The Latest Hi-tec Equipment

Brian's clinic has some of the best modern equipment including the latest Scanning Laser, Pulsed Magnetic Therapy, Power-Assisted Manipulation and Hyperbaric Oxygen Therapy..

The Laser and Pulsed Magnetic Field machines used in conjunction with each other are particularly beneficial in the case of broken bones. The combination encourages bone cells to form scar tissue and then new bone, in turn, swelling is reduced which helps circulation and blood flow to the area, which encourages nature to take over and gives the healing process a head start. A very useful treatment for those bikers who 'absolutely must' race again at the next meet! More info

Other forms of treatment include short wave diathermy, interferential therapy, ultra sound, various other lasers, traction, spinal manipulation and acupuncture, as well as a fully equipped rehabilitation gym.

Hyperbaric Oxygen Therapy

How does it work?

Oxygen is transported dissolved in the blood and also in combination with haemoglobin in the red blood cells. Although haemoglobin carries most of the oxygen, it is only the dissolved oxygen that passes into the tissues. Breathing pure oxygen under hyperbaric conditions increases up to 10 times the oxygen dissolved in blood plasma to reach areas where the circulation is diminished or blocked and so improve recovery. The extra oxygen has additional benefits because it greatly enhances the ability of white blood cells to kill bacteria. It also reduces swelling and allows new blood vessels to grow more rapidly into the affected areas.

What is High Dosage Oxygen Treatment?

It is increasing the concentration of just the same oxygen we breathe normally in air. A hyperbaric chamber is needed to allow the pressure around the body to be increased. We all live under the pressure of the atmosphere and the extra pressure required for this treatment is small. The technology is very well established, as all commercial aircraft are hyperbaric chambers equipped with oxygen breathing systems!

High Dosage Oxygen Treatment, (HDOT) often called Hyperbaric Oxygen Therapy (HBO), has a hundred year history, but doctors have only recently recognised that even when the level of oxygen in the blood is normal there can be a severe deficiency in the tissues. Now the science is understood this use of oxygen is expanding rapidly around the world. The treatment involves breathing pure oxygen in a chamber at 1.5 to 2.5 times normal atmospheric pressure for an hour a day.

                View inside Hyperbaric Oxygen Chamber

How will breathing Oxygen help?

The air that we breathe usually provides enough oxygen for both normal body metabolism and the repair of tissue damage after injury or illness. However, tissue damage or disease also involves the blood vessels within the tissue and this may reduce blood flow. So, just when more oxygen is needed, the supply is reduced and recovery may be limited or even prevented. By increasing the concentration of oxygen in the blood more can be delivered to damaged tissue to establish normal oxygen values and so allow rapid recovery to take place.

What are the treatments like?

This is a simple, non-invasive and painless treatment which most patients find pleasurable and relaxing. You will be treated in a comfortable purpose built chamber. The treatment session is in three phases:

1. Compression:
2. Treatment: The treatment begins when the pressure reaches the prescribed level. You may then rest, sleep, read, listen to music or watch a DVD. It is your opportunity to relax and get better!
3. Decompression:

Control Panel

How often will I be having the treatment?

This depends on what your Doctor/Specialist feels is appropriate. The sessions last just over an hour and are ideally repeated daily five days a week but even twice weekly will be of benefit, for up to 20 sessions.

Are there any side-effects?

At the dosage used in this treatment there are no side effects from the oxygen. However, the change in pressure may cause some ear or sinus discomfort. More than 1.6 million sessions (at the time of printing) have been carried out in this country without a single serious problem! Note that HDOT has been used in the NHS for more than 50 years.

Fractured Tibia and Fibula

Typical fractured clavicle (collar bone)

Note: The Chamber can actually be decompressed at any time and whilst breathing oxygen, you cannot suffer decompression sickness ("the Bends").

There is a wealth of information on the subject of Hyperbaric Medicine, including many controlled studies.

