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Wireless Professional
User Manual
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Chattanooga Wireless Professional User Manual

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Page 1
Wireless Professional
User Manual EN
Page 2
QUICK START GUIDE
EN
Note
- It is strongly advised to carefully read the contraindications and safety measures described in chapter 1 and 2 in this manual before using your device.
- For detailed information on usage also see Chapters 3 to 14 of this manual.
1. Turn the 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 category by using the navigation pad (up/down)
4. Confirm your choice with the centre button.
5. Stick the electrodes on the patient and connect the modules.
6. Turn on the modules, being careful to respect the order of activation of the modules, the turning-on order corresponds to the channel numbering.
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QUICK START GUIDE
EN
7. Validate everything by pressing the button below the START symbol.
If the mi-SCAN function is activated, a short sequence of measures is 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 energies of the channels. To pause the device, press the centre button.
9. At the end of the programme press the centre button to return to the main menu or press the On/Off button to turn off the device.
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CONTENTS
EN
1. How to Use the Medical Equipment (Intended Use) .......................................................................................... 7
1.1 Fields of application ..............................................................................................................................................................................7
1.2 Therapy objectives ................................................................................................................................................................................7
1.3 Indications .................................................................................................................................................................................................8
1.4 Contraindications ..................................................................................................................................................................................8
1.5 Secondary eects ................................................................................................................................................................................. 9
2. Safety Information ....................................................................................................................................................10
3. Description of the Wireless Professional ............................................................................................................. 18
3.1 Device components and accessories .......................................................................................................................................... 18
3.2 Explanation of symbols (connections and nameplates) ..................................................................................................20
3.2.1 Symbols on device and AC Power Supply ............................................................................................................................20
3.2.2 Symbols on Charging Tablet/Docking Station and AC Power Supply ....................................................................22
3.3 Description of the device components .................................................................................................................................... 24
3.3.1 Remote Control ...............................................................................................................................................................................24
3.3.2 Modules ............................................................................................................................................................................................... 25
3.4 Description of key accessories .....................................................................................................................................................26
3.4.1 Smart 4CH docking station and Removeable tablet ..................................................................................................... 26
3.4.2 Basic 2 CH docking station ........................................................................................................................................................27
3.4.3 The 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 is selected, Modules need to be turned on, mode ........................................................ 31
3.5.4 Display during treatment ............................................................................................................................................................32
3.5.5 Display during pause in treatment ..........................................................................................................................................33
3.5.6 Display at the end of a treatment .......................................................................................................................................... 34
4. Device Setup...............................................................................................................................................................35
4.1 Smart 4CH Docking station - Connecting the unit, performance check ..................................................................35
4.2 Charging the Remote Control and the Modules ...............................................................................................................36
4.3 Multi-Sessions mode – Synchronisation with few remotes and Smart 4CH Docking station .................... 38
4.4 Basic 2CH Docking station - Connecting the unit, performance check ................................................................. 39
5. How to Perform a Treatment, Performance Check ........................................................................................40
5.1 Select a Program ............................................................................................................................................................................... 40
5.2 Adjust treatment options ................................................................................................................................................................ 41
5.3 Electrode placement .........................................................................................................................................................................41
5.4 Body positioning of the patient .................................................................................................................................................. 42
5.5 Connecting the modules to the electrodes ........................................................................................................................... 43
5.6 Starting the treatment ....................................................................................................................................................................44
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CONTENTS
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5.7 Ending the treatment ......................................................................................................................................................................46
5.8 Performance Check .......................................................................................................................................................................... 46
6. Treatment Options, Functions and Device Settings ........................................................................................47
6.1 How to use the Motor Point Pen ............................................................................................................................................... 47
6.2 Treatment Options – Muscle Intelligence™ Technology ................................................................................................49
6.2.1 Selection of the body area ..........................................................................................................................................................49
6.2.2 Energy management ...................................................................................................................................................................50
6.2.3 Triggering of contraction ............................................................................................................................................................. 51
6.3 Available Functions ............................................................................................................................................................................53
6.3.1 The Favorite List ...............................................................................................................................................................................53
6.3.2 The Lock Out function ................................................................................................................................................................. 54
6.3.3 The Synchronisation Signal ........................................................................................................................................................56
6.3.4 Identify modules ..............................................................................................................................................................................57
6.4 Available device Settings ................................................................................................................................................................58
6.5 WIRELESS PROFESSIONAL SOFTWARE
(firmware update remote control, customized programs, patient history) ................................................................. 60
6.5.1 Firmware update of the Remote Control ........................................................................................................................... 60
6.5.2 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 customized stimulation programs .......................................................................................................................64
6.5.2.4 Remote Synchronization ......................................................................................................................................................... 67
6.5.2.5 Configuration/Settings ............................................................................................................................................................. 68
6.5.2.6 Help ................................................................................................................................................................................................... 69
7. Troubleshooting .......................................................................................................................................................70
7.1 Errors shown on display ..................................................................................................................................................................70
7.2 Behaviour of the Module LEDs ....................................................................................................................................................73
7.3 Behaviour of the Docking Station LEDs ................................................................................................................................. 74
7.4 Others ......................................................................................................................................................................................................75
8. Care, Maintenance, Transport, Environmental Statement ............................................................................78
8.1 Care .......................................................................................................................................................................................................... 78
8.2 Maintenance ........................................................................................................................................................................................ 79
8.3 Transport .............................................................................................................................................................................................. 80
8.3.1 Transport of the 4CH device key components and the Tablet (o site treatment) ........................................ 80
8.3.2 Shipping the entire 4CH unit (incl. Smart Docking Station) ........................................................................................ 81
8.3.3 Transport of the 2CH device key components .................................................................................................................. 82
8.3.4 Shipping the entire 2CH unit (incl. Basic Docking Station) ......................................................................................... 83
8.4 Enviromental Statement, Expected Life .................................................................................................................................. 84
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CONTENTS
EN
9. Technical Data, Standards, Guarantee, Patents ............................................................................................... 85
9.1 Technical Data ..................................................................................................................................................................................... 85
9.1.1 General information ....................................................................................................................................................................... 85
9.1.2 Neuro-Stimulation Parameters ................................................................................................................................................86
9.1.3 RF data .................................................................................................................................................................................................86
9.1.4 Information on electromagnetic compatibility (EMC) ................................................................................................. 87
9.1.5 Enviromental conditions .............................................................................................................................................................. 87
9.2 Standards ..............................................................................................................................................................................................88
9.3 Guarantee ............................................................................................................................................................................................. 88
9.4 Patents ................................................................................................................................................................................................... 88
10. EMC Tables ...............................................................................................................................................................89
10.1 Electromagnetic emissions .......................................................................................................................................................... 89
10.2 Electromagnetic immunity ....................................................................................................................................................... 90
10.3 Recommended separation distances ....................................................................................................................................92
11. Contact ........................................................................................................................................................................93
12.Electrotherapy Theory ............................................................................................................................................ 94
12.1 Introduction .........................................................................................................................................................................................94
12.1.1 The fundamental law of electrostimulation .......................................................................................................................94
12.1.2 Summary ...........................................................................................................................................................................................98
12.1.3 References .........................................................................................................................................................................................99
12.2 The Optimum Current ...................................................................................................................................................................99
12.2.1 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 wave ................................................................................... 100
12.2.2.3 Shape of the electrical stimulation wave .......................................................................................................................101
12.2.2.4 Duration of rectangular electrical pulse ....................................................................................................................... 102
12.2.2.5 Compensation for the rectangular pulse ......................................................................................................................104
12.2.3 Summary ......................................................................................................................................................................................... 105
12.3 Basic concepts of excitation electrophysiology ................................................................................................................ 105
12.3.1 Introduction .................................................................................................................................................................................... 105
12.3.2 Study of the excitation process using a constant current ........................................................................................107
12.3.3 Excitation by a current with any shape ............................................................................................................................109
12.3.4 Chronaxy - excitation constant relationship .................................................................................................................109
12.3.5 Hydraulic model of excitation ................................................................................................................................................110
13. Available Therapy Programs ................................................................................................................................112
13.1 Standard Version Programs and their usage ........................................................................................................................112
13.1.1 Program category REHABILITATION I .................................................................................................................................. 113
13.1.2 Program category PAIN RELIEF .............................................................................................................................................122
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CONTENTS
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13.1.3 Program category VASCULAR .................................................................................................................................................131
13.1.4 CONDITIONING I .........................................................................................................................................................................139
13.2 Full Version Programs and their usage (Indication Specific Programs) ................................................................ 144
13.2.1 REHABILITATION II ..................................................................................................................................................................... 146
13.2.2 AGONIST / ANTAGONIST .......................................................................................................................................................160
13.2.3 PROGRAMMES FOR HAEMOPHILIACS ............................................................................................................................163
13.2.4 NEUROLOGICAL ......................................................................................................................................................................... 166
13.2.5 PAIN RELIEF II ................................................................................................................................................................................174
13.2.6 CONDITIONING II ...................................................................................................................................................................... 190
14. How to Use the Wireless Professional on Specific Indications .................................................................209
14.1 Overview ........................................................................................................................................................................................... 209
14.2 Disuse atrophy rehabilitation (standard protocol) ...........................................................................................................211
14.3 Rehabilitation of the peroneus muscles following an ankle sprain ......................................................................... 213
14.4 Rehabilitation of low back muscles .......................................................................................................................................216
14.5 Treatment of patellofemoral syndrome ...............................................................................................................................219
14.5.1 Lateral tracking..............................................................................................................................................................................219
14.5.2 Post-traumatic condition ....................................................................................................................................................... 222
14.6 ACL ligamentoplasty .................................................................................................................................................................... 224
14.7 Rehabilitation of the gluteal muscles following total hip replacement ................................................................ 228
14.8 Rehabilitation of the shoulder .................................................................................................................................................230
14.8.1 Rotator cu tendinopathy ....................................................................................................................................................... 231
14.8.2 Shoulder instabilities ................................................................................................................................................................. 235
14.8.3 Adhesive capsulitis ..................................................................................................................................................................... 238
14.8.4 Cardiac Rehabilitation ..............................................................................................................................................................241
14.9 Reflex sympathetic dystrophy (or Complex regional pain syndrome) .................................................................244
14.10 Endorphinic treatment of Rachialgia and Radiculalgia ..............................................................................................249
14.10.1 Endorphinic treatment of cervical pain............................................................................................................................251
14.10.2 Endorphinic treatment of thoracic back pain ............................................................................................................. 253
14.10.3 Endorphinic treatment of low back pain ....................................................................................................................... 255
14.10.4 Treatment of lumbosciatic pain ........................................................................................................................................258
14.11 Hemiplegia - Spasticity ...............................................................................................................................................................261
14.11.1 Dorsiflexion of the hemiplegic foot .................................................................................................................................... 262
14.11.2 Spasticity ........................................................................................................................................................................................264
14.11.3 The hemiplegic hand ................................................................................................................................................................268
14.11.4 The hemiplegic shoulder ....................................................................................................................................................... 270
14.12 Treatment of venous insuciency ....................................................................................................................................... 273
14.12.1 Venous insuciency without oedema ............................................................................................................................ 273
14.12.2 Venous insuciency with oedema ................................................................................................................................... 275
14.13 Treatment of arterial insuciency in the lower limbs ................................................................................................278
14.13.1 Stage II arterial insuciency .................................................................................................................................................279
14.13.2 Stage III arterial insuciency ................................................................................................................................................281
Page 8
. HOW TO USE THE MEDICAL EQUIPMENT INTENDED USE
EN
Note
- This manual is considered as an accessory of the therapy unit and therefore it should accompany it at all times.
- The specific instructions provided given here are conditions for the intended use and correct operation of the equipment as well as the safety of the patient and the operator using it.
- Please read the entire manual carefully and section 2 in particular, since information concerning several chapters is only given once, before using your device!
1.1 Fields of application
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/ NMES).
The Wireless Professional physiotherapy unit is an important supplement to medical and therapeutic treatment for use in hospitals, clinics, general practices and at a patient’s home by a therapist.
1.2 Therapy objectives
The Wireless Professional is a multifunctional electrotherapy unit for the post surgical and conservative treatment of muscular imbalance as well as pain management.
The following therapy forms are provided by the unit:
• TENS (trasncutaneous nerve stimulation) for painmanagement
• NMES (neuromuscular electrical stimulation, also EMS)
• FES (functional electrical stimulation)
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. HOW TO USE THE MEDICAL EQUIPMENT INTENDED USE
EN
1.3 Indications
The physiotherapy unit is indicated in the treatment of most musculoskeletal injuries and diseases as well as in postoperative treatment after joint surgeries and in the treatment of several pain indications. Examples:
As an NMES device, indications are for the following conditions:
- Retarding or preventing disuse atrophy
- Maintaining or increasing range of motion
- Re-educating muscles
- Relaxation of muscle spasms
- Increasing local blood circulation
As a TENS device, indications are for the following conditions:
- 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
Do NOT use the Wireless Professional on patients with:
• Implanted electronic devices. Do not use the device if you have a cardiac stimulator, implanted defibrillator or other implanted electronic/electrical device. Epilepsy
• Pregnancy (do not use on abdominal region)
• Serious arterial circulation problems in lower limbs
• Abdominal or inguinal hernia
• Do not use chest stimulation on patients with cardiac arrhythmia
• This could cause an electrical shock, burns, electrical interference or death
Heart disease
If you have suspected or diagnosed cardiopathy you should follow the precautions for use recommended by your doctor.
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. HOW TO USE THE MEDICAL EQUIPMENT INTENDED USE
EN
Note
Metalwork and/or prosthesis equipment
The presence of metalwork and/or prosthesis 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 to have no harmful eect on osteosynthesis equipment.
1.5 Secondary effects
Currently, there is no evidence of desired or undesired secondary eects caused by electrotherapy units.
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. SAFETY INFORMATION

