- Frank`s Hospital Workshop
Contents
1. Li 3 1 2 LABEL PLACED ON THE PROBE WARNING ABOUT PROXIMITY OF APERTURE OF LASER OF THE STATED WAVELENGTH POWER AND LASER CLASS ca oyy EZ OA AR OA OA EE APPENDIX PAGE 24 FROM 25 3 1 3 LABEL PLACED ON THE LASER CLUSTER WARNING ABOUT PROXIMITY OF APERTURE OF LASER OF THE STATED WAVELENGTH POWER AND LASER CLASS 3 1 4 LABEL FOR MARKING OF THE LASER WORKPLACE WARNING ABOUT PROXIMITY OF 3B CLASS LASER Co APPENDIX PAGE 25 FROM 25 ez2. BTL 5000 Laser S GUIDE USER OBSAH 1 USER S GUIDE Hine 4 1 1 ipiga terle 0 EEE EE EEE EE EE EE 4 1 2 Light The Principle of Laser Light and its Specifics sssssen emen 4 1 3 Types ofLaserS cer dene 6 1 3 1 SOUL 6 1 3 2 Wavelength primarily semi conductor lasers sessssseee emen eene nnne 6 1 3 3 B am Operation MOG Luanda e 7 1 3 4 Type GL BEA ua 7 1 3 5 Laser Class defined by the Output 1 niit kved agenda b ndet ran Ere Inge asse ta buken nende be 7 1 3 6 Ure E 8 14 Basic Physical Quantities oreet prede Laco rnt artes ene dE bred need ect HE i Orta ede erede ene erede sekken 8 1 5 Biologick inky laseru o n zk m v konu neinvazivn ho laseru eesee 9 1 6 AKUPUNGIUKG TER 10 1 6 1 Frequencies for Laser Acupuncture According to Dr Nogier sseeeee 10 1 6 2 Frequencies for Laser Acupuncture According to Dr Voll EAV see 11 2 SETUP OF LASER GENERATOR tette neces n a pnm maa ca asa crac Fonts s no ana aod ae cadens sare a anke d aadis aaien 12 2 1 Access ECC o RNS 12 2 2 Setup and Control of Laser Therapy ssssssssseeee eene eee nennen enn enne en nre nennen nnns 12 2 2 1 Bot 12 2 2 2 zeli 13 2 2 3 OUTPUTS SH probe xy ss Ims 1
3. via phytohemaglutinin stimulation e increased fibroblast activity for keloids these activated fibroblasts are able to perform resorption of fibrin e phagocytosis activation e activation of the Na K pump on the membrane e activation of metabolic processes in the cellula partly through the Na K pump and Ca transport affection partly through direct activation of the mitochondrial system e changes of local level of important mediators inflammatory histamin substances prostaglandins or e g endorphins When performing an in vitro experiment no difference can be seen between laser beams applied in continuous and pulse modes However when performing an in vivo experiment we observe marked differences between a continuous beam and a beam adjusted to a certain defined mode In physical therapy this phenomenon can be observed when performing electrotherapy or applying ultrasound It seems that for a complex organism with its numerous information systems and feedbacks a physical quantity modulated to a certain frequency features one additional quality specific information transmitted by this frequency The effect of laser beam in acupuncture is totally specific A laser beam affects tissue in a way fully comparable with the effect of an inserted needle but without any pain or complications related to the needle insertion The skin above the acupuncture point is a light conductor for the laser beam We find it interesting that in laser
4. 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 1 5 mean radiation output W x application time s emitted power dose J cm irradiated area cm Knowledge of basic physical quantities which is also acquired in obligatory training significantly facilitates grasp of the laser therapy BIOLOGICK CINKY LASERU O N ZK M VYKONU NEINVAZIVN HO LASERU Specific physical qualities of a laser beam result in specific clinical effects The most considerable clinical effects are e analgesic effect A e antiphlogistic effect F e antiedematous effect E e biostimulation effect B e vasodilatation effect V All these effects are based on positively established and verified mechanisms e acceleration of microcirculation e increase of intracellular activity of many enzymes particularly in Krebs cycle e increased oxygen circulation improved glucose utilization e DNA synthesis stimulation
5. beam therapy They are particularly suitable for the treatment of larger area injuries where using of a standard laser probe would be too laborious for the therapist because of the necessity of sweeping Laser clusters can irradiate evenly a much larger area at a time e g 25cm There are many types manufactured of various power and wavelength and the customers can choose according to their needs Division of laser clusters by the wavelength e red clusters e infrared clusters e combined clusters both red and infrared All laser clusters include focusing beam which facilitates focusing of the laser beam even when using protective means A particularly useful feature is the possibility of using combined clusters both red and infrared which enable to perform both types of therapy with one accessory START STOP button aAmearnanrv lacer etan power cable label with classification and aperture laser aperture direction of laser heam radiatinn SETUP OF LASER GENERATOR PAGE 22 FROM 25 2 8 Note The probes are constructed in the way that the active surface of the button does not protrude the outline of the probe This prevents from accidental pressing e g in case of laying the cluster on a flat surface such as a desk etc Ageing of the laser cluster The semiconductor laser diodes used in this equipment have a limited lifetime During this time the diode ages which leads to decrease of its
