BTL Magnetotherapy 5000 User manual

BTL-5000
Magnetotherapy
USER’S GUIDE
V100RK13/07/2006
MAGNETOTERAPIE - UŽIVATELSKÁ PŘ ÍRUČ KA BTL Physiotherapy
1 MAGNETOTHERAPY............................................................................................. 4
2 MAGNETOTHERAPY – PHYSICAL BACKGROUND.................................................... 5
2.1 Magnetic Field ................................................................................................. 5
2.1.1 Stationary Magnetic Field .............................................................................. 5
2.1.2 Alternating Magnetic Field ............................................................................. 5
2.1.3 Pulse Magnetic Field..................................................................................... 6
2.1.3.1 Device Options......................................................................................... 6
2.2 FMF Technology............................................................................................... 6
2.3 Magnetic Field Units ......................................................................................... 8
3 THERAPEUTIC EFFECTS OF MAGNETOTHERAPY ................................................... 9
3.1 Analgesic Effect ............................................................................................... 9
3.2 Antiphlogistic Effect.......................................................................................... 9
3.3 Trophic Effect .................................................................................................10
3.4 myorelaxation and spasmolytic effect, ................................................................10
3.5 Vasodilatation Effect........................................................................................10
3.6 Antiedematous Effect .......................................................................................10
4 RECOMMENDED DOSAGE OF MAGNETOTHERAPY ................................................11
5 BIBLIOGRAPHY ..................................................................................................12
6 SETTING AND CONTROL OF MAGNETOTHERAPY – TECHNICAL PARAMETERS .......15
6.1 Magnetic Field Intensity ...................................................................................15
6.2 Therapy Time..................................................................................................15
6.3 Physiological Effects........................................................................................15
6.4 Selection of Th e rapy ........................................................................................15
6.4.1 Magnetic Pulses ..........................................................................................15
6.4.1.1 Pulse, Pause, Frequency – Setting ............................................................16
6.4.2 Series of Magnetic Pulses ............................................................................16
6.4.2.1 Pulse, Pause, Frequency, Repeating – Setting of Series...............................16
6.4.3 Continuous Magnetic Field............................................................................17
6.5 Pulse Shape ...................................................................................................17
6.5.1 Rectangular Pulses......................................................................................17
6.5.2 Rectangular Protracted Pulses ......................................................................18
6.5.3 Exponential Pulses ......................................................................................19
6.5.4 Sinusoidal Pulses ........................................................................................19
6.5.5 Triangular Pulses ........................................................................................19
6.6 Modulation......................................................................................................20
6.6.1 Random Frequency ......................................................................................20
6.6.2 Burst..........................................................................................................20
6.6.3 Sine Surges ................................................................................................20
6.6.4 Trapezoid Surges ........................................................................................20
6.6.5 Symmetric Surges........................................................................................22
6.7 Test of Connected Applicator ............................................................................22
7 APPLICATORS....................................................................................................23
7.1 “DISC" Applicator ............................................................................................23
7.1.1 Technical Parameters...................................................................................23
7.1.2 Shape of the Magnetic Field of the Applicator .................................................24
7.2 “DOUBLE DISC" Applicator ...............................................................................25
7.2.1 Technical Parameters...................................................................................25
7.2.2 Shape of the Magnetic Field of the Applicator .................................................26
7.3 “Multi DISC" Applicator ....................................................................................27
7.3.1 Technical Parameters...................................................................................27
7.3.2 Shape of the Magnetic Field of the Applicator .................................................28
7.4 “Solenoid 30” Applicator ...................................................................................29
7.4.1 Technical Parameters...................................................................................29
7.4.2 Shape of the Magnetic Field of the Applicator .................................................29
7.5 “Solenoid 60” Applicator ...................................................................................30
7.5.1 Technical Parameters...................................................................................30
7.5.2 Shape of the Magnetic Field of the Applicator .................................................30
7.6 “Linear" Applicator...........................................................................................31
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7.6.1 Technical Parameters...................................................................................31
7.6.2 Shape of the Magnetic Field of the Applicator .................................................31
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MAGNETOTERAPIE - UŽIVATELSKÁ PŘ ÍRUČ KA BTL Physiotherapy
1 MAGNETOTHERAPY
Magnetotherapy is one of the basic physiotherapy procedures. Its basic form - application of static magnetic field. i.e. the permanent magnet - has been used since time immemorial as one of natural healing sources. However, only the coming of electronics and powerful switching elements enabled rapid development of low-frequency pulse magnet therapy, the effects of which are several times higher than those of the static magnetic field. The recently performed studies imply that therapy performed by means of pulse electromagnetic field is up to 100 times more effective than the application of stationary magnetic field. That is why the pulse magnetotherapy is nowadays becoming one of widespread physiotherapy methods. At some conditions (e.g. chronic pains in degenerative articular diseases) this method has proven successful as therapy with long-lasting therapeutic effect even when other therapy methods failed.
Pulse magnetotherapy can be very effective in case of correct indication and application. It can also be recommended for use in combination with other therapy methods, such as pharmacotherapy, the effects of which are usually supported by magnetotherapy. That is why magnetotherapy should neither be left out in case of comprehensive approach to treatment, nor given preference as monotherapy.
The latest findings about physiological response of the organism to the electromagnetic field imply the following effects of magnetotherapy:
analgesic effect,
antiedematous effect,
antiphlogistic effect,
trophic effect (acceleration of healing and growth),
myorelaxation and spasmolytic effect,
vasodilatation effect.
The following chapters contain brief explanation of physical background of magnetotherapy and physiological mechanisms of its effect with emphasis on application in individual fields of medicine. The Encyclopaedia, which is a separate attachment of this User’s Guide, contains the list of recommended parameters of magnetotherapy at selected diagnoses.
The designing of this device utilizes the experience acquired during the development, manufacturing and long-standing clinical operation of the BTL-09 device and state-of-the-art devices of the BTL-4000 and BTL-5000 series. During the designing of new magnetic applicators for this device there was developed a brand new technology - so called “FMF“ (“Focused Magnetic Field”) technology. Thus we managed to increase the electromagnetic field intensity on the patient side and significantly reduce the electromagnetic field intensity on the applicator side, turned away from the patient. Colloquially said, the magnetic field was moved from the improper side to the side where it is desired. Thanks to these construction elements and thanks to state-of-the-art sources based on the principle of electronic switching elements we have managed to reduce the power consumption significantly while preserving the same electromagnetic field intensities.
