laser report winter 2012

Laser Report - Winter 2012

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In The News at MeditechNew Years

Product SpecialWebinars & Advanced

Training 2012

In The News at Meditech

As 2012 begins, Meditech, the organi-zation, re-dedicates itself to the task of continuing to improve the standard of excellence in the design, manufacture and clinical application of Laser Ther-apy Systems. This task has never been simple or easy, and this year will be no exception. The research and experience gained over the past, will however form a solid basis for future enhancements, some of which have already been in-corporated into our current products. These achievements should improve the therapeutic experience for both practi-tioners and patients.

On this note, we have recently added two outstanding engineering specialists to our staff, along with several outside consultants, which will enable us to continue to create exciting new systems with advanced technological features.

Over the past two years, we have un-dertaken research, in conjunction with the Institute of Optical Sciences at the University of Toronto, to explore the performance and longevity of our su-perluminous and laser diodes and will

use this data to further improve our systems’ performance. This again is a complex subject and to the best of our knowledge, no other manufacturer has instituted this type of study, which we feel is essential to ensure the durability, functionality and clinical performance of the devices.

In summary, our objectives in 2012 are to continue to improve the quality and wider application of our systems. We will also continue to provide industry leading training and educational pro-grammes for all therapists, in order to optimize clinical outcomes.

We are pleased to announce that in the last quarter of 2011, sales of the BioFlex Professional Systems increased by more than 20% and this trend is expected to accelerate in 2012.

We recently had visits from Drs. Karim and Farzana Mohamed from Kenya, whose family operates medical clinics in Mombasa, Nairobi and London, and in April of 2012 will open a new clinic in Vancouver, BC. Both are physicians and have used a number of laser devices in the past and after a thorough review,

have selected the BioFlex System for their new clinic. In addition, they antic-ipate installation of these systems in all their clinics located around the globe.

Elizabeth and Ben Yuen, in Bedford, Nova Scotia, have placed an order for eleven additional systems to be shipped early in the New Year. This will bring the total number of BioFlex Systems in their clinic to thirty one, making it one of the world’s largest free-standing laser therapy clinics. This is a singular achievement indeed and the Yuen’s and their staff are to be congratulated on their initiative and leadership.

Dr. Moona Rahemtulla who operates clinics in Kitchener and Owen Sound, in December added five BioFlex Profes-sional Systems to his already existing eleven, which he has utilized with great success since 1999.

At the Meditech clinic, we are pleased to report a continuing stream of pa-tients from around the globe and in most instances these individuals obtain what can be termed as dramatic results. Most of these patients had been un-able to find medical solutions at major

IN THIS ISSUE

Literature Review

Abstracts of InterestRoberta Chow, MD

& Benjamin Yuen, DC2012 Training ScheduleSocial Commentary

Laser Therapy for the Treatment of

Neck Pain

WINTER 2012

Annual Subscriptions (3 Issues) $50


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IntroductionOver the years the neck is subjected to repeated stress, trauma, wear and tear. Often injuries may not cause pain at the time of the event, however become symptomatic many years later. In brief, repeated injuries have a cumulative ef-fect, eventually resulting in the degener-ation of the cervical spine components. The majority of cases of neck pain are secondary to degenerative change. The individual’s overall physical condition often dictates how rapidly one can re-cover from an injury and whether the neck will become a chronic problem.

The treatment of cervical pain has long been overlooked by clinicians and re-searchers, particularly compared to low back pain. The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and its Associated Disorders clarified our understanding of this problem. This project involved seven years of work compiled from a database of more than 50 researchers, located in nine different countries and 19 specialized clinical and scientific disciplines.

Based on the Task Force findings regard-ing epidemiology, risk factors, course ,

prognosis etc., treatment guidance was established. The review concluded that Laser Therapy was the single encom-passing therapeutic approach deemed to be effective in the treatment of this entity, based on existing scientific evi-dence.

EpidemiologyOver the course of any single year, the prevalence of neck pain in the general population ranges from 12.1-75.5% and when associated with disability, ranges from 1.7-11.5%. The number of persons seeking care for whiplash asso-ciated disorders (WAD) has been on the rise over the past three decades.

Based on this information, it is evident that neck pain and its associated symp-toms, including headaches, radiation of pain to the extremities, numbness and tingling, etc., are more prevalent than previously recognized.

Risk FactorsNeck pain is the end result of a variety of etiological factors, including the fol-lowing risk factors, some of which are modifiable, i.e. high level quantitative job demands, sedentary work positions

and repetitive, precise working posi-tions.

Non-modifiable risk factors include age, gender and genetics. There is a lack of evidence that workplace interventions are effective in decreasing the incidence of neck pain in the workforce.