EN
Definitions
It is mandatory to read the safety statements before using the physiotherapy unit. The safety statements are classified as follows:
Safety information
Danger!
This term indicates an imminent hazard. If not avoided, this hazard could result in death 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 anesthetics, oxygen-rich environments, skin cleansing agents and disinfectants.
Caution!
This term indicates a potential hazard. If not avoided, this hazard can result in minor personal injury and/or product/property damage.
Warning!
This term indicates a hazard. If not avoided, this hazard can result in death or serious injury.
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. SAFETY INFORMATION

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Warning!
Patient hazard -
- Only authorized individuals are allowed to operate the Wireless Professional. Individuals are authorized after receiving training in the operation of the unit and reading this operating on manual.
- Before using the therapy unit, the operator must ascertain that it is in correct working order and operating condition. The cables and connectors, in particular, must be checked for signs of damage. Damaged parts must be replaced immediately, before use.
- Stop therapy immediately if you have doubts about the device settings and/or the therapy protocol.
- Patients must be fully conscious while being instructed in the use of the therapy unit and during therapy.
- The choice of the therapy parameters to program and of the therapy protocols to use is restricted to the responsible physician or therapist. It is the physician’s or therapist’s decision whether or not to use the unit on a specific patient.
- The patient must be familiar with the functions of the Wireless Professional remote control with the modules and the 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 turing of the modules), e.g. paralytic patients, must never be left unattended during therapy.
- Any accessories used with Wireless Professional must first be approved by the manufacturer.
- The utmost caution is advised under the following conditions. Depending on the judgement of the responsible physician, the unit may only be applied under supervision and with the parameters defined by the responsible physician. Otherwise the exercise may be too strenuous for the patients with :
1. hypertension (> stage 2), ischemic heart disease and cerebrovascular diseases
2. cardiovascular diseases
3. pregnancy
4. under 16 years of age
- Never apply the electrodes:
• Near the head
• On the front and side of the neck
• Counter-laterally, i.e. do not use two poles connected to the same channel on opposite sides of the body.
• On or near skin lesions of any kind (wounds, swelling, burns, irritation, eczema, cancerous lesion, etc.)
- If the person is pregnant or menstruating do not place electrodes directly on the uterus area or connect pairs of electrodes on either side of the abdomen to avoid any risk for the mother and/or the baby.
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. SAFETY INFORMATION

EN
- Never allow muscular contraction during a stimulation session to result in movement. You 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.
Warning!
- Extreme caution should be taken when in use around small children and babies! Sucient distance to the device and its accessories is mandatory for their safety!
- Never leave the device unattended when it is switched on! Switch the device o and disconnect the electrodes from the modules!
- After use, store the device in a safe place to avoid other people not informed to use the device!
- This device is not a toy but a medical device where misunderstanding or misuse can cause damage!
Warning!
Shock hazard - Strictly observe the following warnings. Failure to do so could endanger the 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 to reach at room temperature for about 2 hours, until any condensation has disappeared.
- Electrosurgical equipment or defibrillators. Disconnect the electrodes from the device before using electrosurgical equipment, or a defibrillator, to avoid cutaneous burns from the electrodes and destroying the device.
- Electronic surveillance equipment. Do not apply stimulation near electronic surveillance equipment (e.g. cardiac monitors, ECG alarms), as there is a risk they may not work properly whilst the electrical stimulation device is being used.
- Electromagnetic radiation. Do not use the stimulator in areas in which unprotected devices are used to emit electromagnetic radiation. Portable communications equipment can interfere with the device.
- Cancer. Do not apply stimulation if you have progressive cancer or near any cancerous tumour. The increased metabolism, caused by certain modes of stimulation, is likely to encourage cancer cells to spread
Page 14
. SAFETY INFORMATION

EN
- Do not use the Wireless Professional in water or in a humid atmosphere (sauna, Bath, Shower etc.) that would cause electronic failure.
- Water protection. The unit is not protected from the ingress of water
- When connecting the unit to other equipment or when creating a medical system, check that the sum of leakage currents will not cause any hazard. Please contact DJO GLOBAL if you have questions regarding this matter.
- No modification of this equipment is allowed.
- Do not open the product and its accessories as there is risk of electrocution
- Muscle shortening. During the muscular contraction phase it is recommended to hold the extremities of the stimulated limbs to avoid any shortening of the muscle during contraction, which could cause cramps.
- Contralateral stimulation. Do not use two terminals connected to the same channel on opposite segments of the body (for example, a positive terminal on the left arm and a negative terminal on the right arm).
- Loss of sensation. Proceed with caution if stimulation is applied to areas of the skin where the level of 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 contact with skin or eyes. Should this occur, wash the aected area with water and consult a doctor.
- Strangulation. Do not wind cables around the neck. Tangled cables can cause strangulation.
- Post-surgery. Proceed with caution after recent surgery.
- Accessibility of the power adaptor. The plug socket must be close to the power adaptor and be easily accessible.
- Internal bleeding. Proceed with caution if you are prone to internal bleeding; for example, after an injury or a fracture.
The Wireless Professional must only be operated in dry rooms.
- Before cleaning and service interventions, turn the remote control and the modules o and disconnect the tablet from the power line by removing the power cord from the wall outlet.
- Liquids and foreign material (such as dust, metal etc.) must not be allowed to enter the remote control, the modules, the charging tablet or the power supply. If such material has entered into the units, it must be immediately checked by a service technician, before it can be reused.
- Electricity supply. Never connect the stimulation cables to an external power supply, as there is a risk of electrocution
Page 15
. SAFETY INFORMATION

EN
Warning!
Equipment malfunction - these warnings can cause equipment malfunctions that result in patient hazards
- Magnetic and electrical fields are capable of interfering with the proper performance of the unit. For this reason make sure that all external devices operated in the vicinity of the unit comply with the relevant EMC requirements. X-ray equipment, MRI devices, radio systems and cell phones are possible sources of interference as they may emit higher levels of electromagnetic radiation.
Keep the unit away from such equipment and verify its performance before use.
- Do not use the Wireless Professional within one metre of short wave or microwave devices as this could alter the currents generated by the stimulator. If you are in any doubt as to the use of the stimulator in close proximity to another medical device, seek advice from the manufacturer of the latter or from your doctor.
- 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 equipment.
- Refer repair and maintenance to autorised persons. Persons are authorized after training by a specialist trained and commissioned by the manufacturer.
- Inspect the Wireless Professional and it’s accessories for damage and loose connections at least once a year. Damaged and worn parts must be immediately replaced with original spare parts by autorised sta.
- Do not apply stimulation near the area of an implant, such as cochlear implants, pacemakers, skeletal anchorage or electric implants. This could cause an electrical shock, burns, electrical interference or death
- Never use the Wireless Professional or the AC adaptor if it is damaged or open. There is a risk of electric shock.
- Disconnect the AC adaptor immediately if there is abnormal heating or smell, or if smoke comes from the AC adaptor or the device.
- Do not place the docking station in a confined space (carrying case, drawer etc.) when charging the device. There is a risk of electrocution.
Page 16
. SAFETY INFORMATION

EN
Caution!
Patient hazard - these cautions need to be observed to avoid the risk of electrical shock or other negative eects to the patient.
- Do not apply stimulation close to metal. Remove jewellery, piercings, belt buckles or any other metallic product or device in the area of stimulation.
- Be careful if the patient has sensitivity problems or is not able to communicate that he or she feels discomfort, however light.
- Never begin an initial stimulation session on a person who is standing. The first five minutes of stimulation must always be performed on a person who is sitting or lying down. In rare instances, people of a nervous disposition may experience a vasovagal reaction. This is of psychological origin and is connected with a fear of the muscle stimulation as well as surprise at seeing one of their muscles contract without having intentionally contracted it themselves. A vasovagal reaction causes heart to slow down and blood pressure to drop, which produces a feeling weakness and a tendency towards fainting. If this does occur, all that is required is to stop the stimulation and for the person to lie down with the legs raised until the feeling of weakness disappears (5 to 10 minutes)
- Never allow muscular contraction during a stimulation session to result in movement. You 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.
- Do not disconnect any module that is switched on during the stimulation session. They must be switched o first.
- Do not use the stimulator while driving or operating machinery.
- Do not apply stimulation during sleep.
- Do not use the stimulator at altitudes of over 3,000 meters.
- Always turn o the stimulator before moving or removing any electrodes during a session, to avoid electrical shock to the patient.
- Do not try to place electrodes on a body part not directly visible without assistance.
- Attach the electrodes in such a way that their entire surface is in contact with the skin.
- For obvious reasons of hygiene, each patient must have their own set of electrodes. Do not use the same electrodes on dierent patients.
- Some patients with very sensitive skin may experience redness under the electrodes after a session. Generally, this redness is completely harmless and usually disappears after 10 to 20 minutes. Never start another stimulation session in the same area, however, if the redness is still visible.
- Before each use clean and disinfect the motor point pen tip that is in contact with the skin.
- When using the WIRELESS PROFESSIONAL SOFTWARE to customize programs, take special care that the parameters customised and applied by you to the patient are as you wanted them to be (program architecture shown on screen before treatment starts).
Page 17
. SAFETY INFORMATION