6. irradiating from larger distance the diverged laser beam is too dispersed mme oS R 11 07 ims A 1 and therapeutic effects are lower If the injured area is larger it is necessary to treat it similarly as with convergent probes and continuously sweep over the affected area With convergent probes it is necessary to continuously sweep the beam over the whole injured area With laser clusters the therapy is applied contactless the aperture of the laser cluster is immediately above the injury in case of a larger injured area it is possible to sweep over it similarly as with convergent probes The area of the laser cluster is stated on the relevant tab under its picture and in the technical parameters typically 25cm We recommend not setting an area smaller than stated in the technical parameters in case of a larger area increase it by multiples When calculating therapy parameters the device assumes that the whole area is irradiated evenly which is achieved by the above mentioned continuous sweeping A the area Lem et The maximum accessible area also depends on the connected laser dos probe cluster for low power probes the maximum area that can be set g can be reduced by the device if the maximum therapy time 99 59 could be e 16 0 exceeded mai last 9 10 100 100 100 After pressing the area button it is possible to set the area by steps by the select knob It is also possible t
7. maximum output Since all laser diodes are calibrated before mounting into the cluster the equipment is able to measure the actual output of the diode and can adjust the maximum output that can be set according to the status of the laser diode If the output drops under 40 96 of the value stated on the cluster label because of a defect of the cluster or ageing of the diode we recommend installing a new cluster According to the value of the output just being emitted by each individual laser diode the emission of the laser diode is regulated This ensures that the value on the screen is correct and it is not necessary to use an external measuring device for the cluster Owing to the losses which occur on optical interfaces inside clusters the maximum output that can be set may be lower than the output stated on the cluster label USE OF SAFETY EYEWEAR According to applicable standards both the therapist and patient must use safety eyewear which prevents from damage to eyes in case of undesirable hitting by the laser beam The protective eyewear supplied by BTL was approved by the Czech Occupational Safety Research Institute and certified under the number 235 T 010 1999 SETUP OF LASER GENERATOR PAGE 23 FROM 25 3 APPENDIX 3 1 WARNING LABELS PLACED ON THE CASE OF THE DEVICE AND ON THE LASER PROBE 3 1 1 LABEL PLACED ON THE CASE OF THE DEVICE WARNING ABOUT OCCURRENCE OF VISIBLE AND INVISIBLE RADIATION OF CLASS 3B
8. not satisfied with them you can edit them and save the program as a user one 2 2 10 LASER SEQUENCES 2 3 2 3 1 This item enables to run sequences of therapies selected by the name or by the program number It is possible to create new sequences and edit the existing ones A sequence is a set of individual therapies followed one after another and it is necessary to create individual programs which are to be included in the sequence before creating the sequence Unlike the ultrasound and electro sequences the laser sequences do not contain the time parameter for individual sections Time is displayed for individual sections only for information and cannot be changed because it is directly influenced by the dose which is pre set in each section and by the currently connected probe cluster That is why when the probe cluster is changed the time of individual sections and the total time of the sequence are changed Time changes in the way so that the needed dose is reached in each section of the sequence The total time of a sequence is limited to 99 59 Area is set globally for the entire sequence before the start of therapy Each sequence can be saved with its physiological effects among the user programs For details see Chapter USER SEQUENCES in the BTL 5000 Series USER S MANUAL SPECIFIC SETTINGS Besides common settings each generator has some specific setting items These items are included in the specific settings menu i
