SYMBYX DuoCare 904 User manual

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Contents
1General information............................................................................................................................................ 8
1.1 Product description ......................................................................................................................................8
1.2 Separate power supply source (mains supply transformer) .......................................................................9
1.3 Essential performance and basic safety...................................................................................................... 9
1.4 Temperature range for use indoors/outdoors: ........................................................................................... 9
1.5 User restrictions ..........................................................................................................................................9
1.6 General caution and warning statements................................................................................................... 9
2Device description and use................................................................................................................................10
2.1 Device design.............................................................................................................................................10
2.2 Operation description of laser treatment (general)..................................................................................11
2.3 General risks and hazards with medical lasers..........................................................................................11
2.4 Device overview ........................................................................................................................................12
3Primary operating functions..............................................................................................................................13
3.1 Charging of the battery .............................................................................................................................14
4Treatment controls............................................................................................................................................15

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4.1 Overview chart of the treatment controls ................................................................................................ 16
4.2 Treatment examples..................................................................................................................................17
5Treatment adjustments.....................................................................................................................................17
5.1 Skin phototype, hair colors........................................................................................................................17
5.2 Skin types, body modifications, tattoo colors...........................................................................................18
5.3 Body constitution .......................................................................................................................................19
6Medical recording..............................................................................................................................................19
7Device application specification........................................................................................................................20
7.1 Description ................................................................................................................................................20
7.2 Medical purpose........................................................................................................................................20
7.3 Patients......................................................................................................................................................20
7.4 Operator....................................................................................................................................................20
7.5 Application................................................................................................................................................. 20
7.6 Environment..............................................................................................................................................20
7.7 Frequency of device use............................................................................................................................21
7.8 Treatment/application time per patient...................................................................................................21
7.9 Treatment interval.....................................................................................................................................21

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7.10 Number of treatments per patient ............................................................................................................21
7.11 Treatment session interval........................................................................................................................21
7.12 Contraindications.......................................................................................................................................21
7.13 Side effects................................................................................................................................................21
7.14 Patient reaction.........................................................................................................................................21
7.15 Patient population..................................................................................................................................... 22
7.16 Intended OPERATOR .................................................................................................................................23
7.17 Operator responsibilities...........................................................................................................................23
7.18 Responsible organization .......................................................................................................................... 24
7.19 Patient position .........................................................................................................................................24
7.20 Training......................................................................................................................................................25
8General battery safety information ....................................................................................................................25
8.1 Battery safety ............................................................................................................................................. 27
8.2 Warnings and precautions.........................................................................................................................27
8.3 Recycling of batteries................................................................................................................................29
8.4 Replacement of battery .............................................................................................................................30
8.5 Transport and storage of the battery housing ..........................................................................................30

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9Laser safety........................................................................................................................................................31
9.1 General laser safety information............................................................................................................... 31
9.2 Class 3B potential hazards.........................................................................................................................32
9.3 Maintenance and control of emitted output power.................................................................................32
9.4 Protective eyewear. Personal protective equipment................................................................................34
10 General electrical and mechanical safety......................................................................................................34
10.1 Cleaning/disinfection procedures ..............................................................................................................34
10.2 Visual inspections......................................................................................................................................35
10.3 Information for service technicians...........................................................................................................36
11 Description of controls, messages, and indicators........................................................................................37
11.1 LCD-display................................................................................................................................................37
11.2 Treatment control .....................................................................................................................................37
“superficial”...........................................................................................................................................................37
11.3 Treatment control .....................................................................................................................................37
“low”......................................................................................................................................................................37
11.4 Treatment control .....................................................................................................................................38
11.5 Treatment control .....................................................................................................................................38