EN
Caution!
Equipment damage -
- Do not let the modules get in contact with massage oils or any other products of the
same type that could damaged the device or its accessories.
- Check that the voltage and frequency ratings of your local power line are those indicated on the type plate of the power supply.
- Do not expose the Wireless Professional to direct sunlight, because some of the components may reach unacceptably high temperatures.
- The presence of children, and pets does not normally aect the proper functioning. However, Keep pets and children away from the product. Also, keep the unit clean and protect it from dust and lint. The safety rules and regulations set forth apply in any case.
- It is recommended to use the transport bag that comes with the unit, for transport of the device, and to use a proper transport box to ship 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 motor point pen supplied by the manufacturer. Other electrodes and motor point pens may have electrical properties that are unsuitable for or may damage the Wireless Professional.
- Size of electrodes. Do not use electrodes with an active area of less than 16 cm² due to the risk of associated burning. Proceed systematically with caution when the density of the current is over 2 mA/cm².
- Do not place the electrodes or pen in water.
- Do not apply solvents of any kind to the electrodes or pen.
- Skin irritation. Some people, with very sensitive skin, may experience redness under the electrodes after a session. Generally, this redness is totally harmless and usually disappears after 10 to 20 minutes. However, never start another stimulation session on the same area if the redness is still visible
- Instructions for electrodes. See the usage and storage instructions displayed on the bag of electrodes
Page 18
. SAFETY INFORMATION

EN
Note
- For best results, wash and clean the skin of any oil and dry it before attaching the electrodes.
- Never use a set of adhesive electrodes for more than 15 sessions as the quality of the contact between the electrode and the skin, which is essential for the patient’s comfort and the eectiveness of the stimulation, gradually deteriorates.
- For information on use and storage please consult the instructions found on the electrodes packaging.
Note
Biocompatibility
Those parts of the Wireless Professional unit that come into contact with the patient when used as intended, are designed to fulfil the biocompatibility requirements of the applicable standards.
Page 19
. DESCRIPTION OF THE WIRELESS PROFESSIONAL

EN
3.1 Device components and accessories
Model: Wireless Professional 4CH Part number: 2532xxx
Your kit contains (included in delivery):
QUANTITY DESCRIPTION PART NUMBER
2 remote control 00113x
4 stimulation modules 984350
1 smart 4 CH docking 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 electrodes (5x10 cm 2 snap connections)
42203
1 user manual and practical guide on on CD/USB 46262xx
1 quick start guide/warning leaflet 885932
1 bottle of gel 602047
1 motor point pen 980020
1 carrying case 680041
2 lanyards 1494
1 white protection sleeve 5529024
1 blue protection sleeve
5528535
1 Set of colored module clips
5529220
Page 20
. DESCRIPTION OF THE WIRELESS PROFESSIONAL

EN
Model: Wireless Professional 2CH Part number: 25326xx
Your kit contains (included in delivery):
QUANTITY DESCRIPTION PART NUMBER
1 remote control 00113x
2 stimulation modules 984350
1 Basic 2 CH docking 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 (5x10 cm 2 snap connections)
42203
1 user manual and practical guide on on CD/USB 46262xx
1 quick start guide/warning leaflet 885932
1 bottle of gel 602047
1 motor point pen 980020
1 transportation pouch 680085
1 lanyard 1494
1 white protection sleeve 5529024
1 Set of colored module clips 5529220
Page 21
. DESCRIPTION OF THE WIRELESS PROFESSIONAL
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EN
3.2 Explanation of symbols (connections and nameplates)
3.2.1 Symbols on device and AC Power Supply
Read the user manual or operating instructions
Caution! Observe warnings set forth in operation manual!
The Wireless Professional is a class II device with internal electric power and type BF applied parts.
20xx
The power switch On/OFF button is a multi-function button.
20xx
The name and address next to this factory symbol is the manufacturer. The date is the manufacturing date.
20xx
LATEX
FREE
REF
The number next to this symbol is the article reference number
CE

Device complies with Council Directive 93/42/EEC as amended, concerning medical devices.
The number next to this symbol is the serial number
20xx
WEEE Mark (European Directive 2002/96/EC). Indicates separate treatment from general waste at end of life.
20xx
Keep dry
IP IP
IP classification indicates the degree of protection and thus defines its suitability for use under various ambient conditions.
IP 20 on the unit means the protection is eective against ingress of foreign solid objects (diameter greater than 12.5 mm) IP02 on the carrying case means the device is protected against ingress of water (when tilted up tp 15°)
Page 22
. DESCRIPTION OF THE WIRELESS PROFESSIONAL
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EN
20xx
Non-ionising radiation
LATEX
Not made with natural latex rubber
20xx
Keep away from direct sunlight
Page 23
. DESCRIPTION OF THE WIRELESS PROFESSIONAL

EN
Alternating current input on AC power supply
Direct current output from power supply
Protection class II equipment. The AC Power Supply device has double insulation.
The Wireless Professional is a class II device with internal electric power and type BF applied parts.
20xx
The name and address next to this factory symbol is 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, concerning medical devices.
Read the user manual or operating instructions
Caution! Observe warnings set forth in operation manual!
The number next to this symbol is the serial number
20xx
WEEE Mark (European Directive 2002/96/EC). Indicates separate treatment from general waste at end of life.
20xx
Keep dry
20xx
Keep away from direct sunlight
3.2.2 Symbols on Charging Tablet/Docking Station and AC Power Supply
Page 24
. DESCRIPTION OF THE WIRELESS PROFESSIONAL
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EN
Indoor use only
The Geprüfte Sicherheit (“Tested Safety”) or GS mark indicates that the equipment meets German and, if available, European safety requirement for electrical devices. Here, approved by TÜV.
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. DESCRIPTION OF THE WIRELESS PROFESSIONAL
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3.3 Description of the device components
3.3.1 Remote Control
Note
Emergency stop function: By pressing the central button or the On/O button on one of the
modules during stimulation, the device pauses.
A On/O button (press briefly to switch on, press and hold for more than 2 seconds to switch o, while browsing the lists press briefly to return to the main menu) B 4 multifunction buttons:
• Functions related to icons are located on the screen (e.g.: info, main menu, placement of electrodes, etc.)
• Selection of stimulation channel to increase or decrease the energy level of stimulation
C Navigation pad D Validation or pause button during stimulation E Port for the USB cable or the docking station connector
A
D
E
C
B
Page 26
. DESCRIPTION OF THE WIRELESS PROFESSIONAL
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EN
3.3.2 Modules
A module is composed of two pods. A On/O button (press briefly to switch on, press for 1 second to switch o, during stimulation press to 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 big, they will loose the connection, stop with the stimulation immediately and the LEDs will flash red and green.
- Emergency stop function: By pressing the central button or the On/O button on one of the modules during stimulation, the device pauses.
Page 27
. DESCRIPTION OF THE WIRELESS PROFESSIONAL
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3.4 Description 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 for the AC adapter and for the USB cable connected to the front of the docking station E Storage bin
D
C
A
E
B
Page 28
. DESCRIPTION OF THE WIRELESS PROFESSIONAL
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EN
3.4.2 Basic 2 CH docking station
A Remote control charging connector B Location for positioning the modules C Location for positioning the modules to be recharged D Charger plug
A
B
C
D
Page 29
. DESCRIPTION OF THE WIRELESS PROFESSIONAL
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EN
3.4.3 The Motor Point 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 pen, to locate the motor point B Snap connection for the positive pod of the module (pod with illuminated button)
A
B
Page 30
. DESCRIPTION OF THE WIRELESS PROFESSIONAL
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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 chosen program category (marked with a blue focus, displayed bigger)
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. DESCRIPTION OF THE WIRELESS PROFESSIONAL
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3.5.2 Display in Programme selection mode
A Name of the programme category B Additional programme information C Visualisation of programme options D Back to main menu E Adding programme to Favourites list F Selection of programme level G Configuration of programme options
A
C
D E F G
B
Note
- For the visualisation of the program information (B), please use the left/right direction of the navigation pad, and scroll within the information by using the up/down direction 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 Favourite list.
- If dierent program levels are available, icon “F” will be displayed. To change the program levels, please press the button below the icon. Up to 3 dierent levels might be available. From level to level dierent parameters (e.g. frequency, pause duration etc.) are changing to make the treatment more challenging according to the process in rehabilitation (level 1 for beginners, level 3 for trained persons).
- If programme options are available icon “G” will be displayed. Please press the button below the icon to enter the program option setting screen
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. DESCRIPTION OF THE WIRELESS PROFESSIONAL
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3.5.3 Diplay when programm is selected, Modules need to be turned on, mode
A Total programme time (minutes) B Module activation indication C Module battery level D Back to previous menu E Skip function allows you to jump programme sequences (if available) or
Programme time increase function (if available)
F +TENS function (if available) G Start Session H Programme architecture
• 3-sequence programme: Warm-up, Work, Relaxation
• Programme with 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 treatment). After activating the number of channels required for the treatment (1 up to 4) press start to start the treatment.
- “E” functions are not available within all programs, symbols will only be displayed in programs available
- “F” the “+TENS” function allows you to combine a TENS programme with a selected basic programme. The function will be displayed for the channels if available. (see as well …)
- “H” the dierent program architectures are:
• 3-sequences program: a) Warm-up b) Work c) Relaxation
• 1-sequence program, a) continuous work
ba c
a
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. DESCRIPTION OF THE WIRELESS PROFESSIONAL
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3.5.4 Display during treatment
A Total remaining programme time (min) B Energy level bar graph for each channel C Energy level for each channel D Intensity background is:
Dark background = active channel Bright background = inactive channel E Indication relating to the channel:
• TENS: channel providing a TENS current
• I-II: channel group
F Number 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 o.
C D E
A
B
G
H
F
Note
“D” intensity control
- Channels can be selected/de-selected by pressing the corresponding button below.
- To change intensity during treatment, channel needs to be selected (dark blue background).
- While channel is not selected (light blue background) stimulation will be performed with the set intensity.
- This function allows you to change the intensity for each channel itself or more than 1 at the same time (by marking the designated channels).
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. DESCRIPTION OF THE WIRELESS PROFESSIONAL
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3.5.5 Display during pause in treatment
A Maximum energy 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 session
A
B C D
Note
Emergency stop function: By pressing the central button or the On/O button on one of the
modules during stimulation, the device pauses.
Page 35
. DESCRIPTION OF THE WIRELESS PROFESSIONAL
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3.5.6 Display at the end of a treatment
Note
- For programs using the mi-range feature the percentage of time spent above the minimum
threshold will be displayed as well.
- To turn the unit o, press the On/O button on the remote control for more than 2 seconds. This
will switch o as well all modules.
A Average energy level of all the channels used during the contraction phase B Maximum energy level achieved by the channel during contraction phases C Back to main menu (HOME). For programs using the mi-range feature the percentage of time spent
above the minimum threshold is displayed.
A
B
C
Page 36
. DEVICE SETUP

