Calcification: formation-resorption cycle

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3 patients suffering from calcifying tendonitis of supraspinatus, resting phase, were treated with Hilterapia®. Treatment lasted 14 days.

Total Tx: 10Tx/week: 5Scanning mode: 730 mJ/cm2 x 3 timesPoint to point: 490 mJ/cm2 x 4 s (calcification trigger point assessed by sonography)

Constant shoulder score(*), VAS score and US assessment at:• T/0• T/1 after 30 days• T/2 after 60 days

Methods

(*)It is the recommended scoring system of the European Society of Shoulder & Elbow Surgery (SECEC/ESSE)

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0102030405060708090

100

T0 T1 T2

Pt 1Pt 2Pt 3

Constant Scale

3

02468

101214161820

T0 T1 T2

Pt 1Pt 2Pt 3

VAS score (0-20)

0

20

4

Calcifying tendonitis of supraspinatus Case 3 : 14,5 mm

T/0 T/1 (30 days later)

5

T/0 T/1 (30 days later)

Calcifying tendonitis of supraspinatus Case 3 : 14,5 mm

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Results

These preliminary data indicate that Hilterapia® has got good results on the resorption of the calcification, on shoulder functionality and decrease/control of pain

Particularly, HILT is able to induce resorption of calcifying tendonitis of supraspinatus

Finally, Hilterapia® has to be inserted in a complex rehabilitation program

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Early treatment and recovery of the injured athlete(Lubich et al. 1997. Medicina dello Sport. 50; 1: 71-83)

88 athletes (age11-73) with traumatic/overload pathologies* affecting

Ankle and foot Tendonopathies-Distortions 28

Knee Tendonopathies-Synovitis 20

Muscles/Tendons Distraction-Fascitis 11

Shoulder Impingement syndr.-Tendonopathies 9

Iliopubic region Adductors pain syndrome 4

Wrist-elbow Epicondylitis-Styloiditis 9

* the table shows the more common pathologies

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ma ...

Treatment protocol and laser settings

10 Tx completed in 2 weeks5 Tx / week1 Tx / dayScanning mode: 13.7 – 15.8 W/cm2, 40-60 sPoint to point: 8.7 – 9.5 W/cm2, 7 s

- treatment was performed by the same operator in all sessions

- device emission power was tested periodically

- dose was calibrated according to the skin phototype (race, color, ethnicity) and, in

case, skin pigmentations

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Evaluation of the results:

- VAS scale

- Functionality through active and passive goniometric evaluation

- Times of recovery

10

ma ...Results

0

10

20

30

40

50

60

70

80

Excellent Good Poor

75 %

18 %

7 %

Early treatment and recovery of the injured athlete

• EXCELLENT: disappearance

of the pain and restoration

of the functionality

• DISCREET: attenuation of

the pain and increase of the

functionality

• ANY EFFECT: scarce or any

improvement of the

symptomatology

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Treatment of rectum-adductors syndrome (Verardi et al. 2000. Medicina dello Sport. 53; 4: 342-350)

31 athletes, age: 15 yrs.÷ 56 yrs.

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RECTUM-ADDUCTORS SYNDROME It consists in an insertional tendinopathies of m.m. adductors and/or rectum-adductors, eventually associated to an osteoarthopathy of the insertional pubic zone, with a microtraumatic origin.

Frequent in football, it presents a biomechanical or postural disequilibrium.

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ma ...

Treatment protocol and laser settings

10 Tx completed in 2 weeks5 Tx / weeks1 Tx / dayScanning mode: 13.7 – 15.8 W/cm2, 90-120 sPoint to point: 8.7 – 9.5 W/cm2, 7 s (after 5th Tx)

Monotherapy

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ma ...

Results

0

5

10

15

20

25

30

35

40

45

50

Excellent Good Poor

45 % 42 %

13 %

Treatment of adductors syndrome

• EXCELLENT: disappearance

of the pain and restoration of

the functionality

• DISCREET: attenuation of the

pain and increase of the

functionality

• ANY EFFECT: scarce or any

improvement of the

symptomatology

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Treatment of Tendinopathies in Athletes(Mondardini et al. 1997. Medicina dello Sport.)

79 athletes (age 10-64) with different tendon pathologies

Insertional tendinopathies

Tenosynovitis: stenosing, hypertrophic

Peritendinitis

Tendinosis

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ma ...