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“deep” ...................................................................................................................................................................38
11.6 One Joule control ......................................................................................................................................38
“1J” ........................................................................................................................................................................38
11.7 Audible information signal control............................................................................................................39
“sound mute” .........................................................................................................................................................39
11.8 Visible information signal indicator...........................................................................................................39
11.9 Battery status indicator.............................................................................................................................39
11.10......................................................................................................................................................................39
11.11 Laser emission control...........................................................................................................................40
12 Technical specifications (general) .................................................................................................................41
13 Technical specifications (laser)......................................................................................................................42
14 Definitions .....................................................................................................................................................43
15 Labels and symbols........................................................................................................................................45
16 Limitation of liability......................................................................................................................................48
17 Disposal and recycling of the device .............................................................................................................48
18 Transport and packaging of the device and/or battery housing...................................................................48
19 Manufacturer contact information ...............................................................................................................48

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20 Electromagnetic compatibility (EMC)............................................................................................................49
20.1 Electromagnetic Emissions –guidance and declaration ...........................................................................50
20.2 Electromagnetic Immunity –guidance and declaration............................................................................51
20.3 Separation distances –portable and mobile RF communications ..............................................................53
21 Applied standards..........................................................................................................................................54

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1General information
This operating and user manual applies to the DuoCare 904 Laser by SYMBYX. This laser device is manufactured for SYMBYX Pty Ltd of Australia by
Spectro Analytic Irradia AB of Sweden. Note: Irradia also manufacture an identical product called the MID-Lite Laser.
Pease read the ACCOMPANYING DOCUMENTS before the product is used. The reader is advised to keep the manual on hand for future reference,
when necessary. MEDICAL ELECTRICAL EQUIPMENT requires special precautions regarding ELECTRO MAGNETIC COMPATABILITY (EMC) that need to
be put into action. According to the EMC information provided in the ACCOMPANYING DOCUMENTS, portable and mobile RF communication
equipment can affect MEDICAL ELECTRICAL EQUIPMENT.
The use of accessories, cables, and transducers other than those specified herein as replacement parts for internal components, with the exemption
of transducers and cables sold by the manufacturer of the EQUIPMENT, may result in increased EMISSIONS or decreased IMMUNITY of the
EQUIPMENT. The EQUIPMENT should not be used adjacent to, or stacked on top of, other equipment. If it is necessary to use the EQUIPMENT under
those circumstances, the EQUIPMENT should be continuously observed in order to verify normal operation in the configuration in which it is used.
The RESPONSIBLE ORGANIZATIONS are advised to carry out all adjustments and cleaning and disinfection PROCEDURES as specified herein. The
RESPONSIBLE ORGANIZATIONS are reminded that the assembly of EMC SYSTEMS, as well as modifications during the actual service life, is evaluated
as regards to the requirements of IEC60601-1. Many countries have regulations, laws, requirements, and standards for personal protective equipment
and the installation and use of lasers, including their clinical use. Contact the appropriate national agency for the correct user requirements.
1.1 Product description
This product is a TRANSPORTABLE, HAND-HELD and INTERNALLY POWERED MEDICAL ELECTRICAL EQUIPMENT that is a NON-INVASIVE CLASS IIIb
ACTIVE THERAPEUTIC DEVICE, with which the OPERATOR administers TRANSIENT PULSED CLASS 3B INFRARED A (IRA) LASER radiation to a PATIENT.
The equipment consists of two parts, the INTERNALLY POWERED HAND-HELD device which emits LASER light through the APPLIED PART (or laser
APERTURE), and the Lithium-Ion battery charger which can charge and power the device through the MAINS SUPPLY. The HAND-HELD device is
classified as a TYPE B APPLIED PART and is considered to be a CLASS II electrical equipment when connected to the MAINS SUPPLY through the
Lithium-Ion battery charger, and INTERNALLY POWERED when not. The MAXIMUM MAINS VOLTAGE is 250 V.
The ENCLOSURE of the MAINS SUPPLY TRANSFORMER and the HAND-HELD device are classified as IP20. The equipment is classified for CONTINUOUS
OPERATION in NORMAL USE. The SECONDARY CIRCUIT of the equipment, i.e., its INTERNAL POWER SOURCE, is only RATED suitable for connections to
the MAINS SUPPLY at primary voltages of 100-240 VAC ± 10% by using the accompanying Lithium-Ion battery charger. The INTERNAL PWER SOURCE
is a COMPONENT WITH HIGH-INTEGRITY CHARACTERISTICS, which consists of a Lithium-Ion battery pack containing two 3.7 VDC Li-Ion cells in series.

