Mettler Sys Stim 240 User manual

®

Sys

Stim

240

*

Instruction Manual

1333 South Claudina Street • Anaheim, CA 92805, U. S. A.

Toll Free: (800) 854–9305 • Telephone: [phone] • FAX: [phone]

Web Site: http://www.mettlerelectronics.com • Email: [e-mail]

IR9–58 Rev.H_05/16/16
Copyright © 2012 by Mettler Electronics Corp.—Anaheim, CA

Mettler Electronics Corp. — Rev.H_05/16/16

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Sys*Stim 240 Instruction Manual — Rev.H_05/16/16

Table of Contents

Section Title Page

1 Introduction 5

1.1 Introduction to the Sys*Stim 240 5

1.2 Introduction to this Manual 6

1.3 Safety Precautions 6

1.4 Caution 7

1.5 Shipping Damage 7

1.6 Package Contents 8

1.7 Limited Warranty 8

2 Symbol Glossary and List of Abbreviations 9

2.1 Symbol Glossary 9

2.2 Control descriptions 13

2.3 Laser and Cluster Applicators – Controls, Output aperture and Indicators 14

2.4 List of Abbreviations 15

3 Installation 17

3.1 Installation Instructions 17

3.2 A Brief Operational Overview of the Sys*Stim 240 20

3.3 Optional setting 21

3.4 EMC Guidance 22

4 Operating Instructions 27

4.1 A Note About Electrodes 27

4.2 General Operating Instructions 28

4.3 Quick Set-up for Electrical Stimulation 29

4.4 Set-up for Light Therapy 30

4.5 Using Preset Programs 32

4.6 Saving a Treatment Protocol 33

4.7 Interferential (IFC, 4-Pole) Procedure 34

4.8 Premodulated (IFC, 2-Pole) Procedure 35

4.9 Medium Frequency (Russian) Procedure 36

4.10 Biphasic Procedure 37

4.11 High Volt Procedure 38

4.12 Microcurrent Procedure 40

4.13 TENS, Symmetrical Biphasic Procedure 41

4.14 TENS, Asymmetrical Biphasic Procedure 42

4.15 DC Low Amplitude Procedure 43

4.16 Using the pencil electrode 43

4.17 Combination Therapy Setup Procedure 45

5 Indications, Contraindications, Precautions and Adverse Reactions 47

5.1 Indications for Medium Frequency (Russian), Biphasic, High Volt Pulsed
Current (HVPC), Interferential (4P) and Premodulated (2P) waveforms

5.2 Additional Indications for Microcurrent, Interferential (4P), Premodulated
(2P), Biphasic and TENS waveforms

5.3 Indications for DC (Direct Current) Mode 47

5.4 The laser and cluster applicators of the Sys*Stim 240 emit infrared energy for: 47

47

47

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5.5 Contraindications for Neuromuscular Electrical Stimulation 47

5.6 Contraindications for Laser Light Therapy 48

5.7 Warnings for Neuromuscular Electrical Stimulation 48

5.8 Precautions for Laser Light Therapy 48

5.9 Precautions for Neuromuscular Electrical Stimulation 49

5.10 Side Effects/Adverse Reactions for Neuromuscular Electrical Stimulation 49

6 Maintenance and Troubleshooting 51

6.1 Cleaning the Sys*Stim 240 51

6.2 Routine Maintenance 51

6.3 Troubleshooting the Sys*Stim 240 52

7 References 59

8 Specifications 61

8.1 General Specifications 61

8.2 Waveform Specifications 62

8.3 Optional Laser Performance 65

8.4 Optional Applicator Specifications 65

9 Accessories 67

9.1 Ordering Information 67

9.2 Sys*Stim 240 Accessories 67

List of Figures

No. Title Page

1.1 Sys*Stim 240 5

2.1 Sys*Stim 240—Control Panel and Display 13

2.2 Laser Applicator Label Descriptions—Top 14

2.3 Laser Applicator Label Descriptions—Bottom 14

3.1 Sys*Stim 240, Bottom View Showing battery door 18

3.2 Sys*Stim 240, Bottom View—Installing the battery 19

3.3 Sys*Stim 240, Back View Showing the On/Off Switch and Power Cord and
Patient Safety Cable Connections

3.4 Sys*Stim 240, Side View Showing the Electrode Cable Connection 19

3.5 Sys*Stim 240, Side View Showing the Installation of the Applicator Holder 19

3.6 Sys*Stim 240, Front View Showing the Laser or Cluster Cable Connector 20

4.1 Touch Controls and Display 27

4.2 Electrode Sizes and Current Density 28

8.1 Interferential (IFC, 4-Pole) Waveform 62

8.2 Premodulated (IFC, 2-Pole) Waveform 62

8.3 Medium Frequency (Russian) Waveform 62

8.4 Biphasic Waveform 63

8.5 High Volt Waveform 63

8.6 Microcurrent Waveform 63

8.7 TENS, Sym. Waveform 64

8.8 TENS, Asym. Waveform 64

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Sys*Stim 240 Instruction Manual — Rev.H_05/16/16

Section 1: Introduction

1.1 Introduction to the Sys*Stim 240

Thank you for purchasing the Sys*Stim 240 two-channel neuromuscular stimulator with optional
light therapy capability. The technically advanced Sys*Stim 240 provides Interferential (4 pole),
Premodulated (2 pole), Medium Frequency (Russian), Biphasic, High Volt Pulsed Galvanic,
Microcurrent, TENS-Asymmetrical Biphasic, TENS-Symmetrical Biphasic and Galvanic (Continuous
DC) waveforms. In addition the Sys*Stim 240 offers an optional laser or cluster applicator for light
therapy.

New touch-sensitive technology has been used to make starting a treatment easy. The high­resolution color display allows you to monitor all treatment parameters continuously. The
patented M Wheel™ provides easy navigation through all of the menus.

Figure 1.1— Sys*Stim 240

Treatment protocols complete with electrode placement guidance, allow you to quickly program
treatment parameters for your patients. There is even space to save your own special treatment
protocols for each waveform and for light therapy.

The Sys*Stim 240 has an optional battery pack so that you can take either electrical stimulation or
light therapy to your patient. A carrying case is also available which holds the units and all the
accessories necessary for therapy on the road.

The Sys*Stim 240 has been certified by Intertek Testing Services to meet the requirements for ETL
Listing per the following standards:

 UL 60601-1 Standard for Safety Medical Electrical Equipment, Part 1: General

Requirements for Safety.

 CSA C22.2.601.1 M90 Medical Electrical Equipment – Part 1 General

Requirements for Safety

 IEC / EN 60601-1 Standard for Safety Medical Electrical Equipment, Part 1:

General Requirements for Safety

 IEC / EN 60601-2-10 Medical Electrical Equipment Part 2: Particular

Requirements for the Safety of Nerve and Muscle Stimulators

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 IEC / EN 60601-2-22 Medical Electrical Equipment – Part 2-22: Particular

Requirements for Safety and Essential Performance of Surgical, Cosmetic,
Therapeutic and Diagnostic Laser Equipment

 IEC / EN 60825-1 Safety of Laser Products Part 1: Equipment Classification and

Requirement

 IEC / EN 62471 Photobiological Safety of Lamps and Lamp Systems

In addition, the Sys*Stim 240 also meets the following standards for radio frequency emissions
and immunity:

 IEC / EN 60601-1-2 Medical Electrical Equipment—Part 1-2: General

Requirements for safety—Collateral Standard Electromagnetic Compatibility
Requirements and Test

 FCC 47 CFR, FCC Sub Part 18 Industrial, Scientific and Medical (ISM) Equipment

Mettler Electronics Corp. has been certified by VTT Expert Services LTD to be compliant
with EN ISO 13485:2003 and MDD 93/42/EEC Annex II requirements. In addition, Mettler is
certified by DQS Medizinprodukte GMBH to be compliant with ISO 13485:2003 (CMDCAS)
Canadian Medical Device requirements.

1.2 Introduction to This Manual

Read the contents of this manual before treating patients with the Sys*Stim 240.
This manual has been written to assist you with the safe operation of the Sys*Stim 240. It is

intended for use by the owners and operators of the Sys*Stim 240. The goal of this manual is to
direct the correct operation and maintenance of this unit.

The specifications and instructions presented in this manual are in effect at the time of its
publication. These instructions may be updated at any time at the discretion of the manufacturer.

 The operating manual is required for safe use of the unit. If you lend or transfer the unit to

another party such as a facility, be sure to provide this manual with the unit.

 Carefully read the Safety Precautions before operating the unit. Follow the precautions given.
 To prevent injury to the operator or patient or property damage, the manual uses the

following terms and symbols to represent varying levels of danger. Make sure you understand
what these symbols mean before reading the manual.

Improper handling may result in a high risk of death or serious
injury.

Improper handling may result in a risk of death or serious injury.

Improper handling may result in injury or property damage.

Calls attention to Danger, Warning, or Caution items
This particular symbol means "Electric Shock Hazard."

Indicates an action to be avoided.
This particular symbol means: "Do Not Disassemble."

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Sys*Stim 240 Instruction Manual — Rev.H_05/16/16

Indicates a mandatory action.
This particular symbol means "Remove the plug from the power

outlet."

1.3 Safety Precautions

The Sys*Stim 240 operates with high voltages. Qualified biomedical technicians with training in
neuromuscular stimulator and light therapy service should perform servicing of the Sys*Stim 240
or it should be returned directly to the factory. To maximize safety during use, the unit should be
plugged into a grounded wall outlet. General safety guidelines for medical electronic equipment
should be followed.

Service may be obtained from the manufacturer by sending the Sys*Stim 240 in its original
shipping container to Mettler Electronics Corp., 1333 South Claudina Street, Anaheim, CA 92805,
ATTN: Service Department. (Telephone toll free: (800) 854–9305, Alternate telephone number: 1
(714) 533–2221)

NOTE: All warranty repairs must be performed by Mettler Electronics Corp. or by a service facility
authorized by Mettler Electronics to perform warranty repair work.

A service manual for the Sys*Stim 240 is available from Mettler Electronics Corp. for a nominal
charge.

1.4 Caution

Rx only. Federal law restricts the sale of this device to, or on the order of a physician, dentist,
veterinarian or any other practitioner licensed by law of the state in which he practices.

The electric energy delivered by this device may possibly be lethal. Treatment should be
administered only under the direct supervision of a health care professional. The stimulus
delivered by this device may be sufficient to cause electrocution. Electrical current above 25 µC
must not flow through the thorax because it may cause a cardiac arrhythmia.

If you choose to use either the optional cluster or laser applicator, use the protective glasses on
both you and your patient to prevent eye exposure to infrared light.

1.5 Shipping Damage

Your new Sys*Stim 240 is shipped complete in one carton. Upon receipt, please inspect the carton
and the unit for visible and hidden damage. If you discover any damage, hold all shipping
materials, including the carton, and call the shipping agent who delivered the unit. They are
responsible for all damage in transit; therefore, all claims should be filed directly with them. The
factory will not be responsible for any damage in shipment, nor allow any adjustments unless
proper formal claim has been filed by the receiver against the carrier.

The carton in which your new Sys*Stim 240 was received is specially designed to protect the unit
during shipping. Please retain all shipping materials in the event that you will need to return
your unit for servicing. NOTE: All warranty repairs are to be performed by Mettler Electronics
Corp. or an authorized Mettler Electronics warranty repair center.

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1.6 Package Contents

Your new Sys*Stim 240 comes complete with all the necessary components to perform
neuromuscular electrical stimulation. Below is a list of items that are included in the shipping
carton.

1. Sys

2. Two electrode cable sets, (ME 2260)

3. One package V Trodes, 2" diameter (ME 2702)

4. One package V Trodes, 2.75" diameter )ME2703)

5. Two pin to banana adapters, (ME 2027)

6. One patient safety switch, (ME 2403)

7. Detachable U.L. listed, hospital–grade line cord (ME 7293)

8. Instruction Manual on a CD ROM

Stim 240

*

1.7 Limited Warranty

The Sys*Stim 240 neuromuscular electrical stimulation with optional light therapy is warranted
against defects in materials and workmanship for a period of two years from date of purchase. The
Sys*Stim 240 cluster and laser applicators are warranted against defects in materials and
workmanship for a period of one year from date of purchase. The battery is warranted against
defects in materials and workmanship for a period of 90 days from date of purchase. During the
applicable warranty period Mettler Electronics Corp. will, at its discretion, either repair or replace
the Product without charge for these types of defects.