Anatomy & EtiologyMost instances of neck pain are caused by disorders of the spine involving some type of mechanical derangement. Typi-cally, the subjective sensation of pain is the result of muscle strain, spasm and/or ligamentous injury. Other sources include disc herniation, osteoarthritis, spinal/foraminal stenosis and degenera-tive disc disease (DDD).

Anatomically the cervical spine has 7 vertebrae covered by the soft tissues, including muscles, ligaments, tendons, nerves and blood vessels.

A spinal segment is made up of 2 ver-tebrae, the intervertebral disc and the nerve roots that branch out from the spinal cord. The cervical vertebrae are the smallest vertebrae in the spine, as they do not require the weight bear-ing function of those in the lower back.

Laser Therapy For The Treatment Of Cervical Spine Pathologies

medical clinics previously. As a result, our international reputation continues to grow.

Personally, I recently had the occasion to address a section of the Ontario Medical Association and over fifty MDs turned out on a cold, wintry night in December for a presentation. A month earlier, I had the opportunity to speak to twelve surgeons at the Scarborough Medical Centre, most of whom are

attendants at their wound clinic, the largest such institution in Canada.

The reception at both of these events was outstanding and once again, vin-dicates the sentiment that motivated physicians today place less faith in phar-maceuticals and are looking for more effective therapeutic options.

In the face of economic adversity and political turmoil, 2011 proved to be a

difficult year, however, our progress and resolve never wavered and we expect to build on that in the coming year. All indications to date are positive!

On a final note, I extend my Best Wishes to all of you for the New Year and thank you for your continuing support. The focus of Meditech remains the individ-ual patient’s welfare and we trust that you share that objective.

Fred Kahn, MD, FRCS(C)


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Spinal nerves exit on either side through the foramen between the vertebrae of each segment.

A common cause of neck pain is the re-sult of pressure on the nerve root which may cause sensory loss and/or motor dysfunction. The intervertebral discs consist of a strong outer connective tis-sue layer, known as the annulus fibrosus and a shock absorbing gel-like centre called the nucleus pulposus.

With increasing age, cervical discs be-come dehydrated and demonstrate di-minishing flexibility. This may result in the nucleus pulposus extruding through the annulus fibrosus, commonly termed a disc herniation. The biochemical effect can also induce neuritis and disc frag-ments can compress the spinal cord and/or the nerve roots.

In some instances, the cervical disc may degenerate as the result of direct trauma. Without a direct arterial supply, cervical discs heal slowly or fail to achieve this objective completely. Symptoms often create a sense of nagging discomfort, including stiffness, numbness and tin-gling in the extremities, a loss of power

in the musculature, all the result of spi-nal cord or nerve root impingement.

The joints between the vertebrae are called facet joints and provide mobility to a limited degree. These joints allow the neck to flex, extend and rotate over a moderate range. The small movements of each individual joint however com-bined, make the spine relatively flexible.

Osteophytes are bony projections (bone spurs) that form around the joints and are part of nature’s arthritic response mechanism. These limit the range of joint motion and again, cause pain. Over time, degenerative changes in the cervical vertebrae, discs and joints can result in cervical stenosis with resulting spinal cord compression. In addition to the symptoms already listed, this may cause debilitating chronic pain, loss of strength and difficulty performing fine motor skill tasks.

Course & PrognosisThe majority of individuals with chron-ic or acute neck pain do not experience a significant degree of resolution of symp-toms with conventional therapeutic methods. In fact, between 50-85% of

those affected, experience recurrent neck pain between 1 to 5 years after diagnosis. The prognosis associated with this con-dition, along with increasing age, poor physical and often mental health, predi-cates a guarded prognosis with regard to activity levels and quality of life.

Laser Therapy & Neck Pain ResearchOver 21 randomized controlled clinical trials have investigated the efficacy of Laser Therapy in relation to neck pain. Roberta Chow et al. performed a sys-tematic review and meta-analysis of 16 randomized controlled clinical trials to assess the efficacy of Laser Therapy uti-lized in the treatment of neck pain. Her ground breaking research was published in the Lancet in 2009. Dr. Chow con-cluded that Laser Therapy reduces pain immediately after treatment in acute cases and up to 22 weeks after com-pletion of treatment in patients with chronic neck pain.

Konstantinovic et al. reported that acute neck pain with radiculopathy treated with Laser Therapy, provided more effective short term relief of pain in the arms and an increased range of neck extension, compared to placebo procedures.

Ozdemir et al. performed a double blind placebo controlled study and concluded that Laser Therapy is success-ful in relieving pain and improving func-tion in cervical osteoarthritic disease.

