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Operators Manual

1. Fima Mima Channel A _ u Li LI Channel B Average Average Milliamps Milliamps iS NeuroTrac Multi TENS Operation Manual The NeuroTrac Multi TENS records up to five sessions per day for a period of 60 days This feature allows the therapist to check each individual session to ensure that the patient is using the device properly at the prescribed times Viewing Detailed Statistics When your device is locked and you press the concealed button it displays the global statistics as described in previous chapter You can see more of your recorded home compliance by pressing the following buttons A to scroll the Days Press A to view the total time and average intensity mA for each day The day number is displayed on the top left corner of the LCD Press A and scroll through the days after the last day the Global statistics will be displayed B to scroll Sessions of the selected day Press B to see the session time and sesson average mA for each channel The number of sessions recorded for the selected day is displayed on top middle of the LCD as SESSIONS X Y where X is the selected session and Y is the total number of sessions recorded this day SET which programme was used Select the session and see which programme was used on each channel by pressing the SET button Selected Selected day 1 60 session 1 5 i n SESSION 13 E h T ore rr Total session HR rir o TLL TT
2. NeuroTrac MultiTENS DUAL CHANNEL TENS amp EMS UN M Hz Hz 400 En CON E ut POB MULTI TENS Operators Manual Visit our website www veritymedical co uk for detailed application protocols VAVIVERITY NeuroTrac Multi TENS Operation Manual Warnings This unit must be used with the guidance of a Physiotherapist or Doctor Type BF equipment Continuous Operation Do not insert lead wires into a mains power supply Do not immerse unit into water or any other substance Do not use the NeuroTrac Multi TENS unit in the presence of a flammable anaesthetic gas mixture and air or with Oxygen or Nitrous Oxide fusing rechargeable 9 Volt PP3 Nickel Metal Hydride batteries be sure to use a CE approved battery charger Never connect the NeuroTrac Multi TENS directly to a battery charger or to any other mains powered equipment We advise not to use Ni Cad rechargeable batteries Patient Electrodes are for single patient use only Keep out of reach of children Do not use this stimulator on your facial area unless you are under strict guidance from a qualified Clinician Application of electrodes near the thorax may increase the risk of cardiac fibrillation Operation in close proximity e g 1m to a shortwave or microwave therapy equipment may produce instability in the stimulator output x Simultaneous connection of a patient to a high frequency surgical equipment ma
3. 3 98 100 Melzack R Wall P D 1965 Pain mechanisms a new theory Science 150 971 979 Tulgar M McGlone F Bowsher D Miles J B 1991 b Comparitive effective ness of different stimulation modes in relieving pain part II A double blind controlled long term clinical trial Pain 4 156 62 Walker J 1992 When self help begins at home Prof Nurse 7 10 662 4 393 NeuroTrac Multi TENS Operation Manual Neuromuscular Stimulation Goldfuss AJ 1993 Effect of muscular tension on knees stability Medicine and Science in Sports 5 267 271 Gibson J N A Smith K Rennie Mj 1998 Prevention of disuse muscle atrophy by means of electrical stimulation Maintenance of protein synthesis The Lancet 1 Oct Jansen J K S Lomo T Nirolaysen K 1973 Hyperinnevation of skeletal muscle fibre Dependence on muscle activity Science 181 559 56 1 McMiken D Martin Todd Smith Colin T Strengthening of human quadriceps muscles by cutaneous electrical stimulation Scandinavian Journal of Rehabilitation on Medicine IS 1 25 8 1983 Standish WD Valiant GA et al The effects of electrical stimulation of normal quadriceps on Strength amp Girth Medicine and Science in Sports amp Exercise Vol 14 November 3 pp 194 197 Osterber A Graf W Eeg Olofsson K Hallden M Pahlman L 1999 Is electrostimulation of the pelvic floor an effective treatment for neurogenic faecal incontinence Osterber A Graf W
4. Before using this equipment you must first seek the advice of your Physiotherapist or Doctor Read this operating manual before using the unit TENS and STIM should not be used i By patients fitted with a demand style cardiac pacemakers unless so advised by their Doctor During pregnancy unless medically advised By patients with undiagnosed pain conditions k By patients with undiagnosed skin conditions With patients who have diminished mental capacity or physical competence who cannot handle the device properly On anaesthetised or desensitised skin When driving a vehicle or operating potentially dangerous equipment i Do not place electrodes gt Over carotid sinus nerves gt Over larynx or trachea gt Inside mouth gt Over the area of the heart unless so advised by your Doctor gt On your facial area unless under strict guidance from a qualified Clinician i The patient should use the unit only as prescribed id Do not immerse the unit in water or any other liquid If you experience skin irritation this may be due to over stimulation In this case leave the skin to heal and use TENS only for the periods prescribed Turning the current up too high can cause skin irritation In this case allow the skin to heal and use TENS at a lower intensity Some people experience an allergic reaction to the adhesive coating on the surface of the electrode If this happens use a different make of electrode or change the electrode If it
