LightForce Therapy High Intensity Laser DEEP. FAST. SAFE.
Enovis ® is a world leading orthopaedic company focused on helping people maintain and regain the joy of natural mobility. Offering a diverse portfolio of products and solutions to prevent injury, rehabilitate muscles, bones and joints and treat pain, we strive to help people live their lives to the fullest. We believe that our powerful brands, comprehensive range of products, extensive distribution network, unwavering focus on quality, innovation and customer service, and our strong relationships with orthopaedic and physical therapy professionals have all contributed to our leading market position. We have award winning manufacturing facilities across the globe with industry leading product design teams to continue the development and production of new products.
THE POWER OF INTEGRATED BRANDS
We stand out as a collection of integrated brands. Brands that have already established their name and reputation in the marketplace. Each product brand retains its individuality with the support of the ENOVIS ™ corporate umbrella. Taken together, the Enovis product range delivers an unparalleled continuum of care.
Chattanooga ® is the world’s largest manufacturer of rehabilitation equipment for treating musculoskeletal, neurological and soft tissue disorders. For over seven decades, Chattanooga has set a benchmark for leadership, reliability and excellence. Our products contribute to better treatment outcomes in hospitals and private clinics worldwide.
PROUD OF OUR PAST. READY FOR YOUR FUTURE.
75+ YEARS
1977 Traction Released the first motorized traction system, the TX ® Traction Unit
2004 CPM, Cefar Tens and Compex ARTROMOT ® CPM, CEFAR ® Tens and Compex ® added to the product portfolio
2020 Next Gen SW and Electrotherapy GENERATION 2020 A new generation of electrotherapy and RPW devices are launched
Bruce Spears VP
John Maley Owner
Jack Walker Co-founder
Hank Kanies Sales
1947 Founded in Chattanooga, Tennessee, by local athletic trainer Lee Jensen and his business partner Jack Walker, the Chattanooga Group began life as Chattanooga Pharmacal Company
1948 Hot and Cold Therapy Chattanooga entered the hot and cold therapy market with the introduction of the Hydrocollator ® Moist Heat Steam Pack ®
1981 Intelect Ultrasound Launched the first Intelect ® device, the Intelect ® 200 ultrasound unit
2011 Shockwave Entered the Shockwave market, been a success story and main driver of our growth in international markets.
2021 High Intensity Laser Therapy DJO acquires LiteCure, making Chattanooga the world’s
largest High Power Laser manufacturer and provider
LIGHTFORCE
Physical Agent Laser Light
LightForce devices are known around the world for innovative technology and evidence-based treatment solution. With thousands of customers across the globe, Chattanooga estimates over 1 million treatments
Clinical Effect Photobiomodulation (PBM)
are performed per month with LightForce solutions.
Modality Photobiomodulation Therapy (PBMT) / HILT / LLLT…
Understanding Terminology LightForce Therapy devices provide high intensity laser therapy (HILT) enabling photobiomodulation (PBM) to take place at cellular level. “Cold Laser”, “Low-Level Laser Therapy (LLLT)” and “Low-intensity Laser Therapy (LILT)” are all terms previously used in the laser therapy field. The key point is that laser therapy, no matter the terminology used, affects the body through a process called photobiomodulation (PBM). More recently, based on a consensus in the field, the term photobiomodulation therapy (PBMT) was added to the National Library of Medicine MeSH database as an entry term to the existing record of laser therapy. 1
LightForce THERAPY is our own modality
1. Anders JJ, Lanzafame RJ, Arany PR. Low-level light/laser therapy versus photobiomodulation therapy. Photomedicine and Laser Surgery. 2015; 33(4):183-184
LIGHTFORCE THERAPY INDICATIONS LFT CAN ADDRESS PAIN AND TISSUE REPAIR ASSOCIATED WITH:
• Back pain • Tendinopathy
TMJ
Placebo + EX
PBM + EX
Rotator Cuff Tendinopathy
PBM : 10,5W – 1064nm + EXERCICE program for all 3 times a week for 4 wks
ROTATOR CUFF TENDINOPATHY ELSODANY ET AL. 2018 1
9 8 7 6 5 4 3 2 1 0
7.9 7.7
Epicondylitis
-2.8
-3.4
4.9
4.3
-6
-6.1
1.9
1.8
Baseline
4 weeks
6 monthes
SIGNIFICANT AND LONG TERM IMPROVEMENT OF SYMPTOMS ASSOCIATED WITH ROTATOR CUFF TENDINOPATHY 1
Carpal Tunnel Syndrome
PBM + Physio
Physio only
PBM : 30W – 980nm Physio : hot pack + IFC + US 3 times a week for 4 wks
KNEE OA KIM ET AL 2016 2
9 8 7 6 5 4 3 2 1 0
Arthritis
7.3 7.2
-1.4
5.8
-4.2
3.1
Plantar Fasciitis
Baseline
4 weeks
BETTER RESULTS ON IMPROVEMENT OF PAIN AND FUNCTION IN KNEE OA PATIENTS WHEN PBM IS ADDED 2
Ligamentous injury
1.
