................................................25
3.1.4 Label for marking of the laser workplace, warning about proximity of 3B-class laser.............................25
STRANA 3 Z 25
1 USER'S GUIDE
1.1 INTRODUCTION
This User's Guide is intended to make you familiar with the BTL-5000 Laser device designed for performing non-
invasive, low level laser therapy. At the same time, it will give you general instructions on how to perform low level
laser therapy in clinical practice.
Please note that, according to applicable legislation, the staff operating therapy lasers must be trained by
competent institutions.
1.2 LIGHT-THE PRINCIPLE OF LASER LIGHT AND ITS SPECIFICS
The nature and qualities of light can be interpreted in more ways, according to classic, relativistic or quantum
physics. However, the basic nature of light itself as either a particle/corpuscular or an electromagnetic/wave
mechanism remains unreachable for our senses and it is incomparable to any other level of reality. Therefore, we
can only accept conclusions and deductions of numerous experiments.
Laser radiation has specific qualities:
• totally monochromatic: maintaining only one wavelength
LASER 635 nm
Intensity
500 700400
600
800
Intensity
nm
BULB
800 1600400 20001200
nm
USER'S GUIDE | PAGE 4 FROM 25
• totally polarized – waves are absolutely spatially oriented on a defined area
Linear polarization
• totally coherent – it is absolutely oriented in time - maxima and minima of all waves are identical in time
and the waveforms are the same
Coherent light Non-coherent light
A laser beam of a high output represents the “death ray” of sci-fi authors of old; it can destroy material or matter.
However, a laser beam of low output (not exceeding 500 mW) shows slightly different effects on living organisms
and tissues, especially significant stimulative effect – see the part concerning clinical effects of low-power laser
beam.
The word LASER stands for Light Amplification by Stimulated Emission of Radiation.
The first theoretical postulates on a laser beam were laid down by Albert Einstein in the early twentieth century,
describing the theoretical possibilities of a stimulated emission of light in 1916-1917. However, the first laser unit
was not constructed until 1960, following other important discoveries in the area of the so called quantum
radiotechnique (N.G. Basov and A.M. Prochorov of the former USSR and C.H. Townes of the USA received a
Nobel Prize for these discoveries in 1964).
The medical application of laser light followed soon after. At first, only high intensity laser beams were utilized.
Lasers of this type provide a source of energy that can destroy (cut, shear) as well as evaporate and, using its
thermic effect, cauterize tissue.
E. Mester, a Hungarian scientist, was the first to introduce the stimulative effect of a low intensity laser. He
conducted his experiments - which are still of a great importance - in the late sixties.
USER'S GUIDE | PAGE 5 FROM 25
1.3 TYPES OF LASERS
Lasers can be divided according to several criteria:
1.3.1 SOURCE
• solid lasers (ruby laser)
• liquid lasers
• gas lasers - helium-neon, argon
• semi-conductor lasers (GaAs, GaAlAs) – now the most important of the non-invasive therapy lasers
The advantages of semi-conductor lasers include a significant miniaturization of the source, robustness and
immunity to damage and the theoretic possibility to construct a laser unit of any wavelength, according to the
user's requirements. Nevertheless, some lasers still remain at experimental level (see below).
1.3.2 WAVELENGTH (PRIMARILY SEMI-CONDUCTOR LASERS)
• blue lasers – approx. 400-500 nm
• green lasers – approx.500-550
• red lasers – approx.600-700nm
• infra-red lasers – approx.700-950 nm
Visible spectrum
500nm 700nm
cosmic radiation; gamma-rays, X-rays, UV radiation
400nm
600nm
infrared radiation, microwaves, radio waves, very long waves
Laser beam penetration through the tissue is largely dependent on the wavelength. In general, green and blue
lasers are still being developed and their clinical use is extremely limited. Most commonly used are the beams in
the wavelength of red light. After 2-3 mm penetration through living tissue, their intensity is reduced to half. This
predetermines red laser beams to be used especially in therapy of mucous membrane and skin diseases. Since
the output is absorbed by a very small column of the tissue, devices of an output of 50 mW or lower are usually
fully sufficient.
The intensity of infra-red lasers is reduced to half after penetration of 2-3 cm through the tissue. These lasers are
used especially in treating of deeper-located structures (joints, muscles, insertions...). Since the output is
absorbed by the column of the tissue, and since we want the intensity on the target area deep in the tissue to be
sufficient, we recommend using devices of a minimum output at least 50 mW.
