Multi Radiance Medical MR4 ActiVet Protocol Manual

Equine Treatment Protocol Manual

Multi Radiance Medical® 6521 Davis Industrial Parkway Solon, OH 44139 USA 440-542-0761 www.multiradiance.com

English Edition: Solon, OH USA

Distributed in the United States of America by Multi Radiance Medical® With permission Version 1.2 Not for Resale

Without limiting the rights under copyright reserved above, no part of this publication may be reproduced, stored in, or introduced into a retrieval system. It also cannot be transmitted in any form or by any means (electronic, mechanical, photocopying, recording or otherwise), without the prior written permission of the above editor. The scanning, uploading and distribution of this book via the Internet or via any other means without the permission of the editor is illegal and punishable by law. Please purchase only authorized copies of this manual. The Multi Radiance Medical logo, brand and product names are registered trademark(s) and service mark(s) of Multi Radiance Medical. All other brand and product names mentioned are trademarks of their respective owners.

The manual, is intended for a variety of practitioners including: Veterinarians, Veterinary Technicians, and other users. It contains general information related to use of the Multi Radiance Medical device, the MR4 ACTIVet Pro. The manual describes the main effects of light and laser on animals and examines phenomenon of interaction between low-level laser and biological tissues. The methods presented are the most frequently utilized protocols in veterinary practice and should produce very beneficial outcomes. The MR4 ACTIVet Pro is a patented therapeutic veterinary device, which uniquely combines the synergetic influence of four electromagnetic radiances (super pulsed infrared laser radiation, pulsing broadband infrared radiation, pulsing Red and Blue light) and a fixed magnetic field. Please also note the included lists of indications and contraindications for laser.

These veterinary conditions and treatment protocols should be considered as beginning fundamentals for you to build, as you gain experience with the technology. They are not intended to be complete or exhaustive in nature, nor are they the only protocols that can produce successful outcomes. As you gain experience, through use of your MR4 ACTIVet Pro Laser System, your confidence will also grow.

Disclaimer: This information is provided as a guide only. The publishers and authors make no claim that photobiomodulation (laser/light therapy), and/or Multi Radiance Medical medicine/therapy will be effective in treating any conditions listed in this publication. Individual practitioner discretion is essential in determining an appropriate form of treatment.

The information included in this manual is specific to the use of the MR4 ACTIVet Pro. The use of this information with other devices is not recommended. Please read all information included with your unit carefully.

D-SUP500-300USA

Table of Contents

Page

Introduction .......................................................................................................1

Welcome from Multi Radiance Medical .........................................................1

What is Low Level Laser Therapy ...................................................................2

Multi Radiance Advantage ............................................................................3

Why use Multi Radiances? ............................................................................4

Why use Multi Radiances? (continued) ..........................................................5

Quick Summary: Methods & Techniques ....................................................... 6

Photo Probes ................................................................................................7

The Priority Principle (Pain/Spasm) .................................................................8

The Priority Principle (Rehab/Recovery) ..........................................................9

Quick Reference Guide ...............................................................................10

Equine Treatment Protocols ...........................................................................11

Bowed Tendons Protocol ............................................................................. 12

Hygroma Protocol .......................................................................................14

Osteoarthritis Protocol ................................................................................16

Pain (General) Protocol ...............................................................................18

Post Op Incisions Protocol ...........................................................................20

Quarter Crack Protocol ...............................................................................22

Strains and Sprains Protocol ........................................................................24

Suspensory Ligament Protocol ....................................................................26

Sweeney Protocol .......................................................................................28

Wounds Protocol ........................................................................................30

Acute Injuries Protocol ................................................................................32

LaserPuncture Protocol................................................................................33

Equine Appendices .........................................................................................34

Treatment Methods ....................................................................................35

Treatment Techniques ................................................................................. 36

Important Final Words ................................................................................37

Introduction:

Welcome from Multi Radiance Medical

Welcome!

