GymnaUniphy Duo 500 User manual

DUO 500

ELECTROTHERAPY UNIT

OPERATING INSTRUCTIONS

Your supplier is:

The DUO 500 is made in Belgium by GymnaUniphy

At the beginning of these Operating Instructions you will find an exploded view of the Duo 500 and its accessories.

The numbers on the drawings correspond to the numbers in these Operating Instructions.

We advise you to go through these Operating Instructions, while you get familiar with your new Duo 500.

2	DUO 500 – Operating Instructions - version 1.0 - 12/2001

1 TABLE OF CONTENTS

1	TABLE OF CONTENTS ........................................................................................	3
2	SAFETY REGULATIONS......................................................................................	9
2.1	Electrical safety ....................................................................................................	9
2.2	Explosion prevention...........................................................................................	9
2.3	Operational safety ................................................................................................	9
2.3.1	Operational safety - Generalities ...........................................................................	9
2.4	Transportation and storage...............................................................................	10
2.5	Use of the Duo 500 .............................................................................................	10
2.6	Medical Device Directive ...................................................................................	10
2.7	Technical Control ...............................................................................................	10
2.7.1	Inspection interval ................................................................................................	11
2.7.2	Inspection results .................................................................................................	11
3	INSTALLATION...................................................................................................	12
3.1	Introduction ........................................................................................................	12
3.2	On receipt of your Duo 500 unit........................................................................	12
3.3	Connecting and starting ....................................................................................	12
3.4	Language selection............................................................................................	12
3.5	Hooking up accessories on the connectors....................................................	13
3.5.1	Electrotherapy-connectors 18 19............................................................................	13
3.5.1.1 Vaginal, anal or rectal stimulating probes.....................................................		13
3.6	Functional test....................................................................................................	14
3.7	New owner ..........................................................................................................	14
3.8	Liquidation ..........................................................................................................	14
4	CONTROLS.........................................................................................................	15
4.1	Introduction ........................................................................................................	15
4.2	Controls, connectors, standard accessories...................................................	15

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5	SELECTION OF A TREATMENT ........................................................................					16
5.1	Different therapeutic possibilities - generalities ..............................................					16
5.2	Start menu............................................................................................................					16
5.3	Therapeutic keys.................................................................................................					16
5.4	Selection of a treatment method by means of OBJECTIVES..........................					17
5.4.1 Objective Electrotherapy, example of a selection.................................................						17
5.4.2 Objective ET Iontophoresis, example of a selection					.............................................	19
5.5	Selecting a treatment method through INDICATION LIST...............................					19
5.6	Selecting a treatment method through a PROGRAM-NUMBER......................					21
5.7	Selecting programs for DIAGNOSTICS .............................................................					22
5.8	Direct selection of a CURRENT SHAPE ............................................................					24
5.9	Selection of a treatment out of the MEMORY ...................................................					25
6	GENERAL OPERATING INSTRUCTIONS..........................................................					26
6.1	Introduction .........................................................................................................					26
6.2	Electrotherapy – Display ....................................................................................					26
6.3	Yellow keys – select menu or select parameter / modify ................................					27
6.4	The UPand DOWN-keys			and ..................................................................		28
6.4.1	Browsing with the keys		and .......................................................................			28
6.4.2	Modifying parameters with the help of the keys				and ..................................	28
6.5	Return key	.....................................................................................................				29
6.6	Help key ?	- Request detailed explanation....................................................				29
6.7	Channel selection key A or B .......................................................................					30
6.8	Enter key	- call intensity display .................................................................				31
6.9	Intensity buttons		and	- content of the channel windows..............		33
6.9.1	Electrotherapy 4-poles – adjust intensity .............................................................					33
6.9.2 Bursts – adjust intensity........................................................................................						33
6.9.3	Alternating channels - adjust intensity ..................................................................					34
6.9.4 Iontophoresis – adjust intensity ............................................................................						34
6.9.5 Sequential programs – adjust intensity.................................................................						35
6.9.6 Intensity - end of treatment, content of the channel windows...............................						35
6.10	Pause key	- interrupt the treatment temporarily........................................				35