5. Eeg Olofsson K Hallden M Pahlman L 1999 Is electrostimulation of the pelvic floor an effective treatment for neurogenic faecal incontinence 36 NeuroTrac Multi TENS Operation Manual Troubleshooting Problem Cannot reach maximum mA level or The unit cuts off stimulation at certain level or When increase the intensity zero mA is flashing or Power is cutting off when using Solution It is normal behaviour in our and any other quality muscle stimulators and TENS machines and in most cases resolves itself please read the guideance below The stimulation intensity will drop to zero if you simply press the mA button and no electrodes are connected to the channel on which you increase the intensity You should attach a pair of electrodes to the lead wire and the lead should be connected to the channel on which you increase the stimulation intensity mA Our unit is designed to detect any poor or intermittent connection across the electrodes and to cut off the stimulation output mA when it does so This is a safety precaution It is designed to prevent the user from inadvertently turning up the output stimulation current in the presence of a poor or intermittent connection and then experiencing a large unexpected powerful surge in the stimulation if and when the connection 1s re established Reasons for no connection if you use surface skin electrodes Check if both electrodes are connected to the
6. continues try reducing the pulse width If the problem still persists try moving the electrode position each day by just the width of the electrode making sure the electrode positioning is still over the dermatome di Keep unit out of reach of children Only use CE approved skin electrodes If in doubt about the use of the NeuroTrac Multi TENS unit call your Doctor Therapist Clinician or your distributor for advice x NeuroTrac Multi TENS Operation Manual Description of Unit amp Functions Lead Wire and Pin Power Select CH A Programme SY ae Select CH B Programme EN PARK amp D AN 7 Lock PRG 1 button Selects the desired programme POI P13 TENS programmes Channel A P14 P17 STIM programmes Channel A amp B PC1 PC3 Custom programmes Channel A amp B PRG 2 button Selects the desired programme POI P13 TENS programmes Channel B NOTE PRG 2 is disabled for P14 P17 and PC1 PC3 SET button Configures custom programmes Sets time for TENS programmes P01 P13 ESC button Stores customised programme time and returns to the home screen Power button Turns unit on off and ends the current programme 7 NeuroTrac Multi TENS Operation Manual Quick Start Instructions l Insert a 9 volt PP3 Alkaline battery Alternatively insert a rechargeable Nickel Hydride battery Which is safer and has a much longer life than the Ni Cad recha
7. emissions IEC 61000 3 3 Table 202 Guidance and manufacturers declaration electromagnetic immunity The NeuroTrac product is intended for use in the electromagnetic environment specified below The customer or the user of the NeuroTrac product should ensure that it is used in such an environment and that precautions regarding that environment are heeded Immunity test IEC 60601 Compliance Electromagnetic environment test level level guidance Electrostatic 6 kV contact 1 6 kV contact Floors should be wood concrete or discharge ESD 8 kV air ceramic tile If floors are covered with IEC 61000 4 2 synthetic material the relative humidity should be at least 30 Power frequency Power frequency magnetic fields should 50 60 Hz be at characteristic levels of a typical magnetic field location in a typical commercial or IEC 61000 4 8 hospital environment NeuroTrac Multi TENS Operation Manual Table 204 Guidance and manufacturer s declaration electromagnetic immunity The NeuroTrac productis intended for use in the electromagnetic environment specified below The customer or the user of the N euroTrac product should ensure that it is used in such an environment Immunity IEC 60601 test test level Electromagnetic environment Compliance guidance level Portable and mobile RF communications equipment should be used no closer to any part ofthe NeuroTracTM product including cables t
8. i ee ae eee OE PC1 CON BST MODWR J So S T S IPC2_ CON BST MODWR J So S T S PC3 CON BST MODWR T T ST T S MODALITIES CON Constant TENS Stimulates constant frequency and pulse width on both channels BST Burst TENS Stimulates nine pulses of 200uS at 150Hz repeated two times per second MOD Modulated TENS Stimulates over a six second cycle modulating frequency and or pulse width P11 Frequency starts at 100Hz decreasing exponentially to 65Hz Pulse width starts at 200US decreasing exponentially to 100uS P12 Frequency starts at 10Hz increasing exponentially to 90Hz Pulse width fixed at 200uS HAN 3 second of 100Hz followed by 3 seconds of 2 Hz W R Work Rest Stimulation Stimulates constant frequency and pulse width on both channels with work rest intervals 12 NeuroTrac Multi TENS Operation Manual Home Compliance Lock Mode Function A concealed Lock button is included in the NeuroTrac Multi TENS unit which allows the clinician to accurately monitor the Home Compliance of the patient between appointments Whenever you lock the device it resumes or starts to record the statistics of use If the unit is not locked the statistics are not stored in the memory You can lock the unit in two ways Press the concealed button and L T or L P will be flashing on the LCD press B to select one of the options L P This will lock the selected programme and will not allow user to a