9. the dose or output according to the values given below in the parts concerning individual attachments Note The attachments are not included in standard accessories of the BTL 5000 series devices The attachments are not designed for the laser clusters 2 6 1 DENTAL ATTACHMENT meer ur v When using the dental optical attachment it is necessary to increase the dose by 15 when using probes with wavelength of 685 nm or 830 nm 2 6 GYNAECOLOGICAL ATTACHMENT P M When using the gynaecological optical attachment it is necessary to increase the dose by 25 when using probes with wavelength of 685 nm or 830 nm 2 6 3 ENT ATTACHMENT When using the optical attachment for ENT it is necessary to increase the dose by 20 96 when using probes with wavelength of 685 nm or 830 nm Before each use it is necessary to sterilize the attachments for 10 minutes at the temperature of 120 C SETUP OF LASER GENERATOR PAGE 21 FROM 25 2 6 4 HOW TO CONNECT THE ATTACHMENT Unscrew the brass cover of the probe s head In its place screw the plastic attachment with the light waveguide plugged in Make sure that the plastic attachment is fixed fast and the light waveguide is immovable If you want to replace the attachment by another one simply loosen the head by approximately one thread take out the previous attachment put in the new one and tighten the head 2 7 LASER CLUSTERS Laser clusters are used for the laser
10. to 500 mW USER S GUIDE PAGE 7 FROM 25 N QA v 1 3 6 1 4 Note The stated values are only rough exact classification of the hygienic class is more complicated and shall be performed according to applicable standards 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 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 outpu
11. 3 2 2 4 est elle 13 2 2 5 pu m 14 2 2 6 Distance between the Probe Cluster and the Irradiated Surface sse 15 2 2 7 Time of Therapy summen T 15 2 2 8 Course of Signal Duty Factor DF nennen nennen enne nennen sn terrent nre nes 15 2 2 9 Physiological c 17 2 210 Laser SEQUENCES E sd 17 2 33 Specife Settings airsean eee a danse usages a AE AE st dagtid fantes E EREE 17 2 3 1 Blora EEE A A 17 2 3 2 7 010 0109 eg 10 LE 18 2 3 3 Self calibration of the Laser Probe sssssseseseeeneneneeene nennen enne ennt nennen nnne nns 18 2 4 Locking of the Equipment If Door Opens ssessseseeeeeeeene nem mneen nemen enn aeriene iadair 19 2 4 1 COM IN OUT reo iie dE made 19 V ORE W dluie M cashed hagas ahah dea ake ah aces hace gee eter tene 20 2 6 Optical Attachments for Laser Probes sssssssssseseeeeeeene eene nennen enne enne eren nennen nnne nenne 21 2 6 1 Dental Attachment eiecti a eec Eie Eun cuesta feos erre ken tud Ee neu iu eE un 21 2 6 2 Gynaecological Attachments ionic et racista e reete ge resa ka ted ie eda Rats ur a aa Era nares eos p E Bees 21 2 6 3 ENT Attachtmert pvr 21 2 6 4 How to Connect the Attachment enne nnne
12. The equipment works either in continuous i e uninterrupted or in pulse mode If the zero value of the laser beam output frequency is set the 140 equipment works in the so called continuous mode it can be also recognized visually the laser beam shines constantly and does not blink run 0 00 100 100 1000 If a non zero positive value of frequency is set the equipment works in the pulse mode the laser beam is blinking Note the human eye can recognize blinking of the beam up to the frequency of approx 25 Hz higher frequencies are subjectively perceived by the human eye as continuous Frequency is a second key parameter of therapy it is also a fixed component of the program diagnosis and the device does not change it at internal calculations the user can change it freely Frequency can be set within the range stated in the technical parameters of the device The process of frequency setup is similar to that of other therapy parameters After pressing the frequency button it is possible to set frequency by steps by the select knob It is also possible to set the value directly by the numerical keyboard see Chapter 2 4 2 Numerical keyboard of the BTL 5000 Series USER S MANUAL Under the displayed current value of frequency there are quick jump buttons after pressing one of them the frequency value changes to the value written on the button and further setting goes on from this value Frequency is set by ce
13. acupuncture in contrast with other forms of laser therapy the wavelength of a laser beam is not of a big USER S GUIDE PAGE 9 FROM 25 amp 1 6 1 6 1 importance however red lasers are slightly more effective and the output of the device is of no importance at all we can even use a laser pen We conclude that in this method of application it is not the effect of a physical quantity itself but the above mentioned transmission of information that plays the key role Many treatments utilize several effects of laser light at a time e g treatment of the varicose ulcer combine analgesic stimulative as well as bactericidal effects AKUPUNCTURE As stated above laser beam has a specific effect on acupuncture points adequate to use of an acupuncture needle The laser acupuncture has several advantages it is non invasive painless many patients report non pleasant sensations when acupuncture needle is being inserted and saves time even for sedative techniques the treatment lasts no more than several tens of seconds Modulation by Nogier frequencies or EAV frequencies is very useful and it is commonly used in acupuncture Application of these frequencies for the most frequent diagnoses is stated below For details see specialized literature FREQUENCIES FOR LASER ACUPUNCTURE ACCORDING TO DR NOGIER Frequency Hz Use and Area of Application U 1 14 Universal whole body Chaotic changes tissues and transitional epith
