BTL – 07p
operating manual & user's guide
page 16
Combined therapy
Combined therapy is the application of two or more kinds of energy. Classic diadynamic currents comprised of
simultaneous low frequency galvanic and pulse currents are also considered a form of combined therapy.The
procedure generally includes the following combinations:
ultr low frequency currents
ultr amplitude modulated mid-frequency currents
ultr TENS
Ultrasound and low frequency currents
Can be used with one unit or by connecting two separate units (BTL-06 + BTL-07p). The desired current with
an adjustable intensity should be brought to the emitter head. The other electrode is placed opposite the emitter
head so that the ultrasound field and the low frequency current are both located in the treatment area.
Mechanism of action
The myorelaxation is effective, if the proper frequency (100 - 200 Hz) is used. The combined therapy with a 3 MHz
ultrasound frequency is suitable especially for treating the located myospasm, uncoordinated muscle fibres and
the trigger points.
The risk of galvanic effect is heightened. It can be seen on the emitter head rather than on the skin. To guarantee
the patient’s safety it is necessary to be aware of this, especially if higher frequencies are used.
Application time
Usually 3 - 6 minutes. The application time can be extended with the positive step method. In acute states or in
cases when the treatment area is small, the length of the therapy should be reduced.
Intensity
Set the ultrasound intensity at 0.5 - 0.7 W/cm
2
for 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 sensitive in a hyperalgeic zone, and the patient may even feel pain. The threshold motor and above
threshold motor pre-set intensity evokes a motor response. If the pain threshold is not reached, use the same
intensity for the therapy. Otherwise adjust the low frequency component intensity according to the current used
and effect desired.
The size of the indifferent desk electrode should be 2x - 10x larger so that the sensitivities are located on
the ultrasound margin.
Total number of procedures
A total of 2 - 3 treatments is recommended, based on the indi effect. Five or more treatments are
recommended only in special cases.
Frequency of procedures
Daily or as a pre-medication (postisometric relaxation-PPR).
Procedure Prescription
Name, surname, date of birth, insurance company.
Name and number of diagnosis and stage of disease.
Name of procedure, type of the unit (BTL-06 + BTL-07p).
Emitter head size, frequency, characteristic and intensity of the ultrasound component, mode of application.
Characteristics of the low frequency component, therapeutic intensity.
Treatment location. Placement and indifferent electrode size.
Application time and application changes during treatment (step).
Frequency of procedure and changes during treatment.
Total number of procedures.
Date of next appointment.
Date of prescription, name and signature of prescribing physician.