Chattanooga Wireless Professional Скачать руководство пользователя страница 96

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95

EN

WIRELESS PROFESSIONAL

We will therefore need to understand the fundamental law that it must observe in order to find the 
optimum qualities of this current. 
This first chapter aims to provide a reminder and explanation of this law. 
This is followed by a second chapter which, on the basis of this fundamental law and ideas surrounding it, 
determines the qualities of the optimum current.

At the turn of the last century, well-known physiologists such as Weiss, Hoorweg, Du Bois Reymond and 
Lapicque managed to discover the fundamental law of electrostimulation and its mathematical expression.

Based on Hoorweg’s work, Weiss (a Parisian doctor and physiologist) emphasised the importance of the 
quantity of electrical charges created by the stimulation current. His experiments led to the fundamental 
observation that to achieve stimulation, it is not the type of current that is significant, but the quantity 
of current in a specified period of time. In other words, if the stimulation threshold values are given as a 
quantity of electricity (in electrical charges) that must be created to achieve these, the values are similar 
even if the electrical pulse with the same overall duration is a different shape.

Fig. 2

As a reminder:

the quantity of electrical charges (

𝑄

) supplied by an electric current with intensity (

𝐼

in a given time (

𝑡

) is the product of the intensity multiplied by the time.

𝑄 =  𝐼 𝑥 𝑡

Since the quantity of electrical charges provided by the stimulation current is the fundamental factor, 
Weiss studied the way in which the necessary quantity of charges is modified in order to achieve the 
threshold (i.e. to cause stimulation) based on the duration of the current being applied. 
He performed a series of measures to determine the relationship between the quantity of current and the 
duration of the pulse for durations ranging from 0.23 to 3 ms.
From his experiments, Weiss found that there is a linear relationship between the quantity of charges 
required to reach the stimulation threshold and the duration of the pulse (Fig. 2).

Quantity 

of current 

required to 

reach the 

stimulation 

threshold

Duration of the pulse

Linear relationship between the duration of the electrical pulse and the amount of 

electricity applied to reach the stimulation threshold:

𝑄 =  𝑞  + 𝑖𝑡

Содержание Wireless Professional

Страница 1: ...Wireless Professional User Manual EN...

Страница 2: ...Remote Control on by pressing the On Off button 2 Upon activation the screen displays a list that gives you access to the categories of programmes 3 Select a program category and a program within the...

Страница 3: ...performed Throughout the duration of the test it is important to stay still and be perfectly relaxed When the test is complete the programme can begin 8 Start the stimulation by increasing the energie...

Страница 4: ...he Motor Point Pen 28 3 5 Description of key Displays shown 29 3 5 1 Display in Programme Category selection mode Home Screen 29 3 5 2 Display in Programme selection mode 30 3 5 3 Diplay when programm...

Страница 5: ...Additional Functions of the SOFTWARE when having a WIRELESS PROFESSIONAL device 61 6 5 2 1 History list 62 6 5 2 2 Create a patient s list and monitor their treatment progress 63 6 5 2 3 Create custo...

Страница 6: ...Introduction 99 12 2 2 Characteristics of the optimal current 99 12 2 2 1 Electrical stimulation wave produced by the current generator 99 12 2 2 2 Type of establishment of the electrical stimulation...

Страница 7: ...wing total hip replacement 228 14 8 Rehabilitation of the shoulder 230 14 8 1 Rotator cuff tendinopathy 231 14 8 2 Shoulder instabilities 235 14 8 3 Adhesive capsulitis 238 14 8 4 Cardiac Rehabilitati...

Страница 8: ...n The Wireless Professional is a stimulator designed for use by health professionals to ensure electric stimulation treatments in pain management TENS as well as for neuro muscular stimulation EMS NME...

Страница 9: ...onditions Symptomatic relief and management of chronic intractable pain Adjunctive treatment for post surgical and post trauma acute pain Relief of pain associated with arthritis 1 4 Contraindications...

Страница 10: ...osthesis equipment metallic equipment in contact with the bone pins screws plates prostheses etc is not a contraindication The electrical currents of the Wireless Professional are specially designed t...

Страница 11: ...th or serious injury Danger Explosion hazard Wireless Professional is not designed for use in areas where an explosion hazard may occur An explosion hazard may result from the use of flammable anesthe...

Страница 12: ...remote control must be within easy reach of the patient allowing them to stop therapy if needed Patients unable to operate the emergency stop function either by stopping on the remote control or by tu...

Страница 13: ...e lives of the patient the user and other persons involved Before use allow the Wireless Professional to reach room temperature If the unit has been transported at temperatures below 0 C 32 F leave it...

Страница 14: ...sensation is lower than normal Do not apply stimulation to a person who cannot express themselves Battery leakage If there is leak from a component take steps to ensure the liquid does not come into c...

Страница 15: ...or Exercise caution when using electrotherapy while the patient is connected to monitoring equipment with electrodes attached to the body Stimulation could disrupt the signals sent to the monitoring e...

Страница 16: ...should always stimulate isometrically this means that the extremities of the limb in which a muscle is being stimulated must be firmly fixed so as to prevent any movement that results from contraction...

Страница 17: ...it Always use the AC adaptor power supply provided by the manufacturer to recharge the unit Do not store the modules and remote control for a long time with empty batteries Only use electrodes and mot...

Страница 18: ...tween the electrode and the skin which is essential for the patient s comfort and the effectiveness of the stimulation gradually deteriorates For information on use and storage please consult the inst...

Страница 19: ...ing station 6831xx 1 AC adaptor 6490xx 1 USB cable 601163 2 Bags of small electrodes 5x5 cm 1 snap connection 42204 2 2 bags of large electrodes 5x10 cm 1 snap connection 42223 2 2 bags of large elect...

Страница 20: ...station 101091 1 AC adaptor 108x 1 USB cable 601163 1 Bag of small electrodes 5x5 cm 1 snap connection 42204 1 1 bag of large electrodes 5x10 cm 1 snap connection 42223 1 1 bag of large electrodes 5x...

Страница 21: ...anufacturing date 20xx LATEX FREE REF The number next to this symbol is the article reference number CE 0473 Device complies with Council Directive 93 42 EEC as amended concerning medical devices The...

Страница 22: ...t i on of t h e W i r e l e ss P r of e ss i on a l 21 EN WIRELESS PROFESSIONAL 20xx LATEX FREE REF Non ionising radiation LATEX Not made with natural latex rubber 20xx LATEX FREE REF Keep away from...

Страница 23: ...the manufacturer The date is the manufacturing date 20xx LATEX FREE REF The number next to this symbol is the article reference number Device complies with Council Directive 93 42 EEC as amended conce...

Страница 24: ...P r of e ss i on a l 23 EN WIRELESS PROFESSIONAL Indoor use only The Gepr fte Sicherheit Tested Safety or GS mark indicates that the equipment meets German and if available European safety requiremen...

Страница 25: ...ff button press briefly to switch on press and hold for more than 2 seconds to switch off while browsing the lists press briefly to return to the main menu B 4 multifunction buttons Functions related...

Страница 26: ...o pause Flashing green LED ready Flashing yellow LED stimulation on B Groove to wind up the cable C Pod containing battery A B C Note When the distance among the remote control and the modules is too...

Страница 27: ...ion of key accessories 3 4 1 Smart 4CH docking station and Removeable tablet A Removable tablet B Connector to charge the remote control C Docking bay to position the modules to be recharged D Port fo...

Страница 28: ...e ss P r of e ss i on a l 27 EN WIRELESS PROFESSIONAL 3 4 2 Basic 2 CH docking station A Remote control charging connector B Location for positioning the modules C Location for positioning the module...