14. al to the skin resistance The acupuncture point is indicated by a local jump in the skin resistance During measuring the device generates a sound the pitch of which corresponds to the value on the bargraph Since basic skin resistance of patients differs it is possible to change the sensitivity of measuring during the process of acupuncture measuring by the select knob manual setting manual setting icem laret freser Tomt eem laser 9 iced art d enis pe E ket ammet Eur od imu Ears p Ea ue end TS pee y len essa du Burm LLLI MEME pn 94 00 imsi SA me 02 05 Imsi To find an acupuncture point slowly sweep the probe with the acupuncture attachment above the place of an expected location of the acupuncture point After finding the acupuncture point it is possible to start therapy by pressing the button on the probe During irradiation the device suspends the search mode and returns to it after stopping the therapy or after activating the pause Owing to the fact that the acupuncture attachment significantly attenuates the passing laser beam the equipment corrects the maximum adjustable output when irradiating in the acupuncture mode If you irradiate using the acupuncture attachment and the acupuncture mode is off it is necessary to manually recalculate the dose or output for the 8596 attachment attenuation SELF CALIBRATION OF THE LASER PROBE The probes are calibrated by
15. ds 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 CS 1 3 1 3 1 TYPES OF LASERS Lasers can be divided according to several criteria SOURCE e solid lasers ruby laser e liquid lasers e gas lasers helium neon argon e 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
16. e device tries if necessary to adjust the output of the probe cluster so that the therapy time is 1 minute DOSE This value represents the power density to the area J cm manual setting i thei dosage J cm It is a key therapy parameter therefore its value is a fixed part of the Mi program diagnosis and the device does not change it at internal E calculations the user can change it freely Dose can be changed within the P 1 00 range stated in the technical parameters of the device It is the maximum id range and in practice with some types of probes clusters it is not possible fa en noo 100 m to reach the upper limit because they do not have enough power for it and the necessary time of therapy would exceed the limit of 99 59 After pressing the dose button it is possible to set dose by steps by the select knob It is also possible to set the value directly by the numerical keyboard see chapter 2 4 2 Numerical keyboard of the BTL 5000 Series USER S MANUAL Under the displayed current value of dose there are quick jump buttons after pressing one of them the dose value changes to the value written on the button and further setting goes on from this value SETUP OF LASER GENERATOR PAGE 12 FROM 25 2 2 2 2 2 3 2 2 4 FREQUENCY This parameter states the number of cycles in the time interval of 1 sec its manual setting unit is Hertz Hz the frequency Hz
17. elium body openings mouth nose eyes B 4 56 Nutritive effect chest and abdominal cavity Nerve tissue peripheral parts of spine back and top parts of head and neck Psychosomatic disorders subcortical areas lower parts of face G 146 Emotional diseases cerebral cortex nervous system frontal and temporal parts of head lateral parts of nose USER S GUIDE PAGE 10 FROM 25 CS 1 6 2 FREQUENCIES FOR LASER ACUPUNCTURE ACCORDING TO DR VOLL EAV Frequency Hz 1 20 Tachycardia 1 70 Abscess furunculosis 1 75 Psychostimulating and sympathicotonic effect 2 20 Fatigue lipothymia exhaustion restlessness pains of legs 2 45 Haematoma edema excessive menstrual bleeding associated with myoma bleeding from varices insomnia vegetative disorders sinusitis Neuralgia anxiety sleeping disorders Eczema connected with kidney secretory function disorder hypertension with increased diastole renal insufficiency Paralytic paralysis Cystitis prostate diseases diseases of large intestine bronchitis eczema accompanying lung and vascular diseases gout joint aches stomach problems including ulcers paresis varix haemorrhoids USER S GUIDE PAGE 11 FROM 25 N QA v 2 1 2 2 2 2 1 SETUP OF LASER GENERATOR ACCESS PASSWORD According to applicable standards each laser device must be protected against unauthorized handling In case of the BTL 5000 series it is guaranteed by the access password If