Laser Therapy There are many treatment options avail-able for neck disorders, whether chronic or acute. These demonstrate varying de-grees of effectiveness but generally do not resolve the problem permanently. Laser Therapy, on the other hand, is a conservative approach that is non-inva-sive, non-toxic, has no adverse effects; moreover it delivers consistent, highly effective and reproducible results.

At the cellular level, Laser Therapy demonstrates improvement in cellular

Spinal Cord

Normal Segment of the Cervical Spine

FacetJoint

NerveRoot

Vertebral Body

AnnulusFibrosus

NucleusPulposus

Intervertebral Disc


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metabolism, an increased production of ATP, enhanced neurological transmission and significant regeneration of the cellular components of the tissues.

At the systemic level, there is stimulation of the immune response and increased production of endorphins and cortisol, the precursor of cortisone.

CASE PROFILESThe two cases described below were selected to illustrate the effectiveness of this therapeutic approach in the hundreds of simi-lar cases that we treat at our clinic on an annual basis.

CASE 1Diagnosis: Disc Herniation with Right Nerve Root Irritation

History:The patient is a 21 year old pro golfer who injured his cervical spine performing exercises. This resulted in radiation of pain to the right scapular area, shoulder and the lateral aspect of the arm. In addition, there was numbness and tingling in the extremity. The patient suffered from constant severe pain, had difficulty sleep-ing and was unable to engage in any meaningful physical activities for several weeks.

The MRI revealed a right paracentral disc her-niation at the C5-6 level and a 4 mm right perineural cyst at the C4-5 level. Prior to Laser Therapy the pain had continued to increase in severity and necessitated taking 6 or more Tylenol tablets each day.

Physical Examination:A moderate degree of tenderness was noted from C3-T1. The range of motion of the cervical spine with regard to flexion, extension, lateral rotation and lateral flexion was less than 10% of normal. Paracervical muscle spasm was pronounced. There was no evidence of gross motor impairment and no sensory deficit, however reflexes on the right were hypoactive.

Treatment Program:Laser Therapy was applied initially for 5 consecutive days and subsequently every 2-3 days over the succeeding 3 weeks, for a total of 13 treatments.

Progress:After 5 treatments, subjective improvement achieved was in excess of 80%. Range of motion of the cervical spine had increased to 50% of normal range and paracervical muscle spasm was minimal.

After 13 treatments the patient was asymptomatic. Range of motion of the cervical spine was within normal limits. No tender-ness was noted and the utilization of analgesics had been completely discontinued. The patient was fully functional.

For maintenance therapy, weekly treatments were advised for several weeks with periodic reduction and phasing out therapy over the course of a year.

This will be correlated with the patient’s activity levels as he continues his professional career in golf.

Spinal Cord

NORMAL DISC

HERNIATED DISC

Nerve RootIrritation/

Compression

Protrusion

Annulus Fibrosus

NucleusPulposus


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CASE 2Diagnosis: Advanced Degenerative Osteoarthritis of the Cervical-Thoracic Spine

History:The patient is a 73 year old real estate executive who was involved in a plane crash 23 years previously. He had chronic/acute pain over many years, which had progressed significantly over the past 3 months. He had difficulty turning his neck, driving and engaging in many routine physical activities. He had utilized chiropractic adjustments and analgesics to relieve symptoms, with minimal tem-porary improvement at best. X-rays revealed degenerative disc disease from C3 to C7 and left foraminal narrowing at C2-3, C3-4 and C4-5 secondary to extensive osteophyte formation.

Physical Examination:Moderate tenderness was noted from C3-T2. The range of motion of the cervical spine with regard to flexion, extension, lat-eral rotation and lateral flexion was less than 20% of normal. Significant muscle spasm was noted in the paracervical area and extended to the trapezii. Neurological examination was found to be within normal limits.

Treatment:Initially Laser Therapy treatments were administered on 6 consecutive days and subsequently every 2-3 days over the succeed-ing 10 weeks, for a total of 26 treatments.

Progress:After only 4 treatments, subjective improvement of 60% was reported and the cervical range of motion had improved to over 50%.

At the termination of the course of Laser Therapy comprising 26 treatments, the range of motion of the cervical spine was within normal limits. There was no tenderness on palpation and no muscle spasm was noted. The patient had not utilized pharmaceuticals in several weeks and was able to perform all normal physical activities without limitation.

