BTL BTL-07p Operating Manual Download Page 11

BTL – 07p  

operating manual & user's guide 

page 11 

II. USER'S 

GUIDE 

Mechanical waves with a frequency higher than 20,000 Hz are called ultrasound. Ultrasound is not generated 
electronically for the application of therapy and is classified as mechano-therapy. 

Mechanism of action 

If a minimal air gap between emitter head and body surface is eliminated, the emitter head vibration will be more 
easily transferred deeply into the tissues in the form of longitudinal waves. Every cell in the path of the ultrasonic 
"beam" will begin to oscillate: a micro-massage is followed by a transformation from gel to sol (jelly structures 
becoming liquefied) and transformation from mechanical to thermal power, with deep warming of tissues. 
The amount of heat generated is dependent on the amount of energy that is absorbed. Other effects of ultrasound 
(solution degassing, cavitation arising of cavities in humour, and local alkalization) are negligible with the small 
intensities and ultrasound doses that are used for physical therapy. 
The prophylaxis of ultrasound side-effects must include the knowledge that molecular oscillation occurs not only in 
the course of the ultrasonic beam but, as a result of humour transportation to areas that are distant from the 
application site, may possibly result in the restoration of former epistaxis or the acceleration of menstruation. 
The quality of an ultrasonic beam and its distance from the emitter head determine its characterization as a close 
or distant ultrasonic field. Great variation in ultrasound intensity caused by interferential effects and low beam 
divergence is typical characteristics of a close ultrasonic field. The length of the close field is directly proportional 
to the effective emitting surface of the emitter heads (ERA) and indirectly proportional to the frequency. For 
example, the length of a close field with a 4 cm

2

 ERA emitter head and a 1 MHz frequency is approximately 10 

cm; the length of a close field with a 1 cm

2

 ERA emitter head and a 1 MHz frequency is 2 cm. 

The characteristics of a distant ultrasonic field are increasing beam divergence, gradual decrease in intensity and 
almost no interferential processes. 
Therapeutic effects take place mostly in a close field. Since the ultrasonic beam in a close field shows marked 
interferential effects (interference of applied and reflected waves, both constructive and destructive), the result is 
an uniform ultrasonic beam. The beam’s peaks of intensity (local increase in intensity caused by constructive 
interference) may reach values many times higher than the preset value (the rise of stationary waves). 
The Beam Non-uniformity Ratio (BNR) illustrates how often peaks of intensity exceed preset values. This value is 
characteristic for an ultrasonic head when the frequency is fixed. A good quality head should not exceed 6. With a 
preset intensity of 1 W/cm

2

, the intensity should not exceed 6 W/cm

2

 in any part of the ultrasonic beam. 

 

The BNR of older ultrasonic heads, as well as many of the newer ones (where the producer does not mention 
the BNR), is often 20 or more! 
 

The Effective Radiating Area (ERA) is always smaller than the actual surface area of the emitter head (the ERA is 
determined by the size of the piezoelectric crystal or ceramic table that generates ultrasound by oscillating). The 
dose of ultrasound (amount of power emitted to surface area) is therefore related to the ERA, not to the actual 
surface area of the emitter head. 
 

Refraction and reflection of ultrasound 

follow the laws of wave physics. They originate from ultrasonic wave 

transmission between tissues and the differences in vibration flow speed in these tissues. Therapeutic application 
must include elimination of the air gap between the emitter head and skin (a 10

-9

 m thick air gap causes 99 % 

ultrasonic wave reflection because of the marked difference in the air and skin flow speed. With a pre-set intensity 
of 1.0 W/cm

2

, the tissue receives only 10 mW/cm

2

  - energy without any biological effect). Therefore, modern 

ultrasonic heads have a built-in optic and/or acoustic unit that gives a signal and stops the time counter when 
contact is insufficient. 
Ultrasonic beam power increases (constructive interference) and decreases (destructive interference) occur as a 
result of interference in the close field, which reaches its peak (up to 35 %) at the soft tissue-bone boundary. 
It is necessary to move the emitter head continuously (see below) to prevent tissue lesions at

 

peaks of intensity. 