For service under this warranty, the Product must be returned by the buyer within the applicable
warranty period to Mettler Electronics Corp. Shipping charges to Mettler Electronics Corp. under

this warranty must be paid by the buyer. The buyer must also include a copy of the sales receipt
or other proof of the date of purchase. If the Product is returned without proof of the date of
purchase, it will be serviced as an out–of–warranty product at Mettler Electronics Corp.'s
prevailing service rates.

Alteration, misuse, or neglect of the Product voids this warranty. Except as specifically set forth
above, Mettler Electronics Corp. makes no warranties, express or implied, including without
limitation any implied warranty of merchantability or fitness for a particular purpose, with
respect to the Product. If any implied warranties apply as a matter of law, they are limited in
duration to one year.

Mettler Electronics Corp. shall not be liable for any indirect, special, consequential or incidental
damages resulting from any defect in or use of the Product.

Any legal action brought by the buyer relating to this warranty must be commenced within one
year from the date any claim arises and must be brought only in the state or federal courts located
in Orange County, California.

Some states do not allow limitations on how long an implied warranty lasts, or the exclusion or
limitation of incidental or consequential damages, so the above limitations or exclusions may not
apply to the buyer. This warranty gives the buyer specific legal rights, and the buyer may also have
other rights which vary from state to state.

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Section 2—Symbol Glossary, Control

Descriptions and List of Abbreviations

2.1 Symbol Glossary

Stop all treatments selector

Start or pause a treatment

Enter control used to select an item.

Sys*Stim 240 Instruction Manual — Rev.H_05/16/16

Channel one selector

Channel two selector

Light (laser) therapy selector

Information selector

Interferential (4-pole) symbol

Select a preset protocol

Medium Frequency (Russian)

Biphasic

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High Volt Pulsed Galvanic

Microcurrent

TENS-Symmetrical Biphasic

TENS-Asymmetrical Biphasic

Galvanic (Continuous DC)

Amplitude Modulation (Vector, Surge and Reciprocation)

Pulse width and frequency

Frequency Modulation

Polarity functions

Time

Output intensity

Laser applicator in use

Cluster applicator in use

10

No light therapy applicator installed

Sys*Stim 240 Instruction Manual — Rev.H_05/16/16

Enter passcode

Begin or forward (not selected)

Begin or forward (selected)

Back (not selected)

Back (selected)

Time in status bar

Output in status bar

Pencil electrode function active

Battery status

Device plugged in and running on mains power supply.

Info options

System check being conducted

AC power

Attention, consult instruction manual.

Warning symbol indicates that the device emits laser energy and that proper
precautions listed in this manual need to be taken.

Type BF Equipment—Class I

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Mettler Electronics Corp. — Rev.H_05/16/16

Mains On.

Mains Off.

Fuse rating symbol

Patient safety switch symbol

Recycle the rechargeable lithium ion battery.

Rechargeable lithium ion battery, dispose of separately from other trash.

UL Recognized Component Mark

Tested to comply with FCC standards

CE mark on battery

ETL and C–ETL Listed

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2.2 Control Descriptions

Sys*Stim 240 Instruction Manual — Rev.H_05/16/16

Figure 2.1— Sys*Stim 240, control panel and display

1. Back-lit LCD display

2. Stop all treatments button

3. Channel 1 selector button

4. Enter button

5. Light (Laser) selector button

6. Information selector button

7. Channel 2 selector button

8. M Wheel™ rotary control dial

9. Start / Pause treatment button

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2.3 Laser and Cluster Applicators – Controls, Output aperture and

Indicators

1

2

3

4

5

6

Figure 2.2— Laser Applicator Label Descriptions—Top

1. Laser Output Aperture 4. “Laser Activate” Capacitance Switch

2. Aperture Warning Label 5. Increase Output Energy (repeat dosage)

3. Laser On Indicator 6. Decrease Output Energy

Laser Warning Labels

The laser applicator has four warning labels; two of these labels are visible on figure 2.2. These
two labels are the international Laser Hazard symbol which is located on the “Laser Activate”
capacitance switch pad, and the other is the yellow Laser Aperture label which has an arrow
pointing to the laser aperture at the front of the laser applicator.

The two other labels are shown in figure 2.3 below.

1 2

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Figure 2.3—Laser Applicator Label Descriptions—Bottom

1. Laser Aperture Label 2. Explanatory Label

Sys*Stim 240 Instruction Manual — Rev.H_05/16/16

Laser On Indicator

The green Laser On indicator illuminates when the laser is lasing. When the laser beam is turned
off after the treatment time has elapsed, the Laser On indicator will turn off.

Note: When the Sys*Stim 240 turned on, the Green Indicator will flash momentarily and you will
hear a brief beep, this is normal and is provided as a start-up lamp test.

Please Note: When there is a problem with the laser applicator, the Laser On indicator will glow
an amber color. The blue LEDs will not be illuminated, but it is possible that the laser diode will be
active and therefore eye protection is still warranted. If the amber indicator light comes on and
stays on when the capacitive switch is activated, return the laser applicator for service.

Laser Activate Capacitance Switch

The “Laser Activate” capacitance switch is located on the handle section of the laser applicator
membrane. The capacitance switch works by measuring the practitioner's body capacitance across
a sensing ‘Pad’. The ‘Pad’ is a rectangular shaped area and has the words “Laser Activate” on it. By
placing a finger or thumb over the ‘Pad’, the capacitance is increased and the switch is activated.
The advantage is that it requires no force to actuate, and therefore reduces the strain a
practitioner may experience holding down a mechanical switch for possibly long periods of time.

Increase/Decrease Output Energy Keys

The two membrane keys on the handle section of the applicator are used to increase or decrease
the dosage energy. During the laser treatment, these keys are locked out so that the dosage
cannot be accidentally increased.

2.4 List of Abbreviations

AM — Amplitude Modulation (intensity is changed over time)
CC — Constant Current
CV — Constant Voltage
FM — Frequency Modulation (frequency is changed over time)
Hz — Hertz (pulses per second)
J — Joules
J/cm² — Joules per square centimeter
LCD — Liquid crystal display

-6

A — Microampere (1 x 10
mA — Milliampere (1 x 10-3 ampere)

s — Microsecond (1 x 10-6 second)
ms — Millisecond (1 x 10-3 second)

mm:ss — Minutes and seconds in timer
bps — Bursts per second

pps — Pulses per second
s — Seconds

ampere)

Ser. No. — Serial Number
V — Volts
AC — Alternating Current

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Mettler Electronics Corp. — Rev.H_05/16/16

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Sys*Stim 240 Instruction Manual — Rev.H_05/16/16

Section 3—Installation

3.1 Installation Instructions

1. When installing the unit, pay attention to the following:

 Install the unit beyond the reach of possible water splashes.
 Install the unit where it will not be adversely affected by atmospheric pressure,

temperature, humidity, sunlight, dust, ventilation, salt air, sulfur, or other such harmful
substances.

 Protect the unit against instability, vibration, or impact (including during transportation).
 Do not leave the unit in locations with combustible airborne materials such as combustible

anesthetic gases mixed with oxygen, nitrogen suboxide and air, or combustible disinfecting
agents or cleaning agents mixed with air.

 Do not install the unit where chemical products are stored or where gases may be emitted.

2. The Sys

units operating in close proximity to it. Avoid operating the Sys*Stim 240 adjacent to and
simultaneously with operating shortwave devices.

3. If you have chosen the optional battery pack, install the battery as seen in Figures 3.1 and 3.2.

4. To install the optional battery first remove the power cord. Then, remove the screws located

on the back panel of the Sys*Stim 240 on either side of the specification label using a Phillips
screw driver, Figure 3.1.

5. Place the battery into the compartment as shown in Figure 3.2. Turn the unit upside down

while installing the battery.

6. Close the battery compartment lid and reattach it by tightening the Phillips head screws.

7. Connect the line cord to the back of the Sys

8. Plug the line cord into a grounded wall outlet that is rated at 100-240 VAC 50/60 Hz. Your

mains power supply must match the voltage requirements listed on the serial number label of
your device. Do not connect the Sys*Stim 240 to a power supply rated differently than that
described above.

9. The line cord comes equipped with a standard 3–prong plug. This plug provides grounding for

the Sys*Stim 240. Do not defeat its purpose by using 3–to–2 prong adapters or any other
means of attaching to a wall outlet.

Stim 240 may be susceptible to interference originating from shortwave diathermy

*

Stim 240. (See Figure 3.3)

*

10. If the optional battery is installed, it will begin charging as soon as the line cord is plugged into

the wall and the Sys*Stim 240 is turned on using the switch on the back of the unit. The
charging status will be displayed on the display. Full charging takes up to four hours. The unit
may be used while it is charging.

11. Plug the electrode cables (ME 2260) into the electrode cable connections as seen in Figure 3.4.

12. If you have chosen to purchase either the optional laser or cluster kit, then install the

applicator holders in Figure 3.5 on the side of the unit using the Phillips head screws included
with the holders. Plug in the applicator into the front of the device as seen in Figure 3.6 and
insert into the holder on the side of the unit. When using either the cluster or the laser

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Mettler Electronics Corp. — Rev.H_05/16/16

applicator, you must wear the protective glasses and instruct your patient to wear the glasses
during treatment to prevent exposing the eyes to infrared energy.

13. Finally, plug the patient safety cable into the back of the unit as shown in Figure 3.3.

14. Once you have verified proper functioning of your Sys

Stim 240, using the instructions in

*

Section 4, please go online to www.mettlerelectronics.com to register your product.

15. The optional battery pack may only be used in the Sys

Stim 240 or Sonicator 740. Do not

*

attempt to use other batteries than Mettler part number ME7401. The batter is a lithium ion
battery. Additional precautions for handling the optional battery include:

• Do not store the Sys*Stim 240 for long periods with the battery installed.

• Keep the Sys*Stim 240 plugged into the mains to assure full battery charge when
needed.

• Do not ship the Sys*Stim 240 with the battery installed.

• Avoid shorting the battery

• Do not immerse in water.

• Do not disassemble or deform the battery

• Do not expose the battery to fire.

• Do not dispose of the battery in fire.

• Avoid excessive physical shock or vibration.

• Keep out of the reach of children.

• Never use a battery that appears to have suffered abuse.

• Lithium ion batteries are recyclable.

• Regulations for disposal vary for different countries. Dispose of in accordance with local

regulations.

• Batteries are shipped with between 30% and 50% rated capacity and this provides a

minimum of 90 days shelf life when stored at 25°C. If the temperature exceeds 25°C over
this time then the shelf life will be reduced and provisions should be made to recharge
the battery periodically.

• In order to prevent parasitic drain on the battery, the electronics will go into a shutdown

mode at 2.4±0.08V/parallel-cell-group. If this should happen, the battery pack will
require an initial low charge to activate the electronics prior to the implementation of the
normal charge. Any SMBus version 1.0, or higher, compatible charger is capable of
providing this initial pre-charge.

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Figure 3.1— Sys*Stim 240, Bottom View

Showing battery door

Sys*Stim 240 Instruction Manual — Rev.H_05/16/16

Figure 3.2— Sys*Stim 240, Bottom View—

Installing the battery

Figure 3.3— Sys*Stim 240, Back View

Showing the On/Off Switch and Power Cord and Patient Safety Cable Connections

Figure 3.4— Sys*Stim 240, Side View

Showing the Electrode Cable Connection

Figure 3.5— Sys*Stim 240, Side View

Showing the Installation of the Applicator Holder

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Figure 3.6— Sys*Stim 240, Front View

Showing the Laser or Cluster Cable Connector

3.2 A Brief Operational Overview of the Sys*Stim 240

The Sys*Stim 240 has touch sensitive controls that include the patented M Wheel which is used to
scroll through menu selections and increase or decrease treatment time, stimulation intensity or
laser dosage. Below are listed some of the other features of the product.

1. Each menu item is color coded so that the clinician can determine

the status of a particular menu item. A white background denotes
an item that can be selected. A yellow background shows where
the curser is. A dark blue background indicates that you have
selected the item and now you can change its value. If a menu item
is grayed out, it cannot be selected or edited.

2. Press either the Channel 1 or Channel 2 key to go to the Electrical

Stimulation screen.