Conclusions• The two cases presented are typical of the problems that we see on a daily basis.• Almost invariably, subjective symptoms disappear early in the course of Laser Therapy and patients are returned to a

relatively normal range of motion and function, without the use of pharmaceuticals.• Frequency and duration of treatment, along with correct positioning of the treatment arrays and probes, are critical to

the process of achieving optimal therapeutic results.• All indications are that the cervical spine is best treated in a relatively neutral position with the patient comfortably

seated in a chair.• Customization of protocols, as required, includes pulse frequency, duty cycle, waveform, duration, etc.• Attention to detail facilitates the course of healing.• Generally, protocols are initiated at lower settings, which may be increased as clinically dictated.• Based on our knowledge and experience, we recommend that Laser Therapy be utilized as the treatment of choice in

dealing with pathologies of the cervical spine.

Fred Kahn, MD, FRCS(C); David Kunashko, DC

References available upon request.

Disc Degeneration

Bone Spurs(osteophytes)


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At Meditech we are aware that duty cycle is utilized to change the dosage directly, however, pulse frequency is more challenging insofar as “cause and effect” are concerned.

The text compiled by Tuner and Hode states that when treating chronic pain it can be beneficial to begin with a low frequency, mainly to modulate the degree of the individual patient’s pain, and then move to higher frequencies to counter the inflam-mation. This is a widely shared view among advanced Laser Practitioners and supports the reality that it is generally advisable to start out at lower frequencies and move to higher levels, as the patient’s clinical response dictates. There are a number of publications that support the use of varying frequencies to change the effects of Laser Therapy. These include the following: Martin D. et al. Lasers in Surg and Med. Suppl 3: 83, 1991, Fagnoni V et al. Laser Abstracts. 2: 23-36, 1985 and Al-Watban J. Clin. Laser Med Surg. 22(1), 15-18, 2004 and the study by Ando published in 2011. This study focused on the effects of pulse frequency in treatment of traumatic brain injuries in mice. The author concluded that a 10-Hz pulse frequency had a more positive therapeutic effect than continuous or 100-Hz pulse frequencies. One should be aware that all these studies and opinions indicate that many factors remain to be discovered and most conclusions are temporary.

The Role of Frequency In Laser Therapy

Comparison of Therapeutic Effects between Pulsed and Continuous Wave 810-nm Wavelength Laser Irradiation for Traumatic Brain Injury in Mice

Ando T, Xuan W, Xu T, Dai T, Sharma SK, Kharkwal GB, Huang YY, Wu Q, Whalen MJ, Sato S, Obara M, Hamblin MR. PLoS One. 2011. 6(10):e26212

Background & ObjectiveTranscranial low-level laser therapy (LLLT) using near-infrared light can efficiently penetrate through the scalp and cranium and can allow non-invasive treatment for traumatic brain injury (TBI). In the present study, we compared the therapeutic effect using 810-nm wavelength laser light in continuous and pulsed wave modes in a mouse model of TBI.

Study Design/Materials & MethodsTBI was induced by a controlled cortical-impact device and 4-hours post-TBI 1-group received a sham treatment and 3-groups received a single exposure to transcranial LLLT, either continuous wave or pulsed at 10-Hz or 100-Hz with a 50% duty cycle. An 810-nm Ga-Al-As diode laser delivered a spot with diameter of 1-cm onto the injured head with a power density of 50-mW/cm2 for 12-minutes giving a fluence of 36-J/cm2. Neurological severity score (NSS) and body weight were measured up to 4 weeks. Mice were sacrificed at 2, 15 and 28 days post-TBI and the lesion size was histologically analyzed. The quantity of ATP production in the brain tissue was determined immediately after laser irradiation. We examined the role of LLLT on the psychological state of the mice at 1 day and 4 weeks after TBI using tail suspension test and forced swim test.

ResultsThe 810-nm laser pulsed at 10-Hz was the most effective judged by improvement in NSS and body weight although the other laser regimens were also effective. The brain lesion volume of mice treated with 10-Hz pulsed-laser irradiation was significantly lower than control group at 15-days and 4-weeks post-TBI. Moreover, we found an antidepressant effect of LLLT at 4-weeks as shown by forced swim and tail suspension tests.

ConclusionThe therapeutic effect of LLLT for TBI with an 810-nm laser was more effective at 10-Hz pulse frequency than at CW and 100-Hz. This finding may provide a new insight into biological mechanisms of LLLT.


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Background Neck pain is a common and costly condition for which pharmacological management has limited evidence of efficacy and side-effects. Low-Level Laser Therapy (LLLT) is a relatively uncommon, non-invasive treatment for neck pain, in which non-thermal laser irradiation is applied to sites of pain. We did a systematic review and meta-analysis of randomized controlled trials to assess the efficacy of LLLT in neck pain.

MethodsWe searched computerised databases comparing efficacy of LLLT using any wavelength with placebo or with active control in acute and chronic neck pain. Effect size for the primary outcome, pain intensity, was defined as a pooled estimate of mean difference in change in mm on a 100 mm visual analogue scale.