Multi Radiance Medical is pleased to welcome you as a new veterinary partner providing Super Pulsed Laser (SPL). Our company goal is to provide superior laser and light products and provide an excellent return on your investment. From the highest degree of safety available, to ease of use, Multi Radiance Medical devices are designed with you in mind. By offering a variety of products designed to ﬁt in every aspect of your practice, we minimize all limitations that allow you to maximize your ability to achieve outstanding clinical outcomes. We look forward to working with you and answering any questions you may have, from simple operation of the device to building protocols for use in practice.

The Manual

The Multi Radiance Medical ACTIVet protocol manual is written for novice and advanced low level laser users. This protocol manual will provide basic step-by-step instructions on many common conditions seen in everyday practices across a wide array of veterinary patients.

Along with various techniques and methods of laser application, a brief introduction to photobiomodulation (PBM) or the photobiological interactions between light and biological tissue will be presented. These tools will assist you in getting the best outcomes possible when adding low level laser to your treatment approach. The protocol sections detail some of the most common conditions seen in daily practice. Device settings and treatment times are provided for the ACTIVet. The Priority Principle (PP) is introduced and explained in detail, providing clear, easy to follow, numerical steps to create a solid foundation to treat common problems but also an even wider array of conditions. Throughout the manual you will ﬁnd recommendations from our Multi Radiance Veterinary Team on best clinical practices as well as Quick Start Tips.

Before continuing, review all included literature with your device. This will provide you with the latest information available on indications of use, contraindications as well as any other considerations that may be relevant or useful to know. All presented protocols should be considered a starting point. They are not intended to be complete or exhaustive in nature, nor are they the only protocols that can produce successful outcomes.

Beneﬁts of laser/light treatments?

Over 5,500 studies and papers produced by researchers across the globe have documented effects of laser and light on a variety of conditions – a new paper is

published every day and a half. It is no longer a question whether or not light can have beneﬁcial effects. The question now is with what parameters will the most reliable and consistent clinical outcomes be delivered?

Effectiveness of treatments is derived mainly from effects of these radiances on cells themselves. The generation or liberation of many important biomolecules is uniquely derived from light absorption. Even subtle amounts of non-thermal energy can initiate repair processes and assist in reductions of pain.

Laser or light devices simply initiate natural healing processes. These events occur not from the heating of tissues (photothermal) but are directly traceable to photochemical processes. Super pulsing eliminates risks associated with thermally heating tissues.

With the advent of global internet, laser therapy speciﬁc resources can be readily accessed. Sites such as LaserTherapyU.org, Google Scholar and Laser.nu are excellent resources for reviewing contemporary literature and science.

scholar

Swedish Laser Medical Society

Introduction:

What is Low Level Laser Therapy?

Photobiomodulation

All light, whether laser or ordinary, is part of the electromagnetic spectrum of energy and composed of photons, or “packets” of energy. Therapeutic uses for light have been demonstrated for over half a century and the varying wavelength (or colors) of light have been identiﬁed and deﬁned as “photobiomodulation” or PBM. The North American Association for Photobiomodulation Therapy (NAALT) has recognized that PBM is a non-thermal process that stimulates or inhibits biological processes.

One of the basic mechanisms of action is the acceleration of electron transfer by absorption of visible (red and blue) and near infrared (NIR) light. Damaged or injured cells emit enzymes that encourage the absorption of photons and thus alter their redox state. These cells are unable to participate in the healing process. After photons are absorbed by chromophores, a variety of biological processes are stimulated that transform the light energy into biochemical energy and release signal molecules to amplify the effect.

Adenosine triphosphate (ATP), Nitric Oxide (NO) and Reactive Oxygen Species (ROS) have all been linked to light absorption. The creation or release of these molecules can create a cascade effect within the tissues, releasing secondary messengers, improving proliferation and cell motility.