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6.11	Stop key - interrupt the treatment immediately .........................................		36
6.12	Starting up the unit out of STAND-BY ..............................................................		37
7	SOME PARTICULAR THERAPEUTICAL AND PARAMETER POSSIBILITIES 38
7.1	Introduction ........................................................................................................		38
7.2	CONTRA-INDICATIONS on the display ............................................................		38
7.3	The option INFORMATION.................................................................................		39
7.4	Electrode placement ..........................................................................................		39
7.5	Iontophoresis......................................................................................................		42
7.6	Sequential current shapes.................................................................................		44
7.6.1	Sequential current shapes – advantages............................................................		44
7.6.2 Sequential current shapes – intensity ..................................................................			44
7.6.3 Sequential current shapes – selection .................................................................			45
7.7	Constant Current - Constant Voltage ...............................................................		47
7.7.1	Generalities..........................................................................................................		47
7.7.2	Pelvic re-education ..............................................................................................		47
7.8	Setting different current or therapy forms per channel (A + B) ....................		47
7.9	Both channels (A + B) – automatic copying of the same current shape ......		48
7.10	Modify Standard programs................................................................................		49
7.11	Expert Mode & Expert Times.............................................................................		50
7.11.1	NMES-currents – special mode.......................................................................		50
7.11.1.1		Active rest (REST) ....................................................................................	51
7.11.1.2		Use of the second ON period (ON2).........................................................	51
7.11.1.3		Frequency variation ( ) ..................................................................	51
7.12	Alternating channels ( ) ...............................................................................		51

7.13NMES-currents and 4-pole interferential currents - graphical representation

	of the current......................................................................................................	52
8	DIAGNOSTIC PROGRAMS ................................................................................	53
8.1	Introduction ........................................................................................................	53
8.2	Determine Rheobase and Chronaxie................................................................	53
8.3	Determine Rheobase and Accommodation Quotient .....................................	55
8.4	Record S-D curve ...............................................................................................	56
8.4.1 S-D curve – Adjust intensity.................................................................................		57
8.5	Storing data in the memory...............................................................................	58

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8.6	Pain points...........................................................................................................	58
9	TREATMENT MEMORY ......................................................................................	59
9.1	Introduction .........................................................................................................	59
9.2	Save Therapy program / Diagnostic program ..................................................	59
9.3	Open saved programs ........................................................................................	61
9.3.1 Opening through a list of names...........................................................................		61
9.3.2 Opening through a number...................................................................................		63
9.4	Erasing data.........................................................................................................	63
9.4.1	Erasing through list of names ...............................................................................	64
10	SYSTEM SETTINGS AND BASIC SETTINGS ....................................................	65
10.1	Introduction .........................................................................................................	65
10.2	Language selection.............................................................................................	65
10.3	Sound ...................................................................................................................	65
10.3.1 Acoustic signal at the end of treatment .............................................................		65
10.3.2 Acoustic signal when pressing a key.................................................................		66
10.3.3 Sound during ET Stimulation.............................................................................		66
10.3.4	Sound volume ...................................................................................................	66
10.3.5 Beep ET (Electrotherapy) contact .....................................................................		66
10.4	‘Stand-by’ time.....................................................................................................	66
10.5	Starting window text ...........................................................................................	66
10.6	Copying parameters into another channel .......................................................	67
10.7	System information.............................................................................................	68
10.8	Testing Electrode cables and electrodes..........................................................	68
10.8.1	Testing Electrode cables ...................................................................................	68
10.8.2	Testing Electrodes.............................................................................................	69
10.9	Error history.........................................................................................................	69
10.10	Working hours.....................................................................................................	70
10.11	Reset working hours...........................................................................................	70
10.12	Restoring standard programs............................................................................	71
11	INDICATIONS AND CONTRA-INDICATIONS.....................................................	72
11.1	Electrotherapy - indications...............................................................................	72
11.2	Electrotherapy - contra-indications...................................................................	75
11.2.1 Electrotherapy monophasic pulses / iontophoresis - contra-indications............		75