FindingsWe identified 16 randomized controlled trials including a total of 820 patients. In acute neck pain, results of two trials showed a relative risk (RR) of 1.69 (95% CI 1.22-2.33) for pain improvement of LLLT versus placebo. Five trials of chronic neck pain reporting categorical data showed an RR for pain improvement of 4.05 (2.74-5.98) of LLLT. Patients in 11 trials reporting changes in visual analogue scale had pain intensity reduced by 19.86 mm (10.04-29.68). Seven trials provided follow-up data for 1-22 weeks after completion of treatment, with short-term pain relief persisting in the medium term with a reduction of 22.07 mm (17.42-26.72). Side-effects from LLLT were mild and not different from those of placebo.

InterpretationWe show that LLLT reduces pain immediately after treatment in acute neck pain and up to 22 weeks after completion of treat-ment in patients with chronic neck pain.

Efficacy of Low-Level Laser Therapy in the Management of Neck Pain: a Systematic Review and Meta-Analysis of Randomized Placebo or

Active-Treatment Controlled TrialsChow RT, Johnson MI, Lopes-Martins RA, Bjordal JM. Lancet. 2009. 374(9705):1897-908

To view the presentation in its entirety visit

www.internationallaser.org


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Pain in the cervical spine is the second most commonly reported musculoskeletal problem, with up to 45% of the population affected at least once in their lifetime. Acute neck pain may last only a few weeks, while chronic recurrent symptoms can increase over the years without resolution. Symptoms of cervical spine pain are often debilitating which result in loss of normal function, absenteeism from work, deterioration of the individual’s lifestyle and a cost of millions of dollars directed to modulating symptoms.

Degenerative osteoarthritis is the most common etiological factor involved and may become symptomatic following even minor trauma. The most frequent etiological factor is the wear and tear secondary to aging. In addition, the con-ventional Biomechanical Dysfunction Model of neck pain, a new paradigm, has emerged for several important but little known connections between the cervical musculature and the dura mater; this cast new light on the clinical pathology involved. At the same time many studies and therapeutic trials indicate that laser treatment for this clinical entity appears to be the most effective therapeutic approach available.

Pathology of Neck Pain: A Paradigm ShiftBenjamin Yuen, DC

To view the presentation in its entirety visit

www.internationallaser.org


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Chiropractic Manipulative Therapy and Low-Level Laser Therapy in the management of cervical facet dysfunction: a randomized controlled study

Saayman L, Hay C, Abrahamse H. Journal of Manipulative Physiological Therapy 2011. 34(3):153-63.

PurposeThe aim of this study was to determine the short-term effect of chi-ropractic joint manipulation therapy (CMT) and low-level laser therapy (LLLT) on pain and range of motion in the management of cervical facet dysfunction.

MethodsSixty ambulatory women between the ages of 18 and 40 years with cervical facet joint pain of more than 30-day duration and normal neurologic examination were randomized to receive 1 of 3 treat-ment options: (1) CMT of the cervical spine, (2) LLLT applied to the cervical facet joints, or (3) a combination of CMT and LLLT. Each participant received 6 treatments in 3 weeks. The main outcome measures were as follows: the Numerical Pain Rating Scale, Neck Disability Index, Cervical Range of Motion Instrument, and Baseline Digital Inclinometer. Measurements were taken during weeks 1 (baseline), 2, 3, and 4.

ResultsNo differences existed between the 3 groups at baseline. A significant difference was seen between groups 1 (CMT) and 2 (LLLT) for cervical flexion, between groups 1 (CMT) and 3 (CMT + LLLT) for cervical flexion and rotation, and between groups 2 (LLLT) and 3 (CMT + LLLT) for pain disability in everyday life, lateral flexion, and rotation.

ConclusionAll 3 groups showed improvement in the primary and secondary outcomes. A combination of CMT and LLLT was more effective than either of the 2 on their own. Both therapies are indicated as potentially beneficial treatments for cervical facet dysfunction. Further studies are needed to explore optimal treatment procedures for CMT and LLLT and the pos-sible mechanism of interaction between therapies.


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Fundamentals of Laser Therapy: Myths and Realities

Tuesday February 16th

12:30 – 1:00pm EST or 3:30 – 4:00pm EST

Thursday February 21st

12:30 – 1:00pm EST or 3:30 – 4:00pm EST

What is Laser Therapy? Is more power better? Is Laser better than Light Emitting Diode (LED)? What is the role of frequency in Laser Therapy? Although the benefits of Laser Therapy are now well established, over-representation of the facts, even unintentionally, can make the educational process more difficult than necessary for new clinicians incorporating the technol-ogy. Join us to learn more about Laser Therapy in an evidence-based format that will put you at the forefront of this exciting technology.