EN
4.1 Smart 4CH Docking station - Connecting the unit, performance check
Connect the AC adapter supplied with your device to the removable tablet 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 Connector for the USB cable
A
B
C
Note
- It is highly recommended to fully charge the batteries of the remote control and modules before
first use to improve their performance and life span.
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. DEVICE SETUP
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4.2 Charging the Remote Control and the Modules
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 by using the USB connector 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 modules into the slots provided for this purpose. To do this place the pod without the On / O button in the location indicated with the dotted line. Do the same for the other modules. Once the modules are placed for charging, their battery level is shown by the blue LEDs of the docking station.
Page 38
. DEVICE SETUP
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EN
A
B
A First LED blinking = low battery Second LED blinking = battery level average, a session can be performed Third LED blinking = good battery level All LEDs are lit and not blinking any more = battery completely full
B The LED above the button indicates that the tablet is connected to the power supply. It lights:
Blue = modules can be charged Red = right after connecting to the power supply during self test
The button allows synchronizing modules and remote 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 control, when you turn the module on, just before starting the stimulation session. The battery level of the remote control is always visible in the upper right corner. Small green indicators show how many modules are turned on and recognised by the remote control. The batteries of the remote control and the modules are designed to stand at least 3 days with 5 treatments per day.
A Module battery level B Remote control battery level C Number of modules switched on and recognised by the remote control
A
C
B
Page 39
. DEVICE SETUP
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EN
4.3 Multi-Sessions mode – Synchronisation with few remotes and Smart 4CH Docking station
Smart 4CH Docking station is able to synchronise any Wireless Professional module(s) and remote(s) plugged on it. Modules plugged on the station will be automatically synchronized and recognized by the remote plugged as well on the station. The B button described in 4.2 Chapter allows synchronizing Modules and Remote control which is usually done automatically by the unit.
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 separate control until the next synchronization. Sessions can be started independently.
First, plug the number of module(s) necessary for Session 1 (1, 2 or 3 modules) plus the first remote to be synchronized.
After plugging o modules and remote in use for session 1, plug the remaining modules and the second remote to be synchronized for Session 2.
Same process is applicable for several remotes.
Note: 2 kinds of sleeve protection (white and blue) are delivered with the 4CH devices to allow recognition between remotes.
Page 40
. DEVICE SETUP
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EN
4.4 Basic 2CH Docking station - Connecting the unit, performance check
Connect the AC adapter supplied with your device to the docking station and then plug it into a power outlet. It is strongly recommended that you fully charge the remote control batteries and modules before first use in order to improve its performance and life expectancy.
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 connector, which comes with your kit and connect it with the tablet and remote control to charge modules and remote at same time or by connecting the remote control to a computer.
Charge the Modules:
Place the modules into the slots provided for this purpose. To do this place the module without the On / O button in the location indicated with the dotted line. Do the same for the other module.
Page 41
. HOW TO PERFORM A TREATMENT, PERFORMANCE CHECK
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EN
See also Chapter “Description of the Wireless Professional”
1. Turn the Remote Control on, by pressing the On/O button.
2. Upon activation the screen displays a list that gives you access to the categories of programmes.
3. Select a program category by using the navigation pad (up/down)
4. Confirm your choice with the centre button.
Note
- When you turn on the remote control the first time, the language set up will be displayed first. Chose your preferred language and press the center button 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 electrode placement, program parameters and program explanation, is available.
- Use the navigation pad (left/right) to display them and to scroll (up/down) within an explanation for getting more information.
- You can find the program information as well within this manual.
5.1 Select a Program
After selecting a programme category the available programs within this category will be displayed. To select a program, use the navigation pad (up/down) and confirm your choice with the centre button.
A Placement of electrodes applicable to the programme B Programme parameters C Programme explanation
A B C
Page 42
. HOW TO PERFORM A TREATMENT, PERFORMANCE CHECK
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5.2 Adjust treatment options
For most programmes, dierent options can be enabled or disabled. For detailed descriptions of the options available see: Chapter “Treatment Options”
1. Press the program options button to enter the options menu.
2. To mark an item, use the navigation pad (up/down).
3. To change settings of the marked option, use the central button.
4. To store the changed settings press the confirmation button
5.3 Electrode placement
The placement of the electrodes belongs to the indication that is supposed to be treated. Please find detailed recommendations regarding the electrode placement:
- within usage of the Motor Point Pen
- within 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 button) may benefit from a “prime” location that is likely to increase the ecacy of the treatment. This is the case particularly for muscular electrostimulation programmes requiring strong muscular contractions, for which it is recommended that the electrode with positive polarity is placed on the motor point of the muscle. The choice of electrode size (large or small) and the correct positioning of the electrodes on the muscle group that needs to be stimulated are determining factors and are essential for stimulation to be eective. As a result, always use the size of the electrodes shown on the images. Unless advised otherwise by a doctor, always follow the positions specified on the images.
A
A Confirm / store program option settings
Page 43
. HOW TO PERFORM A TREATMENT, PERFORMANCE CHECK
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5.4 Body positioning of the patient
To determine the stimulation position to be used based on the position of the electrodes and the programme chosen, please refer to the images of where the electrodes are positioned.
A Body position B Positioning of the electrodes
A
B
The position of the person 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 isometrically is always recommended to prevent cramps and muscle soreness after the session. For example, when the quadriceps are stimulated, the patient will be placed in a seated position with the ankles fixed with straps to prevent the knees extending. For other types of programmes (for example, analgesic programmes), which do not cause muscle contractions, position the patient as comfortably as possible.
Page 44
. HOW TO PERFORM A TREATMENT, PERFORMANCE CHECK
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5.5 Connecting the modules to the electrodes
Once the electrodes are stuck to the skin of the patient, fix the pods by sliding them onto the electrode snap until it clicks into place.
Note
The insertion direction marked by:
- the On/O 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 damage ­Pulling the pods without respecting their pulling direction can damage the attachment system.
A stimulation module consists of two poles:
• A positive pole (+) = the pod with an illuminated button
• A negative pole (-) = the other pod of the module
A separate electrode must be connected to each of the two pods.
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. HOW TO PERFORM A TREATMENT, PERFORMANCE CHECK
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5.6 Starting the treatment
Before starting the stimulation, the remote control asks you to turn on the modules, one after the other, by pressing their button On/O. For each module detected by the remote control, the device will prompt you to switch on another, up to a maximum of 4 modules. If you want to use a limited number of modules for your session, press the START button after the number of modules you want has been detected.
After activating the modules, press START to start with the therapy:
• Stimulation always starts at intensity level 0.
• Select a channel to change the intensity by pressing the corresponding button.
• The channel will be marked dark blue.
• Use the navigation pad (up-down) to increase or decrease 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 more than 1 at the same time (by marking the designated channels).
Note
If mi-SCAN has been activated (default setting):
- This function adjusts the electrostimulation session to the physiology of each patient. Just before starting the work session, mi-SCAN tests the muscle group and automatically adjusts the settings of the stimulator to the excitability of this area of the body.
- In order to ensure optimum eciency and comfort of the session it is recommended to perform the mi-SCAN measurement before each session.
- This function is implemented at the beginning of the programme by a short sequence in which measurements are made.
- Throughout the duration of the test, it is important to stay still and be relaxed.
- When the test is complete, the programme can be started by increasing the intensity levels of the channels.
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. HOW TO PERFORM A TREATMENT, PERFORMANCE CHECK
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Note
- Be careful to respect the order of activation of the modules, the activation order corresponds to the channel numbering.
- Colored modules process is described in the document to ease identification if needed.
- Press the central button on the Remote Control, or the On/O button on one of the modules during stimulation, the device pauses.
Stimulation energy settings (intensity level)
For programmes which cause muscle contractions, it is important to use the maximum stimulation energies, i.e. always at the limit of what the patient is able to tolerate. This means that, in a stimulated muscle, the number of fibres working depends on the stimulation energies. The maximum stimulation energies must therefore be used in order to engage as many fibres as possible. Below a significant stimulation energy, the number of fibres engaged in the stimulated muscle is too low to considerably improve the quality of the muscles. The maximum energy will not be reached during the first session but after at least 3 sessions, during which the energy to produce strong muscle contractions 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 progressively contraction by contraction throughout the work sequence. The energies used should also be increased session by session.
For TENS treatments, stimulation is only sensory. The intensity must therefore be increased until the patient has a pins and needles sensation (tingling) that is not considered painful.
For neuromuscular electrostimulation programmes which do not cause tetanic muscle contractions (frequencies < 10Hz), the energies must be increased gradually until muscle twitching is produced that can be clearly seen or felt.
Progression through the dierent levels
Generally speaking, it is not advisable to progress through the levels too quickly and to aim to reach the maximum level too quickly. The dierent levels correspond to progression in rehabilitation using electrostimulation. Furthermore and without exception, level 1 is the starting point and should be used until the therapeutic targets have been reached. One of these targets is for the patient to be able to tolerate a significant amount of stimulation energy. Stimulation energies should therefore be given priority in order to have a many fibres working as possible before changing the level.
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. HOW TO PERFORM A TREATMENT, PERFORMANCE CHECK
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5.7 Ending the treatment
When the preset therapy time elapses:
• the device stops the therapy session automatically
• the intensity of all channels drops to 0.
You can stop a treatment as well by:
• activating the pause and returing to program selection
• turning the device completely o, by pressing the On/O button of the remote control for more than 2 seconds.
To turn the unit o, press the On/O button on the remote control for more than 2 seconds. This will switch o all modules as well.
5.8 Performance Check
If the unit can be operated as described 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 during operation): If there is a risk in usage or a malfunction identified:
• the device will ask you to correct it (see also Chapter “Problems and Solutions”)
• or automatically shut down immediately
In this situation, you may attempt to restart the unit by turning it briefly o and on again. With the unit switched o, check that all plugs are correctly connected. If the error message persists when the unit is switched on again have the unit insprected by an authorised service technician before using it again.
Note
At the end of your stimulation session it is recommended to store the remote control and the modules in the docking station to recharge the units.
Page 48
. TREATMENT OPTIONS, FUNCTIONS AND DEVICE SETTINGS
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6.1 How to use the Motor Point Pen
The Motor Point Pen supports in locating the optimal electrode position for the mucle stimulation (e.g.: locating the motor point of the vastus medialis of the quadriceps).
Background:
Muscular electrostimulation programmes are programmes which subject the muscles to work. The progress achieved depends on the kind of work to which the muscles are subjected, that is to say the programme chosen. The electrical pulses generated by these programmes are transmitted to the muscles (via the motor nerve) through self-adhesive electrodes. The positioning of the electrodes is one of the determining factors in ensuring a comfortable electrostimulation session. It is therefore essential to devote special care to this aspect. The correct placement of the electrodes and the use of significant energy allow a large number of muscle fibres to work. The greater the energy, the greater the spatial recruitment, that is to say the number of fibres working, and therefore the greater 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 excitable. Although the location of the various motor points is now well known, there may nevertheless be variations of up to several centimetres between dierent individuals.
The Motor Point Pen, combined with the motor point program, allows determining with greater accuracy the exact location of the motor points for each individual and thus ensuring the greatest eectiveness of the programmes. It is recommended to use this programme and the pen before any initial muscular electrostimulation session. Once located, the motor points can be easily identified by using a skin-marker pencil or in any other way, thus avoiding the need to repeat this process before each session.
Electrode placement: One stimulation channel is a module consisting of two pods: A positive pole (+) = the pod with an illuminated button A negative pole (-) = the other pod of the module
The positive electrode is the one connected to the positive pod (with an illuminated button). It is supposed to be attached at the motor point of the muscle.
Note
The Motor Point Pen is designated only to be used in combination with the program “Motor Point”.
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. TREATMENT OPTIONS, FUNCTIONS AND DEVICE SETTINGS
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Locating the motor point with the Wireless Professional: e.g.: locating the motor point of the vastus medialis of the quadriceps
1. Apply a large electrode at the top of the thigh (the muscle belly).
2. Connect the negative pod of the module (pod without illuminated button) to the snap pin of the large
electrode located towards the inner surface of the thigh.
3. Spread a thin but even layer of conductive gel over the inner surface of the thigh in the position
indicated for the positive electrode position (the motor point area), spreading the gel a few extra centimetres in all directions.
4. Connect the positive pod of the module (pod with illuminated button) to the snap connection of the
motorpoint pen and bring the tip of the pen in contact with the conductive gel.
5. Switch on the remote control, select the Motor point programme (program category: Rehabilitation),
then switch on the module and start the 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 gel, to avoid triggering an electrode fault message.
7. As soon as you observe a muscle response in form of twitching, you have located the vastus medialis
motor point. Visually locate this motor point and apply a small electrode that should be centred over the motor point.
8. Remove the pen from the positive pod and connect the positive pod to the small electrode, which
should be correctly centred over the motor point of the vastus medialis.
Warning!
Patient hazard - patient contamination Before each use of the Motor Point Pen, clean and disinfect the pen, expecially the tip that comes into contact with the patients skin.
Note
While using the pen, it might lose contact with the skin coated in gel (even if this is just for a fraction of a second). In this case, the stimulation will be interrupted and the equipment will signal an electrode fault. In such a case, ignore the message, put the tip of the pen back in contact with the skin and gradually increase the energy while moving the pen over the gel layer.
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. TREATMENT OPTIONS, FUNCTIONS AND DEVICE SETTINGS