The studies and research describing the Cytochrome C Oxidase (CCO) stimulation/ATP generation are only part of the story needed to explain all the effects of photobiomodulation. NO has dual roles in both providing vasodilation of vessels and pain relief. Directly acting as a neurotransmitter, it is essential for normal nerve cell action potential in impulse transmission activity.

Vasodilation allows for greater trafﬁc of immune cells into tissue, which is highly relevant to the treatment of joint inﬂammation. Indirectly, the vasodilation effect of NO can enhance nerve cell perfusion and oxygenation, inhibit the release of histamine and other inﬂammatory mediators from mast cells, and inhibit prostaglandin synthesis. This process not only reduces inﬂammation but also causes temporary vasodilation bringing much needed oxygen, fuel molecules and other metabolites to the injured tissue aiding in their natural healing.

ATP

1. Photon Absorbtion

2. Mitochondria Activation

3. Increased ATP Production

Result: Stable,

Healthy Cell

ATP

Introduction:

Multi Radiance Advantage

Twenty years in development and constant evolution, Multi Radiance Medical’s MR4 product lines are patented unique devices that combine multiple wavelengths, light sources and electromagnetic energy to provide the most tested, reliable and clinically signiﬁcant devices currently available.

The primary effects of the PBM are based on photochemical and photophysical changes and not the result of thermal inﬂuence in tissue. Phototherapeutic effects are connected to reinforcement of microcirculation in target tissues and the activation of biomolecules, potentiating both physical and biochemical processes and the continual photodissociation of nitric oxide from a protein binding site (heme or copper center) such as those found in cyctochrome c oxidase. However, light absorption creates heat as a byproduct. Laser, like ultrasound, at low levels, can stimulate while at higher levels it becomes destructive if a continual buildup of heat within target tissues occurs.

Before any reaction can occur, the emitted photon must be absorbed by the body. Absorption is dependent on several factors, treatment technique (being on the skin versus distance), the tissue state (injured versus uninjured), but wavelength is the key factor in being able to deliver light to tissues and getting it absorbed. A device with a poor thermal proﬁle will likely have a poor penetration proﬁle that may result in a rapid conversion of the light energy to heat, losing the beneﬁcial effects of the therapy.

Leal-Junior, et al. studies the effects of depth of penetration with multiple wavelengths of 660nm Red LED, 860nm IRED and 905nm SPL to establish how various wavelengths and light sources interact when applied concurrently through the skin. The data suggests and demonstrates when the combined wavelengths were compared to the predicted measurement (summated total of each individual wavelength’s percentage of light penetration) the actual penetration of the combined sources was nearly 100% greater at all of the time points. The authors conclude that a combination of multiple wavelengths creates a “synergism” or Cascade Effect that enhances each individual wavelength’s ability to penetrate the skin.

The Cascade Effect results in a beneﬁcial increase in the percentage of light that penetrates through the skin. The increase in the skin penetration time proﬁle created by multiple wavelengths allows greater amounts of light energy to penetrate subdermally with lower average mean power outputs of power. This improves the overall efﬁciency of energy transfer. By requiring much smaller doses, the likelihood of energy being trapped at the surface and converted to heat is reduced. This enhances the effect of PBM on pain modulation, inﬂammation reduction and promotion of tissue repair. The Cascade Effect may also explain the differentiation between doses recommended by World Association for Laser Therapy. In many cases the doses for super pulsed lasers can be 1/2 to 1/10 that of continuous wave lasers.

While higher doses and shorter treatment times are often desirable, increasing power without regards to the tissue impact can have negative consequences. Only with super pulsing can you deliver watts (25 W or 25,000 mW) of energy to the tissue without fear of thermal build up or photodamage. They operate like a very high speed camera ﬂash – very large “burst” of light energy but only 100 nanoseconds (billionths of seconds) duration. This ensures the coefﬁcient of tissue relaxation is not exceeded and therefore heat (the end product of light absorption) is not spread to the surrounding tissues.

Introduction:

Why use Multi Radiances?