2.
1 - ElsodanyAM, AlayatMSM, Ali MME, KhapraniHM. Long-Term Effect of Pulsed Nd:YAGLaser in the Treatment of Patients with Rotator Cuff Tendinopathy: A Randomized Controlled Trial. PhotomedLaser Surg. 2018 Sep;36(9):506-513. 2- Kim GJ, Choi J, Lee S, Jeon C, Lee K. The effects of high intensity laser therapy on pain and function in patients with knee osteoarthritis. J Phys Ther Sci. 2016 Nov;28(11):3197-3199
• Bursitis / Capsulitis • Nerve compression / Radiculopathy
• Arthritis • Muscle and ligament injury
Headaches
PBM + EX
Placebo + EX
Adhesive capsulitis
PBM : 10,5W – 1064nm + EXERCICE program for all 5 times a week for 4 wks
NECK PAIN INCE ET AL. 2023 3
9 8 7 6 5 4 3 2 1 0
Back Pain
7.4
7.1
-3.2
-3.7
4.2
3.7
-4.7
-5.2
2.4
1.9
Baseline
4 weeks
3 monthes
SIGNIFICANT AND LONG TERM IMPROVEMENT OF SYMPTOMS ASSOCIATED WITH CERVICAL RADICULOPATHY WITH PBM AS ADJUNCT TO EXERCICE 3
Strain
Placebo + EX
PBM + EX
ACHILLES TENDINOPATHY TUMILTY ET AL. 2016 4
PBM: 10W–810-980nm 3 times a week for 4 wks + EXERCICE program for all, 2 times a week
9 8 7 6 5 4 3 2 1 0
8.6
7.8
-5.1
-4.7
-6.3
3.5
2.4
2.3
-7.8
0.05
Baseline
4 weeks
3 monthes
IMPROVED OUTCOMES FOR ACHILLES TENDINOPATHY WITH PBM AS ADJUNCT TO EXERCISE TWICE A WEEK 4
Achilles tendinopathy
3.
4.
3, İnce S, Eyvaz N, Dündar Ü, Toktaş H, Yeşil H, Eroğlu S, Adar S. Clinical Efficiency of High-Intensity Laser Therapy in Patients With Cervical Radiculopathy: A 12-Week Follow-up, Randomized, Placebo-Controlled Trial. Am J Phys Med Rehabil. 2024 Jan 1;103(1):3-12. 4 - Tumilty S, Mani R, Baxter GD. Photobiomodulation and eccentric exercise for Achilles tendinopathy: a randomized controlled trial. Lasers Med Sci. 2016 Jan;31(1):127 35.
HOW DOES LIGHTFORCE THERAPY WORK?