Note
The authors of this User’s Guide are aware that such a small space is not sufficient for detailed description of the entire magnetotherapy issue. They therefore had to make some generalizations and simplifications resulting from the limited scope of this text. More details you can find in the available literature (see Chapter 5 Bibliography)
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2 MAGNETOTHERAPY – PHYSICAL BACKGROUND
2.1 MAGNETIC FIELD
Magnetic field is an integral part of electromagnetic field which consists of the electric and the magnetic components. Both components of the electromagnetic field are mutually closely connected and cannot exist without each other, , except in the following two special cases:
electrostatic field in which the magnetic component of the field is zero, and
stationary magnetic field in which the electric component is zero.
Owing to the used frequencies up to 150 Hz and owing to the design of the BTL applicators, the magnetic component of the field predominates over the electric. For short we will call the field by the commonly used term “magnetic field” hereinafter. The presence of a magnetic field is sensed primarily through its force effects by which it affects magnetically conductive things, moving charges and conductors with electric current flowing through them. The force effects are not very important for our theory, because biological objects are diamagnetic. However, it is necessary to take these force effects into account in case of metal implants, especially those which are fixed in soft tissues and are not made of antimagnetic materials.
Another interaction between the magnetic field and the matter occurs at the moment when the matter is exposed to the magnetic field. At that moment, individual free molecules are orientated in a way to minimize the energy inside the field. In case of biological objects, these forces act against the bonds between atoms, molecules and ions in the tissues, which consequently influences also the cellular processes.
The effects important for physiotherapy are based on electrodynamic induction discovered by the physicist M. Faraday in the 19 conductor in the magnetic field, voltage appears on it. If you make a closed loop of the moving conductor, electric current will flow through it. As Faraday discovered, this phenomenon also works the other way around – if the magnetic field moves or changes in the course of time (instead of the conductor), a similar effect occurs. These discoveries were only a short remove from the application of alternating magnetic fields in therapy.
In case of living organisms, the moving charges (the conductor moving in the magnetic field) are represented by the circulating body fluids (blood, lymph). In case of exposition to alternating magnetic field it refers to its individual more electrically conductive parts - the vascular bed (including circulating fluids), peripheral nerves, CNS neural paths and, last but not least, also individual ions and charges on cellular membranes.
th
century. In practice, if you are moving the electric
2.1.1 Stationary Magnetic Field
Stationary magnetic field arises around permanent magnets but also around moving electric charges which move at a constant speed (direct current) Electric charge may be carried e.g. by ions (electric current flowing in liquids) and electrons (electric current flowing in conductors). In the latter case, a magnetic field similar to that around the permanent magnet arises around the electric conductor with constant direct electric current flowing through it.
2.1.2 Alternating Magnetic Field
Time behaviour of this field is usually derived from the sinusoidal mains voltage. In common practice, devices most often generate the fields of a frequency of 50 Hz and the sinusoidal waveform. The magnetic fields of these devices change their polarity in the course of time. These fields, even though with much lower intensity, exist in the surrounding of each electric conductor, transformers and motors supplied from the AC mains.
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2.1.3 Pulse Magnetic Field
This field is characterized by fast changes of field; individual pulses are close to rectangular pulses, their edges are very steep. That is why in the pulse magnetic field the electric component is higher and is permanently present beside the magnetic component. Some studies, which deal with comparison of individual magnetic field types, point out the very high efficiency of the pulse magnetic field in comparison with the stationary magnetic field. Therefore the question arises whether the positive results of the pulse magnetic field are not caused by the more intensive electric component of the field.
Out of all possible pulse types, the BTL – 5000 device has been equipped with the following ones. These pulses cover the entire spectrum of required applications, from acute to chronic states.
2.1.3.1 Device Options
The device can be set to generate the following pulse types:
rectangular pulses,
rectangular protracted pulses,
exponential pulses,
sinusoidal pulses,
triangular pulses and
continuous magnetic field.
All the above listed magnetic field waveforms can be further modulated and the following surges of basic pulses can be created:
trapezoid surges,
sine surges,
symmetric surges.
It is also possible to create groups of magnetic pulses - so called bursts. The option of random sweep of the basic selected frequency is available too. All these parameters can be set in well-arranged manual mode. Preset programs and recommended diagnoses are available too.
2.2 FMF TECHNOLOGY
FMF = Focused M agnetic F ield
In dependence on their spatial distribution, magnetic fields are divided into uniform and non­uniform. The uniform field has the same intensity and the same direction in all points of the
space.
The applicators were designed using state-of the-art ferromagnetic and magnetic materials which allow to assemble highly effective magnetic concentration systems. These elements focus the electromagnetic field into the desired space towards the treated body part. Therefore the magnetic field of the BTL applicator is intentionally non-uniform and focused.
Standard Magnetic Applicator FMF Technology Applicator of DISC Type
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The sides of the applicator are identified as the patient side, from which the magnetic field is emitted to a higher extent, and the operator side, at which the field intensities are several times lower. blue indicator light
Patient / Application
Side of the Applicator
The side is marked with the
pictograph of a “patient in the
magnetic field”. The intensities at
this side of the applicator are much
higher than those at the operator
side. During the operation of the
device the operator should not touch
Side turned away from the patient
(operator side)
Side marked with the BTL logo.
It is also equipped with blue
indicator lamp which indicates the
operation of the applicator
(continuous light, fast blinking)
and its readiness for operation (slow
blinking)
this side of the applicator.
Example of possible use of the magnetic applicator with FMF technology:
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The magnetic field of the solenoid type applicators is focused inward:
Standard applicator and its FMF technology applicator magnetic field - focused magnetic field
2.3 MAGNETIC FIELD UNITS
Devices BTL-4000 and BTL-5000 use for the magnetic field induction (B) the unit according to the SI international unit system – Tesla (T) or its one thousandth - millitesla (mT).