To register for the webinar, please contact Melissa at 1-888-557-4004 or by email at [email protected]. Please let us know which webinar time slot you are interested in so we can give you the appropriate Webinar ID.

Future Webinar Topics

• Marketing a Laser Therapy Clinic• Laser Therapy for Sports Injuries• Laser Therapy for Repetitive Strain Injuries and Tendinopathies• Veterinary Applications• Laser Therapy for Neck Pain

For future webinar dates and times, please visit www.bioflexlaser.com/training/webinars.php

Webinars 2012


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Advanced Training 2012

Musculoskeletal Pain WebinarPain is the most common etiological factor responsible for patient visits to healthcare practitioners. As we all know, pain is only a symptom, the result of existing pathology and Laser Therapy treats the underlying pathology at the cellular level. It is essential to comprehend the relationship between Pathology, Symptoms and Therapy. This Advanced Training course will clarify these relative factors and details, particularly with regard to recommended treatment strategies.

• The Systemic Effects of Photons – Immunomodulation, Mary Dyson, PhD• Musculoskeletal Pain Literature Review, Fernanda Saraga, PhD• Acute Conditions, Slava Kim, Clinic Director• Chronic Conditions, James Donovan, BKin(Hon), DC, DAc

Chronic Pain WebinarNeuropathies are conditions affecting neurological pathways, particularly the peripheral nerves. They are the product of a vari-ety of etiologies including systemic, traumatic, repetitive stress etc. This Advanced Training course will focus on the application of Laser Therapy in the treatment of these problems.

Included in the programme will be the need of establishing a correct diagnosis, the development of appropriate protocols and the proper application of both the large surface arrays and the laser probes. All aspects of Laser Therapy will be reviewed including dosages, frequency of treatment, and the combination with complementary modalities. Included will be a review of the literature regarding the management of both chronic and acute clinical conditions.

• Musculoskeletal and Neuropathic Conditions Research Review, Fernanda Saraga, PhD• Chronic Musculoskeletal Conditions, Renato Liboro, MD(INT)• Neuropathic Conditions, Slava Kim, Clinic Director

Low Back Pain Advanced Training Webinar• Effective Protocols and Treatment Regime: How to Treat Non-responsive Cases, Ben Yuen, DC, MSc, MCC• Clinical Outcomes of Laser Therapy in Low Back Pain Cases, James Donovan, BKin(Hon), DC, DAc • Factors Affecting Dosage, Fernanda Saraga, PhD

Wound Healing SeminarDate to be announced - Meditech International, 415 Horner Ave. Unit 1, Toronto, Ontario

Meditech’s Advanced Training on Wound Healing offers clinicians a one day seminar focused on gaining a better understand-ing of wound pathology. This course provides invaluable hands-on training with the BioFlex Laser Therapy System for the treatment of wounds. The keynote speaker for this even is Dr. Mary Dyson, an expert in the field of Laser Therapy for Wound Healing. A review of the literature will be followed by Dr. Dyson’s lecture – Soft Tissue Repair. Subsequent presentations will include a number of diverse clinical cases, customization of protocols, hands-on demonstrations and training in the Meditech Wound Care Facility.

• Case Profiles, Fred Kahn, MD, FRCS(C)• Wound Healing Literature Review, Fernanda Saraga, PhD• Soft Tissue Repair, Dr. Mary Dyson, PhD• Principles of Wound Care and Clinical Cases, Slava Kim, Clinic Director

For more information or to register for the advanced training webinars or courses, please visit http://www.bioflexlaser.com/training or contact Melissa at 1-888-557-4004 or by email at [email protected].


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Dr. Seuss’s story of Thidwick moose begins one autumn day

on the northern shore of Lake Win-na-Bango where a herd of moose – big-hearted Thidwick and 60 others – are seeking moose moss to munch. A Bingle Bug happens by and asks Thidwick for permission to ride on his antlers. Thidwick consents: He has plenty of antler to share. The bug tells a tree spider about the deal and the spider is soon building webs in Thid-wick’s antlers.

A bird settles next, then the bird’s wife, and then the bird’s uncle, a woodpecker who drills holes in the antlers and makes nesting places for four squirrels. More squatters arrive: a bobcat, a turtle, three mice, a fox, a bear, and 362 bees. Winter approach-es and Thidwick must get to the lake’s distant southern shore. His beneficia-ries refuse permission. They proceed to decide the argument democrati-cally and, predictably, Thidwick loses the vote. Suddenly, the big-hearted moose realizes that he has lost his free-dom – and that he lives solely for the creatures who have staked claims to his benevolence.