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1.2 Separate power supply source (mains supply transformer)
This device is specified to be connected only to the Lithium-Ion battery charger, Model 2241Li from Mascot.
1.3 Essential performance and basic safety
The device does not have an essential performance, the absence of which may result in an unacceptable risk. Basic safety is maintained when the
device is stored, handled, and operated in normal condition, and in accordance with its normal use and intended use.
1.4 Temperature range for use indoors/outdoors:
Charge of batteries: 0⁰C to 35⁰C ±3⁰C (The device is connected to the battery charger but not used on a patient)
Discharge of batteries: 0⁰C to 28⁰C (The device is used on a patient whether connected to or disconnected from the battery charger)
Storage: -20⁰C to 50⁰C (Short or long-term transportation and storage when not using the device)
1.5 User restrictions
Various safety features have been included and built into the design of the device. Failure to follow the instructions for the use, transport and
storage of the device can lead to battery fluid leakage, heat generation, fire or battery explosion. Failure to follow the security precautions and
instructions for use may lead to a potentially dangerous exposure of the eyes (by intra beam viewing at close range), or thermal skin injury (by
applying high output power on dark pigmented skin). To prevent these situations from occurring, as well as to ensure safe use of the device, the
security precautions mentioned in this manual should be strictly observed.
1.6 General caution and warning statements
“WARNING: The use of controls, adjustments to the device, or performance of procedures other than those specified herein may result in
hazardous situations.”
This warning intends to inform the operator that BASIC SAFETY may be compromised by not using the device in its normal condition and in
accordance with its normal use and intended use.
“WARNING: No modification of this equipment is allowed.” This statement addresses the HAZARDS that can follow an unauthorized modification
of the EMC EQUIPMENT, e.g., BASIC SAFETY may be compromised by a modification or an alteration of the normal condition of the device.
This device is a Class 3B laser product. Warning: Do not look at direct and non-diffuse reflections, and avoid intra-beam viewing. Safety glasses are
provided with every laser.

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2Device description and use
This device is a transportable, hand-held and battery-operated medical laser product, with which the operator administers non-invasive transient
class 3B infrared laser light to reduce pain and inflammation, as well as to promote tissue repair and recovery. This device is intended to be used
as a supplementary treatment modality intended to be operated by a variety of practitioners, e.g., doctors, nurses, veterinaries, dentists,
physiotherapists, dermatologists, chiropractors, and massage therapists. The treatment modality of medical laser devices is commonly called Low
Level Laser Therapy (LLLT), or laser therapy.
Laser is an acronym for Light Amplification by Stimulated Emission of Radiation and emits light with unique properties, which combined cannot be
found in any other light source. These properties can be described briefly as monochromatic, coherent and, generally, highly polarized. Light
consists of oscillating electric and magnetic waves, and our vision interprets colors on the basis of the wavelength content of the light as it enters
the pupil and hits the retina.
The wavelength is described as the distance between repeating units of these waves, and is measured in nanometers (nm). Light with
wavelengths shorter than about 400 nm (ultraviolet) and longer than 800 nm (infrared) are not perceived as visible to the human eye. Visible
light, when described in nm, are as follows: violet 420 nm, blue 470 nm, green 530 nm, yellow 580 nm, orange 610 nm, and red 700 nm. The light
intensity (output power) of lasers is measured in Watts (W). Laser light can be pulsed or continuous, and the beam can be focused, divergent or
collimated. A wide range of lasers are used in laser therapy, and the characteristics and parameters vary depending on their intended use.
2.1 Device design
Laser light applied to the skin or tissue may be absorbed, reflected, transmitted, or scattered. In order to perform the most efficient treatments,
the laser light has to be able to penetrate and reach the area intended to be treated. Superficially situated conditions, such as open wounds,
therefore require a lower dose, power and transmittance compared to those that are situated deep down within the tissue, for example in
muscles and joint disorders.
This device is designed to enable the operator to administer efficient and safe laser treatments with ease.
Generally recommended parameters, which are considered optimal for each treatment point on the basis of studies and clinical practice, have
been built into the design and the controls of the device. The parameters and the dosages are automatically set by the treatment controls. The
laser and the aperture design ensure practicable contact application and improved transmission of light through the tissue. Treatment intervals,
number of sessions, application specification and use are described in this manual. The device complies with regulatory requirements,
harmonized standards, and the medical device directive in order to ensure safe use and a high-quality standard. The device has been third party
tested (CB scheme) to ensure compliance with regulatory requirements.