Owing to the fact that the formerly used unit Gauss (G) has the following relation to millitesla: 1mT = 10 G, the display shows the converted value in mT/10. Then, 1mT/10 = 1G.
Other magnetic field units: Then unit of magnetic field intensity is ampere per meter (A/m). An older unit of intensity is Oersted (Oe). The relation between these two unit is: 1 Oe = 79.577 A/m.
The relation between the magnetic induction and the magnetic intensity is the following:
B = µ
. µo . H
r
where: B is the magnetic induction H is the magnetic intensity µ
µ
is the permeability of vacuum, which equals to 1.2566 . 10-6
o
is the relative permeability of the environment which expresses the magnetic
r
properties of the environment
for vacuum it equals to 1
for magnetically conductive materials the values are much higher than 1 (e.g.
for steel the values range from 100 to 5800)
for air the value is similar as for vacuum, i.e. approximately 1 (1.00000038 to be accurate)
biological tissues from this view can be compared to water, for which the value equals to 0.999991
It can be calculated that for biological tissues a magnetic field induction of 1mT corresponds to a magnetic field intensity of 795.8 A/m.
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3 THERAPEUTIC EFFECTS OF MAGNETOTHERAPY
Magnetotherapy is one of the commonly used physiotherapy procedures. This method has proved successful in some diseases as therapy with long-lasting therapeutic effect (e.g. at chronic pains of vertebrogenous aetiology or at degenerative joint diseases) even when other therapy methods failed. However, it is necessary to consider that, like every therapeutic procedure, magnetotherapy also has a certain failure rate.
It has been proved that for treatment of patients in acute stages it is better to use static magnetic field at the beginning; in chronic diseases it is better to use pulse magnetotherapy. Application of magnetotherapy must always be based on thorough medical history and detailed examination of the patient. It is suitable to take into account that the natural magnetic field of the Earth equals approximately to 0.04 – 0.05 mT (0.4 – 0.5 Gauss). Devices BTL-4000 / BTL-5000 work with magnetic fields the intensity of which may be up to 1000 times higher. Therefore the application requires particular caution, also with respect to the fact that man has no specific receptors for magnetic field and therefore does not perceive it directly – unlike e.g. electric current.
The latest findings about physiological response of the organism to the electromagnetic field imply the following effects of magnetotherapy:
analgesic effect,
antiphlogistic effect,
trophic effect (acceleration of healing and growth),
myorelaxation and spasmolytic effect,
vasodilatation effect.
antiedematous effect,
3.1 ANALGESIC EFFECT
The analgesic effect of magnetotherapy applies in most algesic states of muscular as well as articular aetiology. Detailed description of this effect is quite complicated; its physiological effects have been specified in recent years. According to these findings, the analgesic effect of magnetotherapy is accounted for by increased secretion of endogenous opioids caused by myorelaxation, antiphlogistic and antiedematous effect and maybe also the impact on presinaptic inhibition of nociceptive signals at the level of medullary dorsal horns. The treatment should be combined with aimed pharmacotherapy, manual treatment and relaxation therapy, at least in the initial stage.
3.2 ANTIPHLOGISTIC EFFECT
This effect has not been convincingly explained so far, but recent studies agree on the following principle: The antiphlogistic effect is induced by increased phagocytosis of neutrophils and increased production of hyperoxide. This is followed by induction of hyperoxide dismutase bound to endothelium, which all probably leads to higher concentration of hydrogen peroxide in the exposed area. Owing to the fast that hyperoxide inhibits the activity of catalase, the hydrogen peroxide is not degraded and thus it is able to destroy leucotriens, which belong to the strongest activators of phagocytosis. This mechanism also explains the initial controversial acting of the magnetic field in sterile inflammations as well as in the microbially induced inflammations. This effect also accounts for temporary impairment of rheumatic conditions during the first two or three expositions, when the inflammatory symptoms are intensified by increasingly produced hyperoxide. Simultaneous medication and physical therapy is necessary; the patient must be monitored during the therapy and in case of longer negative reaction the therapy must be stopped.
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3.3 TROPHIC EFFECT
The magnetic field accelerates healing of the skeleton and soft tissues. It is caused by better blood circulation in the exposed area and by irritation of cytoplasmatic membranes. This activates the metabolic chain, the key point of which is the change of the cAMP/cGMP ratio. The acceleration of healing, especially of the skeleton, is described in details in the literature (Chvojka, 1993, 2000).
3.4 MYORELAXATION AND SPASMOLYTIC EFFECT,
Increased blood circulation in the area improves washing away of acidic metabolites which cause painful irritation. In the muscles exposed to the magnetic field there also proceeds increased activity of LDH (lactate dehydrogenase) and efflux of the Ca
2+
ion from muscle cells.
3.5 VASODILATATION EFFECT
This effect is caused by the efflux of Ca2+ ions which causes relaxation of the tonus of the vascular musculature and precapillary sphincters. Probably the n. vagus is also directly influenced and the increased metabolic activity of cells in the exposed area results in creation of EDRF and prostacyclins.
3.6 ANTIEDEMATOUS EFFECT
This effect results from the two above described effects - antiphlogistic effect of the magnet and acceleration of healing and improved blood circulation.
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4 RECOMMENDED DOSAGE OF MAGNETOTHERAPY
Suitable dosage for the particular application can be estimated from the following relations. The resulting dose rises along with:
higher value of magnetic induction (intensity) of the magnetic field B
higher steepness of rising and falling edges of magnetic field pulses dB/dt [T/s],
higher frequency of magnetic field pulses f [Hz] and
longer time of exposition (in hours).
dose = B
* dB/dt * time of exposition * f
max
The optimum dose should range from 4 to 8.
The following procedure for selecting the optimum does of magnetotherapy is recommended:
The applicators should be as close as possible to the patient’s body surface. Direct contact with the body is not necessary, therapy may be applied through the clothes or bandage.
Magnetotherapy should be applied as soon as possible - it will better influence functional disorders, not structural changes.
For sterile inflammations it is suitable to use frequency up to 10 Hz.
For microbially induced inflammations (sinusitises, osteomyelitises) it is suitable to use
pulse frequency about 25 Hz.
In degenerative diseases of locomotive organs the recommended pulse frequency is above 10 Hz.