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6.2 Treatment Options – Muscle Intelligence™ Technology
mi-SCAN (automatic):
Manual selection:
Just before starting a session of neuro-muscular electrostimulation, mi-SCAN analyses the characteristics of excitability in the muscle subjected to stimulation. mi-SCAN detects the chronaxy of the muscle in approximately 10 seconds, by detecting when and how strong a mucle contracts while getting dierent intensitys applied. It allows the stimulator to adjust 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 obtain the same muscle response. As soon as the mi-SCAN function is activated each active channel performs the chronaxy measurement. Where recommended, this function is automatically activated, but can be deactivated and the selection of the body part can be done manually.
6.2.1 Selection of the body area
If the mode for the manual selection of the body area is activated, the user must manually select the area to be treated. An average chronaxy value is used based on the area selected by the user. This choice is made after selecting the desired programme.
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. TREATMENT OPTIONS, FUNCTIONS AND DEVICE SETTINGS
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6.2.2 Energy management
mi-RANGE:
This function indicates the minimum energy threshold for programmes whose eectiveness requires obtaining vigorous muscular twitches. The mi-RANGE function is therefore only available for programmes using low stimulation frequencies (below 10 Hz).
For programmes that allow the mi-RANGE function, the stimulator first prompts you to increase the energy level:
• A beep will accompany the flashing “+” symbols.
• When a muscle pumping is first detected, the “+” symbols stop flashing.
• You are at the minimum energy level to provide therapeutic 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 automatically activated.
mi-TENS:
The mi-TENS function can reduce the appearance of unwanted muscular contractions (e.g. at TENS Gate­Control programs), thus providing maximum comfort and eciency.
Short tests are performed regularly throughout the duration of the programme. A testing phase takes place systematically after each increase in stimulation intensity. In order to allow its smooth progress it is essential to remain perfectly still during this time.
According to the test results recorded by the device, the level of stimulation intensities may be slightly decreased automatically.
Where recommended, this function is automatically activated, but can be deactivated.
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mi-ACTION (voluntary):
6.2.3 Triggering of contraction
In default set up, all trigger functions are deactivated, but can be activated where available.
This is a way of working in which voluntary active muscle contraction triggers an electrical stimulation. Contraction by electrostimulation is perfectly controlled by voluntary triggering of muscle contraction.
From the perspective of maximum eciency, the mi-ACTION working mode requires good muscular qualities. Underperforming muscles may, in some cases, impede the onset of electrically induced contraction.
Programmes used in the mi-ACTION mode have undeniable advantages:
• They require active participation and encourage the patient to engage fully in his or her treatment.
• They give the patient the free choice of triggering a contraction, making the practice of electrostimulation more comfortable.
• They ensure even more eective work as they 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 impaired neuromuscular control.
• They allow the stimulation of stabilising muscles to be integrated during an overall functional movement.
How it works:
The mi-ACTION mode is active during muscle work sequences (it is not operational during sequences of warm-up and relaxation).
The first muscle contraction of the work sequence starts automatically. At the end of the first contraction an active rest phase begins, characterised by muscular twitches.
The voluntary triggering of a new contraction is only possible after a minimum rest period, which varies depending on the programme.
As soon as the voluntary triggering of a contraction is possible, the device emits a beep to inform the user. Once the user hears the first sound signal composed of a beep, the triggering of voluntary contraction is possible. If no voluntary contraction has occurred after a certain period of time, the unit will automatically pause.
To work properly, the mi-ACTION needs a good muscular twitches during the active rest phase.
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If the twitches are not significant enough, the unit beeps and a + sign appears on channels: you must increase the stimulation energy to get good twitching. Similarly, in order to make these twitches possible, it is imperative that the muscles are properly relaxed during 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 operating mode in which the contraction from electrostimulation is triggered by the user by pressing any button on any channel (4 multifunction buttons) on the remote control. Contraction will stop automatically at the end of the time set by the programme. The Trigger ON mode is active during muscle work sequences (it is not operational during sequences of warm-up and relaxation).
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6.3 Available Functions
6.3.1 The Favourite List
For a fast and easy access to the most frequently used programs, they can be added to the program category “Favourites”. It is possible to 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 the program while it is marked in the regular program category and the symbole above the corresponding multifunctional button will change to the symbol for removing the program from the favorite list.
Press the button while the symbol is shown, to remove the program from the Favorite list.
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6.3.2 The Lock Out function
The Lock Out function can be basically activated and deactivated 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 not.
A Deactivation of the Lock function B Activation of the Lock function
A B
Afterwards you will be asked to enter a code. To enter the code you just need to press a combination of any four buttons.
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If enabled, the function allows you to lock the device in a certain configuration before giving it to the patient.
When the function is active the patient can perform only the basic operations:
• increase or decrease the intensity,
• pause the device
• but he or she cannot exit the programme or turn o the device.
To deactivate the Lock Out function during the treatment, pause the device and then hold down the On/ O button on the Remote Control until the display prompts you to insert your key combination to unlock the programme.
If you have forgotten the code just put the remote control on the charging station to unlock.
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6.3.3 The Synchronisation Signal
Synchronisation signal:
This function allows you to notify the 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 inducing powerful muscular contractions and is functional only during the muscular work sequence (contraction - active rest). It can be activated within the program option menu for each corresponding program.
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6.3.4 Identify modules
The identify modules function allows you to allocate dierent colors to the dierent modules for an easier identification of the channels during usage. It can be activated and deactivated within the menu for the Settings at the Remote Control. Default setting is: deactivated
To activate the function:
1. Select the function within the Settings menu of the Remote Control and press the center button. You
will be asked to turn ON ONE module.
2. Turn one the one of the modules you want to advice a color to.
3. Use the left and right arrows to select a color for this channel. The following colors are available: none/
red/green/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 clip to this channel and clip it onto the cable of the module (remark: the best
positioning is close to the module with the on/o button).
6. Press the next button to proceed with the process.
7. You will be asked to turn On ONE module again.
8. To allocate colors to more channels, please follow step 2 until 6 for each reflecting module.
9. When you finished the channel identification settings, press the back button to return to device
settings.
When turning on a module and during the treatment, the screen will now show the reflecting color below its intensity setting bar and in the header of the screen, in the order they had been turned on.
To deactivate the function again, please follow the steps 1 through 9 again, and set all modules to color: none.
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6.4 Available device Settings
Back light intensity:
The backlight intensity can be set in 5%-steps from 10% up until 100%. Default setting: 100%
Buzzer volume:
The buzzer volume can be set in 10%-steps from 0% (= o) to 100%. Default setting: 100%
Backlight dimmer:
The back light dimmer reduces the backlight after the set seconds of time. Possible settings are: 15s, 30s, 60s or “o” Default setting: 60s
Eco mode:
The eco mode can be turned on or o, while activated (on) the Default setting: o
Lock function:
The lock out function can be activated (on) or deactivated (o). Default setting: o
Language:
The language set up allows you to change the language setting of the Remote Control. Default setting: English
Set time:
The set time function allows you to change the time displayed within the header of the screen.
Identify modules:
The identify modules function allows you to allocate dierent colors to the dierent modules for an easier identification of the channels during usage. Default setting: o
Date:
The set time function allows you to change the date displayed within the header of the screen.
System info:
The system info provides information regarding the serial number and the software of the Remote Control.
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Pairing of new module:
The pairing of new module function 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, resets the Remote Control to the default setting. All data stored on the remote control, incl. Device settings, favourites, history etc. will be automatically deleted.
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6.5 WIRELESS PROFESSIONAL SOFTWARE (firmware update remote control,
customised programs, patient history)
The WIRELESS PROFESSIONAL SOFTWARE is a software to be installed on your Computer to extend the capabilities of your WIRELESS PROFESSIONAL 2 and 4CH devices.
The key features included with the SOFTWARE are:
• Update the firmware of your WIRELESS PROFESSIONAL remote Control
• Create your own customized stimulation programs
• Create a patient 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 Control
The WIRELESS PROFESSIONAL SOFTWARE always contains the latest version of the WIRELESS PROFESSIONAL firmware of the remote control and modules.
To update your Remote Control:
1. Download the SOFTWARE from
http://international.chattgroup.com/products/wireless-professional/
2. Run the SOFTWARE
3. Connect your Remote Control to your Computer
The firmware of your remote control will be automaticly updated by the SOFTWARE. Your modules will be automatically updated by the Remote Control when turning them on within the next treatment session.
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6.5.2 Additional Functions of the SOFTWARE, when having a WIRELESS
PROFESSIONAL device
When having a WIRELESS PROFESSIONAL device the SOFTWARE allows you additional functions to be used with your Remote Control.
History List: When having the 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 to this list, the notes you made on them and the history of their treatments.
User Program List: Will show all programs you created an their parameters.
Synchronisation: To synchronise the Remote Control and the SOFTWARE
Settings: For database and application configuration.
Help: You will find instructions to use the SOFTWARE and warnings in here.
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6.5.2.1 History list
When having the Remote Control synchonised with your Computer, all performed treatments will be shown in this list in the order they had been performed, including date, time, patient name (if it was assigned to a patient from the patient list) 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 channels used
Maximum intensity per channel
You can delete a session from the list by clicking on the delete button. You can close the details view by clicking on the reduct button. You can export the list into an Excel file, by clicking on the export button. The SOFTWARE will automatically suggest a name for that file and ask for the location it should be stored to.
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6.5.2.2 Create a patient’s list and monitor their treatment progress
The Patient list will show all patients you added to this list, the notes you made on them and the history of their treatments (automatically transferred from the History List).
To add a patient to the list:
1. Click on the Add button
2. Fill the requested fields for the patient’s personal data. The fields Name, Surname and Pseudonyme are
mandatory. The field Pseudonyme will be filled automatically, but can be changed after.
3. Add Pathology information of notes, if wanted
4. Click on the confirmation/store button. The button appears as soon as the mandatory fields had
been filled. The patient will be automatically shown within the patient list. If you don’t want to store the data, click on the back button, to return to the patient list. All inserted data will be deleted.
Within the patient list you can:
• Select a patient by clicking on the name.
• Edit/Change the patient’s data by clicking on the edit button.
• Export the patient history list into an Excel file, by clicking on the export button. 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 treatment of the patient by clicking on the extend button and reduce the details view by clicking on the reduce button. (see as well History List)
• Mark a patient to be synchronised and become available with your remote control. If you don’t want the patient to be synchronised with your remote control, click on the hook button to remove the hook from the field.
Default setting: synchronisation on
When patients had been added to the patient list and synchronised with the remote control, your WIRELESS PROFESSIONAL will ask you after each treatment session to add the last treatment to a patient from your patient list. To do so:
• Press the next or the center button when the treatment time elapsed
• The patient list will be displayed automatically. Select a patient by using the up/down buttons.
• Confirm by using the confirmation button or the center button
If you don’t want to assign this treatment to a patient of your list, just press the return button to return to the available programs and program category. The treatment will become visible within the history list and the patient list when synchronising the remote control with your computer the next time.
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6.5.2.3 Create customized stimulation programs
When having a WIRELESS PROFESSIONAL the SOFTWARE allows you to create your own stimulation programs.
It is possible to adjust the treatment parameters and create your own stimulation programs, based on the following program architectures:
Continuous Programs
Adjustable parameters:
• Impulse width
• Treatment session length
• Frequency
Modulated Programs
Adjustable parameters:
• Treatment session length
• Frequency
• Impulse width
Work/Relax Programs
Adjustable parameters:
• Impulse width
• Treatment session length
• Warm up / Cool down (on/o) And for the Work and Relax phases separately
• Frequency
• Duration
• Ramp up duration
• Ramp down duration
Values of the adjustable parameters:
Treatment session length: 1 – 240 minutes Impuls width: 30 – 400 µs Frequency: 1 – 150 Hz (at Work/Relax: 0 – 20 Hz for the Relax phase) Ramp-up duration: 0.25 – 10 seconds Ramp-down duration: 0 – 2 seconds at Work and 0.25 – 2 seconds at Relax Duration: 0.25 – 60 seconds Warm-up/Cool down: On/O Note: when activating the warm-up/cool down function, the program will automatically add 5 minutes for warm-up and 10 minutes for cool down to your set treatment time.
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To create your own treatment program the first time:
1. Click on Program
2. Click on the architecture symbol your program is selected to have
3. Enter a name for the program (mandatory) and notes (optional)
4. Adjust the parameter, by clicking on the parameter and changing the values with the + and – buttons
on the screen.
5. Store the program by clicking on the green hook button . This button will be displayed as soon as
the mandatory field had been filled. Your new programs will be shown in the “user program list”.
If you don’t want to store the program, click on the back button, to return to the program list. All inserted data will 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 architecture of the program will be shown.
• Edit/Change the program parameter and notes by clicking on the edit button.
• Export the program parameters into an WIRELESS PROFESSIONAL SOFTWARE file, by clicking on the export button. The SOFTWARE will automatically suggest a name for that file and ask for the location it should be stored to. This feature allows you to share it with any other Computer the SOFTWARE is installed on.
• Delete a program from the list by clicking on the delete button.
• Mark a program to be synchronised and become available with your remote control. If you don’t want the program to be synchronised with your remote control, click on the hook button to remove the hook from the field.
Default setting: synchronisation on
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All programs that had been synchronised with your Remote Control, will be shown in a separate program category called “Personalised Programs”. Please note:
• Programs from the Personalised Programs category list cannot be added to the Favorite program category.
• Mi functions will not be available for customised programs
• Dierent treatment options to be turned on or o, will be available for the 3 dierent program architectures:
- Modulated Programs: none
- Continuous Programs: Bodyzone selection
- 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 trigger button will be pressed)