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2.2 Operation description of laser treatment (general)
Treatment is performed by applying a generally optimal dose of laser energy onto and around a condition, using a point-by-point application
procedure. An audible and visible signal informs the operator when to switch application point. At each signal, the laser aperture is moved ~ 1. 5
cm until the whole condition area has been covered.
The device has four different treatment controls that adjust the dosage and power according to whether the condition intended to be treated is
situated superficially, low, intermediate or deep within the tissue. The operator selects and presses respective treatment control button and
places the laser apertures in contact with intact normal skin, or in non-contact (~ 2 cm air distance) with sensitive and broken skin or open
wounds. The operator then presses the laser emission control button to start the laser treatment, holds the device in position, and switches
application point at each signal. When the area surrounding the condition has been covered, the operator presses the laser emission control
button to stop the laser emission, and reads the LCD display for medical record keeping.
2.3 General risks and hazards with medical lasers
Lasers with an average output power of 500mW or less can potentially cause eye injuries. If the beam is focused in order to deliver a high-power
density treatment, it can cause skin injuries when absorbed into dark pigmentation. Blue light lasers can cause photochemical injuries to the eye if
one looks at the light for a prolonged period of time. Lasers with wavelengths close to the UV-spectrum (400 nm) should be used with caution on
patients that are light sensitive or who are using herbs or drugs causing sensitivity to light. Pulsed visible laser light with a pulse frequency up to
60Hz may trigger photosensitive epilepsy.

2.4 Device overview

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3Primary operating functions
a) Use the key switch to put the device in operational mode (unlocking the device for use). The device enters a STAND-BY state.
b) A yellow Light Emitting Diode (LED) is lit when the key switch is turned, indicating STAND-BY.
c) Press and release the push-button to turn on the device (activate device). The device enters a READY state.
d) A green LED on the push-button indicates that the device is in READY state.
e) LEDs on both the key pad and at the laser apertures are lit in sequence, and a number of audible signals inform the operator that the
device is ready for use.
f) The operator selects a treatment control according to the location and depth of the condition or disorder. The symbols of the controls
are Superficial Low Intermediate and Deep .
g) When a treatment control button is pressed, the adjacent LED is lit for verification.
h) Place the laser apertures either in contact with dry intact skin at the location for treatment or in non-contact (with ~2cm air distance
between the laser apertures and the patient) if the skin is broken and sensitive, as well as over open wounds.
i) Press and release the laser emission control button to start laser emission (Start of action).
j) An audible signal indicates the start of laser emission. The laser aperture LED(s) is lit, indicating laser emission.
k) Hold the device in position.
l) An audible and visual information signal informs the operator when a generally optimal laser energy dose per application point has
been delivered ( -LED indicator).
m) Move the applied part (or laser apertures) approximately 1.5 cm and wait for the next audio/visual information signal.
n) Repeat until the entire area on and around the condition or disorder has been covered (i.e., a shoulder, knee, an elbow, etc.).
o) Press and release the laser emission control button to stop laser emission (Stop of action).
p) Two audible signals indicate stop of laser emission. The laser aperture LED(s) is switched off, indicating that no laser radiation is
emitted.
q) Remove the device from the patient.
r) Read the LCD display for medical record keeping (treatment time and dosage in Joules).
s) Press and release the push-button (ON/OFF) to turn off the device (the device enters STAND-BY).
t) Use the key switch to deactivate the device (i.e., locking the device).
u) Remove the key.
v) Clean the device with disinfectants.
w) Place the device in a safe and dry location (storing).
x) Make sure that the Li-Ion charger is unplugged from the mains supply (wall socket or similar).