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11.2.2	Electrotherapy biphasic pulses - contra-indications .........................................	75
12	INTERFERENCES, WARRANTY, LIABILITY, SERVICE...................................	77
12.1	Interferences.......................................................................................................	77
12.2	Warranty and Liability........................................................................................	77
12.2.1	Guarantee conditions .......................................................................................	77
12.2.2	Liability..............................................................................................................	78
12.3	Service.................................................................................................................	78
13	MAINTENANCE AND CLEANING......................................................................	80
13.1	Cleaning the device............................................................................................	80
13.2	Cleaning electrodes and sponges ....................................................................	80
13.3	Cleaning the incontinence treatment probes ..................................................	81
14	SPECIFICATIONS...............................................................................................	82
14.1	Rectified currents...............................................................................................	82
14.2	Diadynamic currents..........................................................................................	82
14.3	TENS currents ....................................................................................................	83
14.4	NMES currents....................................................................................................	83
14.5	Interferential currents ........................................................................................	85
14.6	Diagnostic programs .........................................................................................	86
14.7	Generalities.........................................................................................................	87
15	TECHNICAL SPECIFICATIONS .........................................................................	88
15.1	Appliance ............................................................................................................	88
15.2	Specifications safety..........................................................................................	89
15.2.1	Appliance..........................................................................................................	89
16	ACCESSORIES...................................................................................................	90
16.1	Standard accessories ........................................................................................	90
16.2	Optional accessories .........................................................................................	90
17	EXPLANATION OF THE SYMBOLS ..................................................................	91
17.1	Symbols at the front side of the appliance ......................................................	91

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17.2	Symbols on the side and back of the appliance ..............................................	92
17.3	General symbols .................................................................................................	92
17.4	Symbols groups of current shapes ...................................................................	93
17.5	Symbols current shapes.....................................................................................	93
17.6	Parameter symbols .............................................................................................	94
17.7	Drawings of the current shapes.........................................................................	96
18	INDEX...................................................................................................................	98

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2 SAFETY REGULATIONS

2.1 Electrical safety

The Duo 500 may only be used in a room equipped with conveniences meeting the legal requirements in force. The Duo 500 must be connected to a properly grounded wall plug that meets the locally applicable requirements for medical rooms.

2.2 Explosion prevention

Do not operate the Duo 500 in a room where inflammable gases or fumes might be present. Switch off the device before starting to disinfect or decontaminate the room where it is placed, for instance.

2.3 Operational safety

2.3.1 Operational safety - Generalities

−The Duo 500 is suitable for continuous use.

−Using the Duo 500 together with a short wave or microwave appliance might have an influence on the output of the Duo 500.

−Using the Duo 500 simultaneously with a high-frequency surgery apparatus might lead to burns under the electro-stimulating electrodes.

−Patients with electrical implants (e.g. pacemaker) may only be treated after gaining medical advice.

−Do not operate the Duo 500 in a wet room.

−Do not disinfect or sterilize the Duo 500.

−Regularly check if the insulation of the electrode cables and the electrodes themselves is still intact. If this is not the case, replace the wiring and/or the electrodes.

−An appropriate and safe use of the Duo 500 is only guaranteed if one uses the standard

and/or optional accessories, mentioned in these Operating Instructions (see Chapter 16: ACCESSORIES)

−In order to warrant the safety of the Duo 500 for a longer period of time, we advise you to have the unit itself and the accessories checked at least once a year during a safety and technical control (refer also to paragraph 2.7).

−The safety standards for electrotherapy recommend not exceeding the current density of 2.0 mArms/cm2. During iontophoresis treatments, however, we recommend not to exceed the current density of 0.2 mArms/cm2. Overstepping might cause skin irritation and burns.