• The information showen in relation to a program will be the information/notice entered within a program at the SOFTWARE (if there is one) and the set program parameters.
• When selecting a program, the remote will not automatically ask you to turn on the Modules and start the treatment. For customized programs, the architecture and parameters of this customised program will be displayed first. You can confirm that this is the parameters you want to treat the patient with by pressing START and the remote control will ask you to turn on the Modules afterwards.
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6.5.2.4 Remote Synchronisation
During the synchronisation process, selected custom programs will be automatically transferred to your device and will be available under the “Personalised Programs” category. Likewise, the patient’s list will also be transferred to your device, and will allow assigning stimulation sessions to a particular patient. During 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 Control, connetected by a line.
• If there is no remote connected, the line will be interrupted by a red X.
• If there is a remote connected to the computer, the Synchronisation symbole will interrupt the line.
To synchronise, click on the synchronisation symbole. The circle on it will start turning while the synchronisation is in process.
Please do not disconnect your remote control from your computer during the synchronisation process, or the process will fail.
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6.5.2.5 Configuration/Settings
Within the Configuration/Setting menu, it is possible to change the application configuration by selecting dierent languages. The following languages are available:
• English
• French
• German
• Spanish
• Italian
• Dutch
• Turkish
• Portuguese
• Danish
• Swedish
• Norwegian
• Finnish
• Czech
• Russian
• Polish
• Greek
It is as well possible to manage your data base with the following functions:
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 click on “backup” and the SOFTWARE will automatically suggest a name for the backup file and ask you where you want to store it.
If necessary, this backup file can then be used to Restore your data. Just click on “Restore”, select the file you want to use to restore your system and confirm.
2. Clear all data
Clicking on “Clear all data” will delete all stored data within the SOFTWARE and reset the SOFTWARE to the default setting.
And the information about the SOFTWARE is included:
• Disclaimer
• Version
• Contact
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6.5.2.6 Help
The Help tap contains a summary of all information required to use the SOFTWARE, including the warnings.
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7.1 Errors shown on display
Problem Possible cause Solution
Electrode failure
Poor electrode connection to the module
Check 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 remote control shows the symbol of an electrode and a disconnected module. Shown on the channel where the problem was detected (in this case channel 1):
Poor electrode/module contact
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Modules out of range
The remote control shows the out of range symbol. Shown on the channel where the problem was detected (in this case channel 1):
Problem Possible 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
isolated place, without any obstacles that may deflect the signals from the remote control.
C. Ensure you are in a place
that allows the signal from the remote control to be reflected.
D. Check the module is switched
on.
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Battery level
Problem Possible 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 battery symbol. Shown on the channel where the problem was detected (in this case channel 4):
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7.2 Behaviour of the Module LEDs
Problem Possible cause Solution
The LED blinks alternately green and red
The module is out of range or is not recognised by the Remote Control.
A. Check the remote control 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 order to
pair them.
The LED is constantly red Module battery level low
A. Check the module is charged. B. Try restarting the module. C. If despite this the LED is still
red, contact the customer
services that have been
stipulated and approved by
the manufacturer.
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7.3 Behaviour of the Docking Station LEDs
Problem Possible cause Solution
The docking station’s central LED lights red
Modules can’t be charged due to no connection to tablet or main power.
A. Ensure 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 lighting sequence
of the docking station upon
activation.
• Remove all modules.
• Remove the remote control.
• Disconnect the USB cable.
If despite this the LED is still red, contact the customer services that have been stipulated and approved by the manufacturer.
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7.4 Others
Problem Possible cause Solution
The stimulator is not working
Device not answering
If the remote control is ON, but does not respond to pressing the key pad buttons: A. Press the ON/OFF button for
2 seconds to turn the device
OFF B. Wait 10 seconds. C. Turn Remote Control ON
again
Low batteries
Ensure the remote control and the modules are charged. When the batteries are completely discharged, 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 to
pair them. C. If, despite this, the device is
still not working, contact the
customer services that have
been stipulated and approved
by the manufacturer.
Bad connections
If the device is on, the intensity bar graphs and controls are on, and you feel no stimulation, check and verify the connection of the electrodes
Lead wire or electrode defective
If the device appears to be functioning, and there is no stimulation, replace the lead wires and/or electrodes
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Problem Possible cause Solution
Display does not come on Low batteries Load batteries
Weak stimulation with loaded batteries
Electrodes dried out, lost their adhesive power and have no adequate connection to th skin.
Replace electrode
Electrode placement
Make the electrodes at least 2” apart
Stimulation stops with loaded batteries
Poor electrode contact
Reapply electrodes, secure firmly. Electrodes must be a minimum of 2 inches apart.
Damaged or worn electrodes or module leadwires
Replace.
Stimulation weakens within minutes of starting treatment with loaded 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 are too close together
Reposition the electrodes. Electrodes must be a minimum of 2 inches apart.
Damaged or worn electrodes or leadwires of modules
Replace.
Ensure proper program is being used
A. Refer to section 6.1 and 7 for a
description of the Programs B. Contact clinician if discomfort
persists.
Stimulation is ineective
Improper electrode placement
Reposition electrodes. Electrodes must be a minimum of 2 inches apart.
Unknown Contact clinician.
Stimulation only felt on one electrode
Improper electrode placement
A. Reposition electrodes.
Electrodes must be a
minimum of 2 inches apart. B. Replace electrodes.
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Problem Possible cause Solution
Stimulation on one channel (side) only
Electrodes A. Worn or damaged B. Improper placement Leadwires among modules worn or damaged
A. Replace. B. Reposition electrode.
Electrodes must be a
minimum of 2 inches apart.
Replace
Intermittent Output Intermittent program in use
Some programs will seem intermittent. This 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 ensure the
electrodes are positioned
properly. B. Change the positioning of the
electrodes slightly.
Remote Control is not loading
USB cable of docking station not connected to Tablet
Check connections
Power cord of Tablet not connected to mains
Modules are not loading
Power cord of Tablet not connected to mains
Check connections
Modules not placed the right way
Check module placement in Tablet
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8.1 Care
Warning!
Shock hazard - Remove the power cord of the Tablet from the wall outlet before cleaning. Shock hazard, equipment damage -
- Liquids must not enter the device and it’s components, incl. the Tablet. If liquids have entered into the components, the Wireless Professional must be immediately checked by a service technician, before it can be reused.
- Never dismantle the remote control, the modules, the docking station or the AC adapter as they contain high-voltage parts with a risk of electric shock.
Warning!
Patient hazard - patient contamination
- Before using the unit on another 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, oxidants and strong organic or inorganic acids with a pH value below 4.
- Use only clear disinfectants to prevent discoloration of the device.
- Do not expose the therapy unit to strong ultraviolet radiation (sunlight) and fire.
- Do not sterilize the stimulator.
- Do not immerse in liquids.
• All parts of the Wireless Professional can be disinfected by wiping down with a disinfectant. Thus, it complies with the special hygiene standards for medical technical equipment.
• All components can be cleaned with common disinfectants and mild household detergents.
• Only use a soft cloth and an alcohol-based, solvent-free cleaning product, to wipe the therapy unit down.
• Allow the device to completely dry before use.
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Warning!
Shock hazard, Equipment damage ­Do not attempt to repair the stimulator or any of its accessories. Never dismantle the device because of risk of electric shock. DJO Global declines all responsibilities for any damages or consequences resulting from unauthorised attempts to open, modify, or repair the stimulator. This 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 is tested prior to distribution. Its characteristics do not vary under normal conditions. If your stimulator contains parts that seem worn or defective, please stop using it and contact the customer service centre that has been stipulated and authorised by the manufacturer regarding an upgrade.
There are no user serviceable parts inside the device. If the device appears to be non-functional, contact DJO Global or your local dealer.
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Caution!
Equipment damage ­Only use the original transport bag for carrying the device around.
8.3 Transport
8.3.1 Transport of the 4CH device key components and the Tablet
(off site treatment)
1. Prepare the device and its accessories for shipping within the original Rehab/Theta/Physio shipping box
2. Turn the device and it’s accessories o.
3. 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 the transport bag.
1. Turn the device and it’s accessories o.
2. Disconnect and dismount the device and it’s accessories by following the guidelines but keep the
Modules in the Tablet.
3. Store the user manual in CD in the outer pocket of the transport bag.
4. Place the accessories in the transport bag as shown in picture below
Remote Control
Motor Point Pen
Tablet and Modules
AC Adaptor (power supply) and USB connector
Electrodes
Bottle of conductive gel
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Caution!
Equipment damage ­Only use the original shipping box for shipping the device. DJO cannot be held liable for transport damage if the device is not packed in its original shipping box.
1. Prepare the device and its components for shipping within the original Wireless Professional shipping
box, by following the guidlines given previously.
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 transport bag at the bottom of the (paper) shipping box b. Cover the transport bag with the paper spacer c. Cover the Docking Station with the protective paper piece and place it in the box d. Place the Bottle of Conductive Gel in the Box e. Put the Remotes Control in their separate paper box f. Place the Remotes Control Box in the slots at the surface. g. Close the Transport Box
8.3.2 Shipping the entire 4CH unit (incl. Smart Docking Station)
a.
d.
b.
e.
c.
f.
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Caution!
Equipment damage ­Only use the original 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 o.
2. Disconnect and dismount the device and it’s components by following the guidelines
3. Place the components in the transport bag as shown in picture below
Modules
Remote
AC Adaptor (power supply) and USB connector
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Caution!
Equipment damage ­Only use the original shipping box for shipping the device. DJO cannot be held liable for transport damage if the device is not packed in its original shipping box.
1. Prepare the device and its components for shipping within the original Wireless Professional shipping
box, by following the guidlines 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 user guide with the paper spacer c. Place the docking station in a specifi box and insert it in the room allowed by the paper spacer d. Put the Remote Control and module in its separate foam box, put it into the paper spacer and cover
the docking station box. Cover the Docking Station with the protective paper peace and place it in the box.
e. Close the Transport Box
8.3.4 Shipping the entire 2CH unit (incl. Basic Docking Station)
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8.4 Enviromental Statement, Expected Life
The Wireless Professional device is electronic equipment and may include substances that can damage the environment. It must not be dispose of with unsorted household or municipal waste. 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 contact DJO GLOBAL for information about the possible recycling of the product.
When the electrodes no longer stick well to your skin, dispose of them in a receptacle out of reach of children and pets.
The product as well as the parts and accessories supplied with it are designed for a minimum service life of 6 years of normal usage.
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. TECHNICAL DATA, STANDARDS, GUARANTEE, PATENTS
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9.1 Technical Data
9.1.1 General information
Model: Wireless Professional 4CH
Part number: 2532xxx
MDD: Class IIa
IP class: IP22
Applied part: Type BF
Power supplies:
Remote Control battery: Lithium polymer (LiPo) rechargeable 3.7[V] / ≥ 1500[mAh].
Module batteries: Lithium polymer (LiPo) rechargeable 3.7[V] / ≥ 450[mAh].
Tablet AC Adaptor:
Only 5 [V] / 3.5 [A] adapters with the reference number 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 2CH
Part number: 25326xx
MDD: Class IIa
IP class: IP22
Applied part: Type BF
Power supplies:
Remote Control battery: Lithium polymer (LiPo) rechargeable 3.7[V] / ≥ 1500[mAh].
Module batteries: Lithium polymer (LiPo) rechargeable 3.7[V] / ≥ 450[mAh].
Tablet AC Adaptor:
Only 5 [V] / 3.5 [A] adapters with the reference number 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!
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9.1.2 Neuro-Stimulation Parameters
All electrical specifications are given for an impedance of 500-1,000 ohms per channel.
9.1.3 RF data
The Wireless Professional may be aected by other devices even if they are compliant with CISPR EMISSION requirements.
Outputs:
Four independent and individually adjustable channels that are electrically isolated from each other.
Pulse 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 increments:
Manual adjustment of stimulation intensity from 0 to 999 (energy) in minimum increments of 0.25 mA.
Pulse width: 30 to 400 s.
Maximum electrical charge per pulse:
96 micro coulombs (2 × 48 C, compensated)
Standard pulse ramp-up time: 3 s (20 %-80 % of maximum current)
Pulse frequency: 1 to 150 Hz.
Transmission and reception frequency:
2.4 [GHz] ISM (2.4-2.4835 GHz)
Characteristics of the modulation type and frequency:
GFSK, +/-320 [kHz] deviation
Eective transmission power: 4.4 [dBm]
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9.1.4 Information on electromagnetic compatibility (EMC)
The Wireless Professional is designed to be used in typical environments that have been approved in accordance with the EMC safety standard EN 60601-1-2.
This device complies with the CISPR standard, indicating that radio frequency (RF) emissions are not likely to cause interference with electronic equipment installed nearby (radios, computers, telephones, etc.).
The Wireless Professional is designed 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 will not be aected by powerful RF (radio frequency) fields from other sources.
For more detailed information concerning electromagnetic emissions and immunity, refer to the EMC tables.
9.1.5 Enviromental conditions
Storage and Transport Conditions
The device must be stored and transported in accordance with the following conditions:
Temperature: -20° C to 45°C
Maximum relative humidity: 75%
Atmospheric pressure: 700 hPa to 1,060 hPa
Temperature: 0° C to 40° C
Maximum relative humidity: 30% to 75%
Atmospheric pressure: 700 hPa to 1,060 hPa
Conditions of use
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9.2 Standards
To guarantee your safety, the Wireless Professional has been designed, manufactured, and distributed in compliance with the requirements of European Directive 93/42/EEC, as amended, on medical devices.
The Wireless Professional also complies with the IEC 60601-1 standard on general safety requirements for electro-medical devices, the IEC 60601-1-2 standard on electromagnetic compatibility, and the IEC 60601­2-10 standard on particular safety requirements for nerve and muscle stimulators.
Current international standards require that a warning be given concerning the application of electrodes to the thorax (increased 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 several innovations with patents pending or already issued.
9.3 Guarantee
This guarantee is valid only if it is accompanied by proof of purchase. Your statutory rights are not aected by this guarantee.
Your Wireless Professional stimulator is guaranteed for a period of 3 years from the date of purchase. The guarantee covers the remote control, the modules, the docking station and the AC adaptor (hardware and labour), but not the batteries, electrodes or the motor point pen.
All defects resulting from poor quality material or workmanship are covered.
This guarantee does not cover damage resulting from impact, accidents, misuse, inadequate protection against moisture, immersion in water or repairs made by unauthorised personnel.
Page 90
. EMC TABLES