3. Press the Laser key to go to the Light Therapy screen.

4. Press the Info key to go to the Information menu.

5. Use the M Wheel to move through menu options or

increase/decrease parameter values. Sliding your finger clockwise
will move the cursor down or increase parameter values. Sliding
you finger counterclockwise will move the cursor up or decrease
parameter values.

6. Press the enter key to select a menu item.

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Sys*Stim 240 Instruction Manual — Rev.H_05/16/16

7. Press the start/pause button to begin a treatment or the pause it in

order to make changes to the electrode setup on your patient. You
can also start a treatment by simply increasing the stimulation
intensity.

8. Pressing the stop button will immediately stop all treatments that

are running.

3.3 Optional Settings

The optional settings include language for all menus and setting the volume for the audio prompts
made by the Sys*Stim 240.

1. Press the info key to enter into the information menu.

2. Use the M Wheel to scroll down to the Volume option and press

enter.

3. Use the M Wheel to select the volume that you want and press

enter. The sound you hear will increase or decrease as you look at
the bar increasing or decreasing.

4. Press enter when the Back button is lit up to return to the

information menu.

5. Use the M Wheel to scroll down to the Select Language option and

press enter.

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Mettler Electronics Corp. — Rev.H_05/16/16

6. Use the M Wheel to scroll down to the Language you want for all of

the menus and screens and press enter.

7. The new language will be set and you will return to the Information

Menu.

3.4 EMC Guidance

CAUTION: Medical Electrical Equipment needs special precautions regarding Electromagnetic

Compatibility (EMC) and needs to be installed and put into service according to the
EMC information provided in the following tables.

Portable and mobile Radio Frequency (RF) communications equipment can affect

Medical Electrical Equipment.

Accessories: Hospital Medical grade power cord of a maximum length of 120 inches or 3 meters

WARNING: The use of accessories, other than those specified, except those supplied or sold by

Mettler Electronics Corp., Incorporated as replacement parts for internal or
external components, may result in increased EMISSIONS or decreased IMMUNITY
of the Sys*Stim 240.

Guidance and manufacturer’s declaration – electromagnetic emissions

The Sys*Stim 240 is intended for use in the electromagnetic environment specified below. The
customer or the user of the Sys*Stim 240 should assure it is used in such an environment.

Emissions Test Compliance Electromagnetic environment-guidance

RF emissions

CISPR 11

Group 1 The Sys*Stim 240 must emit electromagnetic energy in

order to perform its intended function. Nearby
electronic equipment may be effected.

RF emissions

CISPR 11

Class A The Sys*Stim 240 is suitable for use in all establishments

other than domestic and those directly connected to the
public low-voltage power supply network that supplies

Harmonic emissions

Applicable

buildings used for domestic purposes.

IEC 61000-3-2

Voltage
fluctuations/flicker
emissions

IEC 61000-3-3

22

Applicable

Sys*Stim 240 Instruction Manual — Rev.H_05/16/16

Guidance and manufacturer’s declaration – electromagnetic immunity

The Sys*Stim 240 is intended for use in the electromagnetic environment specified below. The
customer or the user of the Sys*Stim 240 should assure that it is used in such an environment.

Immunity test IEC 60601

test level

Electrostatic
discharge (ESD)

±6 kV contact

±8 kV air

IEC 61000-4-2

Electrical fast
transient/burst

IEC 61000-4-4

±2 kV for power
supply lines

±1 kV for
input/output lines

Surge

IEC 61000-4-5

±1 kV differential
mode

±2 kV common
mode

Voltage dips,
short
interruptions
and voltage
variations on
power supply

<5% U

T

(>95% dip in UT)
for 0.5 cycle

40% UT
(60% dip in UT)
for 5 cycles

input lines

70% UT

IEC 61000-4-11

(30% dip in U
for 25 cycles

Compliance level Electromagnetic environment –

guidance

±6 kV contact

±8 kV air

Floors should be wood, concrete
or ceramic tile. If floors are
covered with synthetic material,
relative humidity should be at
least 30%.

±2 kV for power
supply lines

±1 kV for

Mains power quality should be
that of a typical commercial or
hospital environment.

input/output lines

±1 kV differential
mode

±2 kV common

Mains power quality should be
that of a typical commercial or
hospital environment.

mode

<5% U

T

(>95% dip in UT)
for 0.5 cycle

40% UT
(60% dip in UT)
for 5 cycles

Mains power quality should be
that of a typical commercial or
hospital environment. If the user
of the Sys*Stim 240 requires
continued operation during power
mains interruptions, it is needed
that the Sys*Stim 240 be powered

70% U

T

)

T

(30% dip in UT)

from an uninterruptible power
supply.

for 25 cycles

Power frequency

<5% U
(>95% dip in U

T

)

T

for 5 seconds

3 A/m 3 A/m Power frequency magnetic fields

<5% U

T

(>95% dip in U
for 5 seconds

)

T

(50/60 Hz)
magnetic field

IEC 61000-4-8

NOTE UT is the A.C. mains voltage prior to application of the test level.

should be at levels characteristic
of a typical location in a typical
commercial or hospital
environment.

23

Mettler Electronics Corp. — Rev.H_05/16/16

Guidance and manufacturer’s declaration – electromagnetic immunity

The Sys*Stim 240 is intended for use in the electromagnetic environment specified below. The
customer or the user of the Sys*Stim 240 should assure that it is used in such an environment.

Immunity test IEC 60601 test

level

Conducted RF
IEC 61000-4-6

Radiated RF
IEC 61000-4-3

3 Vrms
150 kHz to 80 GHz

3 V/m
80 MHz to 2.5 GHz

Complianc

e level

3 V

3 V/m

Electromagnetic environment - guidance

Portable and mobile RF communications
equipment should be used no closer to any
part of the Sys*Stim 240, including cables,
than the recommended separation distance
calculated from the equation applicable to
the frequency of the transmitter.

Recommended separation distance

d = 1.2√P

d = 1.2√P 80MHz to 800 MHz

d = 2.3√P 800MHz to 2.5 GHz

where P is the maximum output power
rating of the transmitter in watts (W)
according to the transmitter manufacturer
and d is the recommended separation
distance in meters (m).

Field strengths from fixed RF transmitters, as
determined by an electromagnetic site
survey, a should be less than the compliance
level in each frequency range.b

Interference may occur in the vicinity of
equipment marked with the following
symbol:

NOTE 1 At 80 MHz and 800 MHz, the higher frequency range applies.

NOTE 2 These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption
and reflection from structures, objects and people.

a

Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless) telephones and land

mobile radios, amateur radio, AM and FM radio broadcast and TV broadcast cannot be predicted theoretically with
accuracy. To assess the electromagnetic environment due to fixed RF transmitters, an electromagnetic site survey
should be considered. If the measured field strength in the location in which the Sys*Stim 240 is used exceeds the
applicable RF compliance level above, the Sys*Stim 240 should be observed to verify normal operation. If abnormal
performance is observed, additional measures may be necessary, such as reorienting or relocating the Sys*Stim

240.

b

Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 3 V/m.

24

Sys*Stim 240 Instruction Manual — Rev.H_05/16/16

Recommended separation distances between portable and mobile RF communications

equipment and the Sys*Stim 240

The Sys*Stim 240 is intended for use in an electromagnetic environment in which radiated RF
disturbances are controlled. The customer or the user of the Sys*Stim 240 can help prevent
electromagnetic interference by maintaining a minimum distance between portable and mobile
RF communications equipment (transmitters) and the Sys*Stim 240 as recommended below,
according to the maximum output power of the communications equipment.

Rated maximum
output power of

transmitter

W

150 kHz to 80 MHz

d = 1.2√P

Separation distance according to

frequency of transmitter

m

80 MHz to 800

800 MHz to 2.5 GHz

MHz

d = 2.3√P

d = 1.2√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

For transmitters rated at a maximum output power not listed above, the recommended separation distance d in
meters (m) can be estimated using the equation applicable to the frequency of the transmitter, where P is the
maximum output power rating of the transmitter in watts (W) according to the transmitter manufacturer.

NOTE 1 At 80 MHz and 800 MHz, the separation distance for the higher frequency range applies.

NOTE 2 These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and

reflection from structures, objects and people.

Guidance and manufacturer’s declaration

No. Mode Of

Operation

1 Unit tested to 230

VAC for CE

Unit tested to 120
VAC for US/Canada

2 Unit has two

stimulation
channels with
optional Light
therapy

Essential Performance

Degradation Allowed

Unit designed to be failure safe in
abnormal condition

Reset allowed as long as failure
safe

25

Mettler Electronics Corp. — Rev.H_05/16/16

26

Sys*Stim 240 Instruction Manual — Rev.H_05/16/16

Section 4—Operating Instructions

Figure 4.1—Touch controls and Display

4.1 A Note about Electrodes

To ensure safe operation of the Sys*Stim 240, follow the recommendations listed below:

1. We strongly encourage careful maintenance of the electrode system. This includes the lead

wires as well as the pads themselves. Worn cables and/or poor pads (or the wrong sized pads)
can have a significant impact upon treatment results.

2. We recommend the use of Mettler electrodes with this product.

3. Do not exceed the number of recommended uses listed on the instructions for V Trodes, EZ

Trodes or other reusable self–adhesive electrodes.

4. Make sure that the entire surface of the electrode is contacting the patient.

5. Do not use moist hot packs to secure electrodes.

6. To avoid skin irritation due to high current density, do not use electrodes smaller in surface

area than the 2" in diameter V Trode or EZ Trode self-adhesive electrode (ME 2702).

7. Thoroughly moisten the sponge in sponge electrodes prior to using with tap water. The sponge

should be moist. Squeeze out excess water from the sponge to prevent water from pooling
around or between the electrodes. Secure sponge electrodes to the patient’s skin with
electrode straps.

8. Do not use conductive carbon electrodes with this product.

27

Mettler Electronics Corp. — Rev.H_05/16/16

9. Do not use self-adhesive electrodes with the Direct Current mode. They will be rendered

inoperable due to the ion flow of the direct current. Use sponge type electrodes with plain tap
water moistening the sponges.

10. Whenever clinically possible, utilize the largest possible electrode to reduce local increases in

current density. In situations where small pads are required, use the lowest stimulation
intensity necessary to achieve the desired clinical results.

The table below illustrates the relationship between electrode diameter and current density. As
you can see, the current density increases rapidly when diameter decreases.

Diameter

inches

Surface Area

Square inches

1.25 1.2 8.2

2.00 3.1 3.2

3.00 7.1 1.4

1.25 inch
diameter

2.00 inch
diameter

Figure 4.2—Electrode Sizes and Current Density

4.2 General Operating Instructions:

Before you start:

a) Review precautions, contraindications and side effects/adverse reactions

listed in Section 5.

b) Use Mettler Electronics electrodes to ensure safe and effective operation.
c) Verify connection of the line cord to a grounded wall receptacle and the Sys
d) For electrical stimulation, connect electrode cables (ME 2260) into the electrode

connections for the channels that are going to be used.

e) For waveforms that have polarity such as DC, microcurrent and high voltage, the red-

tipped electrode cable is the selected polarity. The black-tipped electrode cable is the
opposite polarity.

f) When the output current remains below the setting for a certain period of time, the

setting may be automatically lowered. Check whether the electrodes are properly
attached before using the Sys*Stim 240.

g) Confirm that the attached electrodes are not touching before starting a treatment. If

you attempt to turn up the output when electrodes are too close or touching an error
message will appear, prompting you to adjust the electrodes.

h) Note: Descriptions of the symbols used on controls are in Section 2.

Current Density

mA/sq in (for 10mA)

3.00 inch
diameter

Stim 240.

*

28

Sys*Stim 240 Instruction Manual — Rev.H_05/16/16

4.3 Quick Set-up for Electrical Stimulation

1.

Turn on the mains power switch located on the back of the unit by
pressing dot on the switch to the “On” position. Image shows
switch in “Off” position.

Press either “1” or “2” to select channel one or two. Please note

2.

that Interferential mode requires both channels.

Insert the electrode cable into the channel connector for the

3.

channel that you will be using.

4.

Place the electrodes on the patient.

5.

Insert the patient safety cable into the jack located on the back of
the unit and hand the end with the button to the patient letting
him/her know that they can push this button at any time during
the treatment to stop it.