The Basics:

At its core, Multi Radiance Medical technology consists of four synergistic light radiances in a single Cluster Probe, creating the patented “Cascade Effect” in tissues to optimize both depth of penetration by targeting different tissues and absorption at deeper target depths. The synchronization of the Super Pulsed Laser (GaAs 905nm), IREDs (860nm), LEDs (660 nm and 465 nm) and along with a Static Magnetic Field optimizes absorption by saturating tissue levels with light from each of the wavelengths, starting with 660nm and penetrating deeper.

Super pulsing operates like a very high speed camera ﬂash – very large “bursts” of light energy, but only 100 nanoseconds (billionths of a second) duration. Only with super pulsing can you deliver watts (25 W or 25,000 mW) of energy without risking thermal damage. This is accomplished by ensuring the coefﬁcient of tissue relaxation is not exceeded and therefore heat (the end product of light absorption) does not spread to surrounding tissues. While the peak power is very high, the average power is similar to other continuous wave low level lasers, but with a very safe rating of 1M (ANSI Safety Rating for Laser Devices).

Technical Advantage:

Static Magnetic Field

The static magnetic ﬁeld of 35 mT assists in keeping photo-activated molecules in dissociated (scattered) states, thereby enhancing their potential activity and energy levels at both molecular and cellular levels. An example of this is where nitric oxide is photo-dissociated from cytochrome c oxidase. With other laser therapy devices, NO will rebind shortly after dissociation. This static magnetic ﬁeld by sustaining the dissociated state of NO, enhances laser induced processes and effects of NO can be further enhanced.

Combined: The Cascade Effect

Multi Radiance Medical laser therapy technology results from the combined efforts of over 20 years of technical and clinical achievements. The core Multi Radiance technology is inclusion of 3 synergistic light radiances in a single Cluster Probe to create the patented “Cascade Effect” in the tissue to optimize both depth of penetration by targeting different tissues and absorption in deeper target depths. The synchronization of the Super Pulsed Laser (GaAs), infrared and red lights (905nm, 860nm and 660nm) optimizes absorption by saturating tissue levels with light from each of the wavelengths, starting with 660nm and penetrating deeper.

LaserSweep

LaserSweep™, developed by and exclusive to Multi Radiance Medical, utilizes a range of frequencies that “sweep” from highest to lowest (from ﬁxed end points) during treatments. By varying the “frequency” of each laser impulse, it effectively changes the laser’s target depth of penetration. In essence, it’s “scanning” the target tissues from superﬁcial to deep. Changes in frequency not only impact penetration depth of the energy, but also the rate at which the energy is delivered. This combination of “variable” depth and dose rate reduces the risk of biological adaptation to the treatment. No continuous wave or high powered Class 4 laser is capable of delivering energy this effectively to depth.

LASER

SWEEP

Introduction:

Why use Multi Radiances?

Super Pulsed Laser (905nm)

True Super Pulsed Laser produces high powered impulses of infrared light, but for very brief durations registering the lowest thermal impact on tissues. True “Super Pulsed” technology operates like a camera ﬂash, a very large burst of light, delivered in a very short amount of time, tens or hundreds of NANOSECONDS. Some

manufacturers use MICROSECONDS, which is 1000 times slower and not super pulsed. It’s the high peak power that creates energy densities necessary to deliver light energy to deeper depths within the body. The longer infrared wavelength combined with the intensity of the light makes super pulsed lasers best suited to treat deep within the body.

Biological Effect: Super-pulsed infrared lasers exert powerful stimulating inﬂuences upon blood circulation, cellular membrane metabolism and nerve function.

Pulsed Non-coherent Narrowband Red (660nm)

All red light photons, regardless of their source (laser, IREDs, LEDs, etc), are signiﬁcantly absorbed by cytochrome c oxidase. And, they carry higher amounts of energy than infrared photons. Therefore, the amount of energy necessary to stimulate photochemical processes with red light is far less than those for infrared. However, pulsing non-coherent red light penetrates only superﬁcially (about 1-2 cm) due to absorption in melanin. So, while depth is limited, red light is ideally suited for superﬁcial conditions. Red light exerts very favorable therapeutic effects on the inﬂammatory process especially in tissues saturated with porous connective tissues. Multi Radiance Medical uses 660nm wavelength to saturate superﬁcial tissue layers, and to enhance the depth of penetration and photon distribution of other wavelengths used.