It would be mean to reveal the end-ing but as the author himself put it, in life-cycle terms, the “old horns

came off so that new ones can grow.” Thus concludes the cautionary tale of Theodore Seuss Geisel’s Thidwick, the Big-Hearted Moose, a parable more evocative now than when first published in 1948. Mr. Geisel was fa-mously liberal, a champion of FDR’s New Deal, yet his liberalism was nei-ther squishy nor sentimental. He once said that his children’s stories were “as subversive as hell,” as Thidwick’s adventures in a modern welfare state wickedly confirm.

Across Europe these days, countries are taking a lesson from Thidwick and shedding tens of thousands of public-sector workers. Much pseudo austerity has taken place. But many benevolent countries are shaking off civil servants at a rapid clip: 20,000 in Denmark; 55,000 in Germany; 70,000 in Romania; 13,000 in Spain – and 490,000, over four years, in Britain.

Other countries prefer hefty salary cuts. In Greece, public-sector wages have been cut by 25 per cent; in the Czech Republic, by as much as 40 per cent.

For these countries, austerity is a form of repentance for cheating, after years in which they routinely bor-

rowed and spent more than they were permitted by European Union rules. They had pledged to keep budget def-icits to less than 3 per cent of GDP. In 2009, of the 27 EU countries, 21 were in violation of this commitment, with Britain (at 14.4 per cent) the worst fis-cal offender of all.

Sweden was perhaps the most fiscal-ly disciplined of the EU countries, a discipline maintained since the 1990s when it hit the wall early on (as did Canada). In 2009, Sweden’s deficit was running at 0.9 per cent of GDP, the lowest in Europe. It became the only euro-club member to need no extraordinary fiscal restraint.

Paradoxically, however, Sweden employs more public-sector work-ers, as a percentage of labour force, than any other OECD country: 31 per cent. (South Korea employs the fewest: 7 per cent.) In its analysis of public-sector employment in Canada, Statistics Canada provides an answer. The further a government goes into debt, Statscan says, the more aggres-sively it tends to cut public-sector jobs, an ostensibly obvious conclusion that nevertheless leads to intriguing tradeoffs. People who want to expand public-sector payrolls must logically champion paying down of the debt.

Sweden has roughly half the federal-provincial public debt of Canada, and sets a good example of pay-as-you-go government.

Canada sustains 3.6 million public-sector workers – one in every five jobs in the entire economy. The country went through a public-sector down-sizing in the 1990s but has since more than replaced the jobs that disap-peared. In Newfoundland and Labra-dor, public-sector workers constitute 30.9 per cent of all jobs, essentially matching Sweden. In Alberta, public-sector workers constitute only 17 per cent. Go figure.

Statscan identifies a number of id-iosyncratic traits in provincial public-sector employment. The Atlantic provinces employ far more public-sector workers, with 135 per 1,000 in-habitants, than the Canadian average of 105.8. British Columbia and Al-berta employ the fewest. Nurtured in socialism, Saskatchewan requires 50 per cent more workers, per 1,000 in-habitants, than Alberta, its next-door neighbour. And Ontario employs more than one million public-sector workers – roughly 100,000 more than when Premier Mike Harris left office in 2002.

Social Commentary

On Wednesday, December 28th, 2011, I noted an article by Neil Reynolds in the Toronto Globe and Mail. This piece aptly explains the economic turmoil prevalent today. In essence, the problem results from the existing poor leadership in so many countries and at so many levels. All decisions, in one form or another, emanate from the top and poor leaders, impoverished in thought and action can only produce a negative impact, leading to disastrous outcomes in health-care, economic conditions, etc.

To reverse this process is frequently difficult - if not impossible. All countries and organizations must therefore periodically re-examine and revise their form of governance, in order to establish a structure that functions in a reasonable and effective manner.

In the age of technology, it is no longer permissible to state that “this is the best we have”; all countries and institutions must strive to become better. The initiation of this step is of the utmost importance, although sometimes it may lead to revolution.

At Meditech, we are aware of our mission to achieve a high level of success in treating a diverse number of pathologies, as we are focused on that objective at all times. Similarly, in the political arena, the focus of the state should be on the welfare of its population and nothing else. Unfortunately at this time, this does not appear to be the case; it is imperative that solutions be found and implemented.