When treating tennis elbows and frozen shoulders it is suitable to expose the C-spine at the same time.
When treating subacute and acute vertebrogenous troubles it is also recommended to expose the pain trigger points (TPs).
Individual expositions must be long enough and repeated. The minimum exposition time is at least 10 minutes, the minimum number of expositions is 10 to 15.
The total daily time of exposition should not exceed 40 minutes.
The best results are achieved when the first 5 to 10 expositions are performed daily or
twice a day.
If magnetotherapy does not start to work within 20 procedures, it fails. An exception is the treatment of pseudo-arthroses, where the first visible signs of healing can be observed, using display methods, not sooner than after 30 procedures.
In approximately 30% of rheumatics there can be expected subjective impairment of the condition after first 3 expositions.
If possible, do not end magnetotherapy at once, but by gradual prolongation of intervals between individual expositions.
Special attention shall be paid to patients with hypotensis and hypertensis. During therapy the significant drop of blood pressure may occur, including all side effects. This reaction usually disappears within 30 minutes after the end of therapy and the adaptation occurs approximately after 5 expositions.
For contraindications see the main User’s Manual of the device - document “BTL-5000 Series
– User’s Manual”, Chapter 6.4 Contraindications”.
max
[T],
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5 BIBLIOGRAPHY
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Pipitone, N. and D. L. Scott. "Magnetic Pulse Treatment for Knee Osteoarthritis: A Randomised, Double-Blind, Placebo-Controlled Study", Current Medical Research and Opinion, Vol. 17, No. 3, 2001, pp. 190-196.
T. L. Richards, M. S. Lappin, J. Acosta-Urquidi, G. H. Kraft, A. C. Heide, F. W. Lawrie, T. E. Merrill, G. B. Melton, and C. A. Cunningham, “Double-blind Study of Pulsing Magnetic Field Effects on Multiple Sclerosis”, The Journal of Alternative and Complementary Medicine, 3, 1, 1997, pp. 21-29.
N. J. Roland, J. B. Hughes, M. B. Daley, J. A. Cook, A. S. Jones, and M. S. McCormick, “Electromagnetic Stimulation as a Treatment of Tinnitus: A Pilot Study”, Clinical Otolaryngology and Applied Sciences, 18, 1993, pp. 278-281.
Sadlonova, J., Korpas, J., Salat, D., Miko, L., Kudlicka, J., "The effect of the pulsatile electromagnetic field in children suffering from bronchial asthma", Acta Physiol Hung., 90(4), 2003, pp. 327-34.
Sadlonova J, Korpas J, Vrabec M, Salat D, Buchancova J, Kudlicka J., ""The effect of the pulsatile electromagnetic field in patients suffering from chronic obstructive pulmonary disease and bronchial asthma"", Bratisl Lek Listy; 103 (7-8), 2002, pp. 260-265."
E. R. Sanseverino, A. Vannini, and P. Castellacci, “Therapeutic Effects of Pulsed Magnetic Fields on Joint Diseases", Panminerva Medica, 34, 4, 1992, pp. 187-196.
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F. Sartucci, L. Bonfiglio, C. Del Seppia, P. Luschi, S. Ghione, L. Murri, and F. Papi, “Changes in Pain Perception and Painduced by Exposure to Oscillating Magnetic Fields”, Brain Research, 769, 1997, pp. 362-366.
B. F. Sisken, M. Kanje, G. Lundborg, E. Herbst, and W. Kurtz, “Stimulation of Rat Sciatic Nerve Regeneration with Pulsed Electromagnetic Fields”, Brain Research, 485, 1989, pp. 309-
316. M. J. Stiller, G. H. Pak, J. L. Shupack, S. Thaler, C. Kenny, and L. Jondreau, “A Portable
Pulsed Electromagnetic Field (PEMF) Device to Enhance Healing of Recalcitrant Venous Ulcers: A Double-blind, Placebo-controlled Clinical Trial,” British Journal of Dermatology, 127, 1992, pp. 147-154.
Sweeney, K. B., Merrick, M. A., Ingersoll, Ch., D., and J. A.Swez, "Therapeutic Magnets Do Not Affect Tissue Temperatures", J. Athl. Train., 36 (1), 2001 March, pp. 27-31.
F. Tabrah, M. Hoffmeier, F. Gilbert Jr., S. Batkin, and C. A. L. Bassett, “Bone Density Changes in Osteoporosis prone Women Exposed to Pulsed Electromagnetic Fields (PEMFs)”, Journal of Bone and Mineral Research, 5, 5, 1990, pp. 437-442.
G. C. Traina, L. Romanini, F. Benazzo, R. Cadossi, V. Canè, A. Chiabrera, M. Marcer, N. Marchetti, and F. S. Snatori, “Use of Electric and Magnetic Stimulation in Orthopaedics and Traumatology: Consensus Conference”, Italian Journal of Orthopaedics and Traumatology, 24, 1, 1998, pp. 1-31.
D. H. Wilson and P. Jagadeesh, "Experimental Regeneration in Peripheral Nerves and the Spinal Cord in Laboratory Animals Exposed to a Pulsed Electromagnetic Field”, Paraplegia, 14, 1976, pp. 12-20.
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6 SETTING AND CONTROL OF MAGNETOTHERAPY –
TECHNICAL PARAMETERS
6.1 MAGNETIC FIELD INTENSITY
The magnetic field intensity can be set from 1 mT/10 (i.e. 1 Gauss) and its maximum value depends on the applicator type and the type of the selected therapy application. For the maximum values in dependence on the applicator type see Chapter 7 Applicators. The step of setting is 1 mT/10 (i.e. 1 Gauss). The set intensity value represents the maximum intensity in space and time The accuracy of the set intensity value is ± 30%.
6.2 THERAPY TIME
Can be set within the range from 1 second to 100 minutes, i.e. from 00:01 to 99:59 [m:s]. The step of setting is 1 second The accuracy of the set time is 2%.
6.3 PHYSIOLOGICAL EFFECTS
The effects are defined for preset diagnoses and the user can define them for customer diagnoses and programs, created and saved by the user. Legend:
A – analgesic
E – antiedematous
F –antiphlogistic
S – trophic, acceleration of healing
R – myorelaxation and spasmolytic (vasodilatation, antiedematous,...)