Biological Effect: Heavily absorbed by cytochrome c oxidase, red light is ideal for localized pain relief, improvement of microcirculation and reduction of inﬂammation.

Pulsed Broadband Infrared (860nm)

IREDs (860nm) emit non-coherent infrared light and while it may penetrate less deeply into the body than the infrared super pulsed laser, it’s a unique biological response. While laser light is monochromatic (single color), the IREDs in the MR4 ACTIVet contain broadband diodes. This creates the ability to “sh ift” bandwidth plus or minus up to 100nm! This varying and constantly changing stimuli reduces biological adaption to light stimuli and further ﬁlls in “gaps” of the Therapeutic Window.

Biological Effect: 860nm light provides many of the same effects as infrared laser, however photophysical changes also occur at cell membranes. This improves circulation and cell membrane permeability and reinforces the laser’s penetration into target tissues.

Pulsing Non-coherent Narrowband Blue Light (465nm)

Pulsing non-coherent blue light penetrates rather poorly, due to the almost complete absorption superﬁcially. A photolytic release of NO from nitrosated proteins is observed indicating that they are light acceptors and signal transducers.vii

Biological Effect: Blue light therapies have shown promise in treating MRSA and inﬂammatory skin conditions.

Wavelengths

Introduction:

Quick Summary: Methods & Techniques

Methods

Unwind Method:

Animals generally respond very favorably to laser therapy. To acclimate and relax, we suggest you begin with the Unwind protocol. Begin with 1000Hz, using the contact-scanning technique, and start at the base of the skull and proceed caudally to the tail at about 1 cm/second. This can be a very useful adjunctive treatment to most laser therapy sessions.

Outcomes can be impacted, both positively and negatively, by “how” the energy is delivered to the animal. Besides the “necessary” dose of energy being delivered by the ACTIVET, under standing how methods and techniques can alter the clinical response is key to getting exceptional outcomes as opposed to just good ones.

Ohshiro’s Method:

When treating the lymphatic system, it is necessary and prudent to treat all proximal locations (in relation to the injury) ﬁrst, therefore opening and encouraging lymphatic ﬂow from the distal areas. This is usually done in conjunction with the “Woodpecker” Technique (1000-3000Hz).

Pontinen’s: Muscle Spasm

Pontinen’s Method is utilized to treat both trigger points and muscle spasm. It is a measured and repeated inhibitory dose (1000Hz) given locally to a trigger point. Note the texture of the muscle and elicited pain response upon palpation prior to treatment. If after a single treatment, there has not been adequate muscle relaxation, repeated bouts may be performed until the desired outcome is reached.

Photohemotherapy

Also known as “transcutaneous laser therapy blood irradiation” is a method of improving the general circulation of blood and microcirculation activation. It can be used as a monotherapy or as an adjunctive method with local treatments to facilitate healing. 50Hz is used primarily (except when done over the heart, 5Hz is used).

Techniques

Contact Technique

This is the most commonly used application technique. Hold the laser emitter in direct, ﬁrm contact with the skin (parting of the hair can be accomplished via the use of the Photoprobes). This will provide a better overall depth of penetration (for IRED and LED light) and a more consistent dose. This is particularly useful when treating painful joints and trigger points. The energy delivered in direct contact can be 3-10 times greater than when applied with non-contact.

Non-Contact Technique

This is less commonly used technique as compared to direct contact, however there are some advantages to this type of technique. Holding the device approximately 1-2 cm above the treatment area, reduces the delivered energy upwards of 30%. This can be advantageous in situations where a smaller dose is necessary, such as in wounds or animals in frail health, or when direct pressure is not possible or desirable.