The BTL-07p signals when there are stationary waves and stops ultrasonic power generation until stationary 
waves are eliminated through more rapid movement of the emitter head. 
As a result of reflection and constructive interference increases in local intensity and temperature may occur, 
particularly in the periosteum-bone boundary. This increase can cause periosteum pain during treatment. When 
this occurs, the intensity must be lowered immediately. 
Ultrasound is primarily absorbed in deep tissues. Since these tissues contain virtually no thermoreceptors, it is 
impossible to perceive a rise in local temperature. Nociceptive receptors are irritated and the patient feels pain 
only if the local temperature exceeds 45

ο

C. Most experts agree that a short-lasting local temperature of 45

ο

is not dangerous. 
As far as classic inflammation (edema, erythema, local temperature increase, pain, and non-function) is 
concerned, additional heat production is contraindicated. In certain cases, only a pulse ultrasound (athermic) can 
be applied. 
In the peracute period of post-traumatic states (up to 24 - 36 hours), even pulse ultrasound application is 
contraindicated (resulting vibrations obstruct capillary

 

proliferation and may cause

 

laggard bleeding). 

Summary of Contents for BTL-07p

Page 1: ...v2 10z6BJ24 03 2004EN operating manual user s guide ...

Page 2: ...nty 8 Maintenance and transport 8 Troubleshooting 8 Technical specifications of probe 9 Technical specifications of unit 9 Pulse width 10 II USER S GUIDE 11 Mechanism of action 11 Methods of application 12 Ultrasound frequency 13 Modes of operation 13 Emitter head size 13 Application time 13 Intensity 13 Procedure frequency 13 Total number of treatments 13 Specific contraindications of ultrasonic ...

Page 3: ...18 Mechanism of action 18 Application time 18 Intensity 18 Total number of treatments 18 Frequency of treatment 18 Procedure prescription 18 A therapeutic example 18 III LIST OF PROGRAM NUMBERS FOR ULTRASOUND THERAPY 19 IV LIST OF PROGRAM NUMBERS FOR COMBINED ULTRASOUND THERAPY ELECTROTHERAPY 25 ...

Page 4: ...by two pilot lights 7 Push button to set acoustic output 8 Push button to change indication of acoustic output 9 Duty Cycle push button 10 Column lights indicating contact of emitter head with skin 11 Small ultrasound emitter head connector 12 Signal lights Ready Emitter heads connected intensity therapy time is set Error Light signal a hardware defect indicating Power Light signal indicating the ...

Page 5: ... connecting and identifying the emitter head The red diode on the emitter head indicates insufficient contact between the emitter head and the tissue If contact is insufficient the control light lights up red The countdown on the TIME display 3 stops Power absorption indicated by the light blinking stops Therapy is interrupted until contact is restored If there is proper contact the control signal...

Page 6: ...f intensity is an area which is exposed to intensity higher than the preset intensity level There is an increased local temperature in these areas BTL 07p emitter heads have a very low BNR Further more the BTL 07p features an optic indicator to signal stationary waves placed on the Bar graph 10 the orange LED diode Respond to this signal by immediately removing the emitter head from the applicatio...

Page 7: ...tly follow the safety instructions below 1 Read the operation manual carefully before you use the instrument for the first time 2 Make sure that the parameters of the mains correspond to those of the instrument 3 The mains must be installed and correspond to valid norms Call a qualified electrician if in doubt 4 If the instrument is exposed to a sudden temperature charge allow at least 1 hour for ...

Page 8: ...he Manufacturer shall not be liable for incidental consequential or special damages arising out of or in connection with product use or performance except as may be otherwise accorded by law This warranty may differ from the warranty terms and conditions provided by your supplier and by applicable laws in your country Maintenance and transport The unit can be cleaned with a damp cloth Do not use a...