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10. EMC Tables
The Wireless Professional needs special EMC precautions and must be installed and started according to the EMC information supplied in this manual.
All RF wireless transmission systems can aect the Wireless Professional. The use of accessories, sensors and cables other than those recommended by the manufacturer may result in stronger emissions or reduce the immunity of the Wireless Professional.
The Wireless Professional should not be used beside or stacked on top of any other equipment. If you must use it side by side or on top of another system, you should check that the Wireless Professional works properly in the chosen configuration The product designation of the Wireless Professional used 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 use in the electromagnetic environment specified below. The customer or user of the device should ensure that it is used in this environment
Emissions test Compliance Electromagnetic environment - Guide
RF emissions CISPR 11
Group 1
The Wireless Professional uses RF energy only for its internal operation. Consequently, its RF emissions are unlikely to interfere with any adjacent electrical device (radios, computers, telephones etc.).
RF emissions CISPR 11
Class B
Wireless Professional is suitable for use in any establishment, other than a private dwelling or a place connected directly to the low voltage mains supply which powers residential buildings.
Harmonic emissions IEC 61000-3-2
Class A
Voltage fluctuations / emission oscillations IEC 61000-3-3
Not applicable
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10.2 Electromagnetic immunity
RECOMMENDATIONS AND DECLARATION BY THE MANUFACTURER CONCERNING ELECTROMAGNETIC IMMUNITY
Wireless Professional is designed for use in the electromagnetic environment stipulated below. The buyer or user of the Wireless Professional must ensure it is used in this recommended environment.
Immunity test
Test level IEC 60601
Observance level
Electromagnetic environment ­Recommendations
Electrostatic discharge (DES) CEI 61000-4-2
±6 kV at the contact ±8 kV in air
±6 kV at the contact ±8 kV in air
Floors must be wood, concrete or ceramic tile. If floors are covered with synthetic material the relative humidity must be maintained at a minimum of 30%.
Fast transient electrical bursts CEI 61000-4-4
±2 kV for power supply lines ±1 kV for input/output lines
Not applicable Battery­powered device
The quality of the electrical power supply should be that of a typical commercial or hospital environment.
Shock waves CEI 61000-4-5
±1 kV dierential mode ±2 kV joint mode
Not applicable Battery­powered device
The quality of the power supply should be that of a typical commercial or hospital environment.
Voltage dips, short interruptions and voltage variations on power supply lines CEI 61000-4-11
<5 % VT (dips >95 % de UT) for 0.5 cycle <40 % VT (dips >60 % de UT) for 5 cycles <70 % VT (dips >30 % de UT) for 25 cycles <5 % VT (dips >95 % de UT) for 5 seconds
Not applicable Battery­powered device
The quality of the power supply should be that of a typical commercial or hospital environment. If the Wireless Professional user requires continuous operation during mains power cuts, it is recommend that the Wireless Professional is powered by a UPS or a battery.
Magnetic field at grid frequency (50/60 Hz) CEI 61000-4-8
3 A/m
Magnetic fields at the mains frequency should be at a level characteristic of a typical location in a typical commercial or hospital environment.
NOTE :VT is the AC supply voltage before application of the test level.
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. EMC TABLES
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RECOMMENDATIONS AND DECLARATION BY THE MANUFACTURER CONCERNING ELECTROMAGNETIC IMMUNITY
Wireless Professional is designed for use in the electromagnetic environment stipulated below. The buyer or user of the Wireless Professional must ensure it is used in this recommended environment.
Immunity test
Test level IEC 60601
Observance level
Electromagnetic environment ­recommendations
Conducted RF IEC 61000-4-6
Radiated RF IEC 61000-4-3
3 Vrms 150 kHz to 80 MHz
3 V/m 80 MHz to
2.5 GHz
3 Vrms
3 V/m
Portable and mobile RF communication devices must only be used relative to the Wireless Professional and its wiring at a distance which is not less than the spacing recommended and calculated using the appropriate equation for the transmitter’s frequency. Recommended spacing d = 1.2 √P d = 1.2 √P 80 MHz to 800 MHz
d = 2.3 √P 800 MHz to 2.5 GHz where P is the maximum output power of the transmitter in watts (W) set by the manufacturer’s specifications and where d is the recommended spacing in metres (m). The field intensity of RF fixed transmitters, as determined by an 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
NOTE 1 At 80 MHz and at 800 MHz ,the high frequency amplitude is applied NOTE 2 These guidelines may not be appropriate for some situations. Electromagnetic wave propagation is modified by absorption and reflection due to buildings, objects and persons.
a The field intensity from fixed transmitters, such as radio telephone base stations (cellular/ wireless) and a mobile radio, amateur radios, AM and FM radio transmissions and TV transmissions cannot be predicted with any accuracy. It may therefore be necessary to consider an analysis of the electromagnetic environment of the site to calculate the electromagnetic environment coming from fixed RF transmitters. If the field intensity measured in the environment where the Wireless Professional is located exceeds the appropriate RF observance level above, the Wireless Professional should be monitored to ensure it is operating properly. In the event of abnormal operation, new measures may then be imposed, such as realignment or movement of the Wireless Professional. b Above the frequency amplitude from 150 kHz to 80 MHz, the field intensity must be < 3 V/m.
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. EMC TABLES
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10.3 Recommended separation distances
RECOMMENDED SPACING BETWEEN A PORTABLE AND MOBILE COMMUNICATION DEVICE AND THE WIRELESS PROFESSIONAL
The Wireless Professional is designed for use in an electromagnetic environment in which radiated RF waves are controlled. The buyer or user of the Wireless Professional can contribute to preventing electromagnetic interference by maintaining a minimum distance between portable and mobile RF communication devices (transmitters) and the Wireless Professional according to the table of recommendations below and according to the maximum output power of the telecommunication device.
Maximum transmitter output power W
Spacing according to the frequency of the transmitter m
From 150 kHz to 80 MHz d = 1.2 √P
From 80 kHz to 800 MHz d = 1.2 √P
From 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 recommended spacing of d in metres (m) can be calculated using the appropriate equation for the transmitter frequency, where P is the maximum output power of the transmitter in watts (W) as set by the transmitter manufacturer NOTE 1 At 80 MHz and at 800 MHz ,the spacing for high frequency amplitude is applied. NOTE 2 These guidelines may not be appropriate for some situations. Electromagnetic wave propagation is modified by absorption and reflection due to buildings, objects and persons.
Note
Mobile HF-Communication units may have influence to the Wireless Professional.
Please ensure that wire less communication devices, like WLAN, mobile phones, wireles telephones and their station, Walki-Talkies keep a distance to the Wireless Professional of at least 3.3 m. (Based upon the maximum output power of a regular mobile phone of 2 W).
Page 94
. CONTACT