6.4 SELECTION OF THERAPY
Press the [therapy] button to open the dialog box (see picture) for selection of the best magnetic field therapy. The following therapy options are available:
magnetic pulses
series of magnetic pulses
continuous magnetic field.
The properties of individual therapies are described in the paragraphs below.
6.4.1 Magnetic Pulses
Standard waveforms of magnetic pulses; it is possible to select between constant and randomly swept frequency of the selected pulses. For selection of the pulse shape use the [pulse shape] button. The following options are available:
rectangular pulses,
rectangular protracted pulses,
exponential pulses,
sinusoidal pulses and
triangular pulses.
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The following modulations can be applied on the magnetic pulses:
burst,
sine surges,
trapezoid surges and
symmetric surges.
6.4.1.1 Pulse, Pause, Frequency – Setting
On pressing of the displayed window the dialog box opens, in which it is possible to set the following pulse parameters: pulse length, pause between pulses and pulse frequency.
Owing to the fact that these values are mutually interconnected through mathematical definitions, any change of a value implies automatic changes of the other values. At setting it is necessary to realize that the pause length must be always longer than the pulse length (construction limits).
The limits for setting differ for various pulse shapes ­for details see Chapter 6.5 Pulse Shape.
6.4.2 Series of Magnetic Pulses
These very interesting magnetic pulse waveforms were first used in the BTL-09 device, but were limited to rectangular pulses only. Devices BTL-4000 / 5000 offer these pulses for all pulse shapes:
rectangular pulses,
rectangular protracted pulses,
exponential pulses,
sinusoidal pulses and
triangular pulses.
In principle is it a mix of pulses of various length and frequency in one series to be repeated. It is advantageous to combine for example long pulses of low frequency with very short pulses of high repeating frequency and thus cumulate the therapy effect. It is also possible to select between constant and randomly swept frequency of the selected pulses.
The following modulations can be applied on the magnetic pulses:
sine surges,
trapezoid surges and
symmetric surges.
6.4.2.1 Pulse, Pause, Frequency, Repeating – Setting of Series
After pressing of the displayed button the dialog box opens, in which it is possible to set the following parameters of the series of pulses: pulse length, pause between pulses, pulse frequency, number in the series and length of the series.
For each period – part of the series – it is possible to set the standard pulse parameters:
pulse length,
length of pause between pulses,
pulse frequency and
number of pulses with this setting to be
generated. After the end of generation of this part the program passes to another one.
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The limits for setting of the pulse length, pause and frequency differ for various pulse shapes – for details see Chapter 6.5 Pulse Shape.
The number of repetitions of individual pulses can be set within the range from 1 to 255. The step of setting is 1 .
The window displays the total number of parts in the series and the [add new] button, the field for displaying the number of the part being edited (10 in this case) and the button for deleting of the selected part of the series. In total it is possible to set 13 parts in one series.
Owing to the fact that the values of the pulse length, pause and frequency are mutually interconnected through mathematical definitions, any change of a value implies automatic changes of the other values. At setting it is necessary to realize that the pause length must be always longer than the pulse length (construction limits).
6.4.3 Continuous Magnetic Field
The BTL 4000 / 5000 devices enable to generate stationary magnetic field, which is similar to the fields around permanent magnets. This field is recommended for the applications where the effects of the pulse electromagnetic field could cause serious problems and it is therefore contraindicated - e.g. in case of increased bleeding conditions, acute states, post-operative conditions etc. The effect of this field is also increased by the presence of permanent magnets in our “disc” type applicators. The application of this type of field is recommended in the first stages of magnetotherapy; approximately after the first or second week it is recommended to change over to the pulse field. Continuous magnetic field can be modulated by slow magnetic field surges of a length of several seconds or more.
sine surges,
trapezoid surges and
symmetric surges.
6.5 PULSE SHAPE
This button serves for selection of the required shape of magnetic pulses. The following options are available:
rectangular pulses
rectangular protracted pulses
exponential pulses
sinusoidal pulses
triangular pulses.
6.5.1 Rectangular Pulses
These pulses are a sort of “gold standard” in pulse magnetotherapy. In addition to the options that are available in the BTL-09 device, device BTL 4000 / 5000 provides also modulation of contour of the following pulses:
trapezoid surges,
sine surges,
symmetric surges and
bursts.
Rectangular pulses can be set within the following range:
pulse length t
from 3 ms to 255 ms
p
o step of setting: 1 ms (from 3 ms to 30 ms)
2 ms (from 30 ms to 50 ms) 5 ms (from 50 ms to 100 ms) 10 ms (from 100 ms to 255 ms)
o a specific value (e.g. 58 ms) can be set using the keyboard
pause between pulses t
o the set pause is always longer than the set pulse length: t
from 3 ms to 65,000 ms
i
> tp
i
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o step of setting: 1 ms (from 3 ms to 30 ms)
2 ms (from 30 ms to 50 ms) 5 ms (from 50 ms to 100 ms) 10 ms (from 100 ms to 200 ms) 20 ms (from 200 ms to 500 ms) 50 ms (from 500 ms to 1000 ms) 100 ms (from 1,000 ms to 65,000 ms)
o a specific value (e.g. 583 ms) can be set using the keyboard
the frequency of pulses can be set within the range from 0.015 Hz to 166 Hz
o step of setting: 0.01 Hz (from 0.01 Hz to 0.30 Hz)
0.02 Hz (from 0.30 Hz to 0.50 Hz)
0.05 Hz (from 0.50 Hz to 1.00 Hz)
0.10 Hz (from 1.00 Hz to 5.00 Hz)
0.50 Hz (from 5.00 Hz to 10.0 Hz)
1.00 Hz (from 10.0 Hz to 30.0 Hz)
2.00 Hz (from 30.0 Hz to 50.0 Hz)
5.00 Hz (from 50.0 Hz to 70.0 Hz)
10.0 Hz (from 70.0 Hz to 100 Hz)
15.0 Hz (from 100.0 Hz to 166 Hz)
o the specific value is calculated by the device from the values of pulse length
and pause length f = 1 / (t
+ tp)
i
6.5.2 Rectangular Protracted Pulses
On the basis of our experience with pulse magnetic fields we designed this new type of currents which utilizes the advantageous properties of rectangular pulses – big steepness of the rising and falling edges. At the same time it significantly reduces the power consumption of the generated magnetic field pulses and extends the duration of the pulse. So it is possible to generate pulses of higher intensities than at standard rectangular pulses with the same power consumption (the same heating of the applicators). Similarly as in standard rectangular pulses, all modulations of pulse contours are available here, including random frequency sweep, preset programs and recommended diagnoses.