Scanning Technique

Scanning technique is used when a larger area needs to be treated. It can be done either in “contact” or “non-contact” mode. This is ideal for treatment of non-localized pain. Be mindful, that the dose delivered is divided over the “entire” scanning area, this will decrease the dose per point and treatment times should be increased to compensate. Non-contact scanning is generally only utilized in cases of wound management and should not exceed 50 cm

Woodpecker Technique

This technique is utilized to encourage lymphatic drainage and to help eliminate gross edema from an extremity. A light, rhythmic pattern of compression is applied to lymphatic locations in the extremity. This technique is usually combined with Ohshiro’s Method.

Introduction:

PhotoProbes

PhotoProbes:

The laser aperture of the ACTIVet device is threaded to allow attachment of speciﬁc PhotoProbes. The probes are constructed of non-toxic, optical organic glass and are polished to facilitate cleaning. The PhotoProbes set contains 4 individual light bending or light focusing lenses, two for Laserpuncture, one for trigger point deactivation and one designed to facilitate wound healing, used to increase the versatility of the device. See manual for instructions on cleaning probes prior and after use.

Disinfect the PhotoProbe before initial use.

While working the the PhotoProbes in Blue Mode, always use the supplied safety goggles supplied with their laser unit, especially near the head/face.

Always remove the PhotoProbes from the device before cleaning, repairing, and disinfection of the PhotoProbes.

Never direct the tips of the PhotoProbes to the eyes

If the surface of the PhotoProbe is cloudy or scratched, do NOT use.

Notes on PhotoProbe Use:

Please review all manuals and instructions included with the d evice prior to ﬁrst use. Be sure to keep all references handy as you begin using the device. The information it contains will be the latest safety information, indications of use, and methods to maintain your equipment in proper working order.

Wound / Dome Probe:

This lens will protect the laser and light emitting diodes from dirt and debris when applying the emitter directly on the skin.

To attach the desired PhotoProbe, gently twist the probe in a clockwise motion. Do NOT over tighten the probe as you may crack, break, or afﬁx the probe permanently

To remove an attached PhotoProbe, gently grasp the probe and twist in a counter clockwise motion. Be sure the probe has been completely unthreaded from the emitter aperture before pulling the probe from the emitter. This will prevent stripping of the threads and damage to the probe itself.

CAUTION: Do NOT over tighten the probe.

Attaching and Removing PhotoProbes:

Auricular Probe:

Auricular acupuncture can be done on the ears, hands or feet to treat conditions that are present anywhere in the body.

Corporal Probe:

Corporal acupuncture is done on points on the body. This probe can also be used for muscle trigger and motor points.

Utility Probe:

This is an inter cavity probe designed for treatment of the mouth, nostrils and ears. It may additionally be used as a point probe for patients that may ﬁnd the corporal probe uncomfortable.

Probe Symptom ACTIVet Treatment Adjuncts

Corporal

or Utility

1000 Hz,

2-5 min / each PRN

Trigger Points and

muscle spasms

Sedation / relaxation

of trigger points and

muscle spasms

Corporal

or Utility

5 or 50 Hz,

1 min

Ideally treated

with BLUE mode

Intra-oral or

intra-nasal use

Wound

5 or 50 Hz,

to wound margins

1 min / each

Post-operative

incisions

Wound care

& general prevention

of contaminants

Introduction:

The Priority PrincipleTM (Pain/Spasm)

Priority #1: Swelling/Edema (also known as Ohshiro’s Principle)

After a traumatic event, a cascade of inﬂammatory events are initiated. Swelling creates a vasocongestion in the tissues, resulting in pain. This is a “systemic” treatment in that it is done generally NOT in the area of the swelling but to the lymphatic system, to encourage good ﬂow and return of lymph. To resolve swelling quickly, begin with 1000-3000Hz and stimulate the most proximal lymphatic ducts to the body for 1-2 minutes, this is done with the “Woodpecker Technique”. Select a second more distal lymphatic location, and similarly apply the same treatment, being sure to not hold the emitter with constant over pressure. Once both sites have been stimulated, you can utilize 1000-3000Hz to encourage lymphatic drainage. With “steady” overpressure, run the ACTIVet over the area of swelling from DISTAL to PROXIMAL in long strokes. Do not circle back, rather break contact with the animal, and start back at the most DISTAL site. This will encourage lymphatic drainage and reduce swelling more quickly.