Страница 29: ...nt Pen Note For detailed information on the usage of the motor point pen please see Rev 6 1 Always use the conductive gel that comes with the product with the motor point pen A Tip of the motor point...

Страница 30: ...on a l 29 EN WIRELESS PROFESSIONAL 3 5 Description of key Displays shown 3 5 1 Display in Programme Category selection mode Home Screen A B A Header showing date time and battery status B Current chos...

Страница 31: ...ection of the navigation pad To add a program to the Favourite list E please press the multifunction button below the icon while program is marked Press the button again to remove the program from the...

Страница 32: ...1 continuous sequence I Active option in the programme J Programme name C D F G A B E H I J Note B the device asks you to activate the next module 1 module needs to be activated at least 1 channel tr...

Страница 33: ...of contractions remaining total number of contractions G Indicator of programme execution H Number and order of attached channels Circle channel recognised but module turned off C D E A B G H F Note...

Страница 34: ...y level achieved by the channel during contraction phases B Back to previous menu C Skip function allows you to skip programme sequences not available for all programmes D Resumes the stimulation sess...

Страница 35: ...be displayed as well To turn the unit off press the On Off button on the remote control for more than 2 seconds This will switch off as well all modules A Average energy level of all the channels used...

Страница 36: ...blet of the docking station B and plug it into a power socket Also connect the docking station s USB cable to the removable tablet C A Rear view of the docking station B Connector for the AC adapter C...

Страница 37: ...nnector connected with the tablet allowing it to charge modules and remote at same time Remote control can also be directly connected to a computer by using USB connector Charge the Modules Place the...

Страница 38: ...control which is usually done automatically by the unit Battery level In the screen Modules need to be turned on the module battery level is displayed on the corresponding channel at the remote contr...

Страница 39: ...A B If you are using 2 or more remotes with the same docking station you will be able to manage separately 2 or more sessions at the same time Remotes and respective synchronized modules are under se...

Страница 40: ...cy Charge the Remote Control by plugging it into the Docking Station Take care that the USB connector is pluged into the Remote Control Note The Remote Control can be charged as well by using the USB...

Страница 41: ...ton to proceed Once you have created your list of favourite programmes it will be displayed first after switching on the remote control Note Additional information about the programmes such as electro...

Страница 42: ...ithin specific indications within your Wireless Professional Depending on the characteristics of the current used for each programme the electrode connected to the positive pole pod with illuminated b...

Страница 43: ...rson to be stimulated depends on the muscle group that requires stimulation and on the programme chosen For programmes requiring muscle contractions tetanic contractions working the muscle isometrical...

Страница 44: ...direction marked by the On Off button on the main pod a small vertical line on the housing of the other pod To remove the modules from the electrode simply make the opposite movement Caution Equipment...

Страница 45: ...ase the stimulation energy intensity on selected channels None selected channels will remain on their set intensity level This feature allows you to change the intensity for each channel itself or mor...

Страница 46: ...ns will be increased gradually so that the patient becomes accustomed to electrostimulation After the warm up which should produce clear muscle twitching the stimulation energies must be increased pro...

Страница 47: ...above the therapy unit has passed the performance check successfully The device also runs performance checks regularly during operation This is what happens if a problem is identified at start or dur...

Страница 48: ...the number of fibres that make progress The motor point The motor point is a point where the motor nerve enters the muscle which is an extremely localised area where the motor nerve is at its most ex...

Страница 49: ...programme 6 Very gradually increase the energy of channel 1 until a value between 5 and 25 is reached while continuously moving the pen tip over the gel layer but without ever losing contact with the...

Страница 50: ...ust the width duration of the pulse to the measured chronaxy value Using a width duration of the pulse corresponding to the chronaxy of the stimulated muscle allows the use of the minimum power to obt...

Страница 51: ...c results If you set the stimulation energy below the ideal range of treatment the stimulator prompts you to raise them again by continuously flashing signs Where recommended this function is automati...

Страница 52: ...ey combine voluntary exercises and electrostimulation that together allow for greater recruitment of muscle fibres They promote the restoration of the body map and motor relearning in patients with im...

Страница 53: ...the resting phase Care should be taken at the end of each contraction phase to get back into a position allowing the best muscle relaxation Trigger ON Manual triggering Automatic stop It is an operati...

Страница 54: ...o add a maximum of 10 programs to the list To add a program to the Favourite list please press the multifunction button below the icon while program is marked The Favorite symbole will be shown below...

Страница 55: ...d within the menu for the Settings at the Remote Control If basically activated The Remote Control will ask before each treatment whether the lock out function shall be active for this treatment or no...

Страница 56: ...perform only the basic operations increase or decrease the intensity pause the device but he or she cannot exit the programme or turn off the device To deactivate the Lock Out function during the tre...

Страница 57: ...user by means of a sound signal of the beginning of a muscle contraction Before each contraction by electrostimulation the remote control emits beeps This function is only available for programmes ind...

Страница 58: ...een blue yellow 4 Allocate the chosen color to the activated module by pressing the confirmation button The screen will show a green hook when allocation was successfull 5 Take the reflecting colored...

Страница 59: ...d on the Default setting off Lock function The lock out function can be activated on or deactivated off Default setting off Language The language set up allows you to change the language setting of th...

Страница 60: ...enables you to add a new module to the Remote Control usually done automatically by the unit 1 up 4 modules can be operated max with one Remote Control Rest to factury setting This function activated...

Страница 61: ...ient list and monitor their therapy progress You can download the SOFTWARE to your computer from http international chattgroup com products wireless professional 6 5 1 Firmware update of the Remote Co...

Страница 62: ...he Remote Control synchonised with your Computer all performed treatments will be shown in this list in the order they had been performed the latest first Patient List Will show all patients you added...

Страница 63: ...and program name the latest first When clicking on the extend symbol of a session the session details will be shown Session details are Treatment time Number of contractions Average intensity of all c...

Страница 64: ...ton The SOFTWARE will automatically suggest a name for that file and ask for the location it should be stored to Delete a patient from the list by clicking on the delete button View details on each tr...

Страница 65: ...tment session length Frequency Impulse width Work Relax Programs Adjustable parameters Impulse width Treatment session length Warm up Cool down on off And for the Work and Relax phases separately Freq...

Страница 66: ...be deleted The User Program List will show all your created programs Within the Program List you can Select a program by clicking on the name When clicking on it all set parameter and the architectur...

Страница 67: ...lection Work Relax Programs Bodyzone Selection Synchronisation Signal and Triggering of contraction please note apart from the regular trigger function the stimulation will only last as long as the tr...

Страница 68: ...ing this process stimulation session s history stored on your Wireless Professional device will also be transferred to the software The screen will show a symbole for your computer and the Remote Cont...

Страница 69: ...ions 1 Backup Restore your data The database administration tab allows you to backup all your data history patient s list and custom programs in a file that can be saved on any storage system Just cli...

Страница 70: ...E N T O P TI O N S F u n c t i ons a n d D e v i c e S e t t i ngs 69 EN WIRELESS PROFESSIONAL 6 5 2 6 Help The Help tap contains a summary of all information required to use the SOFTWARE including th...

Страница 71: ...heck that the electrodes are properly connected to the module Poor electrode connection to the skin Check if the electrodes are outdated worn and or the contact is poor try with new electrodes The rem...

Страница 72: ...ssible cause Solution No connection with modules Modules are out of range from Remote Control A Check that the module and the remote control are less than 2 metres away B Ensure you are not in an isol...

Страница 73: ...ble cause Solution Module battery low During the stimulation a module may turn out to be discharged Stop the stimulation and recharge the discharged module The remote control shows a discharged batter...