Treatment protocol and laser settings

10 treatments (Tx) completed in 2 weeks5 Tx / week1 Tx per day Scanning mode: 13.7 – 15.8 W/cm2, 40-90 sPoint to point: 8.7 – 9.5 W/cm2, 7-10 s

- treatment was performed by the same operator in all sessions

- device emission power was tested periodically

- dose was calibrated according to the skin phototype (race, color, ethnicity) and, in

case, skin pigmentations

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Results

0

10

20

30

40

50

60

70

80

90

Excellent Good Poor

79.8 %

15.1 %

5.1 %

Athlete tendon pathologies treatment

•EXCELLENT: disappearance

of the pain and restoration

of the functionality

• DISCREET: attenuation of

the pain and increase of the

functionality

• ANY EFFECT: scarce or any

improvement of the

symptomatology

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ma ...HILT ®: Sport injuries and pain management(Mondardini P. Atti seminario HILT , Don Gnocchi foundation, 2002, pp 2—9)405 patients (age: 37.5 yrs - media.) with pathologies* affecting

287287 ACUTE AND SUBACUTE PATHOLOGIESACUTE AND SUBACUTE PATHOLOGIES 118 DEGENERATIVE PATHOLOGIES 118 DEGENERATIVE PATHOLOGIES •Shoulder Loin-sacred arthrosis 45•Elbow Gonarthrosis 35•Wrist Cervico-dorsal arthrosis 32•Ankle Algo-dystrophic syndromes 5 •Knee Shoulder arthrosis 1•Joints

* the table shows the more common pathologies

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ma ...

Treatment protocol and laser settings

10 Tx completed in 2 weeks5 Tx / weeks1 Tx / dayScanning mode: 13.7 – 15.8 W/cm2, 40-60 sPoint to point: 8.7 – 9.5 W/cm2, 7 s

- treatment was performed by the same operator in all sessions

- device emission power was tested periodically

- dose was calibrated according to the skin phototype (race, color, ethnicity) and, in

case, skin pigmentations

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0

10

20

30

40

50

60

70

80

Excellent Good Poor

ma ...

Results

Sport traumatology and pain therapy

87.4%

72.6 %

14.8 % 12.6 %

• EXCELLENT: disappearance

of the pain and restoration of

the functionality

• DISCREET: attenuation of the

pain and increase of the

functionality

• ANY EFFECT: scarce or any

improvement of the

symptomatology

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“Complex rehabilitation in “painful shoulder” syndrome from partial tear and from calcific tendinopathy of the rotator cuff ”. Saggini R, University G. D’Annunzio – Chieti - 2007.

Purpose: to estimate the persistence of the results obtained with a complex rehabilitative approach in the treatment of partial lesions and calcific tendinopathy of the cup of the rotator muscles.Discussion: 40 patients affected by partial lesions and calcific tendinopathy of the cuff rotator muscles were clinically controlled for 360 days since the first treatment.Method: The patients were random collected in two groups: the first group was treated with Hilterapia® and kinesitherapy; the second one was treated with high energy electrohydraulic shock waves with rapid gradient and kinesitherapy. The clinical evaluation was based on Costant and Murley protocol; the pain threshold was evaluated by both V.A.S. scale and Fisher algometer; moreover echography evaluation was performed. Results: Both groups of patients showed a significant improvement of subjective and objective conditions related with pain and dysfunctional state of the shoulder.Conclusion: This study proved that it is possible to codify a routine approach in the therapy of the cuff incomplete lesions of the rotator muscles by the use of different physical energy, through both Hilterapia® and high energy electrohydraulic shock waves with rapid gradient.

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“The carpal tunnel syndrome: treatment with Hilterapia® ”. Bodini G, Croce - A.M, Specialistic Rehabilitation Hospital Unity – “San Camillo” Care Facility – Brescia - 2007.

Purpose: to assess the effectiveness of HILT laser treatment for carpal tunnel syndromes.Discussion: in this study were included 25 subjects affected by mild or medium –level carpal tunnel syndrome. Method: The patients underwent HILT laser treatment and were assessed through clinical (e.g. pain gravity though V.A.S. scale, presence of edema), echographic and EMG tests. Assessment was performed before and after treatment and 3 months after its end. Results: Every patient showed an improvement of subjective and objective symptoms, e.g. a decrease of pain, a decrease of local inflammation. Conclusion: This study shows that the Hilterapia® is a valid method to treat the carpal tunnel syndrome, especially in the early stages of pathology.

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“HILT ® treatment in epicondylitis” Ganzit G.P., Gurin E., Institute of Sport Medicine, Torino - 2006.