Priority #2: Tissue Inﬂammation/Infection

Controlling tissue inﬂammation is key to promoting and initiating tissue repair, whether a wound or a strain/sprain. Minimizing the effects of the local tissue inﬂammatory process can be done utilizing Laser, low doses with 50Hz have been shown to reduce the tissue inﬂammatory proﬁle with just a few short treatments. Generally times are 2-5 minutes per location (no scanning), with 5 minutes being utilized more for larger joints or the spine. In some instances, especially in wound care, the presence of infection may inhibit the tissue repair process. The use of blue light has been shown in many cases to reduce bacterial infections, including MRSA. In cases where this may prove beneﬁcial, select Blue Mode - ON and treatment times are 2-5 minutes (longer times for larger areas) with a scanning technique.

Priority #3: Muscle Spasms (also known as Pontinen’s Principle)

A great deal of pain can arise from protective spasm. While it works to prevent further harm to the animal, the mechanism itself can be quite painful. Part of the Pain/Spasm cycle, a muscle spasm can be effectively treated via Laser Therapy and/or with assisted soft tissue mobilization (ASTM) with the use of included PhotoProbes. First detect the spasm via palpation, note the texture prior to treatment. Administer 2-5 minutes at 1000Hz, hold the emitter directly over the spasm, and do not scan. Every few minutes check the intensity and texture of the spasm, noting pain reactions, and continue treatment until spasm has relaxed. This can be repeated on as many locations as necessary or time permits. Alternatively, spasticity responds well to assisted soft tissue mobilization. The included PhotoProbes can combine the effects of Laser Therapy and assisted soft tissue mobilization (AS TM). Using either the Corporal Probe or Utility Probe afﬁxed to the emitter, treatment is provided directly to the muscle spasm with mild overpressure, directly the light into the spasm. Treatment times are 2 minutes per spasm. Repeat for an additional 2 minutes if needed.

Priority #4: Pain

Laser Therapy has been shown to reduce pain, sometimes as fast as one treatment. To do so requires the delivery of an inhibitory dose. In the case of the ACTIVet, these are 1000, 1000-3000, and 5000Hz. The severity of the pain will dictate which setting to utilize: 1000Hz x 10 minutes for mild pain, 1000-3000Hz x 5 minutes for moderate pain and 5000Hz x 2 minutes for severe/acute pain. Treatment should begin with the “Unwind Protocol”. There are two ways to treat pain, local (at the site of injury) and systemic (away from site of injury). These two methods generally both involved scanning slowly, but the “target” of the laser energy is different. In local treatments, the laser is only applied directly to the site of injury. However, doing so will deliver a dose that can inhibit the healing process, delaying the resolution of the inﬂammatory process and prolonging the injury. This type of treatment should be done sparingly, usually in the early stages, just to help control the Pain/Spasm Cycle. In systemic treatments, treatment is done to a site “other” than the injury to help decrease pain. This can be at the Nerve, Roots and Trunks (NRT) at the spinal level, along a dermatome, or via LaserPuncture with the included Photoprobes. 1000Hz with the Corporal Probe attached is utilized for 2 minutes per point to initiate sedation at the treatment point.