If all of the parameters are set correctly (The default treatment

6.

mode is Interferential.) press enter and then use the M Wheel by
dragging your finger in a clockwise direction to adjust the intensity
up. You will notice that if two channels are being used, they will go
up simultaneously. The intensity in the digital display will go up
and the green bar will get larger as the intensity increases. Moving
your finger around the M Wheel in a counterclockwise direction
will decrease the intensity. The time will begin to count down until
the treatment is complete. A buzzer will sound and the end-of­treatment message will appear.

If you want to adjust just one channel in a 2-channel operation,
drag your finger clockwise on the M Wheel and channel 1 will be
highlighted and then channel 2. To select one to adjust, press enter
and then adjust the intensity. If you press enter again, you can go
to the other channel to adjust it independently.

These instructions are an overview of how to start a treatment

7.

quickly. For more details about each waveform, go to its specific
instructions.

29

Mettler Electronics Corp. — Rev.H_05/16/16

4.4 Set-up for Optional Light Therapy

1.

Turn on the mains power switch located on the back of the unit by
pressing dot on the switch to the “On” position. Image shows
switch in “Off” position.

2.

Please note: in order to perform light therapy you must purchase
one of the following kits:

• 2405 Laser (785 nm, 80 mW) applicator kit: includes applicator
holders (left and right), mounting hardware, and two pairs of
protective glasses.

• 2406 Cluster (600/950 nm, 500 mW) applicator kit: includes
applicator holders (left and right), mounting hardware, and two
pairs of protective glasses.

• 2407 Applicator kit: includes the cluster (600/950 nm, 500 mW)
and laser (785 nm, 80 mW) applicators along with applicator
holders (left and right), mounting hardware, and two pairs of
protective glasses.

3.

To reduce the potential hazard associated with using the laser, two
sets of protective glasses have been supplied in the kit with the
applicator(s). It is strongly recommended that both the
practitioner and the patient wear a set of these glasses during
treatment when laser energy is being administered to prevent
inadvertent exposure to laser light energy.

4.

The laser energy emitted by this device is relatively low power but
because it is in the low red/infrared region of the visible spectrum
there is a potential hazard when using this device. Although the
laser beam is divergent and not finely focused it is possible the
laser energy can be a risk to the naked eye. The laser applicator
should never be directed at the eyes of the patient or the
practitioner, particularly during treatment.

Insert the cable from the cluster or the laser applicator into the

5.

connector located at the front of the Sys*Stim 240. You must plug
in the applicator of your choice to proceed to the next step.

6. Press the button labeled with the symbol for light therapy. Use the

M Wheel to increase the number to “01” and then press “Enter”.
Entering this code is a safety feature that prevents unauthorized
use of the laser part of the Sys*Stim 240. If you have both
applicators, you may switch them at any time. The Sys*Stim 240
will automatically recognize the type of applicator plugged in and
will make the necessary adjustments.

30

Sys*Stim 240 Instruction Manual — Rev.H_05/16/16

Press enter to select “Dose”. Adjust the time or dose using the M

7.

Wheel. Press the enter key to accept the dose value before
proceeding to the next step.

Once the desired parameters have been set, the laser output can

8.

be initiated by placing a finger or thumb over the top of the “Laser
Activate” pad on the laser treatment applicator. This pad is a
capacitance switch which relies on the capacitance of the human
body to sense when the practitioner wishes to operate the laser.
Each time suitable contact is made over the pad a beep will sound.
The glass surface of the applicator should touch the skin during
treatment.

Some treatments require the same dosage of laser energy to be

9.

applied at several different points of the patient’s body. Once the
first treatment has been performed (treatment time counted down
to zero, i.e.: Timer is 00:00) the same dosage can be achieved by
pressing the Output “Up” button once on the Laser applicator
(ensure your thumb is off the “Laser Activate” capacitance pad),
the display will show the previous dosage energy and time. Once
the laser applicator has been moved to the application point, the
laser can be activated to deliver this dosage.

When treatment is complete, leave the message stating

10.

“Treatment Complete. Press Enter to Continue.” Press “enter” only
if you wish to do another light therapy treatment. You can also
unplug the cluster or laser applicator at this time.

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Mettler Electronics Corp. — Rev.H_05/16/16

4.5 Using Preset Programs

Press the “Info” button.

1.

You will get the screen to the right. Use the M Wheel to scroll to

2.

either “Electrical Stimulation”, “Light Therapy” or “User Defined
Protocol”. Press “Enter” when you get to the one that you would
like to use.

3.

You may choose between anatomical or general protocols for
electrical stimulation or light therapy. For electrical stimulation you
may also choose a protocol by waveform type.

Each protocol will have a treatment diagram, some notes and the

4.

treatment parameters on one screen. If this is the one you want,
you will press the “Enter” key to go to the treatment screen.

5.

Once you get to the treatment screen, you can change any of the
parameters shown. You would set up the patient for the protocol
that you are using. For electrical stimulation follow the instructions
in section 4.3. For light therapy follow the instructions in section

4.4.

32

Sys*Stim 240 Instruction Manual — Rev.H_05/16/16

4.6 Saving a Treatment Protocol

1. Either select stimulation or light therapy.

2. Setup the protocol that you would like to save into memory.

3. Press the “Info” button.

4. Scroll down to “Save Current Protocol” and press “Enter”.

5. Scroll down to the channel that you have your protocol setup on or

to “Light Therapy” and press “Enter”.

6. A message box will indicate that “Save Current Protocol”

Succeeded along with a number indicating the slot it was saved
into. Press “Enter” to continue. There are ten slots for each
waveform as well as one each for the cluster or laser applicator.
The numbers are assigned in sequence.

33

Mettler Electronics Corp. — Rev.H_05/16/16

4.7 Interferential (IFC, 4-Pole) Procedure

1.

Turn on the mains power switch located on the back of the unit by
pressing dot on the switch to the “On” position. Image shows
switch in “Off” position.

2.

Press either “1” or “2” to select channel one or two. Please note
that Interferential mode requires both channels.

Insert the electrode cable into the channel connector for the

3.

channel that you will be using.

4.

Place the electrodes on the patient.

Insert the patient safety cable into the jack located on the back of

5.

the unit and hand the end with the button to the patient letting
him/her know that they can push this button at any time during
the treatment to stop it.

Use the M Wheel to scroll to any of the parameters that you would

6.

like to change. The parameters and their ranges are listed here for
your reference:
Carrier frequency: 2500, 4000 or 5000 Hz
Interference frequency 0-250 Hz
Frequency Modulation: Low set: 0-250 Hz
High set: 0-250 Hz
Preset Frequency Sweeps: 1-15 Hz, 80-150 Hz, 1-150 Hz
Vector: 10%, 40% and 100%
Type: CC or CV

If all of the parameters are set correctly press “Enter” and then use

7.

the M Wheel by dragging your finger in a clockwise direction to
adjust the intensity up. If two channels are being used, they will go
up simultaneously. The intensity in the display will go up and the
green bar will get larger as the intensity increases. Moving your
finger around the M Wheel in a counterclockwise direction will
decrease the intensity. The time will begin to count down until the
treatment is complete. A buzzer will sound and the end-of­treatment message will appear.

Please note: If you change time

during a treatment, press “Enter” once the time is entered to
restart the timer at the new time. The time will then count down
from the newly entered time. Failure to do this will cause the
treatment to go on indefinitely.

34

8.

Notes: Once you finish turning up the intensity, “Restarting” will
appear to indicate that the vector program is starting.

Sys*Stim 240 Instruction Manual — Rev.H_05/16/16

4.8 Premodulated (IFC, 2-Pole) Procedure

1.

Turn on the mains power switch located on the back of the unit by
pressing dot on the switch to the “On” position. Image shows
switch in “Off” position.

Press either “1” or “2” to select channel one or two. Please note

2.

that Reciprocation requires 2 channels.

Insert the electrode cable into the channel connector for the

3.

channel that you will be using.

4.

Place the electrodes on the patient.

5.

Insert the patient safety cable into the jack located on the back of
the unit and hand the end with the button to the patient letting
him/her know that they can push this button at any time during
the treatment to stop it.

Use the M Wheel to scroll to any of the parameters that you would

6.

like to change. The parameters and their ranges are listed here for
your reference:
Carrier frequency: 2500, 4000 or 5000 Hz
Interference frequency: 1-250 Hz
Frequency Modulation: Low set: 1-250 Hz
High set: 1-250 Hz
Preset Frequency Sweeps: 1-15 Hz, 80-150 Hz, 1-150 Hz
Amplitude Modulation:
Surge: On (s)/Off (s) 5/5, 4/12, 10/10, 10/20, 10/30,
10/50, Manual: 1-240/1-240
Recip: Ch1 (s)/Ch2 (s) 5/5, 4/12, 10/10, 10/20, 10/30,
10/50, Manual: 1-240/1-240
Ramp: 0.5, 1, 2 or 5 seconds
Type: CC or CV
Options: Channel(s) 1 or 2

If all of the parameters are set correctly, position the cursor over

7.

the output window and press “Enter”. Then use the M Wheel by
dragging your finger in a clockwise direction to adjust the intensity
up. You will notice that if two channels are being used, they will go
up simultaneously. The intensity in the digital display will go up
and the green bar will get larger as the intensity increases. Moving
your finger around the M Wheel in a counterclockwise direction
will decrease the intensity. The time will begin to count down until

35

Mettler Electronics Corp. — Rev.H_05/16/16

the treatment is complete. A buzzer will sound and the end-of­treatment message will appear. Please note: If you change time
during a treatment, press “Enter” once the time is entered to
restart the timer at the new time. The time will then count down
from the newly entered time. Failure to do this will cause the
treatment to go on indefinitely.

Notes:

8.

- You will adjust each channel separately for the “Reciprocation”
mode since both channels cannot be “On” at the same time.

- When using the “Surge” or “Reciprocation” modes, once you
turn up the intensity to the desired level, “Restarting” will appear
in a window indicating that the surge or recip program is starting.

4.9 Medium Frequency (Russian) Procedure

1.

Turn on the mains power switch located on the back of the unit by
pressing dot on the switch to the “On” position. Image shows
switch in “Off” position.

2.

Press either “1” or “2” to select channel one or two. Please note
that Reciprocation requires 2 channels.

Insert the electrode cable into the channel connector for the

3.

channel that you will be using.

Place the electrodes on the patient.

4.

5.

Insert the patient safety cable into the jack located on the back of
the unit and hand the end with the button to the patient letting
him/her know that they can push this button at any time during
the treatment to stop it.

Use the M Wheel to scroll to any of the parameters that you would

6.

like to change. The parameters and their ranges are listed here for
your reference:
Duty Cycle (%): 10, 20, 30, 40 and 50
Burst Frequency: 20-100 bps
Amplitude Modulation:
Surge: On (s)/Off (s) 5/5, 4/12, 10/10, 10/20, 10/30,
10/50, Manual: 1-240/1-240
Recip: Ch1 (s)/Ch2 (s) 5/5, 4/12, 10/10, 10/20, 10/30,
10/50, Manual: 1-240/1-240
Ramp: 0.5, 1, 2 or 5 seconds
Type: CC or CV
Options: Channel(s) 1 or 2

36

Sys*Stim 240 Instruction Manual — Rev.H_05/16/16

7.

If all of the parameters are set correctly, position the cursor over
the output window and press “Enter”. Then use the M Wheel by
dragging your finger in a clockwise direction to adjust the intensity
up. You will notice that if two channels are being used, they will go
up simultaneously. The intensity in the digital display will go up
and the green bar will get larger as the intensity increases. Moving
your finger around the M Wheel in a counterclockwise direction
will decrease the intensity. The time will begin to count down until
the treatment is complete. A buzzer will sound and the end-of­treatment message will appear. Please note: If you change time
during a treatment, press “Enter” once the time is entered to
restart the timer at the new time. The time will then count down
from the newly entered time. Failure to do this will cause the
treatment to go on indefinitely.

Notes:

8.

- You will adjust each channel separately for the “Reciprocation”
mode since both channels cannot be “On” at the same time.

- When using the “Surge” or “Reciprocation” modes, once you
turn up the intensity to the desired level, “Restarting” will appear
in a window indicating that the surge or recip program is starting.

4.10 Biphasic Procedure

1. Turn on the mains power switch located on the back of the unit by

pressing dot on the switch to the “On” position. Image shows
switch in “Off” position.

2. Press either “1” or “2” to select channel one or two. Please note

that Reciprocation requires 2 channels.