Страница 74: ...ol is properly turned on B Check that the module and the remote control are less than 2 metres away C Try restarting the module D Place the module and the remote control on the same docking station in...

Страница 75: ...re that the modules are properly placed in their housing B Ensure the charging contacts are clean C Ensure the correct AC adapter is used D Disconnect and reconnect the docking station and check the l...

Страница 76: ...ged charging for a few minutes may be required before the unit turns on A Try to restart the remote control and modules B Place the module and the remote control on the same docking station in order t...

Страница 77: ...aded batteries This is a normal body adaptive process Increase the amplitude intensity if required Stimulation is uncomfortable Amplitude intensity is too high Decrease amplitude intensity Electrodes...

Страница 78: ...is expected Refer to section 6 1 for a description of the Programs Stimulation is not producing the usual sensation Settings and Electrodes positioning A Check that all the settings are correct and en...

Страница 79: ...her patient clean and disinfect it according to the instructions in this section Caution Equipment damage The plastic material used is not resistant to mineral acids formic acid phenols cresols oxidan...

Страница 80: ...is may only be done by persons or repair services authorized by the manufacturer 8 2 Maintenance Your Wireless Professional does not require calibration or frequently safety testings Each stimulator i...

Страница 81: ...Disconnect and dismount the device and it s accessories by following the guidelines 4 Place the accessories within the box as shown in the pictures below 5 Store the user manual in the CD pocket of th...

Страница 82: ...iously Do not place the Remote Control the user manual and the Bottle of Conductive Gel within the transport bag 2 Place the components within the box like shown in the pictures below a Place the tran...

Страница 83: ...inal transport bag for carrying the device around 8 3 3 Transport of the 2CH device key components 1 Turn the device and it s components off 2 Disconnect and dismount the device and it s components by...

Страница 84: ...idlines given previously 2 Place the components within the box like shown in the pictures below a Place at the bottom the electrodes and user guide on CD in the specific box b Cover the electrode and...

Страница 85: ...aste It requires separate disposal at a suitable collection point for recycling of electronic equipment By doing so you will be contributing to the safeguarding of natural resources and health Please...

Страница 86: ...mber 6490xx can be used to recharge the Wireless Professional Battery life Battery life of Remote control and Module batteries approx 5 years cannot be replaced by the user Model Wireless Professional...

Страница 87: ...lse shape Constant rectangular current with pulse compensation to eliminate any direct current component to prevent residual polarisation at skin level Maximum pulse intensity 120 mA Pulse intensity i...

Страница 88: ...gned to withstand foreseeable disturbances from electrostatic discharge magnetic fields from the mains power supply or RF transmitters Nevertheless it is not possible to ensure that the stimulator wil...

Страница 89: ...ased risk of cardiac fibrillation The Wireless Professional also complies with Directive 2012 19 EU on waste electrical and electronic equipment WEEE 9 4 Patents The Wireless Professional incorporates...

Страница 90: ...sed in the text below includes all product variants 10 1 Electromagnetic emissions RECOMMENDATIONS AND DECLARATION BY THE MANUFACTURER CONCERNING ELECTROMAGNETIC EMISSIONS The device is intended for u...

Страница 91: ...ical power supply should be that of a typical commercial or hospital environment Shock waves CEI 61000 4 5 1 kV differential mode 2 kV joint mode Not applicable Battery powered device The quality of t...

Страница 92: ...n electromagnetic survey a must be less than the observance level to be found in each frequency range Interference may occur close to any appliance identified by the following symbol 20xx LATEX FREE R...

Страница 93: ...800 MHz to 2 5 GHz d 2 3 P 0 01 0 12 0 12 0 23 0 1 0 38 0 38 0 73 1 1 2 1 2 2 3 10 3 8 3 8 7 3 100 12 12 23 In the case of transmitters whose maximum output power is not shown in the table above the...

Страница 94: ...uestions you may have about our products and services Please contact your local dealer or your corresponding DJO Global site DJO Global sites are listed on the backside of the cover For technical serv...

Страница 95: ...xternal face To excite the membrane of the nervous fibre i e causing an action potential to appear at its surface the resting potential simply has to be reduced to a certain threshold value which is 5...

Страница 96: ...re given as a quantity of electricity in electrical charges that must be created to achieve these the values are similar even if the electrical pulse with the same overall duration is a different shap...

Страница 97: ...rent intensity a coefficient determined by experiment with the same dimensions as a quantity of electrical charges corresponds to the intersection of the straight line with the y axis and may be calcu...

Страница 98: ...that the chronaxy is a time constant which characterises the excitability of tissue and that its value is the ratio Lapicque s development also shows that even when the length of time that the curren...

Страница 99: ...sidered in terms of the amount of current which is the product of the intensity times the duration of the pulse 2 This amount of current fulfils a fundamental formula where is a linear function of tim...

Страница 100: ...cribes the qualities of the optimum electrostimulation current The optimum current can be defined as being able to reduce the resting potential to the stimulation threshold value under Weiss law while...

Страница 101: ...trical charges in the excitable membrane Fig 1 Analysis of the different ways to establish the stimulation current The pulse times t1 t2 and t3 cannot be used since during these periods Rheobase Fig 1...

Страница 102: ...quired to trigger the action potential Since it is clear that the rectangle is the wave shape capable of providing the quantity of charges with minimum intensity Fig 3 Fig 3 Comparison of different el...

Страница 103: ...3 The third electrical factor which should be minimised in order to produce the most comfortable possible stimulation is electrical energy We know that electrical energy is given by the formula 2 wher...

Страница 104: ...therefore 2 2 2 2 2 2 As we have seen above does not influence the determination of the pulse duration corresponding to the minimum energy The electrical energy passing through the skin and tissue is...

Страница 105: ...not zero Fig 7 Electrical Mean 0 Non compensated series of pulses The electrical mean is not zero which causes polarisation Fig 7 Fig 8 The polarised current equates to a continuous current with a va...

Страница 106: ...ial is sufficiently intense and in the right direction a state of instability is reached and excitation i e the action potential occurs The value that the local potential must reach so that action pot...

Страница 107: ...t of the change in the local potential caused by the electrical charges provided by the current passing through the neuron The increase in the threshold does not occur instantly but gradually and at a...

Страница 108: ...nly study the excitation process produced by a constant current The same study can be carried out using exponential sinusoidal linear progressive or any other type of current as the results are simila...

Страница 109: ...with a value of 1 2 is applied and passes the threshold after 1 85 ms In Figure 2d an even stronger current value 2 is applied and after 0 7 ms With lo rheobase and k excitation constant Chronaxy Fig...

Страница 110: ...occur if V became equal to S In these cases the intensity duration relationship must be reconsidered as the rheobase does not keep the value instead it increases to a value 1 determined by the excita...

Страница 111: ...s to the intensity of the stimulation current and the water moved from A to B to the quantity of electrical charges The water level in tank B reaches a certain level representing the value of the memb...

Страница 112: ...rable stimulation current B Currents of short duration and higher intensity The durations intended here are close to the excitation constant value k In this case as the flow is high the pump action is...

Страница 113: ...nfufficiency II 135 Cramp prevention 136 Capillarisation 137 PAIN RELIEF I 122 TENS Gate control 100Hz 122 Frequency modulated TENS 123 Pulse width modulated TENS 124 Endorphinic 125 Burst 127 Mixted...

Страница 114: ...be used to determine the pulse widths suitable for the patient s muscles ELECTRODES Electrodes positioned depending on the muscle to be stimulated in accordance with the instructions INTENSITY Use the...