−An optimal treatment starts with an examination of the patient. Based upon these findings a treatment plan and treatment objectives can be established. One has to control these plans and objectives very thoroughly during the treatment itself. In that way, possible risks linked to the treatment can be minimized.

−Always keep these Operating Instructions in the vicinity of the appliance.

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2.4 Transportation and storage

The way it is packed up in its original wrapping, the Duo 500 unit is suitable for transportation and storage (for a maximum period of 15 weeks) within the following limits:

-Temperature from –20 °C to +60 °C;

-Relative humidity from 10 % - 100 %, inclusive condensation;

-atmospheric pressure from 500 hPa - 1060 hPa.

2.5Use of the Duo 500

The Duo 500 was exclusively designed to administer the electrotherapy. The use of the unit is strictly limited to authorised and expert personnel (trained in the application of the therapy mentioned above). It is mandatory to follow the directives in these Operating Instructions as closely as possible.

NOTE:

The ambient temperature for operating the Duo 500 is between +10 ºC and +40 ºC.

2.6 Medical Device Directive

The Duo 500 meets the most recent adapted essential requirements of the Medical Device Directive of the European Commission (93/42/CEE).

See Chapter 12 INTERFERENCES, WARRANTY, LIABILITY, SERVICE concerning the liability of the manufacturer.

2.7 Technical Control

The Medical Device Directive of the European Commission (93/42/CEE) makes it mandatory for the user of the Duo 500 to have the unit checked during a safety and technical control at least once a year, and especially after all repairs. This is in accordance with the directive mentioned above.

This safety and technical control consists of:

1.a visual control,

2.a safety check,

3.the examination of all the operating functions and the measurement of the output signals,

4.the control of the alarm functions,

5.the measurement of the over current protective device,

6.the measurement of the ground leakage current and the patient leakage current, in accordance with the EN 60601 safety standard,

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The results of these checks must be recorded in the service logbook.

The service logbook can be found in the back of the “Treatment Guide” under the tab SERVICE.

NOTE:

Safety and technical inspections may only be conducted by a recognized safety inspection body or by a technician approved and qualified as thus by GymnaUniphy.

2.7.1 Inspection interval

The unit is designed in such a way that an annual inspection is sufficient. In the event that the local legislation in the user’s country (or his insurer) imposes shorter intervals, one has to comply with them.

2.7.2 Inspection results

The inspection has been carried out completely when al the topics of the annexed inspection report (see tab SERVICE in the Treatment Guide) have been checked. Abnormalities have to be adjusted (or repaired if necessary) before using the unit again. The intention is that the user makes a certain number of copies of the inspection report, so that there are a sufficient number of copies available for several controls.

NOTE:

Technicians authorized to do so by GymnaUniphy may only carry out repairs. Contact your local Gymna dealer to know their addresses.

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3 INSTALLATION

3.1 Introduction

At the beginning of these Operating Instructions you will find an exploded view of the Duo 500 and its accessories. The numbers in these Operating Instructions correspond to the numbers on the drawings.

3.2 On receipt of your Duo 500 unit

Check if the Duo 500 was not damaged during the shipment. Also check if the accessories are intact and complete.

(See Chapter 16: ACCESSORIES).

In the event of any damage and/or malfunction notify your supplier immediately (= within 3 working days after the delivery) by means of telephone, fax, e-mail or letter.

In the case of damage, the unit may not be operated.

Mains voltage:

The Duo 500 is suitable for a rated mains voltage of 110, 115, 127, 220, 230 or 240 Volt AC / 50-60 Hz. Check if the mains voltage matches the voltage on your own circuitry and electricity supply system. The mains voltage of the unit can be easily adjusted by means of a coin through the mains voltage selector switch 25 (on the bottom of the unit).

3.3 Connecting and starting

−Carefully check the mains voltage (see paragraph 3.2) before connecting the plug to the power point (input mains 22 at the backside of the appliance).