Protracted rectangular pulses can be set within the following range:
pulse length t
from 6 ms to 510 ms
p
o step of setting: 1 ms (from 6 ms to 30 ms)
2 ms (from 30 ms to 50 ms) 5 ms (from 50 ms to 100 ms) 10 ms (from 100 ms to 510 ms)
o a specific value (e.g. 58 ms) can be set using the keyboard
pause between pulses t
o the set pause is always longer than the set pulse length: t
from 6 ms to 65,000 ms
i
> tp
i
o step of setting: 1 ms (from 6 ms to 30 ms)
2 ms (from 30 ms to 50 ms) 5 ms (from 50 ms to 100 ms) 10 ms (from 100 ms to 200 ms) 20 ms (from 200 ms to 500 ms) 50 ms (from 500 ms to 1000 ms) 100 ms (from 1,000 ms to 65,000 ms)
o a specific value (e.g. 583 ms) can be set using the keyboard
the frequency of pulses can be set within the range from 0.015 Hz to 83.3 Hz
o step of setting: 0.01 Hz (from 0.01 Hz to 0.30 Hz)
0.02 Hz (from 0.30 Hz to 0.50 Hz)
0.05 Hz (from 0.50 Hz to 1.00 Hz)
0.10 Hz (from 1.00 Hz to 5.00 Hz)
0.50 Hz (from 5.00 Hz to 10.0 Hz)
1.00 Hz (from 10.0 Hz to 30.0 Hz)
2.00 Hz (from 30.0 Hz to 50.0 Hz)
5.00 Hz (from 50.0 Hz to 70.0 Hz)
10.0 Hz (from 70.0 Hz to 83.3 Hz)
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o the specific value is calculated by the device from the values of pulse length
and pause length f = 1 / (t
+ tp)
i
6.5.3 Exponential Pulses
Similarly as in electrotherapy, these pulses are very interesting thanks to their mild gradual rising and, at the same time, high pulse intensities, which they achieve at very low power consumption. That is why they are suitable especially in the applications where high energy of the electromagnetic field is undesirable but the high pulse intensity is required. These pulses apply especially at stimulation of neural paths by induced currents. At exponential pulses it is also possible to apply surge modulations similarly as at rectangular pulses. Exponential pulses can be set within the following range:
pulse length tp from 6 ms to 510 ms
o step of setting: the same as for rectangular protracted pulses o a specific value (e.g. 58 ms) can be set using the keyboard
pause between pulses t
o the set pause is always longer than the set pulse length: t
from 6 ms to 65,000 ms
i
> tp
i
o step of setting: the same as for rectangular protracted pulses o a specific value (e.g. 583 ms) can be set using the keyboard
the frequency of pulses can be set within the range from 0.015 Hz to 83.3 Hz
o step of setting: the same as for rectangular protracted pulses o the specific value is calculated by the device from the values of pulse length
and pause length f = 1 / (t
+ tp)
i
6.5.4 Sinusoidal Pulses
Classic sinusoidal pulses derived from the mains voltage. They are used particularly for well-tried standard therapies. The setting options are the same as for rectangular pulses, including modulation. Setting options:
pulse length t
from 6 ms to 510 ms
p
o step of setting: the same as for rectangular protracted pulses o a specific value (e.g. 58 ms) can be set using the keyboard
pause between pulses ti from 6 ms to 65,000 ms
o the set pause is always longer than the set pulse length: t
> tp
i
o step of setting: the same as for rectangular protracted pulses o a specific value (e.g. 583 ms) can be set using the keyboard
the frequency of pulses can be set within the range from 0.015 Hz to 83.3 Hz
o step of setting: the same as for rectangular protracted pulses o the specific value is calculated by the device from the values of pulse length
and pause length f = 1 / (t
+ tp)
i
6.5.5 Triangular Pulses
Symmetric triangular pulses with the same rising time and falling time. In some countries their use is very widespread. The setting options are the same as for rectangular pulses, including modulation. Setting options:
pulse length t
from 6 ms to 510 ms
p
o step of setting: the same as for rectangular protracted pulses o a specific value (e.g. 58 ms) can be set using the keyboard
pause between pulses ti from 6 ms to 65,000 ms
o the set pause is always longer than the set pulse length: t
> tp
i
o step of setting: the same as for rectangular protracted pulses o a specific value (e.g. 583 ms) can be set using the keyboard
the frequency of pulses can be set within the range from 0.015 Hz to 83.3 Hz
o step of setting: the same as for rectangular protracted pulses o the specific value is calculated by the device from the values of pulse length
and pause length f = 1 / (ti + tp)
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6.6 MODULATION
For detailed modulation settings press the [mag. param.] window.
6.6.1 Random Frequency
Can be selected for all pulse types. The option switches on the sweep of the set pause length within the range from 0 to + 30%. In the previous device BTL-09 this function was called “wave swing”. For the BTL-4000 / 5000 devices we decided to unify the name with the other types of physiotherapy, such as electrotherapy etc.
6.6.2 Burst
This option cannot be used in the series of magnetic pulses and the continuous field.
It is possible to set the number of pulses in one burst within the range from 3 to 10. The length of so defined burst in [ms] is displayed in the [burst] window.
The length of pause between individual bursts can be set within the limit from 1 to 255 s. The step of setting is:
1 s (from 1 s to 30 s)
2 s (from 30 s to 50 s)
5 s (from 50 s to 100 s)
10 s (from 100 s to 255 s)
a specific value (e.g. 236 s) can be set using the keyboard.
Besides these options it is possible to use some predefined settings – see picture, the value is displayed as the number of
pulses in burst / length of pause between bursts.