18. f itis necessary to set a certain output value or to switch a section on off it is possible to change the output and the device will automatically calculate the other therapy parameters After pressing the output button it is possible to set output by steps and by individual sections Zero value of output means that the section is off It is also possible to set the value directly by the numerical keyboard see chapter 2 4 2 Numerical keyboard of the BTL 5000 Series USER S MANUAL Under the displayed current value of output there are quick jump buttons after pressing one of them the output value changes to the value written on the button and further setting goes on from this value Obviously output can be set only within the range allowed by the connected laser cluster electro parameters electro ameters pisi infra t light o Poy er infra mW 2l 140 mw yese 5e power red Pow EN 20mwY 25 100 200 400 E L Kl ENE f 2 2 5 AREA manual setti This therapy parameter is often changed by the user because each treated theraps laser g eem MET part has a different size This parameter is also available in the ergonomic dosage t mode When using a divergent probe the screen displays the distance je EU IA between the probe and the surface so that the irradiated area equals to ETE m the pre set one The maximum displayed distance is 25 cm and when manpower 30 E Sa TIS akk m
19. g the probe on a flat surface such as a desk etc Ageing of the laser probe The semiconductor laser diodes used in this equipment have a limited lifetime During this time the diode ages which leads to decrease of its maximum output Since all laser diodes are calibrated before mounting into the probes the equipment is able to measure the actual output of the diode and can adjust the maximum output that can be set according to the status of the laser diode If the output drops under 40 96 of the value stated on the probe label because of a defect or ageing of the diode we recommend installing a new probe According to the value of the probe output just being emitted the emission of the laser diode is regulated This ensures that the value on the screen is correct and it is not necessary to use an external measuring device for the probe Owing to the losses which occur on optical interfaces inside probes the maximum output that can be pre set can be lower than the output stated on the probe label SETUP OF LASER GENERATOR PAGE 20 FROM 25 2 6 OPTICAL ATTACHMENTS FOR LASER PROBES Special lightguide attachments serve for leading the laser beam to hardly accessible places The range includes attachments for dentistry gynaecology and otorhinolaryngology ENT The lightguide attachments reduce the maximum achievable output of the probe which they are connected to therefore when they are used it is necessary to make adjustment of
20. he laser beam does and does not shine the so called Duty Factor Duty factor can be changed by the select knob or by the numerical keyboard 1 gt gt 4 1 ci 80 duty factor Ud Additional information pulse ms period ms information about length of the pulse and of the period calculated from the pre set frequency and duty factor frequency Hz information about the pre set frequency Duty factor DF stated in expresses the ratio of the pulse length t to the period tp see picture it can be set only in the pulse mode SETUP OF LASER GENERATOR PAGE 15 FROM 25 Change of value of the duty factor considerably influences the value of the average laser output The following picture shows comparison of two different duty factor settings all other conditions being equal From the picture it is apparent that for higher DF the laser emits higher average output which implies shorter time of irradiation Comparison of two DF settings a f 10Hz P 20 mW DF 50 Average output 10 mW Output mW b f 10Hz P 20 mW DF 90 Average output 18 mW Output mW SETUP OF LASER GENERATOR PAGE 16 FROM 25 SD 2 2 9 PHYSIOLOGICAL EFFECTS The symbols of effects used in the device have the following meanings analgesic antiphlogistic antiedematous biostimulation lt Um m gt vasodilatation For the factory preset programs and diagnoses the effects are filled in If you are