−Place the Duo 500 horizontally and stable.

−The ventilation opening 24 may not be covered.

−No objects may be put on the Duo 500.

−Do not let any liquid drop over the Duo 500.

−Do not put the Duo 500 in direct sunlight and do not put it above a heat source.

If there is no text on the display after switching it on, adjust the contrast by slightly turning the contrast control 27 (at the backside of the unit).

3.4 Language selection

−There is a choice between four languages: English, German, French and Dutch.

−The setting of a language is only possible if there is no treatment in progress.

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−One has to proceed as follows: on the display Start menu, the key Return must be pressed and held during 3 seconds.

−Select the language (Yellow Keys).

−A selected language can be changed with the aid of the keys and .

3.5 Hooking up accessories on the connectors

3.5.1Electrotherapy-connectors 18 19

1)The double-wired electrode cable 35 has at each output a rubber electrode 30 or an adhering electrode 33 (the latter have to be connected by means of an adaptor 34).

ATTENTION:

•When using currents with a galvanic component, such as galvanic and diadynamic currents, pulsating rectangular and triangular currents, the application of adhering electrodes is strongly discouraged because of the danger of cauterisation and etching effects (see also Chapter 14: SPECIFICATIONS)

2)One vaginal or anal stimulating probe, to be coupled directly to the electrotherapy connectors 18 19.

3)One rectal stimulating probe, to be connected through one cable of the double-wired electrode cable 35.

ATTENTION:		A output 18.
•	Electrotherapy on the display at channel A = Output signal on the
•	Electrotherapy on the display at channel B = Output signal on the	B output 19.

3.5.1.1 Vaginal, anal or rectal stimulating probes

For the treatment of e.g. several incontinence problems.

The Duo 500 recognizes the vaginal and the anal probes (= probes equipped with a DINconnector). As soon as one of these probes is connected, the unit will only select alternating currents (TENS, NMES, and bipolar interferential currents) with a Constant Voltage (CV) setting. All other current shapes may not be selected at that time. (See also Chapter 14: SPECIFICATIONS.)

WARNING:

The Duo 500 DOES NOT RECOGNIZE THE RECTAL PROBE and thus allows in principle the use of all sorts of current shapes whenever connected.

In order to avoid unpleasant sensations and cauterisation or etching we advice to utilize exclusively selected Constant Voltage settings (TENS, NMES, and bipolar intermediate

frequency currents) when using a rectal probe

See paragraph 7.7 for more information about the Constant Voltage.

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3.6 Functional test

− During production the Duo 500 is thoroughly checked for electrical safety.

− When switching on the Duo 500, the microprocessor is performing an extensive test In order to verify the correct functioning of the unit.

− Check if the display is functioning properly. If this is not the case, do not continue to use the device and inform the repair services of your local Gymna dealer.

3.7 New owner

The ‘Medical Device Directive’ of the European Commission (93/42/CEE) prescribes that this type of medical equipment should be traceable. That is why we are kindly requesting every (new) owner to urgently give to the local Gymna dealer the name, address and other relevant data of the new owner.

3.8 Liquidation

Turn in the Duo 500 and all its accessories to a company specialised in the liquidation and recycling of electronic products and components. In those countries where there is a “take back” option in force, please contact your local Gymna dealer.

In the event that the owner is willing to destroy the unit himself or if he is willing to take the responsibility for doing this, the following information concerning environmental consequences might be interesting.

The parts of the Duo 500 can be classified into three categories:

1)The basic units, wiring, electrodes and the Treatment Guide are to be considered as electronic or as small chemical waste. They consist of, amongst others, lead, tin, copper, iron, a diversity of other metals and several man-made materials. In most of the countries this waste is classified as “small chemical waste”. Refer to the national regulations in force in your country for that matter.

2)Sponges, sponge sachets only hold organic material and therefore do not need any special attention.

3)Packaging materials and the Operating instructions can be recycled. Depending on the local organization of the waste disposal, they have to be turned in at dedicated collecting points or they have to be evacuated with the regular dustman/ garbage man.