3. Insert the electrode cable into the channel connector for the

channel that you will be using.

4. Place the electrodes on the patient.

5. Insert the patient safety cable into the jack located on the back of

the unit and hand the end with the button to the patient letting
him/her know that they can push this button at any time during
the treatment to stop it.

37

Mettler Electronics Corp. — Rev.H_05/16/16

6. Use the M Wheel to scroll to any of the parameters that you would

like to change. The parameters and their ranges are listed here for
your reference:
Frequency: 1-200 pps
Phase Duration 20-400 µs
Amplitude Modulation:
Surge: On (s)/Off (s) 5/5, 4/12, 10/10, 10/20, 10/30,
10/50, Manual: 1-240/1-240
Recip: Ch1 (s)/Ch2 (s) 5/5, 4/12, 10/10, 10/20, 10/30,
10/50, Manual: 1-240/1-240
Ramp: 0.5, 1, 2 or 5 seconds
Type: CC or CV
Options: Channel(s) 1 or 2

7. If all of the parameters are set correctly, position the cursor over

the output window and press “Enter”. Then use the M Wheel by
dragging your finger in a clockwise direction to adjust the intensity
up. You will notice that if two channels are being used, they will go
up simultaneously. The intensity in the digital display will go up
and the green bar will get larger as the intensity increases. Moving
your finger around the M Wheel in a counterclockwise direction
will decrease the intensity. The time will begin to count down until
the treatment is complete. A buzzer will sound and the end-of­treatment message will appear. Please note: If you change time
during a treatment, press “Enter” once the time is entered to
restart the timer at the new time. The time will then count down
from the newly entered time. Failure to do this will cause the
treatment to go on indefinitely.

8. Notes:

- You will adjust each channel separately for the “Reciprocation”
mode since both channels cannot be “On” at the same time.

- When using the “Surge” or “Reciprocation” modes, once you
turn up the intensity to the desired level, “Restarting” will appear
in a window indicating that the surge or recip program is starting.

4.11 High Volt Procedure

1.

Turn on the mains power switch located on the back of the unit by
pressing dot on the switch to the “On” position. Image shows
switch in “Off” position.

Press either “1” or “2” to select channel one or two. Please note

2.

that Reciprocation requires 2 channels.

3.

Insert the electrode cable into the channel connector for the
channel that you will be using.

38

Sys*Stim 240 Instruction Manual — Rev.H_05/16/16

4.

Place the electrodes on the patient.

5.

Insert the patient safety cable into the jack located on the back of
the unit and hand the end with the button to the patient letting
him/her know that they can push this button at any time during
the treatment to stop it.

6.

Use the M Wheel to scroll to any of the parameters that you would
like to change. The parameters and their ranges are listed here for
your reference:
Polarity: Positive or Negative
Frequency: 10-120 pps
Frequency Modulation: 1-10, 80-120, 1-120 pps
Amplitude Modulation:
Surge: On (s)/Off (s) 5/5, 4/12, 10/10, 10/20, 10/30,
10/50, Manual: 1-240/1-240
Recip: Ch1 (s)/Ch2 (s) 5/5, 4/12, 10/10, 10/20, 10/30,
10/50, Manual: 1-240/1-240
Ramp: 0.5, 1, 2 or 5 seconds
Display: Voltage or Current
Options: Channel(s) 1 or 2

Please note: Frequency Modulation is not available in 2 channel
mode in the interest of patient comfort.

7.

If all of the parameters are set correctly, position the cursor over
the output window and press “Enter”. Then use the M Wheel by
dragging your finger in a clockwise direction to adjust the intensity
up. You will notice that if two channels are being used, they will go
up simultaneously. The intensity in the digital display will go up
and the green bar will get larger as the intensity increases. Moving
your finger around the M Wheel in a counterclockwise direction
will decrease the intensity. The time will begin to count down until
the treatment is complete. A buzzer will sound and the end-of­treatment message will appear. Please note: If you change time
during a treatment, press “Enter” once the time is entered to
restart the timer at the new time. The time will then count down
from the newly entered time. Failure to do this will cause the
treatment to go on indefinitely.

8.

Notes:

- You will adjust each channel separately for the “Reciprocation”
mode since both channels cannot be “On” at the same time.

- When using the “Surge” or “Reciprocation” modes, once you
turn up the intensity to the desired level, “Restarting” will appear
in a window indicating that the surge or recip program is starting.

- Stated polarity is for the red lead wire.

39

Mettler Electronics Corp. — Rev.H_05/16/16

4.12 Microcurrent Procedure

1.

Turn on the mains power switch located on the back of the unit by
pressing dot on the switch to the “On” position. Image shows
switch in “Off” position.

2. Press either “1” or “2” to select channel one or two.

Insert the electrode cable into the channel connector for the

3.

channel that you will be using.

4.

Place the electrodes on the patient.

5.

Insert the patient safety cable into the jack located on the back of
the unit and hand the end with the button to the patient letting
him/her know that they can push this button at any time during
the treatment to stop it.

6. Use the M Wheel to scroll to any of the parameters that you would

like to change. The parameters and their ranges are listed here for
your reference:
Polarity: Positive, Negative or Both
Phase Duration: 1-1,000 ms
Frequency: 0.5-500 pps
Options: Channel(s) 1 or 2

7.

If all of the parameters are set correctly, position the cursor over
the output window and press “Enter”. Then use the M Wheel by
dragging your finger in a clockwise direction to adjust the intensity
up. You will notice that if two channels are being used, they will go
up simultaneously. The intensity in the digital display will go up
and the green bar will get larger as the intensity increases. Moving
your finger around the M Wheel in a counterclockwise direction
will decrease the intensity. The time will begin to count down until
the treatment is complete. A buzzer will sound and the end-of­treatment message will appear.

Please note: If you change time

during a treatment, press “Enter” once the time is entered to
restart the timer at the new time. The time will then count down
from the newly entered time. Failure to do this will cause the
treatment to go on indefinitely.

8.

Notes:

- Stated polarity is for the red lead wire.

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4.13 TENS, Symmetrical Biphasic Procedure

1.

Turn on the mains power switch located on the back of the unit by
pressing dot on the switch to the “On” position. Image shows
switch in “Off” position.

2.

Press either “1” or “2” to select channel one or two.

3.

Insert the electrode cable into the channel connector for the
channel that you will be using.

4.

Place the electrodes on the patient.

5.

Insert the patient safety cable into the jack located on the back of
the unit and hand the end with the button to the patient letting
him/her know that they can push this button at any time during
the treatment to stop it.

6.

Use the M Wheel to scroll to any of the parameters that you would
like to change. The parameters and their ranges are listed here for
your reference:
Phase Duration: 20-1,000 µs
Frequency: 1-250 pps
Frequency Modulation: 0-250 pps
Amplitude Modulation: 40, 60, 80, and 100%
Burst frequency: 0-30 bps
Type: CC or CV
Options: Channel(s) 1 or 2

Please note: Frequency Modulation is not available in 2 channel
mode in the interest of patient comfort.

7.

If all of the parameters are set correctly, position the cursor over
the output window and press “Enter”. Then use the M Wheel by
dragging your finger in a clockwise direction to adjust the intensity
up. You will notice that if two channels are being used, they will go
up simultaneously. The intensity in the digital display will go up
and the green bar will get larger as the intensity increases. Moving
your finger around the M Wheel in a counterclockwise direction
will decrease the intensity. The time will begin to count down until
the treatment is complete. A buzzer will sound and the end-of­treatment message will appear.

Please note: If you change time

during a treatment, press “Enter” once the time is entered to
restart the timer at the new time. The time will then count down

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from the newly entered time. Failure to do this will cause the
treatment to go on indefinitely.

Notes:

8.

- FM and Burst may not be used simultaneously.

- FM may not be used if two channels are selected.

- When using the “AM” mode, once you turn up the intensity to
the desired level, “Restarting” will appear in a window indicating
that AM is starting.

4.14 TENS, Asymmetrical Biphasic Procedure

1.

Turn on the mains power switch located on the back of the unit by
pressing dot on the switch to the “On” position. Image shows
switch in “Off” position.

Press either “1” or “2” to select channel one or two.

2.

Insert the electrode cable into the channel connector for the

3.

channel that you will be using.

4.

Place the electrodes on the patient.

5.

Insert the patient safety cable into the jack located on the back of
the unit and hand the end with the button to the patient letting
him/her know that they can push this button at any time during
the treatment to stop it.

6.

Use the M Wheel to scroll to any of the parameters that you would
like to change. The parameters and their ranges are listed here for
your reference:
Phase Duration: 20-1,000 µs
Frequency: 1-250 pps
Frequency Modulation: 0-250 pps
Amplitude Modulation: 40, 60, 80, and 100%
Burst frequency: 0-30 bps
Type: CC or CV
Options: Channel(s) 1 or 2

Please note: Frequency Modulation is not available in 2 channel
mode in the interest of patient comfort.

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7.

If all of the parameters are set correctly, position the cursor over
the output window and press “Enter”. Then use the M Wheel by
dragging your finger in a clockwise direction to adjust the intensity
up. You will notice that if two channels are being used, they will go
up simultaneously. The intensity in the digital display will go up
and the green bar will get larger as the intensity increases. Moving
your finger around the M Wheel in a counterclockwise direction
will decrease the intensity. The time will begin to count down until
the treatment is complete. A buzzer will sound and the end-of­treatment message will appear. Please note: If you change time
during a treatment, press “Enter” once the time is entered to
restart the timer at the new time. The time will then count down
from the newly entered time. Failure to do this will cause the
treatment to go on indefinitely.

Notes:

8.

- FM and Burst may not be used simultaneously.

- FM may not be used if two channels are selected.

- When using the “AM” mode, once you turn up the intensity to
the desired level, “Restarting” will appear in a window indicating
that AM is starting.

4.15 DC Low Amplitude Procedure

1.

Turn on the mains power switch located on the back of the unit by
pressing dot on the switch to the “On” position. Image shows
switch in “Off” position.

2.

Press either “1” or “2” to select channel one or two.

Insert the electrode cable into the channel connector for the

3.

channel that you will be using.

4.

Place the electrodes on the patient. For this waveform use sponge
electrodes only. Do not use V Trodes.

5.

Insert the patient safety cable into the jack located on the back of
the unit and hand the end with the button to the patient letting
him/her know that they can push this button at any time during
the treatment to stop it.

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6.

Use the M Wheel to scroll to any of the parameters that you would
like to change. The parameters and their ranges are listed here for
your reference:
Polarity: Positive or Negative
Amplitude Modulation:
Surge: On (s)/Off (s) 5/5, 4/12, 10/10, 10/20, 10/30,
10/50, Manual: 1-240/1-240
Recip: Ch1 (s)/Ch2 (s) 5/5, 4/12, 10/10, 10/20, 10/30,
10/50, Manual: 1-240/1-240
Polarity Reversal: If “On” then at 50% of the treatment
time the polarity will reverse.
Options: Channel(s) 1 or 2

7.

If all of the parameters are set correctly, position the cursor over
the output window and press “Enter”. Then use the M Wheel by
dragging your finger in a clockwise direction to adjust the intensity
up. You will notice that if two channels are being used, they will go
up simultaneously. The intensity in the digital display will go up
and the green bar will get larger as the intensity increases. Moving
your finger around the M Wheel in a counterclockwise direction
will decrease the intensity. The time will begin to count down until
the treatment is complete. A buzzer will sound and the end-of­treatment message will appear. Please note: If you change time
during a treatment, press “Enter” once the time is entered to
restart the timer at the new time. The time will then count down
from the newly entered time. Failure to do this will cause the
treatment to go on indefinitely.

8. Notes:

- Stated polarity is for the red lead wire.

4.16 Using the pencil electrode

The pencil electrode is used for the stimulation of small muscles or painful areas. It is also useful to
help identify the exact motor point of a muscle or muscle group. It is used by a therapist for short
periods of time only. Due to its small surface area and large current density, the pencil point
attachment should only be used briefly (a few seconds only) for treating high pain areas. The
attachment that is the size of a quarter is suited for finding motor points and manual stimulation
protocols.

1. Turn on the mains power switch located on the back of the unit by

pressing dot on the switch to the “On” position. Image shows
switch in “Off” position.