Fred Kahn, MD, FRCS(C)

The moose and the modern welfare stateGlobe and Mail - Wednesday, Dec. 28, 2011

NEIL REYNOLDS


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MARKETING SUPPORTEverything you need to Promote and Grow your Practice

For more information on any of these products and services, please contact Melissa at [email protected]

Referral Kit• Resource for generating business and increasing

patient referrals• Includes a Webinar, customized brochures for the

physician and patients, referral pads and supporting scientific research

Clinic Listings• Update your clinic contact information for our new

website so patients can easily find you

NEW! Posters• 3 designs available

Customized Patient Brochures• Individualized for each clinic including clinic name,

location map and contact information• 3 designs from which to choose

Customized Clinic Websites• BioFlex Online will create, host and maintain a website

for your clinic• 9 templates to choose from

Laser Reports• Includes informative articles and upcoming educational

events• Send to your colleagues and patients


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We are pleased to announce the release of the BioFlex Practitioner Software Version 4.0. Meditech International continuously strives to provide you with the latest advances in technology and software in order to enable you to achieve optimal clinical outcomes in your practice.

Features of Version 4.0 include:

• Improved readability, including larger windows and text font• New yellow background for clock status bar for improved visualization when

wearing safety glasses• Clear distinction between predefined and customized protocols• Improved default parameters when customizing protocols• Overall enhanced reliability of software

BioFlex Practitioner Software Version 4.0 is compatible with Windows XP and Windows 7. This software update is available on CD or can be downloaded from the Meditech Bulletin Board. Moreover, it is provided without charge to our valued clients.

Meditech International is now on Facebook! Here you’ll be able to chat with other laser users, learn about upcoming events, interesting research, unique case studies and special offers.Become a fan by visiting https://www.facebook.com/pages/BioFlex-Laser-Therapy

facebook

Would you be interested in writing an article on your experience with Laser Therapy? Articles (1-2 pages) can include:• Interesting case profiles• Challenges and solutions for treating particular conditions• Strategies to increase referrals

Published articles can increase awareness of your clinic by patients and other healthcare practitioners. It is also an opportunity to share your expertise and expand the knowledge-base of Laser Therapy.

If interested, please contact us at [email protected]

Software Update

Submit an Article


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From $375*/mo lease amount

START THE NEW YEAR OFF WITH A NEW MOBILE PROFESSIONAL OR UPGRADE YOUR SINGLE PRO!

Taxes & shipping not included.*On approved credit. 60 month term. 10% buyout.

Bioflex Mobile Professional

For more information please contact Melissa at [email protected]

Bioflex Pro Upgrade

• Portable Carry Bag• Laser Probe• Mini Laptop with over 30 Preset

Protocols and the ability to customize• Main Controller Unit (MCU)• Safety Glasses• Large Surface Treatment Arrays

(Hands-Free Application)• Weight Set

• Shuttle Computer• Main Controller Unit (MCU)• Safety Glasses• Large Surface Treatment Arrays

(Hands-Free Application)• Laser Probe• KVM Switch• Weight Set• Arm

Registration includes course materials, structured classroom presentations and hands-on clinical exposure.

A certificate is presented to all healthcare professionals on satisfactory completion of this course.

For more information or to register for one of our courses please contact Melissa at 1-888-557-4004 or by email at [email protected]

415 Horner Avenue, Unit 1Toronto, Ontario, M8W 4W3Telephone: (416) 251-1055Fax: (416) 251-2116Toll Free: (888) 557-4004

Meditech International Inc. believes in the dictum of “Progress through Education.” As manufacturer of the BioFlex Laser Therapy Systems, the Company is dedicated to the education of participants with regard to all aspects of Laser Therapy. This ensures that systems will be used appropriately, leading to optimal clinical outcomes.

Formal lectures are followed by hands-on training in the application of Laser Therapy for the treatment of soft tissue and sports injuries, wound healing, dermatological conditions and a wide variety of musculoskeletal problems.

Continuing Education (CE) credits are available depending on healthcare professional and provincial regulatory bodies.

Please visit our website, www.bioflexlaser.com for details.

Copyright © 2012 Meditech International Incorporated. ALL RIGHTS RESERVED. 309_110912

LASER THERAPY 2012 Certification Training

January

February

March

April

May

June

July

August

September

October

November

December

20-21

24-25

23-24

27-28

25-26

22-23

20-21

17-18

14-15

19-20

16-17

7-8

Toronto Dates

Remote Dates

Vancouver, BCFebruary

Orange, VAMarch

Red Deer, ABApril

Victoria, BCJune

Edmonton, ABJuly

Vancouver, BCOctober

Calgary, ABNovember

3-4

2-3

13-14

1-2

20-21

26-27

23-24

Certification Training Content:

Principles of Laser TherapyThe Science and Research

Practical ApplicationSystem Operation

Development of a Laser Therapy Practice

www.bioflexlaser.comMedical Device License

HealthCanada

A12233 ISO 13485

Meditech International Inc.

laser report winter 2012

Documents

systems performance

additional systems

bioflex professional

exciting new systems

new clinic

bioflex professional

laser diodes

number of laser devices