NOTE:

In most of the countries it is not allowed any more to dispose off these kinds of appliances through the regular garbage disposal channels (because of the man-made plastics and of the electronic components).

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4 CONTROLS

4.1 Introduction

At the beginning of these Operating Instructions you will find an exploded view of the unit and its standard accessories. The figures below correspond to those on that plan.

4.2 Controls, connectors, standard accessories

1.Display, screen.

2.Selecting a Menu or a Parameter (yellow keys).

3.Increasing and setting of a Parameter; browsing in the lists.

4.Decreasing and setting of a Parameter; browsing in the lists.

5.Key for the Channel selection between A or B.

6.Intensity control for Channel A.

7.Intensity control for Channel B.

8.Key Menu Electrotherapy.

9.Key Start Menu.

10.Key Memory.

11.Key Enter

12.Key Pause.

13.Key Stop.

14.Key Help.

15.Key Return.

16.Indicator light Stand-by (yellow).

17.Indicator lights (yellow) Current passage per channel.

18.Connector Electrotherapy - Channel A.

19.Connector Electrotherapy – Channel B.

20.Mains voltage switch.

21.Fuse holder.

22.Input mains voltage.

23.Label with data of the unit.

24.Ventilation opening.

25.Selection Mains voltage (at the bottom of the unit).

26.Connector RS 232 for service purposes.

27.Contrast adjustment of the screen.

28.Mains voltage cable.

29.Electrode sachets, alvose.

30.Rubber electrodes.

31.Stimulating electrode with sponge.

32.Elastic fixations.

33.Adhering electrodes.

34.Adapter cables 4 mm to 2 mm to connect adhering electrodes.

35.Two-wire electrode cable.

36.Test plug V/V - 4mm.

37.Treatment Guide with Operating Instructions.

RECOMMENDATION:

CAREFULLY preserve the parts you do not use immediately.

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5 SELECTION OF A TREATMENT

5.1 Different therapeutic possibilities - generalities

The Duo 500 is equipped with two channels separated from each other and serving for electrotherapeutic purposes.

These channels can be adjusted independently from each other, this means that one can treat two different indications simultaneously and administer two different therapies.

5.2 Start menu.

There are three different methods to adjust the unit.

1. By means of the Start menu

Via the Start menu the treatment possibilities are represented step by step. These possibilities are the following:Objectives

Indication list Program number Diagnostic programs

2. By means of direct selection of the Therapeutic method.

See paragraph 5.3.

3. Recall the own designed programs by means of the treatment memory.

See Chapter 9 : TREATMENT MEMORY.

5.3 Therapeutic keys

The Therapeutic keys are at the left hand side of the screen and they constitute a rapid way to come to a treatment method.

Key Start menu

Objectives, Indication list, Program number, Diagnostic programs and the list with Contra-indications are now available.

Key Menu Electrotherapy

The current shapes can be directly selected.

Key Memory

Store the program, open it or erase it.

The different possibilities are described in detail in the following paragraphs.

See Chapter 6: GENERAL OPERATING INSTRUCTIONS for more details about the operation of the Duo 500 unit.

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5.4 Selection of a treatment method by means of OBJECTIVES

The Start menu appears automatically the moment the unit is switched on.

The Start menu also appears when pushing the Start menu key.

In the Start menu select Objectives in order to select a specific therapy method.

Select Objectives

5.4.1Objective Electrotherapy, example of a selection

Due to the fact that the objectives of the two proposed therapeutic methods Electrotherapy and Iontophoresis often are essentially different from each other, one gets the choice between those two methods.

Select Electrotherapy

Subsequently a list with Objectives for Electrotherapy follows.

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Select Pain relief

Followed by a list of specifications

Select Acute

Select ET Conventional

See paragraph 7.6 for more information about the difference between ET Conventional and ET Sequential.