Click here for further info including case studies and clinical experience.

or just contact us, we are happy to help.

Pulsed Magnetic Field Therapy and Pulsed Laser for Fracture Healing

The use of Magnetic Fields to aid the healing of bones has been long practised with good results, particularly when applied to non-unions. The FDA in America approved the use of PMFT in the treatment of fractures and non-union fractures in 1979. It is a non-invasive therapy which induces low frequency electrical currents in bone. The whole subject of magnetic fields is extensive and a deep study is beyond the scope of this synopsis. However, there are some readily understandable concepts. Pulsed magnet field therapy (PMFT), sometimes referred to as pulsed electro-magnetic field therapy (PEMFT) is defined in the treatment of fractures as the application of time-varying magnetic fields that induce voltage wave-form patterns in bone similar to those resulting from weight bearing and mechanical deformation. The electrical voltage is induced at right angles to the pulsed or dynamic magnetic field. This is termed electro-magnetic induction. The strength of the magnetic field in clinical applications is from 30 gauss (30G) to as much as 1000G - the earth's magnetic field in comparison is in the region of 0.5G - and a frequency range of 1Hz to about 200 Hz is typically used. All the studies quoted here are regarding pulsed magnetic fields and NOT static magnetic fields. The main requirement is that there is some dynamic interaction i.e. relative movement between the field and target tissue. In long bones, the marrow produces DNA -bearing immature blood cells which transform to become bone. Under normal conditions, therefore, the healing of fractures takes the form of regeneration as opposed to repair. Magnetic fields will penetrate virtually everything so a POP or Baycast cast is no obstacle to treatment with this modality. The physiotherapist would need to mark the approximate area of the fracture, referring to the X-rays for guidance.

Gossling et al in a literature review in 1992 concluded that PMFT was at least as effective as surgery in cases of non-union with an overall success rate of 81% against 82% for surgery, although infected non-unions showed a success rate of 81% with PMFT against 69% for surgery.

Basset et al in 1982 researched results in treating ununited fractures and failed arthrodeses with PMFT. In a large group of patients with an average of 4.7 years non-union, 3.4 previous surgical failures and a 35% infection rate, bony healing took place in 75% of the patients treated with PMFT.

"Laser" stands for Light Amplification by Stimulated Emission of Radiation. The main differences between Laser light and high-intensity light is that Lasers emit a coherent beam i.e. all photons are in phase and synchronised, the light is monochromatic i.e. one single, very specific wavelength and the Laser is applied with a specific dosage in mind, usually measured in Joules per square centimetre. Some Lasers are used in contact with, or very close to, skin and usually have an optical lens giving a divergent beam, frequently in the region of 6 degrees, while some more powerful Lasers emit a non-divergent beam which can scan along easily set parameters along X and Y axes to cover a larger area. The use of a non-divergent beam means that the inverse square law does not apply although clearly it does in the case of the 6 degree divergent beams.

The usual therapeutic wavelengths are in the far red to near infra- red (FR/NIR) wavelengths, ranging from about 600nm (visible red) to 1000nm non-visible infra-red). Most therapeutic Lasers typically have outputs ranging from 5mW (0.05W) to 1000mW (1.0W) and treatment times can vary from mere seconds to several minutes. Some more powerful scanning Lasers such as those used in this clinic can deliver 3W, non-divergent, continuous output and have the capability to produce a thermal burn if applied inappropriately. Some research studies indicate tissue response may be dose dependent as well as being dependent on the irradiation time and irradiation mode. Dickson et al showed a 300% increase in ALP ( alkaline phosphatase) expression in rat femoral fractures irradiated at 10-15 J/cm2 using a 820-830nm laser. Alkaline phosphates levels indicate bone-forming cell (osteoblast) activity. The main effect is photo-chemical and not thermic. Photon irradiation by light in the FR/NIR spectral range has been found to modulate various biological processes in cell culture and animal models. The mechanism of photo-bio-modulation by FR/NIR at the cellular level has been ascribed to the activation of mitochondrial respiratory chain components. Growing evidence suggests that cytochrome oxidase is a key photo-acceptor of light in the FR/NIR spectral range. Cytochrome oxidase is an integral membrane protein having a strong absorbance in the FR/NIR spectral range, detectable in vivo by NIR spectroscopy.