Purpose: to assess the efficacy of Hilterapia® on pain control and functional recovery in patients affected with epicondylitisDiscussion: The Hilterapia® reduces pain and improves the functional state of the hand in epicondylitisMethod: 23 patients (mean age 42 years) have been enrolled. They were tennis players and were affected by epicondylitis, which did not respond to other therapies. The subjects were treated with Hilterapia® (10 sessions). The pain and functional state were assessed before the treatment, after 5 and 10 sessions by Steinbroker scale, VAS and isometric strength. Results: pain significantly decreased after 5 sessions and was furtherly reduced after 10 sessions. Prehension strength strongly increased at the end of the therapy.Conclusion: The treatment with Nd:YAG laser has positive effects on patients affected by persisting epicondylitis due to sport practice.

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“HILT ® treatment in calcific tendinopaty of the shoulder. A controlled perspective study”. Melegati G., Galeazzi Institute for Orthopaedics - 2006.

Purpose: to compare the results obtained with different treatments on 3 groups of patients affected by calcific tendinopaty of the shoulder.Discussion: A correlation has been shown between the disappearance of calcification and improvement of the clinical picture. The best performance in the control of pain symptoms in the post-treatment was obtained with the Hilterapia® . Method: 20 patients have been divided in 3 groups: the first was treated with shock waves, the second was treated with kinesitherapy and the third was treated with Nd:YAG laser. Assessment was made before and after the treatments by the use of the Constant scale, and x-ray 6 months after the treatment.Results: In the B group no significant improvement of the clinical picture was observed. In A and C groups a significant improvement of the clinical picture was obtained. In the C group the best results in the post-treatment were obtained, expecially in the control of the pain. Conclusion: both shock waves and Hilterapia® improve the clinical picture in patients affected by calcific tendinopaty of the shoulder, but Hilterapia® has a greater analgesic effect in comparison with shock waves

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The Nd:YAG laser in the treatment of the lateral ligamental lesions of the ankle. Di Caprio F., Ghermanti R., Grandi G., Buda M., Buda R., Rizzoli Institute for Orthopaedics, Bologna - 2006.

Purpose: valuation of the effectiveness of the treatment with Nd:YAG laser in the ligamental lesions of the ankle. Discussion: The Nd:YAG laser has analgesic, anti-inflammatory, anti-aedematous effects, which can be monitored by clinical observation.Method: 15 athletes with ligamental lesions of the ankle have been enrolled. 10 patients have been treated with Nd:YAG laser and 5 with CO2 laser. Assessment has been made by scale pain, tumefaction area and functional state of the joint before the treatment, after 1, 2, 3, 6, 12 weeks and 14 months from the treatment (follow up)Results: the patients treated with the Nd:YAG laser showed a very fast improvement in the pain symptoms and functional recovery with resume of the training, decrease of tumefaction area Conclusion: In sporting traumatology the effects induced by Hilterapia® hasten the recovery time and this is particularly important in the case of agonists

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“The Nd:YAG laser in the treatment of the osteocartilagineous lesions of the knee”. Buda R., Buda M., Gigolo B., Di Caprio F., Ghermanti R., Zati A., Rizzoli Institute for Orthopaedics, Bologna - 2006.

Purpose: evaluation of the effect of the treatment with Nd:YAG laser in the osteocartilagineous lesions of the knee. Discussion: The Nd:YAG laser induces the growth of jaline cartilage in the lesion foci in a different extent depending on the age of the patients and the position of the lesionsMethod: 7 patients waiting for autologous transplantation of chondrocytes for osteo-chondral lesions of the femoral condyles have been considered. 5 patients have been treated with Nd:YAG laser in between the two arthroscopic procedures, while 2 patients have not been treated. Hystologic and immunohystochemical analyses have been performed on bioptic specimens. Results: In comparison with control, the laser treatment induced increase of grow factors in synovial fluids, decrease of inflammation factors and re-growth of jaline cartilage Conclusion: The Hilterapia® has anti-inflammatory and biostimulating effects, which have been demonstrated with histological and immunohystochemical tests, and induce the re-growth of cartilage.

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“Therapeutic approach with Hilterapia® in the pathology of the shoulder with tenosynovitis of the omeral biceps” Saggini R.,Bellomo R.G., Baldassarre V., Medicine and physics of rehabilitation, University of Chieti - 2006.