21. ically on the surface of the tissue to prevent undesirable reflection and possible reduction of energy absorbed by the tissue It is advisable to degrease the skin before therapy TIME OF THERAPY According to pre set parameters the device automatically calculates other parameters so that the time of therapy is if possible 1 minute Modification of the calculated time if necessary is possible but it is important to take into account that it will also influence the output of the used probe cluster so that the required dose of therapy is achieved Maximum time of therapy is 99 minutes and 59 seconds In the pulse mode it is possible to modify the time of therapy also by changing the duty factor DF value to shorten the therapy increase the E T DF 132 After pressing the time button it is possible to set time by minutes or seconds It is also possible to set the value directly by the numerical keyboard see chapter 2 4 2 Numerical keyboard of the BTL 5000 Series USER S MANUAL separately for minutes and for seconds Time can be also changed directly by turning the time knob course of signal COURSE OF SIGNAL DUTY FACTOR DF m TA Lad J Hz This button serves for displaying of the modulation signal After pressing this button there appears a screen with the displayed waveform of tne lll Iii output signal If a non zero frequency is set it is possible to change the pac ratio between the period in which t
22. n the current configuration of the device see table Tab 2 1 Configuration of output connectors in the BTL 5000 Series USER S MANUAL If the level on the connector s input is active e g in case of open door the equipment for safety reasons does not allow to run a therapy If a therapy is already running it is interrupted PAUSE status and the screen displays a warning optionally together with a sound signal The therapy can be resumed only after the signal on the connector s input subsides i e the door is closed or it can be cancelled by the esc button In case of any questions contact the authorized BTL service department It is also possible to buy the complete door switch set from the BTL supplier COM IN OUT CONNECTOR The door contact is connected between contacts 1 and 3 at the COM IN OUT connector It is possible to preset whether the switch is considered active in the closed or in the open status By default the status is set to active in the closed status i e the door is open For details on setting the activity of the door switch see Chapter 2 3 1 Door Activity i DOOR CONTACT J OUT2 BTL 5000 T T ai 2 4 2 PATIENT OUTPUT CONNECTOR Voiltage is brought in the patient output connector between contacts 3 and 4 Any security equipment with AC or DC voltage output can be connected to this connector The polarity of voltage does not matter the equipment detects it itself and adap
23. nnne nennen nennen nennen nnn enne 22 EN geli M o 22 STRANA 2 Z 25 oS 2 8 US of Satety Eyewear i Saisi 23 3 APPENDIX 24 3 1 Warning Labels Placed on the Case of the Device and on the Laser Probe ccccceesseeeereeeeeeees 24 3 1 1 Label placed on the case of the device warning about occurrence of visible and invisible radiation of ClASS IBEN TA Aae 24 3 1 2 Label placed on the probe warning about proximity of aperture of laser of the stated wavelength power And laser Cl ss sista den sad ssasaadundedis A deat eadcatesansadesssdeatdineaiaeteeaseasedsdsataats 24 3 1 3 Label placed on the laser cluster warning about proximity of aperture of laser of the stated wavelength RO IENRMCEINe rc 25 3 1 4 Label for marking of the laser workplace warning about proximity of 3B class laser 25 STRANA 3 Z 25 CS v 1 1 1 2 USER S GUIDE 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 compete
24. nt institutions 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 e totally monochromatic maintaining only one wavelength LASER 635 nm BULB Intensity Intensity 400 500 600 700 800 nm 400 800 1200 1600 2000 nm USER S GUIDE PAGE 4 FROM 25 N QA v e totally polarized waves are absolutely spatially oriented on a defined area Linear polarization EA P ay a af e 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 2 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 stan
25. o set the value directly by the numerical keyboard see chapter 2 4 2 Numerical keyboard of the BTL 5000 SETUP OF LASER GENERATOR PAGE 14 FROM 25 OR gt 2 2 6 2 2 7 2 2 8 Series USER S MANUAL Under the displayed current value of area there are quick jump buttons after pressing one of them the area value changes to the value written on the button and further setting goes on from this value Area can be also changed directly by turning the intensity knob DISTANCE BETWEEN THE PROBE CLUSTER AND THE IRRADIATED SURFACE When using convergent probes the distance is not measured because the beam is virtually parallel For the laser cluster the distance is not stated either since the distance between the laser cluster aperture and the injury should be minimal although still contactless This parameter therefore applies only to probes with divergent beam The distance is a recommended value which is calculated from the relation between the probe s distance from the irradiated surface divergence of the beam and the size of the irradiated area Its unit is centimetre cm Further it is necessary to take into account the required depth of penetration which has to be subtracted from the distance between the probe and body surface When using an attachment with lightguide not designed for laser clusters or probes with convergent beam sweep evenly over the whole pre set area During therapy let the beam if possible fall vert