Страница 115: ...Hz 4 Hz 3 Hz DURATION OF RAMP UP 1 5 s 1 5 s 0 5 s 1 5 s DURATION OF PHASE 2 min 6 s 7 s 3 min DURATION OF RAMP DOWN 2 s 0 75 s 0 5 s 3 s DISUSE ATROPHY LEVEL 2 25 MIN WARM UP CONTRACTION ACTIVE REST...

Страница 116: ...t s muscles ELECTRODES Electrodes positioned depending on the muscle to be stimulated in accordance with the instructions INTENSITY Use the maximum stimulation energies The first and second sessions h...

Страница 117: ...Hz 4 Hz 3 Hz DURATION OF RAMP UP 1 5 s 1 5 s 0 5 s 1 5 s DURATION OF PHASE 2 min 4 s 10 s 3 min DURATION OF RAMP DOWN 2 s 0 75 s 0 5 s 3 s REINFORCEMENT LEVEL 2 20 MIN WARM UP CONTRACTION ACTIVE REST...

Страница 118: ...se pulse widths equivalent to the chronaxies of the motor nerves of the muscles being stimulated The mi SCAN function can be used to determine the pulse widths suitable for the patient s muscles ELECT...

Страница 119: ...0 Hz 4 Hz 3 Hz DURATION OF RAMP UP 1 5 s 3 s 1 5 s 1 5 s DURATION OF PHASE 2 min 5 s 14 s 3 min DURATION OF RAMP DOWN 2 s 1 5 s 1 5 s 3 s PREVENTION OF DISUSE ATROPHY LEVEL 2 47 MIN WARM UP CONTRACTIO...

Страница 120: ...AN function can be used to determine the pulse widths suitable for the patient s muscles ELECTRODES Electrodes positioned depending on the muscle to be stimulated in accordance with the instructions I...

Страница 121: ...N WIRELESS PROFESSIONAL MUSCLE LESION 30 MIN WARM UP CONTRACTION ACTIVE REST FINAL RECOVERY PHASE FREQUENCY 6 Hz 40 Hz 4 Hz 3 Hz DURATION OF RAMP UP 1 5 s 6 s 1 5 s 1 5 s DURATION OF PHASE 2 min 3 s 1...

Страница 122: ...n order to precisely locate the motor points for each person Locating the motor points is recommended especially for long muscles such as those in the lower limbs quadriceps etc WHY In order to guaran...

Страница 123: ...is it is necessary to use a frequency that is the same as the operational frequencies for the tactile sensitivity nerve fibres i e from 50 to 150 Hz PULSE WIDTH Use very short pulse widths correspondi...

Страница 124: ...ENS FREQUENCY LEVEL PULSE WIDTH TREATMENT TIME 100 Hz 1 30 s 20 min 100 Hz 2 50 s 20 min 100 Hz 3 70 s 20 min FREQUENCY MODULATED TENS FREQUENCY LEVEL PULSE WIDTH MODULATION TIME TREATMENT TIME 50 150...

Страница 125: ...order to restrict the entry of pain impulses upon their return to the posterior horn of the spinal cord We must therefore stimulate the sensitivity fibres on the skin of the painful area To do this it...

Страница 126: ...there is a very significant localised effect The 5 muscle twitches induced every second by stimulation produce very significant hyperaemia which drains the acid metabolites and free radicals that had...

Страница 127: ...S programme Electrodes positioned on the painful area Sufficient stimulation energy to produce a clear tingling sensation Once the TENS combination has been activated the message TENS appears on the s...

Страница 128: ...hich can produce the same endorphinic results as for a standard frequency of 2 Hz PULSE WIDTH The pulse width for the programme is 180 s ELECTRODES Electrodes must be placed after a thorough palpatory...

Страница 129: ...t and on the release of morphine like substances produced by the body endorphins Endorphinic effect The stimulation frequencies vary every 3 seconds producing a combined stimulation of 80 Hz and 2 Hz...

Страница 130: ...placed The other electrode is placed at the end of muscle or muscle group being stimulated If a contracture affects all the muscle fibres the electrodes suitable for neuromuscular stimulation can als...

Страница 131: ...1 3 Ava i l a b l e Th e r a p y P r og r a ms 130 EN WIRELESS PROFESSIONAL DECONTRACTION FREQUENCY TREATMENT TIME 1 Hz 20 min...

Страница 132: ...allow acceleration of the venous blood return 7 Hz produce an analgesic effect by increasing the production of endorphins 5 Hz and end by relaxing the muscles 3 Hz while keeping the blood flow noticea...

Страница 133: ...long periods to increase the flow PULSE WIDTH To make it as comfortable as possible for the patient use pulse widths equivalent to the chronaxies of the motor nerves of the muscles being stimulated Th...

Страница 134: ...n be used to determine the pulse widths suitable for the patient s muscles ELECTRODES Electrodes positioned according to the specific indication INTENSITY Adjust the stimulation energy in order to pro...

Страница 135: ...and walking distance HOW To avoid further reducing the supply of oxygen to the muscle fibres the contractions remain infra tetanising 9 Hz and are separated by long periods of active rest 3 Hz in ord...

Страница 136: ...rtion HOW To avoid further reducing the supply of oxygen to the muscle fibres the contractions remain infra tetanising 7 Hz and are separated by long periods of active rest 2 Hz in order to avoid musc...

Страница 137: ...E WIDTH To make it as comfortable as possible for the patient use pulse widths equivalent to the chronaxies of the motor nerves of the muscles being stimulated The mi SCAN function can be used to dete...

Страница 138: ...are athletes To increase the capillary network and make the muscle fibres more resistant to fatigue HOW When using low stimulation frequencies of 8 Hz the increase in blood flow is greatest in young...

Страница 139: ...Ava i l a b l e Th e r a p y P r og r a ms 138 EN WIRELESS PROFESSIONAL CAPILLARISATION CONTINUOUS STIMULATION FREQUENCY 8 Hz DURATION OF RAMP UP 1 5 s DURATION OF PHASE 25 min DURATION OF RAMP DOWN 1...

Страница 140: ...chronaxies of the motor nerves of the muscles being stimulated The mi SCAN function can be used to determine the pulse widths suitable for the patient s muscles ELECTRODES Electrodes positioned depend...

Страница 141: ...z 6 Hz 3 Hz DURATION OF RAMP UP 1 5 s 1 5 s 0 5 s 1 5 s DURATION OF PHASE 5 min 8 s 7 s 10 min DURATION OF RAMP DOWN 2 s 0 75 s 0 5 s 3 s RESISTANCE LEVEL 3 28 MIN WARM UP CONTRACTION ACTIVE REST FINA...

Страница 142: ...d to determine the pulse widths suitable for the patient s muscles ELECTRODES Electrodes positioned depending on the muscle to be stimulated in accordance with the instructions INTENSITY The maximum t...

Страница 143: ...4 Hz 3 Hz DURATION OF RAMP UP 1 5 s 1 5 s 0 5 s 1 5 s DURATION OF PHASE 5 min 4 s 23 s 10 min DURATION OF RAMP DOWN 2 s 0 75 s 0 5 s 3 s STRENGTH LEVEL 3 38 MIN WARM UP CONTRACTION ACTIVE REST FINAL...

Страница 144: ...d to determine the pulse widths suitable for the patient s muscles ELECTRODES Precision in positioning the electrodes is less significant than for programmes aiming to develop muscle quality The elect...

Страница 145: ...6 Hemiplegic foot 166 Spasticity 168 Hemiplegic shoulder 170 Slow start neuro rehabilitation 172 PERSONALIZED PROGRAMS If programs had been customized and synchronized with the remote control by using...