810nm
980nm
Influence directly the Nociceptor and Dorsal Root Ganglion
Stimulate Cytochrome C
Release Cytochrome C Oxydase
Block Pain signals
Increase ATP production (Energy)
Reduce Inflammation markers
Increase Nitric Oxygen (NO) and Reactive Oxygen Species (ROS) activity
Promote release of endorphins
Restore Energy balance
Mitochondria
Photons
Cell
White matter
ATP
Grey matter
ROS
Anterior median fissure
Dorsal root
NO
Cytochrome C Oxdase
BENEFITS
Pain
Collagen Production
Inflammation & Edema
Bone Formation
Nerve Regeneration
Angiogenesis & Neovascularization
Cartilage Production
Muscle Regeneration & Muscle Atrophy
Epidermis
Dermis
Fat
Muscle
Bone
TOP BIOLOGICAL EFFECTS OF LASER THERAPY 1
Analgesic effect Laser therapy of diseased and damaged tissue produces a suppression of hypersensitive nociceptors, normalization of the membrane firing threshold, and an increased release of tissue endorphins, amongst other mechanisms. In addition to the reduction in inflammation, the result is a decreased patient perception of pain. Decreased inflammation and swelling Laser therapy reduces inflammation through several mechanisms especially via the reduction of pro-inflammatory mediators. Facilitating lymphatic drainage can significantly reduce swelling as well. As a result, inflammation, erythema, bruising, and oedema are reduced. Improved vascular activity Laser light increases the formation of new capillaries in damaged tissue. This improves blood supply to areas with poor circulation.
Accelerated tissue repair and cell growth Photons of light from lasers penetrate deeply into tissue and accelerate cellular reproduction and growth. Laser light increases the energy available to the cells so that they can take on nutrients and get rid of waste products more quickly. Improved nerve function Slow recovery of nerve function in damaged tissue may result in numbness and impaired limbs. Laser therapy accelerates nerve cell regeneration. Trigger points and acupuncture points Laser Therapy treats muscle trigger and acupuncture points without mechanical invasion to aid in providing musculoskeletal pain relief. Immunoregulation Therapy laser photons have an effect on the immune system’s status through modulation of the immune response.
(1) Chung H, Dai T, Sharma SK, Huang YY, Carroll JD, Hamblin MR. (2012), The nuts and bolts of low-level laser (light) therapy. Ann Biomed Eng. Feb;40(2):516-33
POSITIVE OUTCOMES ARE DOSE DEPENDENT
High Intensity laser light needs to reach the mitochondria of the damaged target tissue and the best results are achieved with a sufficient amount of light (number of photons = DOSE).
RECOMMENDATIONS FOR DOSAGES
“USING THE CORRECT DOSAGE CAN SIGNIFICANTLY REDUCE
Our recommendations used in our Protocols
PAIN AND EXPEDITE THE HEALING PROCESS (1).”
10 J/cm 2
Average Subacute indication
6 J/cm 2
Superficial tissue
15 J/cm 2
Deep tissue
Decrease dosage by 20%
Acute / Inflammation
Increase dosage by 20%
Chronic problem
Treatment area can be calculated in number of hand palms or CD size (around 100cm 2 )
CALCULATE THE DOSE NEEDED
DOSE (JOULES) = RECOMMENDED DOSAGE (J/CM²) X TREATMENT AREA (CM²)
Example : Indication Deep and Chronic => 15 J/cm² + 20% = 18 J/cm² Treatment area => equivalent 2 palms : 200cm² Total DOSE needed = 18 x 200 = 3600 Joules
TREATMENT TIME (SECONDS) = TOTAL DOSE NEEDED (JOULES) / POWER APPLIED (WATTS)
The delivery of this DOSE will depend on POWER and TIME. The higher power means shorter the treatment time.
Example : 3600 Joules to be delivered
at 1 Watt => 3600 seconds (1 hour) at 10 Watts => 360 seconds (6 minutes) at 20 Watts => 180 seconds (3 minutes)
Preset protocols are set following these rules. In addition, the Perfect protocol© guide will help to configure the most customized treatment parameters possible for better outcomes.
CONCLUSION
Penetration
Therapeutic Penetration
Off contact 810nm
On contact 810nm + 15% more therapeutic energy
On contact 980nm Deeper wavelength penetration plus larger therapeutic area
The bright area shows the light penetration of 1W delivered in 1 second. The therapeutic effect on cells exceeds this area (shown in red).