Page 9: ...ning up and down After certain time you will hear a sound Release the Frequency button and wait until the bar graph LEDs will stop running the calibration is done You might control it after begin generating and leave the emitter head in the air the red LED should be on put the emitter head into the water the green LED should be on immediately READY signal does not light up Set application time and...

Page 10: ...trols ON OFF switch marking 0 1 Standard accessories 1 ultrasound probe with area 1 cm 2 1 ultrasound probe with area 4 cm 2 1 bottle ultrasound gel 2 spare fuses external Pulse width ti ms tp ms T ms f Hz Duty factor 10 10 20 50 1 2 5 15 20 50 1 4 2 5 17 5 20 50 1 8 1 25 18 75 20 50 1 16 5 5 10 100 1 2 2 5 7 5 10 100 1 4 1 25 8 75 10 100 1 8 0 625 9 375 10 100 1 16 Important Each BTL 07p instrume...

Page 11: ...nic head when the frequency is fixed A good quality head should not exceed 6 With a preset intensity of 1 W cm2 the intensity should not exceed 6 W cm 2 in any part of the ultrasonic beam The BNR of older ultrasonic heads as well as many of the newer ones where the producer does not mention the BNR is often 20 or more The Effective Radiating Area ERA is always smaller than the actual surface area ...

Page 12: ...er head The therapist moves the emitter head in a circular pattern The application time is prolonged proportionally to the ERA and the size of the application site B Application site 1 Local application The ultrasound is applied to the affected site This is the most common type of application and is particularly suitable for the management of muscle spasm chronic post traumatic edemas etc 2 Segmen...

Page 13: ...o large areas is difficult for the therapist lasts too long and the dose is not applied consistently Small ERA 1 cm2 emitter heads are used either to manage trigger points and scars or to manage small uneven surfaces which have to be treated by the subaqual method if the emitter head size is large Application time Individual application times vary They largely depend on the stage of the disease or...

Page 14: ...forehead lobe as the calcified atheroma plate was disturbed It is widely believed that this was not an accident This information is included only as a strong reminder to the therapist that ultrasound is not to be used in these areas A patient must never apply ultrasound to himself or herself even if the application site can be reached easily Peripheral Nerves situated just below the surface on the...

Page 15: ...nless such information is specifically requested However be sure to ask if epistaxis is present or if patient is menstruating 3 Place the patient in the proper position for the therapy 4 Use a sufficient amount of the appropriate contact medium 5 Set the prescribed intensity and time apply the emitter head and switch on the ultrasound 6 Move the emitter head continuously in accordance with the pre...

Page 16: ...continuous ultrasound and at a max 1 0 W cm 2 for a pulse ultrasound with 1 2 PPR or greater Set the low frequency component intensity according to the object When searching for the trigger points set the threshold sensitive intensity outside the area where reflex changes are expected and with this intensity try to get as close as possible to the area The intensity will be above threshold sensitiv...

Page 17: ...ad ERA The application time for dynamic method should be x times longer because the affected area is x times larger than the emitter head ERA An initial intensity of 0 4 0 6 W cm2 is used for continuous ultrasound 1 1 PPR For 1 2 1 4 PPR use the intensity 0 5 1 0 W cm2 and for 1 8 1 16 PPR use the initial intensity 1 0 1 3 W cm 2 The AMP intensity is chosen according to the effect The above thresh...

Page 18: ...c in the injured area The simultaneous ultrasound application followed by increased capillary permeability improved extravasal liquid absorbtion increased vasoactive amines secretion and the influence on the pre capillar spfincters are considered the most effective prevention against the algodystrophic syndrom Physical therapy in the porouses area is contraindicated Use the segmental method only f...

Page 19: ... subacuta 19 Epicondylitis acuta 20 Epicondylitis chronica 21 Epicondylitis subacuta 22 Haematoma chronica 23 Haematoma subacuta 24 Haematoma subchronica 25 Myalgia 26 Myorelaxatio 27 Myospasmus 28 Oedema chronica 29 Oedema subacuta 30 Oedema subchronica 31 Spondylarthrosis ancylopoetica M Bechterevi 32 Sy algodystrophicus Sy Sudeck 33 Tendinitis acuta 34 Tendinitis acuta subaqualis 35 Tendinitis ...