Страница 146: ...198 Low back reinforcement 200 Core stabilization 202 Recovery plus 204 Toning massage 205 Relaxing massage 206 Anti stress massage 207 PAIN RELIEF II 174 TENS Gate control 80Hz 174 Knee pain 175 Trap...

Страница 147: ...able for the patient s muscles ELECTRODES Electrodes positioned on the gluteal muscles must correspond to the specific indication INTENSITY The maximum tolerable stimulation energy which is one of the...

Страница 148: ...TION OF PHASE 6 s 6 s DURATION OF RAMP DOWN 0 75 s HIP PROSTHESIS LEVEL 2 30 MIN WARM UP CONTRACTION REST FINAL RECOVERY PHASE FREQUENCY 45 Hz DURATION OF RAMP UP 1 5 s DURATION OF PHASE 6 s 6 s DURAT...

Страница 149: ...teal muscles The mi SCAN function can be used to determine the pulse widths suitable for the patient s muscles ELECTRODES Electrodes positioned on the quadriceps or only on the vastus medialis in acco...

Страница 150: ...s 6 s DURATION OF RAMP DOWN 0 75 s PATELLOFEMORAL SYNDROME LEVEL 2 DISUSE ATROPHY LEVEL 2 30 MIN WARM UP CONTRACTION REST FINAL RECOVERY PHASE FREQUENCY 45 Hz DURATION OF RAMP UP 1 5 s DURATION OF PHA...

Страница 151: ...on the quadriceps channels 3 and 4 thus preventing any risk of anterior draw movement PULSE WIDTH To make it as comfortable as possible for the patient use pulse widths equivalent to the chronaxies of...

Страница 152: ...ELESS PROFESSIONAL ACL 30 MIN 1ST CONTRACTION CH 1 2 HAMSTRINGS 2ND CONTRACTION CH 1 2 3 4 HAMSTRINGS QUADRICEPS ACTIVE REST FREQUENCY 40 Hz 40 Hz 4 Hz DURATION OF RAMP UP 1 5 s 3 s 0 5 s DURATION OF...

Страница 153: ...le for the patient s muscles ELECTRODES Electrodes positioned according to the specific indication INTENSITY The maximum tolerable stimulation energy on the 4 channels which is one of the key factors...

Страница 154: ...s 0 75 s 0 5 s 3 s ROTATOR CUFF LEVEL 3 20 MIN WARM UP CONTRACTION ACTIVE REST FINAL RECOVERY PHASE FREQUENCY 6 Hz 75 Hz 4 Hz 3 Hz DURATION OF RAMP UP 1 5 s 1 5 s 0 5 s 1 5 s DURATION OF PHASE 2 min 4...

Страница 155: ...patient use pulse widths equivalent to the chronaxies of the motor nerves of the abdominal and lumbar muscles The mi SCAN function can be used to determine the pulse widths suitable for the patient s...

Страница 156: ...IDTH To make it as comfortable as possible for the patient use pulse widths equivalent to the chronaxies of the motor nerves of the abdominal and lumbar muscles The mi SCAN function can be used to det...

Страница 157: ...ending on the muscle to be stimulated in accordance with the instructions INTENSITY The maximum tolerable stimulation energy on the 4 channels which is one of the key factors determining the effective...

Страница 158: ...ESS PROFESSIONAL ATROPHY MODULATED FREQUENCY 30 MIN WARM UP CONTRACTION ACTIVE REST FINAL RECOVERY PHASE FREQUENCY 6 Hz 25 40 Hz 4 Hz 3 Hz DURATION OF RAMP UP 1 5 s 2 s 0 5 s 1 5 s DURATION OF PHASE 2...

Страница 159: ...uscles The mi SCAN can be used to determine the pulse widths suitable for the patient s muscles ELECTRODES Electrodes positioned depending on the muscle to be stimulated in accordance with the instruc...

Страница 160: ...IRELESS PROFESSIONAL FORCE MOD FREQUENCY 30 MIN WARM UP CONTRACTION ACTIVE REST FINAL RECOVERY PHASE FREQUENCY 6 Hz 35 60 Hz 4 Hz 3 Hz DURATION OF RAMP UP 1 5 s 3 s 0 5 s 1 5 s DURATION OF PHASE 2 min...

Страница 161: ...forcement 2 1 These programmes produce contractions for the agonist which are twice as long as for the antagonist PULSE WIDTH To make it as comfortable as possible for the patient use pulse widths equ...

Страница 162: ...Hz 0 Hz 0 Hz 35 Hz DURATION OF RAMP UP 1 5 s 0 s 0 s 1 5 s DURATION OF PHASE 6 s 6 s 6 s 6 s DURATION OF RAMP DOWN 0 75 s 0 s 0 s 0 75 s ATROPHY 2 21 MIN SEQUENCE 1 AGONIST SEQUENCE 1 ANTAGONIST SEQU...

Страница 163: ...4 Hz 70 Hz DURATION OF RAMP UP 1 5 s 0 5 s 0 5 s 1 5 s DURATION OF PHASE 4 s 3 s 3 s 4 s DURATION OF RAMP DOWN 0 75 s 0 5 s 0 5 s 0 75 s REINFORCEMENT 2 17 MIN SEQUENCE 1 AGONIST SEQUENCE 1 ANTAGONIS...

Страница 164: ...nerves of the abdominal and lumbar muscles The mi SCAN function can be used to determine the pulse widths suitable for the patient s muscles ELECTRODES Electrodes positioned depending on the muscle to...

Страница 165: ...EVEL 2 32 MIN CONTRACTION REST FREQUENCY 45 Hz 0 Hz DURATION OF RAMP UP 6 s 0 s DURATION OF PHASE 5 s 9 s DURATION OF RAMP DOWN 1 5 s 0 s HAEMOPHILIA DISUSE ATROPHY LEVEL 1 25 MIN CONTRACTION REST FRE...

Страница 166: ...VEL 1 15 MIN CONTRACTION REST FREQUENCY 70 Hz 0 Hz DURATION OF RAMP UP 6 s 0 s DURATION OF PHASE 3 s 10 s DURATION OF RAMP DOWN 1 5 s 0 s HAEMOPHILIA REINFORCEMENT LEVEL 2 20 MIN CONTRACTION REST FREQ...

Страница 167: ...prevent foot drop during the swing phase of the gait HOW By manually triggering an electrically induced tetanic contraction in the levator muscles of the foot that is synchronised with the gait phase...

Страница 168: ...i l a b l e Th e r a p y P r og r a ms 167 EN WIRELESS PROFESSIONAL HEMIPLEGIC FOOT 13 MIN TRIGGERED CONTRACTION FREQUENCY 50 Hz DURATION OF RAMP UP 0 5 s DURATION OF PHASE 1 5 s DURATION OF RAMP DOWN...

Страница 169: ...idths equivalent to the chronaxies of the motor nerves of the abdominal and lumbar muscles The mi SCAN function can be used to determine the pulse widths suitable for the patient s muscles ELECTRODES...

Страница 170: ...b l e Th e r a p y P r og r a ms 169 EN WIRELESS PROFESSIONAL SPASTICITY 21 MIN TRIGGERED CONTRACTION REST FREQUENCY 35 Hz 0 Hz DURATION OF RAMP UP 4 5 s 0 s DURATION OF PHASE 5 s 5 s DURATION OF RAMP...

Страница 171: ...of the motor nerves of the abdominal and lumbar muscles The mi SCAN function can be used to determine the pulse widths suitable for the patient s muscles ELECTRODES Electrodes positioned according to...

Страница 172: ...b l e Th e r a p y P r og r a ms 171 EN WIRELESS PROFESSIONAL SHOULDER SUBLUXATION 25 MIN CONTRACTION REST FREQUENCY 40 Hz 0 Hz DURATION OF RAMP UP 3 s 0 s DURATION OF PHASE 8 s 8 s DURATION OF RAMP D...