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3.1 Charging of the battery
The device is intended to be used within the temperature range of 0 –28 ⁰C, and charged within the temperature range of 0 –35 ⁰C ± 3 ⁰C.
When the temperature of the battery exceeds 35 ⁰C ± 3 ⁰C, the charging is automatically stopped by a thermal switch. Charging will not be
possible again until the temperature of the battery has returned to a temperature of 35 ⁰C ± 3 ⁰C.
1. Turn off the device with the key switch, and remove the key.
2. Connect the cable connector of the Li-Ion charger to the battery charger on the device.
3. Connect the charger to the mains supply (wall socket).
4. Check that the Light Emitting Diode on the Li-Ion charger is lit (the color orange/red indicates charging of battery).
5. If the orange Light Emitting Diode is not lit, remove the charger from the mains supply and wait until the green Light Emitting
Diode is switched off. Connect the charger to the mains supply and retry.
6. Charge the battery under supervision (do not leave the device unattended).
7. The battery is fully charged when the Light Emitting Diode on the charger turns green.
8. Remove the charger form the mains supply (wall socket).
9. Disconnect the charger from the device by removing the cable connector.
10. Store the Li-Ion charger in a safe and dry location.
If the Light Emitting Diode on the charger blinks between green and orange/red it might be caused by either:
-The temperature of the battery may be too high. Make sure that the device is cooled down to a temperature lower than 35 ⁰C ±
3 ⁰C, but not lower than 0 ⁰C.
-Failure of charger, battery or the connector. Contact service for support.
If the Light Emitting Diode on the charger is not lit –neither green nor orange –then the charger is not functioning as intended. Contact SYMBYX
customer service for support via [e-mail].
Note: The device can be used when connected to the charger, as well as during charging. Connect the Li-Ion charger to the device, then to the
mains supply, and follow the primary operating functions. Remove the charger from the mains supply after use and disconnect the charger from
the device.

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4Treatment controls
The treatment controls are indicated by the following symbols: .
When a control button is pressed, the device sets automatically the parameters required for delivering a generally optimal dose per application
point onto and around a condition. When pressed, the Light Emitting Diode (LED) next to the control button is lit and the output power (in mW)
and dose (in Joules) are shown on the LCD display. The operator identifies at which approximate tissue depth, from the skin surface down, the
condition or disorder is located. The corresponding treatment control button is then selected and pressed.
The operator presses and releases the laser emission control button to start the laser treatment, holds the device in position, and switches
application point at each signal by moving the device approximately 1.5 cm to a new application point adjacent to the one before.
Treatment is ended when the area surrounding the condition or disorder has been covered.
Caution
If the device is switched on, but not used for more than 10 minutes, the applied part (the nut that holds the lens at the laser aperture) may
become 51 °C. If placed in skin contact and with pressure in this condition, it may initially be uncomfortable for the patient. The temperature of
the applied part will, however, drop within a few seconds due to heat dissipation in tissue and become the same as the skin + 2.5 °C. The skin
temperature will not be elevated by more than +2.5 °C.