FACTORS INFLUENCING THE DOSE DELIVERY
1. HIGH CONTINUOUS POWER
The higher the Power delivered to the skin, • the more important the dose to the target tissue, • the deeper the penetration, • the shorter the treatment time, • the better the pain blocking effect.
1W
10W
15W
2. IMPROVING LIGHT PENETRATION
When contact between the Laser head and the skin : • Compression removes competing blood chromophores (blanching), • Opens hair follicles, • Reduces light reflection on the skin between 4-7%, • Collimated beam improves light transmission by increasing energy density, Energy transmitted to the tissues increased by 15%.
3. WAVELENGTH MINIMIZING UNWANTED ABSORPTION
Therapeutic Window
• Interest to both 810 and 980 nm wavelengths due to their ability to be preferentially absorbed by musculoskeletal tissues. • They also minimize the interference of melanin which has an affinity for shorter wavelengths as well as the impact of water within the body which preferentially absorbs longer wavelengths. • Energy that is absorbed by melanin or water in the body is energy that is lost at the target tissue. • The wavelength ratio has to be set depending on the skin colour (melanin concentration).
10 2
Melanin
10 1
Water
Oxy hemoglobin
10 0
10 -1
10 -2
400
600
800
1000 1200 1400
Wavelength (nm)
HIGH CONTINUOUS POWER + ON CONTACT TREATMENT + RIGHT WAVELENGTHS = THERAPEUTIC EFFICIENCY
(1)Clijsen R, Brunner A, Barbero M, Clarys P, Taeymans J. Effects of low-level laser therapy on pain in patients with musculoskeletal disorders: a systematic review and meta- analysis. Eur J Phys Rehabil Med. 2017 Aug;53(4):603-610.
THE LIGHTFORCE SOLUTION
EXCLUSIVE LIGHTFORCE ® TREATMENT HEADS
Small Cone Up to 6W only. OFF
Small Massage Ball Up to 6W only. ON
Large Cone OFF CONTACT. To treat large areas or deep tissues when need of high power settings. Not recommended around the face or on small areas.
Rolling Pin ONLY with 40W – XLi. ON CONTACT only. To treat large areas with an easy movement, reducing light energy loss and allowing physical compression of tissue.
CONTACT (10 cm away from the skin maximum). To treat very narrow or precise areas.
CONTACT only. To treat trigger points, around the face, fingers or toes.
Flat Window Up to 6W only. OFF
Large Massage Ball ON CONTACT only. Most common used, to treat problems on back, hips and large muscle groups.
XL Cone ONLY with 40W – XLi. OFF CONTACT. To keep high power treatment comfortable even at over 25W (Spot size twice bigger than Large cone). To treat large areas or deep tissues when need of high power settings.
CONTACT (10 cm away from the skin maximum). To treat superficial tissues or with boney proeminences.
TREAT DEEPER, FASTER AND EFFICIENTLY...
HIGH POWER AND EFFECTIVE WAVELENGTHS • High power delivered in continuous mode: 40W, 25W or 15W. • Average treatment time of 4-7 minutes. • Clinically proven wavelength: 810 and 980nm wavelength are the most recognized wavelength in laser research. ON CONTACT TREATMENT WITH EXCLUSIVE MASSAGE HEADS • Limited reflection on skin thanks to the patented on-contact delivery system. • More energy transmitted - up to 15% - by compressing the tissue and “blanching” the superficial blood vessels. • Manual tissue work while delivering energy. • Consistent light distribution promoting warming and soothing comfort.
The exclusive LightForce ® patented massage ball allows the clinician to treat patients on-contact.
Compression The on-contact massage ball compresses superficial tissues, displacing excess fluid and helping to enhance laser penetration to deep structures. This compression reduces the impact of superficial absorbers. Collimation The massage ball acts to keep the light beam collimated, helping to reduce energy loss. Refractive Index The fused silica composition of the massage ball helps minimize light loss as it passes from the massage ball into the skin. Reflection On-contact application of delivery to tissue minimizes energy loss due to reflection.
When laser therapy is applied directly to the skin in an on-contact manner, less energy is reflected, and tissue is compressed. This results in much more energy reaching the target tissue.