6.6.3 Sine Surges
The surge length and the pause length can be set separately, both within the range from 1 s to 255 s. The step of setting of both values is:
1 s (from 1 s to 30 s)
2 s (from 30 s to 50 s)
5 s (from 50 s to 100 s)
10 s (from 100 s to 255 s)
a specific value (e.g. 236 s) can be set using
the keyboard.
It is again possible to use predefined surges for setting.
6.6.4 Trapezoid Surges
It is possible to set:
surge rise from 1 s to 255 s
surge duration from 1 s to 255 s
fall of intensity from 1 s to 255 s and
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pause from 1 s to 255 s.
The step of setting of both values is:
1 s (from 1 s to 30 s)
2 s (from 30 s to 50 s)
5 s (from 50 s to 100 s)
10 s (from 100 s to 255 s)
a specific value (e.g. 236 s) can be set using the keyboard.
It is again possible to use predefined surges for setting.
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6.6.5 Symmetric Surges
Another way of setting of trapezoid surges, very widespread in some EU countries.
It is possible to set the "sweep time”, the time of detuning and stabilization of the surge, within the range from 1 s to 255 s. The step of setting is:
1 s (from 1 s to 30 s)
2 s (from 30 s to 50 s)
5 s (from 50 s to 100 s)
10 s (from 100 s to 255 s)
a specific value (e.g. 236 s) can be set using
the keyboard.
The “contour” parameter is the ratio between the change and the stable part of the surge. It can be set within the range from 1% to 100% change. The step of setting is 1%; the influence of setting is best seen on the animated icon on the device. It is again possible to use predefined surges for setting.
6.7 TEST OF CONNECTED APPLICATOR
To verify the function of ther connected applicator press the [Induction of Magnet Accessories] button.
For correct evaluation of the test it is necessary to perform the test on a non-conducting suface - wooden or plastic.
In addition it is necessary that the double disk or multidisk applicators are not on top of each other during the measuring, but beside each other.
The test measures the temperature and magnetic inductivity of the connected applicator. After the measuring the measured values are compared with the standard values and on the basic of this comparison the device evaluates whether the applicator works properly.
If the resulting test value is “ok”, the applicator works properly. If the test result is indicated “low value” or “high value” (see picture), the applicator probably works improperly and it is necessary to contact the service.
Note: Inductivity is a physical quantity which expresses the dimension of the magnetic induction flux through the coil.
Inductivity is one of basic characteristics of the coil - it expresses the ability of the coil to change electric power to magnetic field energy.
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7 APPLICATORS
The parameters of the magnetic applicators have been optimized with respect to the recommended therapeutic applications. Using the FMF technology, the magnetic field is focused to the treated area, which enables, while preserving the same output intensity, to reduce the power consumption of the magnetotherapy device as well as the spurious magnetic field on the non-patient side of the applicators, which may potentially hit the operator. The below described types of applicators can be connected to the BTL-4000 / 5000 device.
7.1 “DISC" APPLICATOR
The Disc applicator is made of plastic. The part which comes into contact with the patient is coated with fine durable leatherette. The applicator is designed using the FMF technology - the patient side emits focused magnetic field, while on the other side the magnetic field is screened so that its impact on the surroundings is as low as possible.
Patient / application
side of the applicator
The side is marked with the
pictograph of a “patient in the
magnetic field”. The intensities at
this side of the applicator are much
higher than those at the operator
side. During the operation of the
device the operator should not touch
Side turned away from the patient
(operator side)
Side marked with the BTL logo.
It is also equipped with blue
indicator lamp which indicates the
operation of the applicator
(continuous light, fast blinking)
and its readiness for operation (slow
blinking)
this side of the applicator.
The magnetic applicator contains also a permanent magnet to increase the effect of soothing the tissue at traumatic and bleeding conditions.
7.1.1 Technical Parameters
Identification - Type: BTL-239-1 Name: Disc Dimensions: 130 x 130 x 30 mm Weight: 1.05 kg Intensity of the Permanent Magnet Field: 23 mT (230 Gauss) Max. Intensity of Pulse Magnetic Field: 102 mT (1020 Gauss) Max. Intensity of Magnetic Field in Total: 125 mT (1250 Gauss) Resistance of the Applicator:
4.2
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7.1.2 Shape of the Magnetic Field of the Applicator
The picture shows the shape of the applicator’s magnetic field on the patient side. The unit of the intensity values is mT/10, i.e. Gauss, and the values are valid at the maximum current flowing through the applicator. The sum of intensity of the permanent magnet field and intensity of the pulse magnetic field is stated. The value 1250 mT/10 is in the centre, on the surface of the applicator.
[cm]
25
20
15
10
[mT/10]
3
5
10
20
50
5
100
200
500
0
1000
1250
051015205101520 [cm]
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7.2 “DOUBLE DISC" APPLICATOR
The double disc applicator consists of series interconnection of two disc applicators. The applicators are mutually orientated in the way that a linearized magnetic field arises between them. Similarly as disc, the “double disc” applicator is made of plastic. The part which comes into contact with the patient is coated with fine durable leatherette. The applicator is designed using the FMF technology - the patient side emits focused magnetic field, while on the other side the magnetic field is screened so that its impact on the surroundings is as low as possible.
Patient / application
side of the applicator
The side is marked with the
pictograph of a “patient in the
magnetic field”. The intensities at
this side of the applicator are much
higher than those at the operator
side. During the operation of the
device the operator should not touch
Side turned away from the patient
(operator side)
Side marked with the BTL logo.
It is also equipped with blue
indicator lamp which indicates the
operation of the applicator
(continuous light, fast blinking)
and its readiness for operation (slow
blinking)
this side of the applicator.
The magnetic applicator contains also a permanent magnet to increase the effect of soothing the tissue at traumatic and bleeding conditions.