Страница 173: ...widths suitable for the patient s muscles ELECTRODES Electrodes positioned depending on the muscle to be stimulated in accordance with the instructions INTENSITY The maximum tolerable stimulation ene...

Страница 174: ...SE FREQUENCY 6 Hz 35 Hz 3 Hz DURATION OF RAMP UP 1 5 s 4 s 1 5 s DURATION OF PHASE 2 min 5 s 15 s 3 min DURATION OF RAMP DOWN 2 s 2 s 3 s NEURO REHAB SLOW START LEVEL 2 20 MIN WARM UP CONTRACTION REST...

Страница 175: ...m the stimulation allows the vicious self perpetuating cycle of pain to be broken HOW The principle involves causing high levels of sensitivity impulses in order to limit the input of pain impulses wh...

Страница 176: ...y return to the posterior horn of the spinal cord PULSE WIDTH The pulse width varies continuously with this programme This avoids habituation by using a system of stimulation that is perceived as more...

Страница 177: ...of sensitivity impulses in order to limit the input of pain impulses when they return to the posterior horn of the spinal cord PULSE WIDTH The pulse width varies continuously with this programme This...

Страница 178: ...to the posterior horn of the spinal cord PULSE WIDTH The pulse width varies continuously with this programme This avoids habituation by using a system of stimulation that is perceived as more pleasant...

Страница 179: ...they return to the posterior horn of the spinal cord PULSE WIDTH The pulse width for the programme is 170 s ELECTRODES Depending on the means of restraint and or the size of the dressing used access t...

Страница 180: ...the session using the mi SCAN function ELECTRODES Electrodes positioned according to the specific indication INTENSITY An essential factor in the effectiveness of electrotherapy is the ability to caus...

Страница 181: ...onaxy that is measured at the start of the session using the mi SCAN function ELECTRODES Electrodes positioned according to the specific indication INTENSITY An essential factor in the effectiveness o...

Страница 182: ...ction Channels 3 and 4 provide Gate control stimulation and use a larger pulse adapted to the chronaxy of the A fibres ELECTRODES Electrodes positioned according to the specific indication Combining 2...

Страница 183: ...1 3 Ava i l a b l e Th e r a p y P r og r a ms 182 EN WIRELESS PROFESSIONAL LOWER BACK PAIN FREQUENCY PULSE WIDTH TREATMENT TIME 5 Hz 250 s 20 min...

Страница 184: ...ecifically on sciatic nerve neuralgia PULSE WIDTH Endorphinic stimulation is primarily aimed at the sensitive A nerve fibres which are best stimulated with pulse width of 200 s However the vascular ef...

Страница 185: ...ENS programme Electrodes positioned on the painful area Sufficient stimulation energy to produce a clear tingling sensation Once the TENS combination has been activated the message TENS appears on the...

Страница 186: ...paravertebral muscles which can be detected by palpation The other electrode is placed on the same muscles 2 or 3 finger widths away from the first one INTENSITY An essential factor in the therapeuti...

Страница 187: ...1 3 Ava i l a b l e Th e r a p y P r og r a ms 186 EN WIRELESS PROFESSIONAL LUMBAGO FREQUENCY PULSE WIDTH TREATMENT TIME 1 Hz 250 s 20 min...

Страница 188: ...impulses in order to limit the input of pain impulses when they return to the posterior horn of the spinal cord For this programme the frequency is modulated 50 150 Hz to avoid habituation PULSE WIDT...

Страница 189: ...be detected by palpation A second electrode is placed on the paravertebral neck muscles INTENSITY An essential factor in the therapeutic efficacy is to cause visible muscle twitching which may in cer...

Страница 190: ...rogramme the frequency is modulated 50 150 Hz to avoid habituation PULSE WIDTH This programme uses very short duration impulses 50 s suitable for the higher level of excitability of the sensitive A fi...

Страница 191: ...g stimulated The mi SCAN function can be used to determine the pulse widths suitable for the patient s muscles ELECTRODES Electrodes positioned depending on the muscle to be stimulated in accordance w...

Страница 192: ...as possible for the patient use pulse widths equivalent to the chronaxies of the motor nerves of the muscles being stimulated The mi SCAN function can be used to determine the pulse widths suitable f...

Страница 193: ...DOWN 2 s 0 5 s 0 s 3 s ENDURANCE LEVEL 3 55 MIN WARM UP CONTRACTION ACTIVE REST FINAL RECOVERY PHASE FREQUENCY 5 Hz 14 Hz 3 Hz 3 Hz DURATION OF RAMP UP 1 5 s 0 5 s 0 s 1 5 s DURATION OF PHASE 5 min 8...

Страница 194: ...printing etc PULSE WIDTH To make it as comfortable as possible for the patient use pulse widths equivalent to the chronaxies of the motor nerves of the muscles being stimulated The mi SCAN function ca...

Страница 195: ...5 s 0 5 s 3 s EXPLOSIVE STRENGTH LEVEL 3 34 MIN WARM UP CONTRACTION ACTIVE REST FINAL RECOVERY PHASE FREQUENCY 5 Hz 111 Hz 1 Hz 3 Hz DURATION OF RAMP UP 1 5 s 0 75 s 0 5 s 1 5 s DURATION OF PHASE 5 m...

Страница 196: ...DTH To make it as comfortable as possible for the patient use pulse widths equivalent to the chronaxies of the motor nerves of the muscles being stimulated The mi SCAN function can be used to determin...

Страница 197: ...table as possible for the patient use pulse widths equivalent to the chronaxies of the motor nerves of the muscles being stimulated The mi SCAN function can be used to determine the pulse widths suita...

Страница 198: ...P DOWN 2 s 1 s 0 s 3 s HYPERTROPHY LEVEL 3 33 MIN WARM UP CONTRACTION ACTIVE REST FINAL RECOVERY PHASE FREQUENCY 5 Hz 55 Hz 10 Hz 3 Hz DURATION OF RAMP UP 1 5 s 1 5 s 0 s 1 5 s DURATION OF PHASE 5 min...

Страница 199: ...table as possible for the patient use pulse widths equivalent to the chronaxies of the motor nerves of the muscles being stimulated The mi SCAN function can be used to determine the pulse widths suita...

Страница 200: ...0 75 s 0 5 s 3 s MUSCLE BUILDING LEVEL 3 26 MIN WARM UP CONTRACTION ACTIVE REST FINAL RECOVERY PHASE FREQUENCY 6 Hz 50 Hz 4 Hz 3 Hz DURATION OF RAMP UP 1 5 s 1 5 s 0 5 s 1 5 s DURATION OF PHASE 2 min...

Страница 201: ...nner in order to maintain and improve the strength of the low back muscles PULSE WIDTH To make it as comfortable as possible for the patient use pulse widths equivalent to the chronaxies of the motor...

Страница 202: ...s 0 5 s 3 s LOWER BACK REINFORCEMENT LEVEL 3 36 MIN WARM UP CONTRACTION ACTIVE REST FINAL RECOVERY PHASE FREQUENCY 5 Hz 50 Hz 4 Hz 3 Hz DURATION OF RAMP UP 1 5 s 1 5 s 0 5 s 1 5 s DURATION OF PHASE 5...

Страница 203: ...scles May be combined with or supplement active dynamic exercises PULSE WIDTH To make it as comfortable as possible for the patient use pulse widths equivalent to the chronaxies of the motor nerves of...