...MOST MUSCULOSKELETAL PATHOLOGIES... Accurately dose and create consistent outcomes for multiple conditions thanks to customizable protocols accounting for: chronicity, body mass, height, skin tone. Patient specifications such as condition, body type, and skin type are taken into account. The in-depth protocol settings provide recommended parameters on treatment heads and power levels to aid in clinician confidence and reduced learning time.
...WITH A SAFE, SMART AND USER-FRIENDLY DEVICE
• Safety recognized: Safe Class IV laser on the market. The only one classified as Class IIa according to the EU medical devices classification. • Consistent outcomes and improved patient comfort thanks to the software helping with head selection and optimizing power density. • Easy customization of treatment parameters for advanced users thanks to Perfect Protocol©. • Smart Handpiece© allows for: • Consistent dosing • Safer treatment by minimizing risk of skin overheating with real-time visual and sensory feedback. • Easier training for new users
Speed too fast
Speed too slow
Recommended Speed
• Quick and easy head change with bayonet release. • Most durable fiber on the market. Extra long for user convenience. • Long period of use thanks to a reliable cooling system.
...AND MORE : EDUCATION AND SERVICE
• Able to interact directly with manufacturer/ Industry leading customer service. • Support available on how to attain return on investment. • Expert technical training on dosing/ treatment concepts. • Ability to save preferred protocols. • Certified installation/ safety check list. • Patient information material delivered with device in local language.
Enovis Institute
ROI calculator tool
Contraindications • Do not treat over growth plates in children • Do not treat pregnant patients over the abdominal area or the low back/pelvic area • Avoid treating around glandular tissue (such as thyroid, testes, ovaries)
• Do not treat over pacemakers or internal pain pumps • Do not treat patients taking photosensitive medications (such as steroids or antibiotics)
FREQUENTLY ASKED QUESTIONS NUMBER OF WAVELENGTHS ?
There is no magic wavelength, The target cell, Cytochrome C, is generously absorbing and responding to everything from 600nm out to 1064 and beyond. The trick is getting the light to the tissue with the help of Power. And blending 810 and 980nm based on skin color and other parameters, is the most well understood, and clinically proven approach.
WHAT ABOUT SUPERPULSING ? The “on” time, the pulse duration, is equal to microseconds (s 10-⁶) and nanoseconds (s 10-⁹). The dose of energy (amount of light) delivered to tissues is miniscule and does not allow to trigger the photobiomodulation in an optimal way. The literature does not support the claims made for this feature as it has been demonstrated that the optimal laser emission to trigger photobiomodulation must be continuous or pulsed with a pulse duration of at least few milliseconds (10⁻³ seconds), as stated by Hashmi, in 2010 in the article “Effect of Pulsing in Low-Level Light Therapy”.
Continuous Mode Example : Average Power = Peak Power = 25W Total Dose = Average Power x time = 25W x 10seconds = 250 Joules
25
Time
Pulsed Mode Example : Peak Power = 300W Average Power = Peak power x Pulse time « on » duration x f = 1,35W Total Dose = Average Power x time = 1,35W x 10seconds = 13,5 Joules
300
Time
ANY SIDE EFFECTS OF LIGHTFORCE THERAPY? Based on peer-reviewed literature, there are no known significant side effects from LightForce therapy for most conditions. Increased blood flow is a positive benefit associated with LightForce therapy that can cause the skin to get flush and the feeling of warmth. These changes are short-lived, typically lasting for up to a few hours. Understanding proper dosing parameters and the use of our Smart Handpiece minimize this phenomena.
WHY REPLACE MY “LLLT DEVICE” ? “Cold Laser”, “Low-Level Laser Therapy (LLLT)” and “Low- intensity Laser Therapy (LILT)” are all terms previously used in the laser therapy field. The main difference is the power available in the device. Class IIIb lasers are only delivering power < 0,5 watt when Class IV lasers are not limited except by technology and cooling function. Increased power enables the clinician to treat a larger area in a shorter time, thus allowing a more efficient delivery of a therapeutic dose to target tissues.
Comparison of the tissue saturation between setting of 1W, 5W and 10W of power. Hand placed in contact with treatement head and light penetration observed with Infrared camera on the other side of the hand.