Purpose: evaluation of the effectiveness of Hilterapia® in the treatment of the tenosynovitis of the omeral bicepsDiscussion: it is suggested that the laser treatment can have analgesic effect together with endorphyne increase, biostimulating effect, anti-inflammatory and anti-edematous effect.Method: 30 patients were enrolled and divided in 2 groups. The former started the HILT® treatment immediately after the enrollment, utilizing the latter group as control. At the end of the treatment for the former group, the latter started the therapy. Assessment was made by VAS, evaluation of joint mobility and muscle strength, echography. The treatment was made utilizing a Nd:YAG laser.Results: Significant reduction or complete disappearance of the pain, reduction or Complete disappearance of the edema of the tendineous sheath.Conclusion: Hilterapia® causes the quite complete reversion of the pain symptoms and a significative decrease in the edema of the tendineous sheath. Therefore it is an effective tool in the treatment of the with tenosynovitis of the omeral biceps

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“HILT ® in the treatment of patellar tendinopathy in sportsman” Buda R, Di Caprio F, Ghermandi R, Buda M., Institutes Rizzoli, Bologna, Poliambulatorio Life, RSM – 2007

Purpose: to evaluate the effects of lasertherapy HILT for rehabilitation of patellar tendinopathyDiscussion: This study shows that the HILT ® treatment is a valid therapeutic method for patellar tendinopathy. Method: 20 patients were divided in two groups: in the former group there was 10 subjects treated with HILTherapy and in the latter there was 10 subjects treated with a CO2 laser. Hilterapia® was performed by a pulsed laser Nd:YAG (maxima fluence=1780J, pulse energy<120 sec; spot= 5mm); CO2 laser treatment consisted of 20W for 15 sec.. Patients were evaluated with clinical and echographic tests before, during and after the treatments. Results: patients of both groups showed an improvement of clinical and echographic parameters. Only two patients complained after HILT ® treatmentConclusion: Patients treated with HILTherapy showed an improvements of clinical parameters and produced a more quick recovery.

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“Hilterapia®. An approach in the treatment of lumbosciatalgy” Finocchiaro S., Poliambulatorio della Misericordia, Pistoia - 2007

Purpose: the aim of this work is to evaluate the efficacy of Hilterapia® in the treatment of lumbosciatalgy.Discussion: in this study is demonstrated that Hilterapia® is efficacious not only to decrease of pain in lumbosciatalgy, but also because biostimulates tissues.Method: 80 patients affected by lumbosciatalgy were included in this study and were divided in two group: one of the groups was treated with a protocol HILT ® through a CO2 laser; the other one was treated with both CO2 laser and Nd:YAG laser. The therapeutic cycle was based on 5 days of treatments for 2 weeks. Follow-up was until 60 days after the end of therapy. Patients were evaluated through V.A.S. scale.Results: patients treated with CO2 laser showed a slow and progressive improvement, while with both laser treatments there was quick improvement.Conclusion: The Hilterapia® showed an early analgetic improvement, moreover this study suggest that Hilterapia® induces a biostimulating effect.

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“Treatment of chronic lumbosciatalgy: back school versus Nd:YAG laser”. Conte PG, Lelli G, Lopresto A, Mazzaracchio M., Rehabilitation division, SS. Annunziata Hospital, Taranto – 2007

Purpose: the aim of this study is to compare the efficacy of the treatment with back school versus the combined treatment back school and laser Nd:YAG. Discussion: the control group (7 subjects) was treated with back school only; the other group (7 subjects) was treated with back school followed laser Nd:YAG therapy. The latter was more effective, suggesting that Nd:YAG laser has a positive effect in treating lumbosciatalgyMethod: The back school treatment was based on different physiotherapeutic exercises (e.g. stretching, Klapp posture…). The Nd:YAG laser was used at different fluences and modality, but with the same total energy (1500). The evaluations of the results was performed by V.A.S. scale. Results: Both the groups of patients showed an improvement of the clinical paramenters, but the subjects treated with both therapies showed a more evident improvement.Conclusion: even if the number of studied patients is small, this study showed the potentiality of Hilterapia® in the treatment of chronic lumbosciatalgy.

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“Comparison between II generation cyclo-oxygenases and HILT in the treatment of backache”. Carrara R., Consulting Room Milici, Catania - 2007

Purpose: to evaluate the effects of Hilterapia® in the treatment of human rachis affections Discussion: The results obtained with Hilterapia® were satisfactory and without collateral effects.Method: 90 patients were divided in 4 groups; the different treatments were the following: 1) Hilterapia® (10 sessions); 2) massage therapy (3 sessions/week); 3) cox2 therapy for 3 weeks (75mg and 90mg); 4) fisiokinesitherapy (20 days). The evaluation was based on clinical parameters and on the presence/absence of phlogistic processes. Results: 78% of patients treated with Hilterapia® showed a decease of painful symptomatology, while only 42% of patients treated with Cox2 therapy showed a clinical improvement. Patients treated with massage therapy and patients treated with fisiokinesitherapy showed an improvement in 75% and 62% of cases. Conclusion: Hilterapia® can be usefully applied for pain treatment in the backache, because it is able to reach deep tissues with safety and induce a prompt decrease of the symptoms.