7.2.1 Technical Parameters
Identification - Type: BTL-239-4 Name: double disc Dimensions: 2x 130 x 130 x 30 mm Weight: 2.15 kg Intensity of the Permanent Magnet Field: 23 mT (230 Gauss) Max. Intensity of Pulse Magnetic Field: 72 mT (720 Gauss) Max. Intensity of Magnetic Field in Total: 95 mT (950 Gauss) Resistance of the Applicator:
8.4
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[cm] [cm]
7.2.2 Shape of the Magnetic Field of the Applicator
The picture shows the shape of the applicator’s magnetic field between the patient sides. The unit of the intensity values is mT/10, i.e. Gauss, and the values are valid at the maximum current flowing through the applicator. The sum of intensity of the permanent magnet field and intensity of the pulse magnetic field is stated. The highest value 950 mT/10 is in the centre, on the surface of the applicator.
mT/10
10
25
50
950
950
100
250
500
750
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MAGNETOTERAPIE - UŽIVATELSKÁ PŘ ÍRUČ KA BTL Physiotherapy
7.3 “MULTI DISC" APPLICATOR
The multi disc applicator consists of series-parallel interconnection of four disc applicators. The applicators are mutually orientated in the way that a linearized magnetic field arises between them. The multi disc applicator was designed as a portable substitute for the solenoid 60 applicator. It can be well used for the applications which require the use of two double discs (application on the extremities). See recommended diagnoses for details. Similarly as disc, the multi disc applicator is made of plastic - harmless polypropylene. The part which comes into contact with the patient is coated with fine durable leatherette. The applicator is designed using the FMF technology - the patient side emits focused magnetic field, while on the other side the magnetic field is screened so that its impact on the surroundings is as low as possible.
Patient / application
side of the applicator
The side is marked with the
pictograph of a “patient in the
magnetic field”. The intensities at
this side of the applicator are much
higher than those at the operator
side. During the operation of the
device the operator should not touch
Side turned away from the patient
(operator side)
Side marked with the BTL logo.
It is also equipped with blue
indicator lamp which indicates the
operation of the applicator
(continuous light, fast blinking)
and its readiness for operation (slow
blinking)
this side of the applicator.
The magnetic applicator contains also a permanent magnet to increase the effect of soothing the tissue at traumatic and bleeding conditions.
7.3.1 Technical Parameters
Identification - Type: BTL-239-5 Name: multi disc Dimensions: 4x 130 x 130 x 30 mm Weight: 4.30 kg Intensity of the Permanent Magnet Field: 23 mT (230 Gauss) Max. Intensity of Pulse Magnetic Field: 72 mT (720 Gauss) Max. Intensity of Magnetic Field in Total: 95 mT (950 Gauss) Resistance of the Applicator:
4.2
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7.3.2 Shape of the Magnetic Field of the Applicator
The function of the multi disc applicator is similar to that of the double disc applicator where four disc applicators are on simultaneously during the therapy. The intensity values are listed in Chapter 7.3.1 Technical Parameters (the unit is mT/10, i.e. Gauss, and the values are valid at the maximum current flowing through the applicator). Then there is stated the sum of intensity of the permanent magnet field and intensity of the pulse magnetic field. The value 950 mT/10 is in the centre, on the surface of the applicator. The shape of the magnetic field of one pair of discs of the multi disc is the same as for the double disc.
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7.4 “SOLENOID 30” APPLICATOR
The basis of construction of this tube-shaped applicator is a carrying tube made of polypropylene (PP), which was chosen because of its favourable mechanical parameters and low weight. Single-layer linear coil is wound on the tube; the external magnetic field is screened off using the FMF technology. The design of the applicator was adapted to the requirement to create linear magnetic field in as large as possible part of the applicator.
7.4.1 Technical Parameters
Identification - Type: BTL-239-2 Name: solenoid 30 Dimensions: 340 x 340 x 300 mm Inner Diameter: 295 mm Weight: 5.75 kg Max. Intensity of Pulse Magnetic Field: 9.3 mT (93 Gauss) Resistance of the Applicator:
3.5
7.4.2 Shape of the Magnetic Field of the Applicator
The picture shows the shape of the applicator’s magnetic field The unit of the intensity values is mT/10, i.e. Gauss, and the values are valid at the maximum current flowing through the applicator.
93
90
80
10 15 20 30 40 50 60
70
80
90
93
1015203040506070
[mT/10]
0 5 10 15 20510152025 25 [cm]
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MAGNETOTERAPIE - UŽIVATELSKÁ PŘ ÍRUČ KA BTL Physiotherapy
7.5 “SOLENOID 60” APPLICATOR
The basis of construction of this tube-shaped applicator is a carrying tube made of polypropylene (PP), which was chosen because of its favourable mechanical parameters and low weight. Single-layer linear coil is wound on the tube; the external magnetic field is screened off using the FMF technology. The design of the applicator was adapted to the requirement to create linear magnetic field in as large as possible part of the applicator.
7.5.1 Technical Parameters
Identification - Type: BTL-239-3 Name: solenoid 60 Dimensions: 620 x 540 x 300 mm Inner Width: 580 mm Inner Height: 480 mm Weight: 10.0 kg Max. Intensity of Pulse Magnetic Field: 8.5 mT (85 Gauss) Resistance of the Applicator:
6.2
7.5.2 Shape of the Magnetic Field of the Applicator
The picture shows the shape of the applicator’s magnetic field The unit of the intensity values is mT/10, i.e. Gauss, and the values are valid at the maximum current flowing through the applicator.
85
80
70
60
50
10 20 30 40 45
50
1020304045
60
70
80
[mT/10]
0 5 10 15 20510152025 25 [cm]
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MAGNETOTERAPIE - UŽIVATELSKÁ PŘ ÍRUČ KA BTL Physiotherapy
7.6 “LINEAR" APPLICATOR
The surface of the linear applicator is made of harmless and durable leatherette. The same type of leatherette is used on the other applicator types.
7.6.1 Technical Parameters
Identification - Type: BTL-239-6 Name: Linear Dimensions: 600 x 290 x 20 mm Weight: 6.10 kg Max. Intensity of Magnetic Field in Total: 36 mT (360 Gauss) Resistance of the Applicator:
3.0
7.6.2 Shape of the Magnetic Field of the Applicator
The picture shows the shape of the applicator’s magnetic field The unit of the intensity values is mT/10, i.e. Gauss, and the values are valid at the maximum current flowing through the applicator.
59 cm
page 31 of 31
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