Страница 204: ...75 s 0 5 s 3 s CORE STABILISATION LEVEL 3 36 MIN WARM UP CONTRACTION ACTIVE REST FINAL RECOVERY PHASE FREQUENCY 5 Hz 50 Hz 4 Hz 3 Hz DURATION OF RAMP UP 1 5 s 1 5 s 0 5 s 1 5 s DURATION OF PHASE 5 mi...

Страница 205: ...lated The mi SCAN function can be used to determine the pulse widths suitable for the patient s muscles ELECTRODES Precision in positioning the electrodes is less significant than for programmes aimin...

Страница 206: ...being stimulated The mi SCAN function can be used to determine the pulse widths suitable for the patient s muscles ELECTRODES Electrodes positioned depending on the muscle to be stimulated in accordan...

Страница 207: ...es being stimulated The mi SCAN function can be used to determine the pulse widths suitable for the patient s muscles ELECTRODES Precision in positioning the electrodes is less significant than for pr...

Страница 208: ...use pulse widths equivalent to the chronaxies of the motor nerves of the muscles being stimulated The mi SCAN function can be used to determine the pulse widths suitable for the patient s muscles ELE...

Страница 209: ...1 Hz Freq mod 1 6 Hz TIME 2 min 1 min 30 s 40 s 5TH SEQUENCE 6TH SEQUENCE 7TH SEQUENCE 8TH SEQUENCE FREQUENCY Freq mod 1 3 Hz 1 Hz Freq mod 1 6 Hz 1 Hz TIME 30 s 30 s 90 s 30 s 9TH SEQUENCE 10TH SEQU...

Страница 210: ...itation of the gluteal muscles following total hip replacement 228 Rehabilitation of the shoulder 230 1 Rotator cuff tendinopathy 231 2 Shoulder instability 235 3 Adhesive capsulitis 238 Cardiac rehab...

Страница 211: ...N S 210 EN WIRELESS PROFESSIONAL Indication Page Treatment of venous insufficiency 273 1 Venous insufficiency without oedema 273 2 Venous insufficiency with oedema 275 Treatment of arterial insufficie...

Страница 212: ...ll known and therefore extremely specific treatments can be proposed which can produce optimum benefits on their own This standard protocol is recommended for the majority of cases of functional disus...

Страница 213: ...for the indication Locating a motor point in this manual This step ensures that the electrodes will be positioned to provide optimum comfort to the patient and optimum effectiveness of the therapy 14...

Страница 214: ...ntarily to initiate and or accompany the electrically induced contraction depending on the given set point 14 3 Rehabilitation of the peroneus muscles following an ankle sprain The purpose of the pero...

Страница 215: ...n the impossibility of feasibly being able to carry out active methods with this level of load 14 3 1 Protocol Treatment at an early stage Weeks 1 2 Reinforcement Level 1 Weeks 3 4 Reinforcement Level...

Страница 216: ...version of the foot As soon as this response is obtained most often after 2 or 3 contractions the barefoot patient is put into standing position This position is particularly useful because it require...

Страница 217: ...the stabilising muscles in the lumbar region through electrostimulation is initially carried out in isometric mode which considerably reduces the mechanical stresses exerted on the vertebral and peria...

Страница 218: ...es one for the right side and the other for the left side Two small electrodes are placed on the muscle body at the level of the lowest lumbar vertebrae at one finger s breadth distance from the spino...

Страница 219: ...y be added to the exercises Additional movement of an upper limb lifting up an arm Additional movement of a lower limb taking one foot off the floor Quick movements of two upper limbs throwing and cat...

Страница 220: ...3 4 Patellofemoral syndrome Level 3 If the patient is experiencing associated pain symptoms TENS stimulation can be performed in addition on the other channels In this case the specific practical rul...

Страница 221: ...s it possible to focus contraction of the vastus medialis which cannot be achieved during voluntary exercises 14 5 1 4 Patient position The focused contraction of the vastus medialis moves the patella...

Страница 222: ...y to increase the energy to the maximum level tolerated by the patient The therapist plays a fundamental role by encouraging and reassuring the patient who can then tolerate levels of energy that prod...

Страница 223: ...traumatic condition Repeated traumas to the knee joint like those caused by the practice of certain sports may entail cartilaginous lesions of the kneecap These lesions can lead to pain of varying in...

Страница 224: ...femoris A large two way electrode is placed at the top of the thigh and a further small electrode is positioned just above For optimum effectiveness the positive pole should preferably be positioned...

Страница 225: ...resses in the shortest time periods possible by activating the proprioceptive reflex One of the potential consequences of the operative procedure is significant disuse atrophy of the quadriceps muscle...

Страница 226: ...lation energy Obtain the first signs of regaining trophicity slight increase in volume improvement in tone etc During the following weeks the objective is the restoration of near normal muscle volume...

Страница 227: ...t is recommended that the small electrodes be placed precisely on the motor points as shown in the illustration or better yet that the motor points be found using the instructions for the indication L...

Страница 228: ...es and taking into account the particular sequential stimulation mode it is not possible to adjust the energy levels of channels 3 and 4 without having previously increased levels on channels 1 and 2...

Страница 229: ...rest between tetanic contractions and final recovery phase at the end of the treatment sequences generate individualized muscle twitches producing vibration in the prosthetic material The three level...

Страница 230: ...the patient s condition allows the patient is placed in a standing position which requires him her to exert additional effort that is beneficial for proprioceptive control If this is not possible all...

Страница 231: ...hologies has evolved considerably in recent years In this chapter we will discuss three pathological conditions of the shoulder for which neuromuscular electrostimulation is a preferred treatment amon...

Страница 232: ...appear to play an important role and most often involve limitations in range of motion pain phenomena and functional constraint The limitations in range of motion observed in specific tests involve f...

Страница 233: ...TION mode When this function is active the initiation of the electrically induced contraction requires voluntary contraction on the part of the patient For this exercise it is recommended that the mi...

Страница 234: ...d infraspinous muscles The electrodes are positioned in the same way as for phase 2 14 8 1 4 Patient position The patient is seated with the arm against his her body the forearm and the hand resting o...

Страница 235: ...mulation energy must be gradually increased to obtain a clear tingling sensation Phase 2 and 3 The stimulation energy must be gradually increased to the patient s maximum sub painful threshold for the...

Страница 236: ...ain coordination muscles of the glenohumeral joint however their efficacy is reinforced by the tone and muscle mass of the deltoid Unlike in the rehabilitation of rotator cuff tendinopathy in which th...

Страница 237: ...should preferably be positioned on the small electrodes For the spinal muscles a small electrode is placed on the fleshiest part of the infraspinous fossa connected to the positive pole a small electr...

Страница 238: ...The stimulation of the infra and supraspinous muscles can be performed simultaneously with active work such as for example proprioception exercises The patient can be placed in the push up position w...

Страница 239: ...tic dystrophy then regresses as the capsule fibrosis and the joint ankylosis develops Clinically we see the development of a first entirely painful acute phase then the shoulder gradually loses mobili...

Страница 240: ...fossa The other small electrode is positioned on the external part of the supraspinous fossa For optimum effectiveness the positive pole should preferably be positioned on the infraspinous muscle 14 8...

Страница 241: ...C I N D I C AT I O N S 240 EN WIRELESS PROFESSIONAL 14 8 3 5 Stimulation energy Phase 1 The stimulation energy must be gradually increased to obtain a clear tingling sensation Phase 2 The stimulation...

Страница 242: ...use of this that neuromuscular electrostimulation has been proposed as an alternative or complementary treatment to physical exercise for heart failure as it enables muscular performance and capacity...

Страница 243: ...all electrodes are placed on the motor points of the vastus medialis and the vastus lateralis Two large electrodes are positioned at the top of the thigh For optimum effectiveness the positive pole sh...