2. Press the “Info” button.

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3. You will get the screen to the right. Use the M Wheel to scroll to

either “Use Pencil Electrode”. Press “Enter” when you get to it and
then select which channel you would like to use for combination
therapy. This will defeat the sensor that detects whether an
electrode has become disconnected and you will be able to use the
pencil electrode successfully. The symbol for pencil electrode will
appear in that channel’s status window.

4. Press either “1” or “2” to the channel that you just enabled the use

of the pencil electrode.

5. Insert the electrode cable into the channel connector for the

channel that you will be using. Attach the pencil electrode to the
black electrode cable using a pin to banana adapter. Attach the red
electrode cable to a dispersive pad. Apply dispersive electrode in
such a manner to prevent transthoracic stimulation.

6. Pressing the switch located on the pencil electrode will allow

treatment currents to be delivered to the patient. Four tips of
different sizes are included with the pencil electrode. The figure on
the left shows an application of the pencil electrode.

7. With the button depressed on the pencil electrode adjust the

intensity of the simulation up to the desired level. Typically you will
use only continuous modes when using the pencil electrode.
Releasing the button will stop the stimulation.

4.17 Combination Therapy Setup Procedure

Application of simultaneous therapeutic ultrasound and electrical neuromuscular stimulation can
be accomplished using the Sys*Stim 240 with any Sonicator® therapeutic ultrasound unit from
Mettler Electronics Corp.

1. Turn on the mains power switch located on the back of the unit by

pressing dot on the switch to the “On” position. Image shows
switch in “Off” position.

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2. Press the “Info” button.

3. You will get the screen to the right. Use the M Wheel to scroll to

either “Use Pencil Electrode”. Press “Enter” when you get to it and
then select which channel you would like to use for combination
therapy. This will defeat the sensor that detects whether an
electrode has become disconnected and you will be able to do
combination therapy successfully. The symbol for pencil electrode
will appear in that channel’s status window.

4. Press either “1” or “2” to the channel that you just enabled the use

of the ultrasound applicator.

5. Insert the electrode cable into the channel connector for the

channel that you will be using. Plug in the black end of the lead
wire into the receptacle on the ultrasound indicated with the
mark. For most Sonicators this will require a pin to banana adapter.
The red lead wire is connected to a dispersive electrode which is
applied to the patient to complete the electrical circuit. When the
electrical output is generated by the stimulator, it will be passed
through the metal ring on the applicator head by means of this
connection.

6. Please review all therapeutic ultrasound precautions and

contraindications listed in the Sonicator instruction manual before
proceeding with combination therapy.

7. The timer on the Sonicator will control the length of time

Ultrasound + Stimulat ion

Application

Dispersive Electrode

ultrasound is delivered. Press “Start” on the Sonicator 740 and
adjust the intensity the Sys*Stim 240 to begin treatment. The
ultrasound intensity is adjusted on the ME 740. When the selected
time has completed on the Sonicator 740, press “Stop” on the
Sys*Stim 240 before removing the applicator from the patient.
This will turn off the stimulation output to the applicator.

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Section 5—Indications, Contraindications,

Precautions and Adverse Reactions

5.1 Indications for Medium Frequency (Russian), Biphasic, High

Volt Pulsed Current (HVPC), Interferential (4P) and
Premodulated (2P) waveforms

 Relaxation of muscle spasms
 Prevention or retardation of disuse atrophy
 Increase local blood circulation
 Muscle re-education
 Maintaining or increasing range of motion
 Immediate post-surgical stimulation of calf muscles to prevent venous thrombosis

5.2 Additional Indications for Microcurrent, Interferential (4P),

Premodulated (2P), Biphasic and TENS waveforms

 Symptomatic relief and management of chronic, intractable pain
 Post-traumatic acute pain
 Post-surgical acute pain

5.3 Indications for DC (Direct Current) Mode

 Relaxation of muscle spasm

5.4 The laser and cluster applicators of the Sys

Stim 240 emit

*

infrared energy for:

 Temporary increase in local blood circulation
 Temporary relief of minor muscle and joint aches, pains and stiffness
 Relaxation of muscles
 Temporary relief of muscle spasms
 Temporary relief of minor pain and stiffness associated with arthritis

5.5 Contraindications for Neuromuscular Electrical Stimulation

1. Powered muscle stimulators should not be used on patients with cardiac demand

pacemakers.

2. Do not use this device on patients who have a cardiac pacemaker, implanted defibrillator, or

other implanted metallic or electronic device, because this may cause electric shock, burns,
electrical interference, or death.

3. Do not use this device on patients whose pain syndromes are undiagnosed.

4. Do not use electrical stimulation in conjunction with high frequency surgical equipment or

microwave or shortwave therapy systems.

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5.6 Contraindications for use of a Therapeutic Laser

1. Avoid direct irradiation of the eyes.

2. Do not use within 4 to 6 months after radiation therapy.

3. Do not use over hemorrhaging regions

4. Do not treat locally over the endocrine glands.

5. Do not treat ischemic tissues in individuals with vascular disease where the blood supply

would be unable to follow the increase in metabolic demand and tissue necrosis might result.

5.7 Warnings for Neuromuscular Electrical Stimulation

1. The long-term effects of chronic electrical stimulation are unknown.

2. Stimulation should not be applied over the carotid sinus nerves, particularly in patients with a

known sensitivity to the carotid sinus reflex.

3. Stimulation should not be applied over the neck or mouth. Severe spasm of the laryngeal and

pharyngeal muscles may occur and the contractions may be strong enough to close the airway
or cause difficulty in breathing.

4. Stimulation should not be applied transthoracically in that the introduction of electrical

current into the heart may cause cardiac arrhythmias.

5. Stimulation should not be applied transcerebrally.

6. Stimulation should not be applied over swollen, infected, or inflamed areas or skin eruptions,

e.g., phlebitis, thrombophlebitis, varicose veins, etc.

7. Stimulation should not be applied over, or in proximity to, cancerous lesions.

8. Consult with the patient’s physician before using this device, because the device may cause

lethal rhythm disturbances to the heart in susceptible individuals.

9. Apply stimulation only to normal, intact, clean, healthy skin.

10. Do not apply stimulation in the presence of electronic monitoring equipment (e.g., cardiac

monitors, ECG alarms), which may not operate properly when the electrical stimulation device
is in use.

5.8 Precautions for Neuromuscular Electrical Stimulation

1. Safety of powered muscle stimulators for use during pregnancy has not been established.

2. Caution should be used for patients with suspected or diagnosed heart problems.

3. Caution should be used for patients with suspected or diagnosed epilepsy.

4. Caution should be used in the presence of the following:

a. When there is a tendency to hemorrhage following acute trauma or fracture;
b. Following recent surgical procedures when muscle contraction may disrupt the healing
process;
c. Over the menstruating or pregnant uterus; and
d. Over areas of the skin which lack normal sensation.

5. Some patients may experience skin irritation or hypersensitivity due to the electrical

stimulation or electrical conductive medium. The irritation can usually be reduced by using an
alternate conductive medium or alternate electrode placement.

6. Electrode placement and stimulation settings should be based on the guidance of the

prescribing practitioner.

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7. Powered muscle stimulators should be kept out of the reach of children.

8. Powered muscle stimulators should be used only with the leads and electrodes recommended

for use by Mettler Electronics Corp.

9. TENS is not effective for pain of central origin, including headache.

10. TENS is not a substitute for pain medications and other pain management therapies.

11. TENS devices have no curative value.

12. TENS is a symptomatic treatment and, as such, suppresses the sensation of pain that would

otherwise serve as a protective mechanism.

13. The long-term effects of electrical stimulation are unknown.

14. Since the effects of stimulation of the brain are unknown, stimulation should not be applied

across the head, and electrodes should not be placed on opposite sides of the head.

15. It is advisable to insulate patients, preferably by use of a wooden treatment table or one that is

completely padded by non–conductive material. Added safety is provided if the patient cannot
touch any grounded metal parts.

16. Limit treatment intensity to 50 mA (50 V) or less, when using small electrodes (2" diameter), to

reduce the chance of thermal burns due to high current density. Avoid current densities
exceeding 2 mA/cm² when using this device.

17. Turn on the stimulator before applying electrodes to the patient.

5.9 Precautions for use of a Therapeutic Laser

1. Only authorized and trained practitioners are to apply the treatment.

2. Protective eyewear to be used always.

3. Ensure shiny patient jewelry is removed from treatment region.

4. Avoid treatment over shiny surfaces.

5. Switch Laser On before applicator is touching the skin, use blue target illumination to direct

treatment to desired application area and then slowly move applicator toward skin surface for
contact. The applicator should be touching the skin during treatment.

6. Use laser therapy only on or over the treatment region.

7. Never look into laser beam or laser aperture.

8. Laser therapy should not be applied in areas of reduced sensation or circulation. Patients

having reduced sensation will not be able to notify the practitioner of discomfort if the
intensities are too high.

5.10 Side Effects/Adverse Reactions for Neuromuscular Electrical

Stimulation

1. Skin irritation and burns beneath the electrodes have been reported with the use of powered

muscle stimulators.

2. Patients may experience headache and other painful sensations during or following the

application of electrical stimulation near the eyes and to the head and face.

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Sys*Stim 240 Instruction Manual — Rev.H_05/16/16

Section 6—Maintenance and Troubleshooting

6.1 Cleaning the Sys*Stim 240

1. The Sys

from the unit before this is done. In the case of stubborn dirt a gentle household cleaner can
be sprayed on the cloth and then wiped on the unit. If this method is used, remove any
cleaner residue with a damp cloth. Do not spray cleaner into the vents of the unit.

2. Do not allow any liquids to penetrate the unit or its accessories while cleaning and

disinfecting. Dry all sockets and connectors that have become wet before any further use!

3. Follow the V Trode package insert for the use and care of the electrodes supplied with the

Sys*Stim 240.

4. For routine cleaning of the electrode cables use soap and water. Thoroughly dry after

cleaning.

5. Even though the patient treatment applicators do not contact open wounds or broken skin it

is still possible for them to carry infections by the mere fact that they contact bare skin. The
applicators should be thoroughly cleaned after a treatment session with one patient is
completed prior to a new session beginning with another patient. The treatment applicators
are not suitable for autoclaving.

Stim 240 can be wiped off with a damp cloth. The power cord should be disconnected

*

6. The treatment applicators should be kept free from any build up of material particularly on

the glass cover protecting the laser diode in the tip of the applicator. Regular cleaning with a
damp cloth soaked in a mixture of mild soap and water is recommended. Note: The Laser or
Cluster Applicator must be disconnected from the front panel socket when cleaning. This is a
precaution to ensure the laser applicator has no power and therefore cannot activate while
looking at the cover glass.

7. If there are concerns about cross infection the applicator's surface which contacts the patient

can be wiped with a surface disinfectant. Care should be taken not to contact the grey plastic
parts of the treatment applicator with the disinfectant.

8. If sponge electrodes are used, clean them with soap and water and thoroughly rinse them to

remove any soap residue.

6.2 Routine Maintenance

1. Standard medical electrical safety checks should be performed annually by qualified

biomedical engineers or technicians trained to perform these procedures. If the light therapy
option is installed, output must be verified on an annual basis. Please refer to the
Maintenance Manual for the cluster and laser calibration procedures or return the product to
Mettler for calibration.

2. Inspect electrode cables and associated connectors for damage.

3. Inspect the light therapy applicator cables and their connectors for damage.

4. The applicator is an integral part of delivering safe and effective laser and light therapy. Avoid

rough handling of the laser and cluster applicators since they are relatively fragile and can be
damaged if dropped or otherwise abused.

5. Never open the Sys

Stim 240. Doing so may lead to malfunctions or accidents.

*

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6. Do not damage, break, modify, bend forcibly, tug on, twist, or bundle the electrode cord. If a

heavy object is placed on the cord or it is pinched or modified, the cord may be damaged,
resulting in fire, electric shock, or other accident.

7. In order to separate the two lead wires, do not pull on them. Use a sharp pair of scissors using

the indentation down the middle of the lead wire as a guide.

8. When cleaning the unit, do not wipe using paint thinner, gasoline, kerosene, polishing

powder, hot water, or chemicals to prevent discoloration of the main unit and applicators.
Wipe with a cloth soaked in cold water or lukewarm water and then wrung out.

9. If you plan to use a unit that has been left standing for some time, always check to ensure that

the unit functions normally and safely.

6.3 Troubleshooting the Sys*Stim 240

Symptom Action

1. Nothing lights when main power

switch is turned on.