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“Clinical results in treatment of gonarthrosis with Hilterapia®” Valent A., Cimone Volley, Modena - 2007

Purpose: to evaluate the efficacy of Hilterapia® in the treatment of gonarthrosis.Discussion: in this study were recruited 15 patients, affected by gonarthrosi; the evaluation of both functionality and pain were evaluated before and after the treatment with Hilterapia®.Method: Each patient was treated for 14 days (5 sessions during the first week, 2 sessions during the second week). HILT therapy was performed by Hiro 3 laser (fluence= 1430-1780 mJ/cm2, frequency= 20-30Hz; total energy= 3000J). Clinical evaluation was performed by V.A.S. scale, Womac form. Follow-up was 1 month. Results: after Hilterapia®, 74% of patients showed an improvement of functionality and 66% of patients showed a decrease of pain.Conclusion: these preliminary showed that Hilterapia® can be successfully used in the treatment of gonarthrosis.

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SCIENTIFIC REPORT:SCIENTIFIC REPORT: Hilterapia® Hilterapia®

CONTENTS

•HILT – High Intensity Laser Therapy•Cytoproliferative activity of the HILT•High Intensity Laser Therapy in arthrosis•High Intensity Laser Therapy in the treatment of gonarthrosis•High Intensity Laser Therapy (HILT)•HILT vs TENS and NSAIDs

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ENERGY FOR HEALTH:ENERGY FOR HEALTH:Proceeding of the International Meeting on Hilterapia® - Venice 2008Proceeding of the International Meeting on Hilterapia® - Venice 2008

CONTENTS • Treatment of proprioceptive balance disorders: comparison between kinesistherapy and Hilterapia®. Bodini G., Croce A.M.• Treatment of chronic low back pain: back school versus Hilterapia®.Conte P.G., Santamato A., Fiore P., Lopresto A., Mazzaracchio M.• Effects of Hilterapia® vs. Viscosupplementation in knee osteoarthritis patients: a randomized controlled clinical trial.Viliani T., Ricci E., Mangone G., Graziani C., Pasquetti P.• Hilterapia® efficiency in handling the post surgical pain after the release of the carpal tunnel. Gleiser J.• Muscle lesions in athletes: case comparison between Hilterapia® and traditional therapy. Valent A.• Effects of pulsed Nd:YAG laser at molecular and cellular level. A study on the basis of Hilterapia®. Monici M., Cialdai F., Fusi F., Romano G., Pratesi R.

Abstract• Hilterapia® and chronic ankle pain syndromes. Saggini R., Bellomo R.G., Cancelli F.• Clinical experience using Hilterapia® in “knee arthrosis”. Sabbahi S.A.• Comparison of the clinical results of Hilterapia® and eswt in the lateral epicondylitis. Kang H.J., Her M.S.

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ENERGY FOR HEALTH:ENERGY FOR HEALTH:Proceeding of the International Meeting on Hilterapia® - Athens 2009Proceeding of the International Meeting on Hilterapia® - Athens 2009

CONTENTS •Relationship between cellular and systemic effects of pulsed Nd:YAG laser. Cialdai F., Monici M.•Laser-tissue interaction principles: beam penetration in tissues.Romano G., Conti A., Fusi F.•The HILT domain by the pulse intensity fluence (pif) formula.Fortuna D., Masotti L.•The challenge of shoulder pain. Vissarakis G., Charamidis N.•“High intensity laser therapy in knee osteoarthritis: comparison between two different pulsed-laser treatment protocols”.Viliani T., Martini C., Mangone G., Pasquetti P

Abstract•Hilterapia® and lymphoedema. Nicolaou V.•CliFrozen Shoulder Syndrome weighted comparison from “static & dynamic” treatment with Nd/YAG 10W pulsed laser. Sicheri M.

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The material of support for The material of support for HilterapiaHilterapia®®

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A complete packet of materials to popularize and propose to the patients the Hilterapia®

TOOL BOXTOOL BOX

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An important and practical tool that it illustrates in the detail the potentialities of the Hilterapia®.

DVDDVD

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A real practical course on the application of the Hilterapia® to the different patologies. With this tool, the doctor can effectively apply the Hilterapia®.

VIDEO MANUALVIDEO MANUAL

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Hilterapia® Course

Laser Safety On line Course

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