Страница 244: ...percentage of motor units recruited and the greater the impact of the progress The general rule is to always try to increase the energy to the maximum level tolerated by the patient The therapist pla...

Страница 245: ...ed Sympathetic Tone Associated with Transcutaneous Electrical Stimulation Anesthesiology 45 575 577 1976 5 Meyer GA Fields HL Causalgia treated by selective large fibre stimulation of peripheral nerve...

Страница 246: ...em However mobilisations massages and all techniques likely to cause or accentuate the pain must be ruled out as they could potentially aggravate the RSD Few therapeutic methods meet these criteria wh...

Страница 247: ...b concerned Upper limb Distal RSD of the upper limb Four large electrodes are used to cover the palms and backs of the hand and fingers Two small electrodes a finger s width apart are placed as high a...

Страница 248: ...knee Four large electrodes are used to cover the knee and surround the kneecap A small electrode is placed at the level of the inguinal fossa just beside the femoral artery and another small electrod...

Страница 249: ...eels paresthesia tingling at the end of the limb being treated Then the energy level is adjusted on the other two channels so that the patient feels an increase in the tingling sensation During the se...

Страница 250: ...mmunoreactivity response to resistance exercise J Sports Sci 1993 11 6 499 452 4 Dzampaeva E T Hearing loss correction by endogenous opioid stimulation Vestn Otorinolaringol 1998 3 13 16 5 Ulett G A H...

Страница 251: ...ree of contracture If left untreated there is a risk that the contracture will become chronic and real atrophy of the capillary network will gradually develop the aerobic metabolism of the muscle fibr...

Страница 252: ...ed muscles 14 10 1 1 Protocol Cervical pain 10 to 12 weeks 14 10 1 2 Treatment frequency Three to five sessions per week for two to three weeks 10 to 12 sessions in total Each session should last at l...

Страница 253: ...duce hyperaemia The mi RANGE function makes it possible to work with certainty within a therapeutically effective range The stimulator prompts you to firstly increase the level of energy a beep sound...

Страница 254: ...contractured muscles 14 10 2 1 Protocol Thoracic back pain 10 to 12 sessions 14 10 2 2 Treatment frequency Three to five sessions per week for two to three weeks 10 to 12 sessions in total A session...

Страница 255: ...aemia The mi RANGE function makes it possible to work with certainty within a therapeutically effective range The stimulator prompts you to firstly increase the level of energy a beep sound accompanie...

Страница 256: ...s why it is generally recommended to combine TENS treatment with the Low back pain programme to make treatment more comfortable for the patient This treatment should be continued for at least ten sess...

Страница 257: ...be easily located by palpitating the lumbar paravertebral muscles For optimum effectiveness the positive pole should preferably be positioned on the painful area Two large electrodes with two outputs...

Страница 258: ...can cause it is recommended to temporarily stop increasing the energy on the first two channels The energy is then increased again on the third channel TENS in order to increase the feeling of parest...

Страница 259: ...ugh the TENS programme reduces the medullar input of the nociceptive impulse Gate control due to painful irradiation of the sciatic nerve Combining endorphinic stimulation with TENS stimulation is ent...

Страница 260: ...ectrode and is attached to the negative pole of the same channel For TENS treatment Two large electrodes are placed on the path of the sciatic nerve one on the lower part of the buttock and the other...

Страница 261: ...rder to cause a distinctive tingling sensation along the painful irradiation of the sciatic nerve The gradual energy increase on the first channel must be sufficient to obtain visible or at least palp...

Страница 262: ...Electrical Stimulation Scand J Rehab Med 9 7 13 1977 5 Waters R McNeal D Perry J Experimental Correction of Foot Drop by Electrical Stimulation of the Peroneal Nerve J Bone Joint Surg Am 57 1047 54 1...

Страница 263: ...lk again by creating a functional gait pattern that the patient is then able to reproduce more easily However this method of gait rehabilitation using FES is not suitable for all hemiplegic patients T...

Страница 264: ...ably be positioned on the lower electrode which corresponds to the motor point of the tibialis anterior 14 11 1 4 Stimulation energy Use the energy necessary to achieve slight dorsiflexion that is eno...

Страница 265: ...leads to the shortening of muscle tendon structures and a reduction in the range of articular movement which can lead to stiffening and misalignment of the joints Use of neuromuscular electrical stimu...

Страница 266: ...ll low frequencies which can also increase spasticity by generating repeated micro stretches of the spastic muscle Spasticity mainly affects the antigravity muscles of the lower limbs and the flexor m...

Страница 267: ...electrodes on the muscle antagonist to the spastic muscle to be treated The stimulation does not act on the spastic muscle but on its antagonist 14 11 2 4 Patient position The patient and body part be...

Страница 268: ...tion of stimulation When the mi SCAN is activated the stimulation session starts automatically with a measurement of the chronaxy This is a short test lasting around ten seconds which allows the optim...

Страница 269: ...other channels In this case the specific practical rules for TENS electrode placement regulation of intensity should be followed for each channel used for this purpose 14 11 3 2 Treatment frequency On...

Страница 270: ...of stimulation and passive motion is therefore given 14 11 3 6 Manual activation of stimulation When the mi SCAN is activated the stimulation session starts automatically with a measurement of the ch...

Страница 271: ...gh stretching of branches of the brachial plexus Vasomotor and trophic disorders of the hand such as those seen in algoneurodystrophy complex regional pain syndrome may be combined resulting in classi...

Страница 272: ...small electrode is placed on the lateral aspect of the shoulder in the middle of the deltoid muscle another small electrode is placed on the outer part of the supraspinatous fossa For optimum effecti...

Страница 273: ...m tolerable energy level is reached The therapist plays a fundamental role in encouraging and reassuring the patient who can then tolerate levels of energy that produce powerful contractions If the TE...

Страница 274: ...on the time of day and how much time the patient has spent standing up We must therefore distinguish between e Venous insufficiency without oedema f Venous insufficiency with oedema The implications f...

Страница 275: ...ossa over the tibial nerve For optimum effectiveness the positive poles should preferably be positioned on these two small electrodes The two other negative poles are connected to the two outputs of a...

Страница 276: ...the leg and then in the thigh without relaxing the compression of the deep veins in the leg In this way the venous blood is pushed in the first stage towards the thigh by a contraction of the leg musc...

Страница 277: ...s the positive pole should preferably be positioned on these two small electrodes For the thigh channels 3 and 4 For the quadriceps channel 3 a large electrode is placed diagonally on the lower third...

Страница 278: ...e electrode placed on the upper part of the calf just below the popliteal fossa 14 12 2 4 Patient position The patient must be in a supine position with his her legs inclined so that gravity encourage...

Страница 279: ...In a clinical examination an arterial murmur can be heard which is evidence of narrowing although the patient has no complaint In Stage II the reduction in the flow causes pain in the legs when walkin...

Страница 280: ...em becomes twofold very little oxygen provided and poor use of what oxygen there is Low frequency stimulation can act on the fibres capacity to use oxygen Considerable studies have shown that low freq...

Страница 281: ...pper part of the popliteal fossa at the nerve trunk of the tibial nerve For optimum effectiveness the positive pole should preferably be positioned on these two small electrodes The two other negative...

Страница 282: ...termittent claudication must be used To carry out a Stage III arterial insufficiency session we will proceed in the same way as in stage II but using a programme adapted to more severe deterioration o...

Страница 283: ...866 5032 E canada orders DJOglobal com CHINA T 8621 6031 9989 F 8621 6031 9709 E information_china DJOglobal com DENMARK FINLAND NORWAY SWEDEN T Denmark 89 88 48 57 T Finland 46 40 39 40 00 T Norway 2...

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