Far red cellular irradiation has been shown to increase electron transfer in cytochrome oxidase, increase levels of mitochondrial respiration and ATP synthesis in isolated mitochondria and also to up-regulate cytochrome oxidase activity in cultured neuronal cells.

This photo-stimulation also induces a cascade of signalling events such as activation of immediate early genes, transcription factors, cytochrome oxidase subunit gene expression as well as other enzymes and pathways related to increased oxidative metabolism.

Photo-stimulation of mitochondrial electron transfer is known to increase the generation of reactive oxygen species which may function as signalling molecules to provide communication between mitochondria and cytosol and nucleus.

Yaakobi and Oron showed that osteoblast/osteoclast population was altered by a 120% increase in ALP and 40% reduction in TRAP in the rat tibia. TRAP (tartarate-resistant acid phosphatase) is an indicator of bone-absorbing cell (osteoclast) activity. Histomorphometric analysis showed volume fraction of new reparative compact bone in the irradiated animals as being 27+/- 9% against 9+/- 7% at 10 days, 88+/-9% against 44+/-9% at 13 days and 94+/- 6% against 58+/-5% at 15 days. The wavelength used in this study was in the far red spectrum of 630-640nm.

Khadra et al investigated the weight percentages of calcium and phosphorus in rabbit tibial bone irradiated by an 810nm GaAlAs laser. These were found to be higher in the irradiated group compared to the control group with P=0.037 for calcium and P=0.034 for phosphorus, suggesting bone matured faster in the irradiated group.

Hyperbaric Oxygen for Wound and Fracture Healing

Effects of Hyperbaric Oxygen:

Increases Oxygen levels in the Tissue

Causes angiogenesis (formation of new blood vessels)

Facilitates Collagen Deposition

Enhances Leukocyte and Macrophage Functions to Fight Infections

Anti-microbial Effect

Stimulates Osteoclastic and Osteoblastic Activity to promote Bone Healing

Directs Multi-functional Precursor of Fibroblast to Bone Formation (Rather than cartilage seen at non-union)
 

ACUPUNCTURE

What is Acupuncture

Acupuncture is one of the oldest recorded forms of medicine having been used over 3,000 years in China. There are several theories as to how the effects are produced. The important thing is that it does work and that any side effects are extremely rare.

The members of the Acupuncture Association of Chartered Physiotherapists (AACP) of which Brian is a member, have a wide range of treatment methods at their disposal. These include manipulation, exercise, heat and ice, electrotherapy etc. Increasingly, physiotherapists are finding acupuncture an effective complement to their established skills.

Research

Research has been able to show that acupuncture stimulates the brain to produce natural pain relieving chemicals – endorphins. These assist the body to heal itself and gain pain relief. There is now increasing scientific evidence to support the effects of acupuncture.

Is Acupuncture Safe and will it work?

Acupuncture is safe when practised by AACP members, who are trained to use the strictest hygiene and therefore only use pre-sterilised disposable needles. Research has shown that 70% of people gain relief from pain with acupuncture. Patients don’t need to believe in acupuncture for it to work. The effects of acupuncture are cumulative, with a build up of effects as treatment progresses.

Why a Physiotherapist?

Chartered Physiotherapists who have completed a 3-4 year degree course based on western medicine with particular emphasis on anatomy and neurophysiology are in a unique position of being able to combine acupuncture with a variety of other treatment methods.

Blood Donation: The National Blood Transfusion Service approves acupuncture treatment provided by AACP members. Ask for a certificate.