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4.1 Overview chart of the treatment controls
The treatment controls overlap each other. There is no risk of harm using one control instead of another. The operator is advised to use the
control they find most suitable or which corresponds best to the condition being treated. The following controls are guidelines only.
Treatment Parameters per application point
Treatment
control
Depth of
conditio
ns being
treated
(in cm
from
skin
surface)
Treatment example
Allotted
time before
beeping
(s=seconds)
Joules
emitted
per laser
aperture
Total
delivered
amount of
laser energy
(Joule) per
treatment
point
Maximum
number of
treatment
points
Total delivered
amount of
energy (Joule)
per treatment
site
Superficial
0 - 1 cm
Swelling, open
wounds (non-
direct contact),
sensitive skin
15 s
0.9
2.7
10
27
Low
0 –3 cm
Elbow, wrist, hand,
foot, Achilles pain
30 s
1.8
5.4
10
54
Intermediate
0.5 - 5 cm
Muscles or joints
such as neck, knee,
shoulder,
abdominals,
hamstring, calf,
back
60 s
3.8
10.8
20
216
Deep
3 - 5 cm
Deep situated
muscles, such as in
the hip, buttocks,
groin, low back
120 s
7.2
21.6
15
324

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IMPORTANT! New patients using laser treatment for the first time should commence at a lower dose and/or treatment time to evaluate reaction. For some
patients suffering complex pain conditions, the laser treatment may cause in rare cases a transient increased pain. SYMBYX recommends a maximum of 30
seconds per treatment point and a total treatment time of 5 minutes in treatment of these patients with complex pain problems/disorder.

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4.2 Treatment examples
The apertures of the device cover a surface area of 4-5 cm², and are moved approximately 1.5-2 cm at each signal. A treatment area of 10 cm² is
covered after 1-2 signals. The examples in the chart below are general guidelines based on patients with normal height and body fat, and with skin
phototype I-III. Adjustments may be necessary for patients with other skin phototypes or with dissimilar heights, sizes or body fat.
Treatment
example
Treatment
control
(controlbutton to
be used)
Laser output
power & dose
(per application
point)
Application
method
Time per
application point
(and distance to a new
adjacent application point
Total
application
points
(number of
information
signals)
Total
treatment
time
Total
application
dose
(Joules delivered)
Open wound
3 x 60 mW
3 x 0.9 J
Non-contact;
over the wound
15 seconds per point,
then move the aperture 1.5-
2 cm
1 - 2
15 –30
seconds
2.7 - 5.4 J
Achilles tendon
3 x 60 mW
3 x 1.8 J
Contact without
pressure;
over the tendon
30 seconds per point,
then move the aperture
1.5-2 cm
2 - 4
1 - 2 min
10.8 - 21.6 J
Neck
3 x 60 mW
3 x 1.8 J
Contact, or contact
pressure
30 seconds per point,
then move the aperture 1.5-
2 cm
7 - 15
7- 15 min
75.6 - 162 J
Knee, Back
3 x 60 mW
3 x 3.6 J
Contact, or contact
pressure
60 seconds per point,
then move the aperture
1.5-2 cm
10 –20
10 - 20 min
108 - 216 J
Hip, groin
3 x 60 mW
3 x 7.2 J
Contact, or contact
pressure
120 seconds per point,
then move the aperture
1.5-2 cm
10 –15
20 - 30 min
216 - 324 J
CAUTION! Be careful when applying the device in contact pressure on elderly people or people with conditions causing them to bruise easily. For the latest update on general
dosage recommendations please visit www.symbyxbiome.com.
NOTE: Contact pressure of 1 to 5 N (Newton) is when the operator presses the device against the skin to remove blood from the tissue which thereby increases the transmission or
penetration of the laser light.