Is line cord connected to outlet?
Does the outlet have power?

Unit may require servicing if none of the above
resolves the problem.

2. Self-Test Failed Turn off the unit and then back on again. If the error

persists the Sys*Stim 240 requires servicing.

3. Screen goes blank or comes up

blank.

There has been an either a hardware or software
error. All patient output has been terminated. Remove
the electrode cables from the unit. Then turn the unit
Off and turn it back ON and retry the treatment. If this
does not correct the problem, the unit requires
servicing. Report the error to service provider to assist
with hardware troubleshooting.

4. Warning - Battery Power Low Plug into wall outlet with the power switch in the “On”

position to charge the battery.

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5. Error E60 - Output Voltage Error There is an output voltage error for electrical

stimulation. This error happens only in constant
voltage mode, when the output voltage exceeds the
target voltage by 20%.

Press “Enter” to return to the waveform screen. Press
the “Start/Pause” key and to restart the treatment and
return to the previously set intensity.

Or press the “Stop” button to stop the treatment and
return to the treatment screen. Pressing the
“Start/Pause” key will restart the treatment at the
beginning. You will need to press “Enter” to begin to
increase the intensity and start the treatment.

If the above does not correct the error. Remove the
electrode cables from the unit. Then turn the unit Off
and turn it back ON and retry the treatment. If this
does not correct the problem, the unit requires
servicing. Report the error to service provider to assist
with hardware troubleshooting.

6. Check Patient Contact This message will appear in the status bar when

intensity is being turned up when the current is not
flowing properly due to electrodes or cables. It will
appear at 5 mA in continuous current or 50 volts in
high volt. Check all cables and electrodes for the
channel that is affected. Then resume turning up the
intensity.

7. Error E65 – Voltage too low

Press “Enter” to return to the waveform screen. Check
the electrodes. Check the electrode cable connections
to make sure that they are connected. Make sure both
electrodes are attached to the cables and to the
patient. Try fresh electrodes and or cables to resolve
this problem.

Press the “Start/Pause” key and to restart the
treatment and return to the previously set intensity.

Or press the “Stop” button to stop the treatment and
return to the treatment screen. Pressing the
“Start/Pause” key will restart the treatment at the
beginning. You will need to press “Enter” to begin to
increase the intensity and start the treatment.

If the above does not correct the error. Remove the
electrode cables from the unit. Then turn the unit Off
and turn it back ON and retry the treatment. If this
does not correct the problem, the unit requires
servicing. Report the error to service provider to assist
with hardware troubleshooting.

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8. Error E70 - Impedance Too High Appears when a current flow is interrupted during

treatment. (e.g., an electrode is detached from the
treatment area, electrode partially detached,
electrodes worn out or electrode cable either not
connected or damaged).

Press “Enter” to return to the waveform screen. Check
the electrodes. Check the electrode cable connections
to make sure that they are connected. Make sure both
electrodes are attached to the cables and to the
patient. Try fresh electrodes and or cables to resolve
this problem.

Press the “Start/Pause” key and to restart the
treatment and return to the previously set intensity.

Or press the “Stop” button to stop the treatment and
return to the treatment screen. Pressing the
“Start/Pause” key will restart the treatment at the
beginning. You will need to press “Enter” to begin to
increase the intensity and start the treatment.

If the above does not correct the error. Remove the
electrode cables from the unit. Then turn the unit Off
and turn it back ON and retry the treatment. If this
does not correct the problem, the unit requires
servicing. Report the error to service provider to assist
with hardware troubleshooting.

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9. Error E80 - Overcurrent Error Appears when the current level spikes (e.g., the

electrode is partly detached from the treatment area
or moved out of position).

Press “Enter” to return to the waveform screen. Check
the electrodes. Check the electrode cable connections
to make sure that they are connected. Make sure both
electrodes are attached to the cables and to the
patient. Try fresh electrodes and or cables to resolve
this problem.

Press the “Start/Pause” key and to restart the
treatment and return to the previously set intensity.

Or press the “Stop” button to stop the treatment and
return to the treatment screen. Pressing the
“Start/Pause” key will restart the treatment at the
beginning. You will need to press “Enter” to begin to
increase the intensity and start the treatment.

If the above does not correct the error. Remove the
electrode cables from the unit. Then turn the unit Off
and turn it back ON and retry the treatment. If this
does not correct the problem, the unit requires
servicing. Report the error to service provider to assist
with hardware troubleshooting.

10. Error E85 – Current too low Check the electrodes. Resume the treatment by doing

the following:
Press “Enter” to return to the waveform screen. Check

the electrodes. Check the electrode cable connections
to make sure that they are connected. Make sure both
electrodes are attached to the cables and to the
patient. Try fresh electrodes and or cables to resolve
this problem.

Press the “Start/Pause” key and to restart the
treatment and return to the previously set intensity.

Or press the “Stop” button to stop the treatment and
return to the treatment screen. Pressing the
“Start/Pause” key will restart the treatment at the
beginning. You will need to press “Enter” to begin to
increase the intensity and start the treatment.

If the above does not correct the error. Remove the
electrode cables from the unit. Then turn the unit Off
and turn it back ON and retry the treatment. If this
does not correct the problem, the unit requires
servicing. Report the error to service provider to assist
with hardware troubleshooting.

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11. Error E90 - Impedance Too Low Check the electrodes. Move further apart, make sure

the area between the electrodes is clean and dry and
then resume treatment by doing the following:

Press “Enter” to return to the waveform screen. Check
the electrodes. Check the electrode cable connections
to make sure that they are connected. Make sure both
electrodes are attached to the cables and to the
patient. Try fresh electrodes and or cables to resolve
this problem.

Press the “Start/Pause” key and to restart the
treatment and return to the previously set intensity.

Or press the “Stop” button to stop the treatment and
return to the treatment screen. Pressing the
“Start/Pause” key will restart the treatment at the
beginning. You will need to press “Enter” to begin to
increase the intensity and start the treatment.

If the above does not correct the error. Remove the
electrode cables from the unit. Then turn the unit Off
and turn it back ON and retry the treatment. If this
does not correct the problem, the unit requires
servicing. Report the error to service provider to assist
with hardware troubleshooting.

12. Error E100, E101, E102, E103, E104,

E105, E106 – System errors

Remove electrode cables from the Sys*Stim 240. Turn
power off and on again. Plug the cables back in, set up
resume treatment. If the error repeats, the Sys*Stim
240 requires servicing. Report the error to service
provider to assist with hardware troubleshooting.

13. Error E110, E111, E112, E113, E

120, E121, E122, E123 – System
errors

Remove electrode cables from the Sys*Stim 240. Turn
power off and on again. Plug the cables back in, set up
resume treatment. If the error repeats, the Sys*Stim
240 requires servicing. Report the error to service
provider to assist with hardware troubleshooting.

14. Error E200, E211, E212, E221, E222,

E231, E232, W241, E242 – System
errors

Remove electrode cables from the Sys*Stim 240. Turn
power off and on again. Plug the cables back in, set up
resume treatment. If the error repeats, the Sys*Stim
240 requires servicing. Report the error to service
provider to assist with hardware troubleshooting.

15. Patient Safety Switch Pressed Check patient status and resume treatment if

everything checks out with the patient.

16. Stop Button Pressed Press start to resume treatment. You will need to turn

back up the intensity for the stimulation.

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Sys*Stim 240 Instruction Manual — Rev.H_05/16/16

17. Unknown or No Applicator

Plug in either a cluster or a laser applicator. If one is
plugged in, inspect the cable and the connector to
make sure they are not damaged. If you have a second
applicator, plug it in and see if the error message is
resolved. If neither applicator is recognized, Sys*Stim
240 requires servicing.

If problem is not addressed above, or if additional troubleshooting guidance is desired, call (800)
854-9305 or email our service department at [e-mail]. The distributor who
sold the Sys*Stim 240 should be able to assist you with a loaner unit during warranty service.

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Sys*Stim 240 Instruction Manual — Rev.H_05/16/16

Section 7—References

References for Neuromuscular Electrical Stimulation:

1. Bélanger A: Therapeutic Electrophysical Agents: Evidence Behind Practice, Williams and

Wilkins, A Walters Kluwer Business, 2010.

2. Cohn JC and Mullin C: Neuromuscular Applications for Electrical Stimulation, from Physical

Agents for the Physical Therapist Assistant, FA Davis Company, 1996.

3. Gillespie CA: Foundations for Electrical Stimulation, from Physical Agents for the Physical

Therapist Assistant, FA Davis Company, 1996.

4. Hooper PD: Physical Modalities-A Primer for Chiropractic, Williams & Wilkins, 1996

5. Kenna KM: Pain Management with Electrical Stimulation, from Physical Agents for the Physical

Therapist Assistant, FA Davis Company, 1996.

6. Knight KL and Draper DO: Electrotherapy from Therapeutic Modalities: The Art and Science,

Lippincott Williams & Wilkins, a Wolters Kluwer business, 2008.

7. Mehreteab TA, Weisberg J and Nelson A: Electrotherapy from Physical Agents: A

Comprehensive Text for Physical Therapists, Appleton & Lange, 1994.

8. Mullin D and Gardner ER: Physiologic Basis of Electrical Stimulation, from Physical Agents for

the Physical Therapist Assistant, FA Davis Company, 1996.

9. Prentice W: Therapeutic Modalities: For Sports Medicine and Athletic Training, Mc Graw Hill

Companies, 2008.

10. Shapiro s: Electrical Currents from Rehabilitation: From Research to Practice, Elsevier, 2008.

11. Sparrow KJ: Electrotherapeutic Modalities: Electrotherapy and Iontophoresis, from Modalities

for Therapeutic Intervention (Contemporary Perspectives in Rehabilitation), F.A. Davis
Company, 2005.

12. Starkey C: Electrical Agents, from Therapeutic Modalities, FA Davis Company, 1999.

13. Stillwell GK: Electrotherapy from Krusen’s Handbook of Physical Medicine and Rehabilitation,

W.B. Saunders Company, 1982.

References for Laser and Light Therapy:

1. Baxter GD: Therapeutic Lasers, Elsevier Limited, 1994.

2. Behrens BJ: Therapeutic Use of Light: Ultraviolet and Cold Laser, from Physical Agents for the

Physical Therapist Assistant, FA Davis Company, 1996.

3. Bélanger A: Therapeutic Electrophysical Agents: Evidence Behind Practice, Williams and

Wilkins, A Walters Kluwer Business, 2010.

4. Bukowski EL and Dellagatta EM: Electromagnetic Radiation: Laser, Ultraviolet, and Diathermy

from Modalities for Therapeutic Intervention (Contemporary Perspectives in Rehabilitation),
F.A. Davis Company, 2005.

5. Cameron MH: Electromagnetic Radiation: Lasers and Light from Physical Agents in

Rehabilitation: From Research to Practice, Elsevier, 2009.

6. Hooper PD: Physical Modalities A Primer for Chiropractic, Williams & Wilkins, 1996

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Mettler Electronics Corp. — Rev.H_05/16/16

7. Knight KL and Hopkins T: Laser and Light Therapy from Therapeutic Modalities: The Art and

Science, Lippincott Williams & Wilkins, a Wolters Kluwer business, 2008.

8. Prentice W: Therapeutic Modalities: For Sports Medicine and Athletic Training, Mc Graw Hill

Companies, 2009.

9. Simunovic Z: Lasers in Medicine and Dentistry, Basic Science and up-to-date Clinical

Application of Low Energy-Level Laser Therapy, LLLT, European Medical Laser Association,

2000.

10. Weisberg J: 26. Lasers from Physical Agents: A Comprehensive Text for Physical Therapists,

Appleton & Lange, 1994.

This manual has been written as a guideline for the correct use of the Sys*Stim 240. Reading the
above references will provide a more complete understanding of the correct use of neuromuscular
stimulation and laser and light therapy.

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Sys*Stim 240 Instruction Manual — Rev.H_05/16/16

Section 8—Specifications

8.1 General Specifications:

Input: 100-240VAC , 50/60 Hz

External Fuse: 1.0 A, 250 V, GDC/S506

5 X 20 mm, Time Delay
2 X T1.0, AL250V

ETL and C-ETL Listed: Model ME 240 (9801427)

Classification: Protective Class I Equipment and Internally Powered

Equipment
Type BF Equipment

Enclosed equipment without protection against ingress of
water.

