Welcome to PhotoMed Technologies' Feasibility Study Systems Site - Page 2

Wellness depends upon myriad bodily systems communicating and working in harmony.

This site is about the people with impaired sensory & motor functioning, chronic wounds, or unmanageable chronic pain. Their path to wellness has been interrupted.

 

(Note: the website pages were published before the shift in perspectives insights.)

 

Could a shift in perspectives account for the physical therapy outcomes?

 

Observing the switch between "offline" and "online" states

The following examples are provided from an engineer's perspective. Practitioners from different specialties use their own jargon to tell the stories. The concepts were what remained after the failures of attempts to "explain" the events from other perspectives.

Muscle relaxation or re-coordination - headaches?

Have you ever had a headache along with unwanted activation of muscles?

 

This common problem appeared in the feasibility studies as an asymmetric activation of muscles. The system of muscle should have been coordinated both at rest and during movement.

Patients reported that the durability of headache relief and increased range-of-motion were greater than from previous therapies. More surprising was that the therapy only required a few minutes.

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Figure 1 – Headaches may be accompanied by asymmetric muscle tension. The unbalanced forces envoke other muscles to provide the forces needed to maintain stability. Could prompting the return to normal symmetry “explain” the unexpected magnitude and durability of relief?

Could a re-coordination of associated muscles provide a better explanation than relaxation?

Of course, the body heals itself; the variable-wavelength therapy (VWT) aims to efficiently re-direct the body's attention to prompt the restart of healing.

 

Like with many practitioner-guided therapies, the intended improvements may be observed during the visit.

 

Muscle relaxation or re-coordination - muscle knots?

Volunteers who arrived with muscle knots described how they depended upon other people’s elbows pressed into their back to get a knot to relax. The common term "knot" suggests a mechanical state along the muscle that can be felt externally as a lump.

The activation errors (knots) remained within a single muscle, typically in their trapezius, despite mechanical stimulation.

A minute or two of therapy could release a knot.  The knots seldom came back right away when all of the knots were released within a muscle or muscle group. The durability of the release suggests the re-coordination within and between muscles.

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Figure 2 - Muscle knots (aka myofascial trigger points) can result from activation differences along a single muscle. Patients reported greater relief and durability than achieved via other methods. Could the re-coordination of muscle fibers “explain” the outcomes?

Could a re-coordination of associated muscle fibers (slow, medium, and fast) provide an explanation  for the durability?

Note that we prefer descriptive terms, such as "knot" that describe the observed impairment. For example, a lump or lumps in an otherwise relaxed muscle. The desired outcome is that the knots disappear in what we call the return to normal functioning (R2N). Other interventions or therapies may achieve the same outcome via different pathways.

The variable-wavelength therapy appears to work locally to release one knot at a time. In other cases, the therapy appears to work bilaterally or quadrilaterally such as when cold limbs resume cycling their comfortable temperatures. A simpler explanation is that the impairment occurs at a different point in the control or feedback processes.

 

Could the recovery of ordinary sensations be a 2-step process?

As might be inferred from Figure 7, the loss of sensation can get stuck “offline”. The pain score may be zero.

 

Without an update, the person's touch maps may report zero sensations for years.

However, the person may have pain upon a change in the texture of their slippers. This suggests that the "offline" state may primarily affect the person's awareness circuits.

Note that pain or noxious sensations may occur despite the awareness of touch being "offline".

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Figure 3 - "George" had diabetes for 40 years. His feet had been offline for 8 years. Then he enrolled in one of PhotoMed’s feasibility studies. His ability to feel again after a few minutes of therapy. However, his touch-maps were not aligned with his skin until he looked to see where he was being touched.  Click here to watch as his foot touch-maps realign.

Of most interest in the studies, fingers and feet could resume their "online" state within a few minutes of the variable-wavelength therapy.

With the curiosity of a profound self-discovery, the patients explored their newly awakened skin. They touched themselves and tested textures. These activities automatically realigned their touch-location maps.

It may sound crazy, but in one case (Figure 3), you can watch the realigning of touch-maps when "George" observes where he is being touched 28 minutes after the reawakening of his feet.

Could the realignment have happened as quickly - or at all - without the cross-sensory perception?

 

Could patient selection favor an "unmanageable" factor?

The feasibility studies used a delayed-entry style to enable comparisons with the patient's previously failed interventions. The failed interventions provide "randomized" control arms. The team employed the null hypothesis for comparing outcomes.

 

The null-hypothesis simply stated, "when the VWT therapy "works", the outcome won't be "better" than the outcome of any previous intervention. The good news - the hypothesis failed (that is, the VWT works).

The null hypothesis failures (it works) applies to many non-invasive therapies whenever the injury returns to normal functioning. Isn't that the aim for physical rehabilitation?

Placing the studies at the end-of-the-line led to recognizing that it is the unmanageable injuries that are most likely to respond to non-invasive therapies. The variable wavelength therapy may be more efficient. See Figure 4.

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Figure 4 - an "unmanageable" state describes injuries that may be more likely to respond to the variable-wavelength therapy. The person may be taking multiple pain medications that no longer "work" or have plateaued in their recovery.

Responses and outcomes data from 500+ volunteers in the feasibility studies suggested how to “predict” who might respond to the test therapy. People who were satisfied with their pain-masking interventions didn’t enroll in significant numbers. The previous interventions “worked” for these patients.

Most volunteers arrived after having failed many modalities. For some, nothing had worked. Others had plateaued with physical rehabilitation or non-healing wounds. They were often taking multiple medications that no longer provided relief.

The studies had no exclusions based on the intensity, duration, or multiple impaired functions. Few volunteers had any reasonable expectations for improvement. They often mentioned how many times that their hope had been stolen by comments that suggested that "no one can help you", others mentioned being told that the nerves in their feet were dead.

The team combed through the data to identify the impairments response rates:

  • Least likely to respond – people who are satisfied with their invasive intervention

    • The intervention must remain present and active to "manage" pain

    • The impaired functioning, such as sensation, often doesn’t resume despite pain relief.

  • Most likely to respond – people who arrive in an “unmanageable” state from mild to horrible

    • The benefits persist after therapy ends – that’s called normal

    • The impaired functions appear to improve before the patient reports pain relief

    • Sensory, motor, skin temperature regulation, and other functions that may be stalled

The variable-wavelength therapy lets practitioners help more of their patients. Now researchers can begin to examine the release of “stuck” ordinary functions. The Instant Verification System can save time and money getting your research project to the finish line.

 

How long might normal last?

The return to ordinary functioning doesn’t imply a durability of any length. It represents a return to the functioning that was ongoing prior to the patient’s injury.

In many cases, the return to normal functioning can resolve more than one sign or symptom. For example, re-coordinating muscle can relieve pain because the pain signal is no longer necessary - the underlying problem has been resolved. Consequently, these “secondary” symptoms do not return as long as the patient retains normal functioning.

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Figure 5 - depiction of the jump starting of healing processes.

The VWT works more like a jump start than replacing a worn out battery. The photons that aren’t absorbed depart at the speed of light. When the therapy ends, it is up to the body to do the rest.

 By Allan Gardiner and Steven Gerhardt, PhotoMed Technologies, Inc.