See the part concerning the emitted power density below.
USER'S GUIDE | PAGE 6 FROM 25
1.3.3 BEAM OPERATION MODE
• pulse lasers
– very short pulses – hundreds of ns, peak output in watts or tens of watts
• continuous lasers
• lasers with modulated operation
output reaches up to several hundreds of mW.
Output
Output
– the pulse length depends on the frequency and on the duty factor; the peak
CONTINUOUS
Mean
value
Time
Time
Output
MODULATED PULSE
Mean
value
Time
Mean
value
Manufacturers usually offer various alternatives, including the possibility of combination of various modes
modulated according to various parameters.
See below the parts concerning clinical effects and use.
1.3.4 TYPE OF BEAM
• convergent (point) beam
• divergent (widening) beam – allows irradiation of a larger area without the need of sweeping the probe over
the treated tissue
• laser scanners – devices for irradiation of large areas
• laser clusters – generate several independent laser beams, which may be of various wavelengths. They
enable to irradiate a large area without the necessity of sweeping over the treated tissue. To some extent
they substitute laser scanners.
1.3.5 LASER CLASS (DEFINED BY THE OUTPUT)
• Class 2: up to an output of 1 mW
• Class 3A (3R, 3M): up to an output of 5 mW and output density of 25 W/m2
• Class 3B: up to 500 mW
USER'S GUIDE | PAGE 7 FROM 25
Note
The stated values are only rough, exact classification of the hygienic class is more complicated and shall be
performed according to applicable standards.
1.3.6 USE
• simple pen lasers ("laser-pen") – usually feature only a very limited range of frequency modes. The
advantage of this type is its perfect portability
• "pocket" lasers – usually designed to fit in a physician's coat pocket; in most cases the probe is connected
with the device's body by a conductor – these devices largely prevail on the market, at present the
manufacturers can equip these devices by probes of an output up to hundreds of mW
• desk-top lasers – usually supplied from the mains, the probe is connected with the device by a cable. The
advantages of this type usually include a wide range of frequency modes and the possibility to set many
different parameters. New generation devices (including BTL-5000 Laser) have also the possibility of
replacement of probes of various wavelengths and outputs. These devices are designed especially for
rehabilitation. One of their advantages is the possibility of building of "sets" of the devices which can provide
as wide range of treatments as possible on a small area.
1.4 BASIC PHYSICAL QUANTITIES
• Wavelength - one of the basic parameters of a monochromatic laser beam (i.e. of only one wavelength). Its
unit is nanometer [nm]
• Output – its unit is mW. The given output is either peak, i.e. pulse amplitude, or mean (average). In case of
the BTL 5000 Laser the screen displays the peak output value measured on the output aperture of the probe.
Use of an optical attachment or light conductor causes approximately a 10% loss of output which shall be
deducted from the displayed value. For each attachment supplied by the manufacturer of BTL devices, the
decrease of output is stated in the attachment's technical documentation.
• It is always necessary to know the output level at the active end of the probe/cluster (output aperture) –
especially when the beam is transmitted by a light conductor, the resulting output can markedly differ from the
output of the source! Every passage between media (source-air, source-lightguide, lightguide-air) lowers the
output.
• The mean output also depends on the chosen mode, i.e. continuous or pulse (The computing unit of the BTL-
5000 Laser takes into account the mode in which the device is working when calculating the treatment time).
• Modulation frequency – its unit is Hertz [Hz] (= number of oscillations per second), sometimes there is in
addition the percentage value of the active state time ("Duty factor") and the pulse width. The most commonly
used are numerical frequencies (5 Hz stimulation, 10 Hz analgesic effect), very common are also frequencies
according to Dr. Nogier (previously used mainly in acupuncture), frequencies according to Dr. Bahr
(nowadays used mainly in acupuncture) or according to Dr. Voll
• Power density - its unit is J/cm2 – power emitted per unit of area. This quantity is improperly called dose –
however, this term has become so common in the laser theory that also in this document the terms "emitted
power dose" or "dose" are used, but they always mean "emitted power density".
Below you can see a formula for calculation of an emitted power dose (Note: this is the dose emitted to the skin
surface, not to more deeply located structures).
USER'S GUIDE | PAGE 8 FROM 25
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