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Subsequently a window appears with the recommended Therapy method (upper line on the screen), together with the parameters (see both displays below) and the advice for the intensity

(lower line of the screen).

When a parameter is selected, one is able to modify the value of the selected parameter by

using the keys and . The advice about the intensity disappears for a while and instead one sees the adjusting range of the selected parameter.

5.4.2Objective ET Iontophoresis, example of a selection

In order to select the treatment method ET Iontophoresis through Objectives, one can proceed in the same manner as was done in the representations above ‘Objectives > Electrotherapy' (see paragraph 5.4.1).

5.5 Selecting a treatment method through INDICATION LIST

The Start menu appears automatically when the unit is switched on. The Start menu also appears when pushing the key Start menu .

Out of the Start menu, one selects Indication list (see below).

Select Indications

An alphabetical list is displayed showing all the Indications on screen.

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Behind a specific Indication, there is an abbreviation of the advised Therapy method, That is to say ET = Electrotherapy and IO = Iontophoresis.

It is possible to browse through the indications by using the keysand .

Select Arteriosclerosis

After having selected one of the Indications one can either further specify it (e.g. acute), or choose from the desired therapy methods (see below).

Select Intensive, local

The display shows the recommended Therapy method, together with the parameters and the advice for the intensity, where both are tailored to the Indication.

See paragraph 6.3 for more explanation about the modification of a parameter.

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5.6Selecting a treatment method through a PROGRAMNUMBER

The Start menu appears automatically when the unit is switched on. The Start menu also appears when pushing the key Start menu

All treatment programs have their own program number.

Out of the Start menu one selects a Program number (see below).

This is the quickest way to enter into the desired program.

Select Program number

The second line (see below) gives concise information about the selected program. Select the correct program number through the keys and

Push the key

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When the desired number is reached, one pushes the key Enter

Press the Enter key

The parameter display appears immediately.

See paragraph 6.3 for more explanation about the modification of a parameter.

5.7 Selecting programs for DIAGNOSTICS

A certain number of current shapes can be applied diagnostically.

Hereby different possibilities are opened enabling the therapists to determine in a simple way the Rheobase and the Chronaxie or dressing up an S-D curve.

Through a certain number of programs one can localize and treat pain points.

The Start menu appears automatically when the unit is switched on. The Start menu also appears when pushing the key Start menu

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In order to determine for instance the Rheobase and the Chronaxie, one starts in the Start menu and one chooses Diagnostic programs.

Select Diagnostic programs

The display shows a list with program options for Diagnostics.

Select Rheobase and Chronaxie

Subsequently the parameter window Rheobase is displayed.

See Chapter 8: DIAGNOSTIC PROGRAMS for detailed information about the diagnostic possibilities of the Duo 500 unit and paragraph 6.3 for more information on how to adjust the parameters.

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5.8 Direct selection of a CURRENT SHAPE

Push the key Electrotherapy

The display shows several main groups of the current shapes (see below).

In this manner one finds and selects the desired current shape very quickly.

Select Unidirectional

The display shows a list of current shapes from which one can choose.

Select Direct current

The display immediately shows the parameters of the selected current shape.

See Chapter 14: SPECIFICATIONS for an overview of the current shapes and their parameters and paragraph 6.3 for more information on how to adjust the parameters.

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5.9 Selection of a treatment out of the MEMORY

One can store treatments in the memory and recall the stored treatments.

See Chapter 9: TREATMENT MEMORY for a detailed discussion about this principle.

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6 GENERAL OPERATING INSTRUCTIONS

6.1 Introduction

The Duo 500 offers numerous possibilities and still remains very easy to operate. The operating principle is logical and consistent. As soon as one gets acquainted with the functions of the various keys and controls, the operational use of the unit is self-explanatory.

In this chapter, the functions of the keys and controls not yet treated previously will be discussed.

See Chapter 4: CONTROLS for a short and concise description of the controls, the numbers of these controls correspond to the numbers of the exploded view of the Duo 500 unit and its accessories in the beginning of these Operating Instructions.