Equipment not suitable for use in the presence of a
flammable anesthetic mixture with air or with nitrogen
oxide.

Certification The Sys*Stim 240 complies with the light-emitting and laser

product performance standards set forth in the Code of
Federal Regulations, Title 21 (Food and Drugs), Parts

1040.10 and 1040.11.

US Patent: D593684

Weight: 4.5 pounds (5.5 pounds with battery)

Dimensions: 13" (L) x 8" (W) x 8" (H)

Temperature
Operating:
Nonoperating:

Humidity:
Operating:
Non-Operating:

Treatment Time: 1-60 minutes

Optional Battery: Rechargeable Smart Lithium Ion Battery Pack rated at

50°F to 104°F

-40°F to 167°F

30% to 75% Relative Humidity at 104°F
Non-Operating, 5% to 95% Relative Humidity, non­condensing

10.8Vand 4.8Ah

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8.2 Waveform Specifications:

Interferential (IFC, 4-Pole)

Figure 8.1—Interferential

Waveform

Premodulated (IFC, 2-Pole)

Figure 8.2—Premodulated

Waveform

Waveform Type: Sinewave
Polarity: None
Current: 0-100 mA peak, 500Ω load

Carrier frequency: 2500, 4000 or 5000 Hz
Interference frequency 0-250 Hz

Frequency Modulation: Low set: 0-250 Hz
High set: 0-250 Hz

Preset Frequency Sweeps: 1-15 Hz, 80-150 Hz, 1-150 Hz
Amplitude Modulation: 10%, 40% and 100%
Type: CC or CV
Available Channels: Channels 1 & 2

Waveform Type: Amplitude modulated sine
wave

Polarity: None
Current: 0-100 mA peak, 500Ω load

Carrier frequency: 2500, 4000 or 5000 Hz
Interference frequency: 1-250 Hz

Frequency Modulation: Low set: 1-250 Hz
High set: 1-250 Hz
Preset Frequency Sweeps: 1-15 Hz, 80-150 Hz, 1-150 Hz

Amplitude Modulation:
Surge: On (s)/Off (s) 5/5, 4/12, 10/10, 10/20, 10/30,
10/50, Manual: 1-240/1-240

Recip: Ch1 (s)/Ch2 (s) 5/5, 4/12, 10/10, 10/20, 10/30,
10/50, Manual: 1-240/1-240

Ramp: 0.5, 1, 2 or 5 seconds
Type: CC or CV
Available Channels: All

Medium Frequency (Russian)

Figure 8.3—Med. Freq. Waveform

62

Waveform Type: Burst modulated sine wave
Polarity: None
Current: 0–100 mA peak, 500Ω load
Frequency: 2500 Hz
Duty Cycle (%): 10, 20, 30, 40 and 50
Burst Frequency: 20-100 bps
Amplitude Modulation:

Surge: On (s)/Off (s) 5/5, 4/12, 10/10, 10/20, 10/30,
10/50, Manual: 1-240/1-240

Biphasic

Figure 8.4—Biphasic Waveform

Sys*Stim 240 Instruction Manual — Rev.H_05/16/16

Recip: Ch1 (s)/Ch2 (s) 5/5, 4/12, 10/10, 10/20, 10/30,
10/50, Manual: 1-240/1-240

Ramp: 0.5, 1, 2 or 5 seconds
Type: CC or CV

Available Channels: All

Waveform Type: Amplitude modulated sine
wave

Polarity: None
Current: 0–100 mA peak, 500Ω load

Frequency: 1-200 pps
Phase Duration 20-400 µs
Amplitude Modulation:

Surge: On (s)/Off (s) 5/5, 4/12, 10/10, 10/20, 10/30,
10/50, Manual: 1-240/1-240

Recip: Ch1 (s)/Ch2 (s) 5/5, 4/12, 10/10, 10/20, 10/30,
10/50, Manual: 1-240/1-240

Ramp: 0.5, 1, 2 or 5 seconds
Type: CC or CV

Available Channels: All

High Volt

Figure 8.5— High Volt Waveform

Microcurrent

+

-

Figure 8.6—Microcurrent

Waveform

Waveform Type: Monophasic twin peak
Polarity: Positive, negative or both
Voltage: 0 to 500 V peak, 500Ω load)
Phase Duration: ~15 µs
Frequency: 10-120 pps
Frequency Modulation: 1-10, 80-120, 1-120 pps
Amplitude Modulation:
Surge: On (s)/Off (s) 5/5, 4/12, 10/10, 10/20, 10/30,

10/50, Manual: 1-240/1-240
Recip: Ch1 (s)/Ch2 (s) 5/5, 4/12, 10/10, 10/20, 10/30,

10/50, Manual: 1-240/1-240
Ramp: 0.5, 1, 2 or 5 seconds
Type: CV
Available Channels: All

Waveform Type: Monophasic or Biphasic square
Polarity: Positive, negative or both
Current: 0 –1,000 µA peak, 500Ω load
Phase Duration: 1-1,000 ms

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TENS, Symmetrical Biphasic

Figure 8.7—TENS Sym. Waveform

Frequency: 0.5-500 pps
Type: CC
Available Channels: All

Waveform Type: Biphasic square
Polarity: None
Current: 0 –80 mA peak, 500Ω load
Phase Duration: 20-1,000 µs
Frequency: 1-250 pps
Frequency Modulation: 0-250 pps
Amplitude Modulation: 40, 60, 80, and 100%
Burst frequency: 0-30 bps
Type: CC or CV
Available Channels: All

TENS, Asymmetrical Biphasic

Figure 8.8—TENS Asym.

Waveform

DC Low Amplitude

Waveform Type: Continuous DC

Waveform Type: Asymmetrical biphasic
Polarity: None
Current: 0 –110 mA peak, 500Ω load
Phase Duration: 20-1,000 µs
Frequency: 1-250 pps
Frequency Modulation: 0-250 pps
Amplitude Modulation: 40, 60, 80, and 100%
Burst frequency: 0-30 bps
Type: CC or CV
Available Channels: All

Polarity: Positive or Negative
Current: 0-4 mA DC, 500Ω load
Amplitude Modulation:
Surge: On (s)/Off (s) 5/5, 4/12, 10/10, 10/20, 10/30,

10/50, Manual: 1-240/1-240
Recip: Ch1 (s)/Ch2 (s) 5/5, 4/12, 10/10, 10/20, 10/30,

10/50, Manual: 1-240/1-240
Polarity Reversal: If “On” then at 50% of the

treatment time the polarity will
reverse.

Type: CC
Available Channels: All

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Sys*Stim 240 Instruction Manual — Rev.H_05/16/16

8.3 Optional Laser Performance:

Output power: Dependent on Applicator (automatically sensed)
Laser diode applicator 80 mW at 785nm
Optional: cluster
applicator

Delivered energy: 0.01 to 99.99 Joules
Operation modes: Continuous and Pulsed
Pulse mode:
Pulse width:

Laser 100 µs nominal
Cluster 50% duty cycle

Pulse frequency:
A) Continuous

B) 10 Hz, 25 Hz, 50 Hz, 100 Hz, 250 Hz, 500 Hz, 1 kHz, 2.5 kHz, 5

C) Sweep from 10 to 5 kHz (inc continuous) in 10 seconds (1

500 mW at 660/950nm

kHz (Pulses per Second)

second at each step)

Timer 0 to 99 minutes 59 seconds, 1 second increments

(decrementing). Audible signal and output termination at
time expiration

8.4 Optional Applicator Specifications:

Laser Applicator

Lasing device: Sanyo Single AlGaAs Diode (Class 3B laser device)
Wavelength: 785 nm ± 10 nm
Power: 80 mW ± 10 mW
Treatment area illumination: Three Blue LED's (470 nm, visible through eyewear

Output activation: Capacitance Switch on Laser Applicator handle
NOHD Nominal Ocular Hazard Distance is less than 35 cm.

MPE (skin only) ~ 3.3 MPE, less than maximum allowable of 5 MPE
Beam spot Elliptical beam spot 2.8 mm x 1.1 mm (elliptical beam area

Divergence Elliptical Beam divergence 18 degrees and 7 degrees

protection that attenuates Infrared/Near Infrared)

of = 9.2 mm²) at the aperture.

Eye protection Uvex glasses with a minimum of 80% attenuation in the

wavelength range of 780 nm to 860 nm. The Uvex glasses
supplied with the unit meet these requirements.

Cluster Applicator

SLD Twelve 950 nm Super luminescent Diodes
LED Seven 660 nm Light Emitting Diodes

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Total Power 500 mW ± 50 mW
Treatment area illumination The 660 nm LED's are visible and illuminate treatment area

Output activation Capacitance Switch on Cluster Applicator handle
Eye protection Uvex glasses with a minimum of 80% attenuation in the

wavelength range of 780 nm to 1200 nm. The Uvex glasses
supplied with the unit meet these requirements.

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Sys*Stim 240 Instruction Manual — Rev.H_05/16/16

Section 9—Accessories

9.1 Ordering Information:

Therapy products and accessories are available from Mettler Electronics authorized Distributors.
For information regarding either Mettler products or a distributor near you, please call toll free,
(800) 854–9305 or phone [phone] in areas outside the continental United States. Ask for
Customer Service. Mettler Electronics is open from 7 AM until 5 PM Pacific Time for your
convenience. You can also reach our Customer Service Department via email at

[e-mail].

9.2 Sys*Stim 240 Accessories

Catalogue # Item Description

2000 4 Sponge electrodes (2" x 2")
2001 24 Sponge inserts (2" x 2")
2002 4 Sponge electrodes (4" x 4")
2003 24 Sponge inserts (4" x 4")
2004 1 Sponge electrode (3.5" x 7")
2005 12 Sponge inserts (3.5" x 7")
2006 1 Sponge electrode (8" x 10")
2007 12 Sponge inserts (8" x 10")
2008 4 Electrode straps (24")
2009 4 Electrode straps (48")
2023 Pencil electrode set with push button stimulation control, (includes handle, 4

different sizes of stainless steel spot electrode tips, and carrying case)

2027 Pin to banana adapter set to be used with ME 2260 or 2201 electrode cables.

Four each, gray.
2230 Bifurcation cable set, 2 cables, one red and one black, pin termination
2221 EZ Trode – 2" diameter round self–adhering, reusable electrodes with lead

wires; case of ten packages (four electrodes/pkg.)
2222 EZ Trode – 2.75" diameter round self–adhering, reusable electrodes with lead

wires; case of ten packages (four electrodes/pkg.)
2223 EZ Trode – 2" x 4" self–adhering, reusable electrodes with lead wires, case of 10

packages (2 electrodes/pkg.)
2224 EZ Trode – 2" square self–adhering, reusable electrodes with lead wires; case of

ten packages (four electrodes/pkg.)
2260 Electrode cable
2401 Laser applicator, 785 nm, 80 mW
2402 Cluster applicator, 600/950 nm, 500 mW
2403 Patient safety switch
2405 Laser (785 nm, 80 mW) applicator kit: includes applicator holders (left and

right), mounting hardware, and two pairs of protective glasses.
2406 Cluster (600/950 nm, 500 mW) applicator kit: includes applicator holders (left

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and right), mounting hardware, and two pairs of protective glasses.
2407 Applicator kit: includes the cluster (600/950 nm, 500 mW) and laser (785 nm,

80 mW) applicators along with applicator holders (left and right), mounting

hardware, and two pairs of protective glasses.
2410 Applicator holder (left) with mounting hardware
2411 Applicator holder (right) with mounting hardware
2702 V Trode –2" diameter round electrodes with lead wires, case of ten packages

(four electrodes/pkg.)
2703 V Trode –2.75" diameter round electrodes with lead wires, case of 10 packages

(four electrodes/pkg.)
2704 V Trode –2" x 4" oval electrodes with lead wires, case of 10 packages (four

electrodes/pkg.)
2705 V Trode –2" square electrodes with lead wires, case of 10 packages (four

electrodes/pkg.)
5403 One pair of protective glasses
7293 Detachable U.L. listed, hospital–grade line cord

73 Three-shelf mobile cart for all Sys*Stim or Sonicator products. Holds unit on the

top shelf with lower shelves for accessories.
7401 Optional battery pack

97 Sturdy stainless steel cabinet with a platform for Mettler electrotherapy

products and three shelves with a plastic door with two locking wheels.

68