26. only within the range allowed by the connected laser probe manual setting 0 0 OUTPUT LASER CLUSTER OM raten lasere 1 00 Hz This therapy parameter is the most dependent on the laser cluster being dose t 1 00 J cm used Each laser cluster has a limiting value of minimum and maximum powes A course oF un E Y Dome signal Eee a laser beam output which it can generate The device reads these data gg i mss LI from the cluster and does not allow to set a value outside this range The mampower 1800 W OC cluster may consist of up to three independent output sections which can time exe y p p p time 00 08 imsi save be separately adjusted i e the red section infrared section and blue SETUP OF LASER GENERATOR PAGE 13 FROM 25 supplementary lighting section Maximum outputs of individual sections are stated on the label on the cluster It is also possible to switch off individual sections and to perform therapy for example only by the red section When setting the other parameters area dose the device sets the output in the way that the therapy time is 1 minute if possible The resulting output is divided linearly among all sections of the laser cluster The displayed output is divided into individual sections which enables clear orientation The first displayed value is the output of the infrared section the second one is the output of the red section I
27. rtain preset steps Setting frequency to 0 means continuous operation Acupuncture therapy requires very precise setting of frequency to the values which cannot be set by steps In such case it is necessary to enter the exact value of frequency by the numeric keyboard or to choose the respective program or diagnosis Nogier EAV in which the frequency is set to the required value OUTPUT LASER PROBE This therapy parameter is the most dependent on the laser probe being used Each laser probe has a limiting value of minimum and maximum laser beam output which it can generate The device reads these data from the probe and does not allow to set a value outside this range When setting the other parameters area dose the device sets the output in the way that the therapy time is 1 minute if possible If it is necessary to set a certain output value it is possible to change the output and the device will automatically calculate the other therapy parameters After pressing the output button it is possible to set output by steps by the select knob It is also possible to set the value directly by the numerical keyboard see chapter 2 4 2 Numerical keyboard of the BTL 5000 Series USER S MANUAL Under the displayed current value of output there are quick jump buttons after pressing one of them the output value changes to the value written on the button and further setting goes on from this value Naturally output can be set
28. t 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 1096 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
29. t 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 CS 1 3 3 BEAM OPERATION MODE e pulse lasers very short pulses hundreds of ns peak output in watts or tens of watts e continuous lasers e lasers with modulated operation the pulse length depends on the frequency and on the duty factor the peak output reaches up to several hundreds of mW Output Output MODULATED Output CONTINUOUS Time 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 e convergent point beam e divergent widening beam allows irradiation of a larger area without the need of sweeping the probe over the treated tissue e laser scanners devices for irradiation of large areas e 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 e Class 2 up to an output of 1 mW e Class 3A 3R 3M up to an output of 5 mW and output density of 25 W m2 e Class 3B up
30. tem which can differ according to which tab generator is active The following part describes specific settings for the laser generator DOOR ACTIVITY 0 Here it is possible to set when the door is considered open if it is when voltage is brought or is not brought to the device see Chapter 2 4 Locking of the Equipment If Door Opens The screen displays the door switch setting and its current status by opening and closing the door you can check if the door status in the device corresponds to the actual status If not switch the door activity from positive to negative or vice versa SETUP OF LASER GENERATOR PAGE 17 FROM 25 CS 2 3 2 2 3 3 In case of any questions contact the authorized BTL service department It is also possible to buy the complete door switch set from the BTL supplier ACUPUNCTURE Using a special attachment the laser generator can measure acupuncture acupuncture not designed for laser clusters Since this attachment is not standardly supplied with the device the acupuncture measuring ere z function is off This item serves for switching the function on m sound for acupuncture When the acupuncture measuring function is on the acupuncture nad button appears among therapy parameters in the manual settings screen After pressing this button you can start measuring of acupuncture The button displays a horizontal bargraph the size of which is directly proportion