See Chapter 7: SOME PARTICULAR THERAPEUTICAL AND PARAMETER POSSIBILITIES.

See Chapter 18: INDEX for the alphabetical index. Here one can quickly find out on what pages of the Operating Instructions the specifically searched reference is discussed.

6.2 Electrotherapy – Display

Channel	Symbol therapy	Symbol selected	Title screen
	method	current shape		Programme number

Channel window A with			Conv. TENS		180
data about:		35:00	Pulse time	40	µs
y	Remaining
	treatment time
y	Polarity		Pulse shape			Parameters
y	Intensity setting	0				selected channel
y	Momentary		CC
	intensity
	(bar graph)		Min. frequency	50	Hz
y	CC / CV					By means of the
						yellow keys
			Max. frequency	150	Hz	besides the
						screen, the
Channel window B:						desired option
			Sweep mode			can be selected
empty here, because
	channel B is not
activated. Also used			Treatment time	35:00
	for the graphic
	representation of a
	current shape		Perceptible, comfortable
			Intensity	Arrow pointing downwards indicates
			recommendation
			(Programmes out of the	that one can browse through list by
			series Objectives /	pressing the arrow sign
			Indication list)

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6.3 Yellow keys – select menu or select parameter / modify

The function of the yellow keys is different from program to program and from menu to menu. This function corresponds to the item next to the yellow key.

Through these keys: a) one selects a menu;

After this selection one is automatically guided into the next display.

That way, one is guided step by step to a program display/treatment display.

b)one selects a parameter;

c)one modifies the selected parameter;

In order to modify the selected parameter one proceeds as follows:

•parameters subject to modifications are outlined.

•A selected parameter remains during 3 seconds into ‘reverse or negative image’. As long as the parameter remains in this reverse image, one can modify the parameter by means of the keys and

NOTE:

At the lower side of the screen one can see the setting range of the selected parameter (in 'reverse/ negative image').

Specific parameters are outlined and cannot be modified anyhow. Such a parameter can be selected however for the function HELP ?

If in the event of Interference (see below), the minimum frequency is equal to the maximum frequency, the modulation time is not relevant, and it cannot be modified either.

Parameter that can be selected but that cannot be adjusted now because of the actual parameter setting

Parameters that cannot be selected (and that cannot be modified) are not outlined (exception is the Electrode Placement).

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6.4 The UPand DOWN-keysand

These keys have a double function:

1)they allow browsing through a list,

2)they make it possible to modify the value of parameters.

6.4.1Browsing with the keys and

In the event that the screen shows more than 6 menus or parameters to make a selection, one can be transferred into different menus or parameters with the help of these keys. The browsing direction is indicated in the lower right corner of the display.

NOTE:

This is only possible when no menu or parameter has been selected.

Browsing can be done up or down. The browsing direction is visualised by the signs V and W in the lower right corner of the display (see below).

6.4.2Modifying parameters with the help of the keys and

One can modify the value of a selected parameter with the help of these keys. The longer one presses the key, the quicker the values modify.

NOTE

When releasing a key and subsequently pressing the key again, the values will modify very slowly again. When pushing the key even longer, the modifications will be carried out at a higher speed again.

The lower line of the display gives the setting range of the selected parameter.

The parameter TREATMENT TIME (see below) can be modified using the keys and

-press 1 x the Yellow Key: time modifies by the minute.

-press 2 x the Yellow Key: time modifies by the second.

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6.5 Return key

This key allows you to return to the previous window.

EXCEPTION : one can browse through a list (e.g. an Indication list) by using the keys

and .

If one is inside a list, one can always go back to the previous menu by pressing the Return key

6.6 Help key ? - Request detailed explanation

The Duo 500 assists to the maximum extent possible when setting up therapeutic treatment. Depending on the menu one is working in, it is possible to request some background

information with the aid of the Help key ?

If no parameter is selected (see below), one receives background information concerning the current shape by pressing the Help key ?

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