Page 20: ...ion time 4 minutes daily 5x a week Total number of treatments 5 6 Apply to edema Patient must feel no pain during application 6 Bursitis acuta Emitter head 4 cm2 Frequency 1 MHz 1 8 PPR Intensity 1 2 W cm 2 Semistatic application Application time 1 3 minutes 0 5 minute steps daily 5x a week Total number of treatments 3 5 Apply to edema Pain must not be aggravated 7 Bursitis chronica Emitter head 4...

Page 21: ...y 2 0 W cm 2 Application time 5 7 minutes 1 minute steps daily Total number of treatments 3 Subaqual application Emitter head distance 10 12 cm Water temperature 20 o C 17 Distorsio chronica Emitter head 4 cm 2 Frequency 3 MHz 1 1 PPR Intensity 1 0 1 5 W cm 2 Semistatic application Application time 5 minutes 3x a week Total number of treatments 6 9 Apply to chronic edema 18 Distorsio subacuta Emit...

Page 22: ...eatments 5 8 In order to have long term effect physiotherapy must immediately follow irradiation 26 Myorelaxatio Emitter head 4 cm2 Frequency 1 MHz for superficial muscles 3 MHz 1 1 PPR Intensity 1 5 2 0 W cm 2 step 0 2 W cm2 Dynamic application Application time 5 minutes 3 5x a day Total number of treatments 5 8 In order to have long term effect physiotherapy must immediately follow irradiation 2...

Page 23: ...step 0 2 W cm 2 Application time 4 minutes 5x a week Total number of treatments 2 5 Subaqual application Emitter head distance 10 12 cm Water temperature 18 25o C Treatment must include immobilization 35 Tendinitis chronica Emitter head 4 cm 2 Frequency 3 MHz 1 1 PPR Intensity 1 0 1 5 W cm 2 step 0 1 W cm 2 Semistatic application Application time 5 minutes 2 3x a week Total number of treatments 5 ...

Page 24: ...d immediately follow irradiation Apply to the triggers that feature typical radiation when detected by either palpation or combined therapy 44 Trigger points superficialis Emitter head 1 cm2 Frequency 3 MHz 1 4 PPR Intensity 0 5 1 0 W cm 2 step 0 1 W cm 2 Semistatic application Application time 2 minutes per trigger 2x a day 5x a week Trigger points are severely sore points usually situated in the...

Page 25: ...AM NUMBERS FOR COMBINED ULTRASOUND THERAPY ELECTROTHERAPY 51 Lumbalgie 52 Myalgia mm superficiales 53 Myalgia mm profundi 54 Relaxatio mm superficiales 55 Relaxatio mm profundi 56 Trigger points mm superficiales 57 Trigger points mm profundi 58 Zona hyperalgesica ...

Page 26: ...tal number of treatments 1 6 55 Relaxatio mm profundi Emitter head 4 cm2 Frequency 1 MHz continual PPR Intensity 0 5 1 0 W cm 2 step 0 1 W cm 2 Electrotherapy AMP FM 100 200 Hz steps 3 3 program 0947 Contralateral electrode placement Intensity at threshold motor Application time 1 10 minutes step 1 minute daily Total number of treatments 1 6 56 Trigger points superficialis Emitter head 1 cm2 Frequ...

Page 27: ...and maintain it at a threshold sensitive C Therapy effect control Set identical parameters as in A including the current intensity and move the head as in A If the therapy is successful the original TP will no longer exist Otherwise repeat the B procedure If a palpably or clinically diagnosed trigger cannot be detected by the method described in A repeat the whole procedure with the ultrasound int...

Page 28: ... any means incl electronic mechanic photographic or other records without previous approval from BTL Industries Limited BTL Industries Limited operates a policy of continuous development Therefore it reserves the right to make changes and improvements to the Product described in this manual without prior notice The contents of this document is provided as is Except as required by applicable law no...

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