EN
We would be happy to answer any questions 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 service from DJO Global, please contact:
[email protected]
Page 95
. ELECTROTHERAPY THEORY

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12.1 Introduction
In recent years, significant progress has been made in field of electrotherapy of which many users are still largely unaware. Changes and improvements in electrotherapy are so numerous that this discipline appears to be a new concept that can only be applied correctly and eectively using sophisticated, high­tech equipment. The aim of these articles is to develop this new concept for potential users and provide anyone already working with this equipment with explanations and data that will allow them, based on current knowledge and scientific work carried out, to optimise the use of their stimulators.
12.1.1 The fundamental law of electrostimulation
Electrostimulation is a technique which involves producing action potentials in the excitable cells (nerve and muscle) using an electric current. Nerve cell membranes have a resting potential with an average value of -70mV, as the internal face of the membrane has negative polarity compared to the external 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 -50 mV on average (Fig. 1). Once this threshold value has been reached the membrane changes from a state of rest to a state of activity. An action potential appears which then moves along the nerve fibre. The nerve impulse either goes towards the muscles to instruct them to contract or returns from the surrounding areas towards the brain to relay information regarding the senses. Electrostimulating the nerve fibre essentially involves reducing the membrane’s resting potential to the threshold value by applying an electric current to the skin. The first question is, of course, which stimulating current to choose.
Which type of current will we use? A single current must obviously be used, one which can reduce the resting potential to the threshold value but keep the patient as comfortable as possible. In other words, the electrical parameters of this current must be kept to a minimum, and its stimulation energy and duration must be as low as possible.
0
+40 +30 +20
+10
0
-10
-20
-30
-40
-50
-60
-70
-80
-90
Action potential
Threshold
Rest potential
Fig. 1
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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 dierent 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𝐼𝑥 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   + 𝑖𝑡
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Weiss therefore discovered the mathematical relationship that links the pulse duration with the amount of electricity required to produce the stimulation. Understandably, he called this relationship the “fundamental formula”:
𝑄
  +
𝑖𝑡
𝑄 = the amount of current required to reach the threshold. This is also the quantity of
electrical charges provided by the stimulation current, as the 𝑄 value is given by the
product (𝐼 𝑥𝑡) of the stimulation current intensity multiplied
by its application time.
𝑡 = length of time that the current is applied, which is known as the pulse duration.
𝑖 = a coecient determined by experiment, with the same
quantity as an electric current (intensity).
= a coecient 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 calculated as the 𝑄 value when 𝑡 is equal to zero.
Lapicque, an electrophysiologist who is more widely known than Weiss, did not actually discover a new law of electrostimulation but he performed a number of experiments which confirmed the fundamental formula. He defined it dierently to mathematically deduce coecients called the rheobase and chronaxy, which he gave physiological meaning.
Lapicque developed the “fundamental formula” as follows:
Q  q + it
or
Q  It
I
: stimulation current intensity
t
: pulse duration
therefore
It  q + it
by dividing the two by 𝑡, Lapicque obtained
𝐼 /𝑡 + 𝑖
which is the relationship between the intensity of the current and the time period in
which it must be applied to achieve stimulation (Fig. 3).
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The rheobase, which is the minimum intensity that must be achieved in order to produce stimulation even if the pulse duration is very long, actually corresponds to the coecient 𝑖 of the Weiss formula which has dimensions of electrical intensity. Lapicque gave the name chronaxy to the minimum length of time in which a current with double the intensity of the rheobase must be applied in order achieve stimulation. In fact, he realised that the chronaxy is a time constant which characterises the excitability of tissue and that its value is the ratio /𝑖.
Lapicque’s development also shows that, even when the length of time that the current is applied is infinite, (𝑡 = ∞), the current must have a minimum intensity known as the rheobase (𝑅h) in order to produce stimulation.
Hyperbolic relationship between the current intensity and pulse duration
demonstrated by Lapicque and given by the formula 𝐼 /𝑡 + 𝑖 , derived from Weiss’
fundamental formula.
if 𝑡 = ∞ therefore /𝑡 = 0
in this case 𝐼 is the rheobase (𝑅ℎ)
and 𝑅ℎ = 𝑖
Intensity-duration curve
Chronaxy
Rheobase
Fig. 3
This means that:
since 𝑅ℎ = 𝑖 when 𝐼 = 2 𝑅ℎ
therefore 𝐼 = 2 𝑖
and 𝑡 is the chronaxy (𝑡 𝑐ℎ)
when 𝐼 = 2 𝑅ℎ
therefore from the equation 𝐼/𝑡+𝑖
the result is 2𝑖  /𝑡𝑐ℎ + 𝑖
therefore 𝑖  /𝑡𝑐ℎ → 𝑡𝑐ℎ = /𝑖
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The chronaxy corresponds to the time value when 𝑄 = 0
i.e. 𝑄   + 𝑖𝑡 if 𝑄 = 0 therefore +𝑖𝑡 = 0 therefore 𝑖𝑡 = and 𝑡  /𝑖
Fig. 4
12.1.2 Summary
Electrical stimulation, i.e. reducing resting potential to the stimulation threshold using an electric current, is a phenomenon that fulfils a fundamental physiological law. This shows us that:
1 The factor determining stimulation is the quantity of electrical
charges created by the current.
Stimulation must be considered in terms of the amount of current, which is the
product (𝐼𝑥𝑡) of the intensity (𝐼) times the duration of the pulse (𝑡).
2 This amount of current fulfils a fundamental formula:
𝑄   + 𝑖𝑡
where 𝑄 is a linear function of time.
Lapicque expresses this formula in another way by the “intensity - pulse duration”
ratio: 𝐼/𝑡+𝑖and he deduced that
a) the rheobase (𝑅ℎ): minimum intensity that must be reached in order to produce
stimulation using an infinite pulse duration
𝑅ℎ = 𝑖
b) the chronaxy (𝑡𝑐ℎ): minimum time in which a current with double the intensity of
that of the rheobase must be applied in order to produce stimulation
𝑡𝑐ℎ = /𝑖
We can note that the chronaxy can be calculated mathematically from Weiss’ fundamental formula as shown in Figure 4.
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. ELECTROTHERAPY THEORY
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12.1.3 References
1. Physiologie Volume II Le Système nerveux et Muscle Charles Kayser, ed. Flammarion
2. Lapicque, L: Définition expérimentale de l’excitabilité Soc. Biologie 77 (1909), 280-283
3. Lapicque, L: La Chronaxie et ses applications physiologiques Hermann & Cie, Paris, 1938
4. Weiss, G: Sur la possibilité de rendre comparable entre eux les appareils servant à l’excitation électrique
5. Arch. itali. Biol. 35 (1901), 413-446
6. Irnich, W: The chronaxy time and its practical importance Pace 3 (1980), 292-301
7. Cours de Physiologie Humaine Volume I Prof. Colin F. Université Libre de Bruxelles
8. Traité de Physiologie Médicale Arthur C. Guyton, ed. Doin
9. Physiologie Humaine Philippe Meyer 2nd edition Flammarion Médecine Science
12.2 The Optimum Current
12.2.2 Characteristics of the optimal current
12.2.1 Introduction
The reminders and ideas developed in the previous chapter, “The fundamental law of electrostimulation”, must be read before starting this chapter, which describes 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 also keeping the patient as comfortable as possible. The second requirement is met by minimising the electrical parameters of the stimulation current, i.e. by using a minimum amount of electrical intensity (𝐼), pulse duration (𝑡) and electrical energy (𝑊). Having set out the conditions, we will now determine the qualities of the current that fulfils these conditions.
12.2.2.1 Electrical stimulation wave produced by the current generator
We can already state that pulses of current, i.e. produced by a current generator, must be used for the following reasons:
• The first point shown by Weiss is the importance of the quantity of electrical charges provided by the stimulation current; however, the quantity of charges can only be controlled by a current generator.
• Only a current generator can ensure stable and reproducible conditions, given the variations in skin resistance.
• If a certain electrical pulse shape is required, only a current generator can maintain a constant current wave shape as it passes through the skin and tissue.
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