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5Treatment adjustments
5.1 Skin phototype, hair colors
Skin pigmentation varies with the amount of melanin in the skin and is assessed on a scale from I-VI. The skin phototype is determined by
complexion (white, brown or black skin) and the result of exposure to ultraviolet radiation (tanning). In connection with laser treatments, darker
brown and black skin and hair are more easily burned due to the absorption of light in melanin. Caution should therefore be exercised when using the
device on dark pigmented skin, dark hair and tattoos, and on moles and nevus, since output powers of 300-500 mW may cause discomfort and,
possibly, burns.
The skin phototype scale can be used as a guideline for treatment on or over tattoos of various colors.
Skin photo-
type, hair type
Typical features
Potential risk of burns by the laser
device
Treatment solution
I
Pale white skin
Never burns, unless the laser is pointed
at a dark nevus or mole, etc.
Move the laser aperture back and forth between different treatment points faster than
the preset treatment signaling times (example every 5 seconds).
Alternatively, perform treatment in a non-contact mode.
II
Fair skin
Never burns, unless the laser is pointed
at a dark nevus or mole, etc.
Move the laser aperture back and forth between different treatment points faster than
the preset treatment signaling times (example every 5 seconds).
Alternatively, perform treatment in a non-contact mode.
III
Darker white skin
Rarely burns, unless the laser is pointed
at a dark nevus or mole, etc.
Move the laser aperture back and forth between different treatment points faster than
the preset treatment signaling times (example every 5 seconds).
Alternatively, perform treatment in a non-contact mode.
IV
Light brown skin
May cause an uncomfortable sting on
darker spots.
Move the laser aperture back and forth between different treatment points faster than
the preset treatment signaling times (example every 5 seconds).
Alternatively, perform treatment in a non-contact mode.
V
Brown skin
May cause an uncomfortable sting on
darker spots.
Move the laser aperture back and forth between different treatment points faster than
the preset treatment signaling times (example every 5 seconds).
Alternatively, perform treatment in a non-contact mode.
This skin type absorbs more laser light/radiation more than paler skin. It is therefore
recommended to double the treatment time given per point.
VI
Black skin
The laser should be used with
supervision and caution should be
taken. May cause an uncomfortable
sting. If patient cannot respond to pain,
burn injury may occur.
Move the laser aperture back and forth between different treatment points faster than
the preset treatment signaling times (example every 5 seconds).
Alternatively, perform treatment in a non-contact mode.
This skin type absorbs more laser light/radiation more than paler skin. It is therefore
recommended to double the treatment time given per point.

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5.2 Body constitution
The patient’s body constitution may influence the dose of laser energy needed to achieve the most efficient results.
In the chart below, general guidelines are described for adjusting the treatment. This chart only applies when treating conditions or disorders that
are not superficially or externally situated, such as wounds.
Body size
Patient example
General adjustment and treatment advice
Very thin or very low muscle
mass
Elderly people, teenagers
Reduce the dose per treatment point by selecting another treatment (e.g., 3.6 J instead of 7.2 J).
And/or avoid using pressure when performing treatment application.
High amount of body fat or
extreme muscle mass
Large people, body builders
Increase the dose per treatment point by selecting another treatment (e.g.,7.2 J instead of 3.6 J).
Use contact pressure when performing treatment application.
NOTE 1. Patients with a low amount of body fat and/or muscle mass or smaller bodies require less application points to cover the area on and around a condition.
NOTE 2. Patients with a high amount of body fat and/or muscle mass or larger bodies may require more application points to cover the area on and around a condition. In
addition, the amount of body fat or muscles surrounding, for instance, a shoulder joint may require a larger dose and longer treatment time to compensate for the
absorption and loss of transmission of laser radiation. Contact pressure removes circulating blood and physically places the aperture closer to the target area or condition
intended to be treated.
6Medical recording
It is recommended that the medical record contains the following information:
•Diagnose, description of condition
•Used treatment control (i.e., output power(s) and Joules per point)
•Application area (i.e., where the laser radiation has been applied)
•Application method (i.e., non-contact, contact, or contact pressure)
•Total treatment time and Joules delivered
•Patient response to treatment