CAN LIGHTFORCE THERAPY BE USED WITH OTHER MODALITIES/TREATMENTS? Yes, it generally works well with other modalities that are designed to promote tissue repair. Best known example is shockwave devices. The mechanisms that are associated with this modality work well with LightForce therapy. Clinical proven benefits are being studied. Generally using modalities that are designed to provide cryotherapy, which generally reduce blood flow and promote vasoconstriction, is not recommended as adjunctive therapy with Lightforce.
FAMILY OF PRODUCTS – ORDERING INFORMATION
STANDARD ACCESSORIES (ALL PRODUCTS)
XLi 40W “Treat larger, deeper areas and provide faster pain relief with real time dosing feedback. Chattanooga’s most powerful laser, the 40W LightForce(r) XLi impacts deep tissue faster for pain relief in less time. The LightForce smart hand piece and onscreen recommendations increase dosing accuracy and help clinicians treat with confidence.”
Safety eyewear : 4 units
Treatment heads set
Laser Type: Class IV, Solid State Laser Wavelength: 980/810 nm Laser Power: 1W – 40W Operating Modes: CW or Pulsed Aiming Beam: 650 nm, < 4.5 mW Dimensions: 43 cm x 28 cm x 26 cm Weight: 9 kg Warranty: 24 months
All international power cords Protective carry bag
OPTIONAL ACCESSORIES
PART NUMBER
PART DESIGNATION AND DESCRIPTION
Rolling Hard case Laser Cart
LTS-4000-L-S8 (XLi) System - Int’l LightForce XLi (40W) Therapy Laser System
SYS-000656-000-00
FEATURE
XLI 40W
XL treatment heads
« Smart » Handpiece
Treatment head recommendation and check
Predefined protocols library
Perfect Protocol©
Chronic / Acute criteria
Battery - mobility
Patient information material kit – local language
XPi 25W “Smarter than your average laser. The 25W LightForce(r) XPi gives real time visual and haptic feedback, allowing clinicians to provide consistent, accurate treatments. The XPi’s built-in intelligence tells users which treatment heads are acceptable or not recommended for different power levels, which helps to provide for safer treatments and less guesswork from clinicians.”
FXi 15W “Treat quickly and consistently on the go. The 15W LightForce(r) FXi is ideal for those practices or athletic training rooms needing to treat in multiple locations in or out of the office. Easily transportable with an integral battery, the lightweight FXi quickly impacts pain while weighing in at only 7 lbs.”
Laser Type: Class IV, Solid State Wavelengths: 980/810 nm Laser Power: 0.5W – 15W Operating Modes: CW or Pulsed Aiming Beam: 650 nm, < 4.5 mW Dimensions: 38 cm x 28 cm x 20 cm Weight: 3.2 kg Warranty: 24 months
Laser Type: Class IV, Solid State Laser Wavelength: 980/810 nm Laser Power: 1W – 25W Operating Modes: CW or Pulsed Aiming Beam: 650 nm, < 4.5 mW Dimensions: 43 cm x 28 cm x 26 cm Weight: 9 kg Warranty: 24 months
PART NUMBER
PART DESIGNATION AND DESCRIPTION
PART NUMBER
PART DESIGNATION AND DESCRIPTION
LTS-2500-L-S8 (XPi) System - Int’l LightForce XPi (25W) Therapy Laser System
LTC-1510-L-B6 (FXi w/ BHP) System - Int’l Light Force FXi (15W) Therapy Laser System
SYS-000837-000-00
SYS-000829-000-00
XPI 25W
FXI 15W
1a Guildford Business Park, Guildford, Surrey, GU2 8XG, UNITED KINGDOM chattanoogarehab.com
Individual results may vary. Neither Enovis, DJO, LLC or any of their subsidiaries dispense medical advice. The contents of this document do not constitute medical, legal, or any other type of professional advice. Rather, please consult your healthcare professional for information on the courses of treatment, if any, which may be appropriate for you. MKT-6456640011-EN - Rev A Copyright © 2024 DJO, LLC, a subsidiary of Enovis Corporation
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