31. the device contains a laser generator the access password is always required after the unit is switched on The password is preset to 0000 by the manufacturer After entering the correct password and confirmation by the enter button it is possible to work with the device If an incorrect password is entered the device makes a warning and awaits a new entry The password can be changed at any time but it cannot be disabled For the process of password change see Chapter 3 2 1 Password Setting in the BTL 5000 Series USER S MANUAL Note If you happen to forget your password you can anytime use the universal one 00000000 SETUP AND CONTROL OF LASER THERAPY On the therapy parameters screen it is possible to select individual laser therapies or laser sequences All pre set therapy values are interconnected by the following mathematical relation Dose Output DF 100 Time Area J cm W S cm All pre set values except frequency influence each other and the device always tries to calculate the therapy parameters in the way that the last pre set parameter is at the value set by the user Other parameters can be changed if necessary except dose which is a key therapy parameter Maximum values of parameters strongly depend on the maximum power of the connected laser probe cluster therefore some values can be set for the probe with the output of 300mW but they are not allowed for the 30mW probe When calculating therapy parameters th
32. the manufacturer and the user cannot calibrate them The internal mechanism in the probe automatically checks the reached output during therapy and makes corrections so that the displayed output corresponds to the output generated by the laser probe cluster If for some reason the output of the probe cluster does not correspond to the pre set values and it is not possible to correct the error the probe cluster is set as defective by its internal automatics it is locked and further therapy cannot be performed with it Self calibration is a function which tries to put back into operation the probe cluster which was locked as described above If self calibration is run on an unlocked probe cluster it has no influence on its functioning CAUTION The self calibration does not in any case replace the required regular calibration and check of the device by the manufacturer or authorized service of BTL 5000 Series devices SETUP OF LASER GENERATOR PAGE 18 FROM 25 24 2 4 1 LOCKING OF THE EQUIPMENT IF DOOR OPENS According to applicable standards each laser generator must be equipped with the safety door switch which prevents generation of the laser beam if the door is open and there is a real danger of hitting an unprotected person by the laser beam This door contact is brought to the rear panel of the device to the COM IN OUT connector and at the same time it could be also brought to the one of the patient output connectors depending o
33. 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 e blue lasers approx 400 500 nm e green lasers approx 500 550 e red lasers approx 600 700nm e infra red lasers approx 700 950 nm Visible spectrum 500nm 700nm 400nm 600nm 44 i cosmic radiation gamma rays X rays UV radiation 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 wan
34. ts to it The minimum supplied voltage is 5V maximum 35V The switched current in the connector is max 10mA It is possible to preset if the switch is considered active in the connected or disconnected status with or without voltage supply By default the switch is set to active in the connected status For details on setting the activity of the door switch see Chapter 2 3 1 Door Activity Door contact SETUP OF LASER GENERATOR PAGE 19 FROM 25 2 5 LASER PROBES Laser probes are used for laser beam therapy There are many types manufactured of various power and the customers can choose according to their needs Division of probes by the wave length e Red probes e Infrared probes Division of probes by the type of the beam e Convergent point beam the probes have additional green lighting for better identification of the point of incidence of the beam e Divergent beam enables to irradiate larger area at a time without the need of sweeping over the treated tissue these probes do not have supplementary lighting power cable direction of laser beam radiation laser aperture label with classification and aperture START STOP button emergency laser stop indicator of laser activity Note The probes are constructed in the way that the active surface of the button does not protrude the outline of the probe This prevents from accidental pressing e g in case of layin
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