Phase #1: Pain / Spasm

Introduction:

The Priority PrincipleTM (Rehab/Recovery)

Priority #5: Tissue Repair

The promotion of tissue repair can be accomplished by delivering a low dose with 1-250Hz x 2 mins locally to an injured area. This setting stimulates healing for bones, muscles, tendons and ligaments. Healing occurs via increases in adenosine triphosphate (cellular energy) from the absorption and conversion of light energy from the ACTIVet. Additionally, tissue repair can be stimulated systemically as well. 50Hz should be included when trying to improve healing. It is done for 5 mins. The location can be determined by ﬁnding the most “proximal” arterial pulsation to the injured site. This will improve the delivery of nutrients to the target tissue via the dissociation of Nitric Oxide (NO), a strong vasodilator as well as pain mediator. This is called “photohemotherapy” (see page 6 for additional information).

Priority #6: Range of Motion

Once Pain/Spasm has subsided and healing begins, focus can then proceed to functional activities. The loss of range of motion impairs joint and muscle function and limits functional activities. The use of Laser Therapy to improve joint ﬂexibility and stiffness is done with an inhibitory dose of 1000Hz x 1 minutes at multiple locations around the joint line. These locations are called AHSHII points, or tender points that surround a joint line. Smaller joints may have 2-3 points, while larger joints can have 8 or more. It is important to treat the entire joint line, from anterior, posterior, inferior etc angles and AHSHII points. The Laser must be kept perpendicular to the joint line, this improves absorption of the light in target tissues. When this is not accessible, the use of the PhotoProbes can “extend” the reach into tighter joint spaces or as a way to treat smaller joints.

Priority #7: Functional Strength

This priority is utilized when there have been breaks in training, function or activities. It can be due to many causes. Returning to activity can cause muscle soreness, 1-250Hz for 2 mins for small muscles and 5 minutes for larger muscles can be used to lessen the pain. Additionally, it can be used prior to performance/training activities (when no injury has occurred) to help reduce oxidative stress that results from muscle demand, improving performance by delivering additional oxygen via dissociation from the oxyhemoglobin, and shortening recovery periods between sessions.

Phase #2: Rehab & Recovery

Animals generally respond very favorably to Laser Therapy. To acclimate and relax them, we suggest you start with the Unwind Protocol using 1000Hz and scan slowly from the base of the skull to the tail, up and down nerve roots adjacent to the spine for 5 minutes depending on animal size.

Guidelines

* When using the Priority Principle guidelines for the protocols that are reviewed in this manual, keep in mind the following indications that are unique for speciﬁc treatment conditions:

“Quick Fix” guidance is provided for all protocols and is intended to provide n ovice clinicians with a means of quickly providing care for a condition. Following the steps of the Priority Principle is the suggested route for optimal outcomes, however, clinicians can get good outcomes by using the “Quick Fix” settings. The protocol should only be utilized for a few sessions (2-4) before switching to the more “symptom” variable method of Priority Principle listed for that condition.

Procedures Per Bout:

Refers to the # of successive Laser Treatments per a Condition, before resting

Frequency:

Refers to How Often to Apply a Laser Treatment

Rest Day:

Refers to Days without Laser, before resuming Treatment

# of Bouts:

Refers to # of repeated rounds of Laser Treatments per condition

Quick Fix

Introduction:

Quick Reference Guide

* The Quickstart Guide is intended to be an easy reference and clariﬁcation to device settings for the ACTIVet and the frequencies listed in the protocols.

Frequency 50 Hz 5 Hz 1000 Hz

1000-3000 Hz

1-250 Hz 5000 Hz

Effect

Tissue Local

Inﬂammation

Tissue Repair

Reduce Pain,

Unwind

Reduce

Swelling

Acute injuries / tissue repair

Reduce

Extreme Pain

Type Stimulatory Stimulatory Inhibitory Inhibitory Stimulatory Inhibitory

Depth Deeper Deepest Superﬁcial

Superﬁcial

Surface

Deep

Skin Surface

Power Low Low High High Medium Very High

+ 30 hidden pages

Multi Radiance Medical MR4 ActiVet Protocol Manual

Specifications and Main Features

Frequently Asked Questions

User Manual