9. is detected at the output of channel A or B the output current will be reset at zero Physical dimensions 119 2 x 69 x 28 7 mm Weight 106g without battery 152g with battery Environmental Conditions for use 10 to 30 degrees Centigrade 0 90 Humidity Environmental conditions for storage amp transport 10 to 50 degrees Centigrade 0 90 Humidity 31 NeuroTrac Multi TENS Operation Manual Warranty Verity Medical Ltd provides a warranty to the original purchaser that this product will be free from defects in the material components and workmanship for a period of 2 years from the date of purchase by the Distributor invoice date from Verity Medical to the appointed Distributor If the distributor from whom the product was purchased by the user is satisfied that the product is defective the user may return the unit directly to this Distributor who will forward it to Verity Medical Ltd All such returns from the Distributor to Verity Medical must be authorised by Verity Medical Ltd in advance The liability of Verity Medical Ltd under this limited product warranty does not extend to any misuse or abuse such as dropping or immersing the unit in water or other liquid substance or tampering with the unit or normal wear and tear Any evidence of tampering will nullify this warranty Customer Service Any queries should be addressed to Verity Medical Ltd Unit 7 Upper Slackstead Farm Farley Lane Braishf
10. motor or acupuncture points tend to respond to low rate stimulation 2 Hz 10 Hz and pulse width of 200 uS The desired effect is for the patient to feel individual pulses PULSE WIDTH Duration The wider pulse widths will deliver stronger stimulation for any given intensity mA setting By using a combination of intensity and pulse duration it is felt that various pulse widths are capable of stimulating different groups of nerve fibres The wider pulse duration is needed to recruit motor fibres where as the narrow pulse duration is used more on the sensory fibres The selection of which pulse duration to use is dependent upon the intended treatment protocol Stimulating the larger nerve fibres 1s thought to reduce the speed and the amount at which information is transmitted along the smaller nerve fibres Also under certain circumstances the brain is thought to produce its own analgesic pain killing substances known as endorphins or endogenous opiods Intensity mA Patients respond differently to the level of intensity this 1s due to differences in individual patient s skin resistance enervation and the type and condition of electrode being used A good formula for setting the intensity is to increase the current so that the patient feels slight muscle contraction but not strong enough to move a joint and then slightly reduce the intensity so that it feels comfortable When using low rate TENS settings individual twitches wil
11. or antiseptic wipe is Do not use cleaning sprays or alcohol based cleaning solutions Control unit disposal please return to Verity Medical LTD or to the appointed distributor ACCESSORIES Battery To change the battery open the battery door on the rear of the control unit by pressing down on the raised rib pattern just below the belt clip Lift the battery out of the compartment This is very easy and can be done by the user i Check periodically for any discharge from the battery Remove battery completely from unit if not in use for any extended period of time typically one week Low battery indicator of 6 9 volts shown on LCD display when flashing change battery for a new one i Preferably use a PP3 alkaline battery Battery disposal please return to the supplier from whom you ve purchased it Lead Wires i The lead wires should be handled carefully and never stretched as this can cause the stimulation to function below normal standards or not at all Examine lead wires before each treatment for loose connections or damage Avoid stretching and twisting the lead wires Store the lead wires carefully after each use i Lead wires Disposal please return to the supplier from whom you ve purchased them Self Adhesive Electrodes Check the short connectors have not become separated from the electrodes Replace electrodes onto plastic film after use If they drop onto the floor debris will a
12. the Pulse Width Press B to set the pulse width US between SOUS and 450uS NOTE If frequency 105 Hz or higher is set the pulse width will be restricted to 300US maximum for safety Press B to set the work seconds WRK between 2 and 99 seconds Press A to set the rest seconds Press B to set the rest seconds RST between 2 and 99 seconds Press A to set the ramp up time Press B to set the ramp up time R UP between 0 0 and 9 9 seconds Press A to set the ramp down time Press B to set the ramp down time R DN between 0 0 and 9 9 seconds Press A to set the current type Press B to set the current type to either synchronous or alternating SYN or ALT NOTE The SYN current stimulate both channels at the same time The ALT current stimulates channel A and then channel B If SYN is selected press A to set the delay between channel A amp B Press B to set the delay DLY between channel A amp B from 0 0 to 4 0 seconds Press the SET button to configure the next phase or press the ESC button to save the parameters 11 NeuroTrac Multi TENS Operation Manual Programmes Mose Frequency puise wiam work Rest up Down Time Frequency Up Down Time TENS ine ae Por CON Ps Po2 CON as POS CON PO rs PO4 CON Ps Pos CON as Poe CON POs Por CON Ps Pos CON Ps Po9 CON Hs P10 est a rs Pn MOD Ps P12 MODs P13 HAN TOPs
13. 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 30 NeuroTrac Multi TENS Operation Manual Specifications TENS and STIM a UE e 11 12 13 Dual channel individually isolated circuits Amplitude 0 90 mA into 500 Ohm load indication only Actual mA will tend to be less than indicated due to electrode impedance at 1000 Ohms load Electrodes in poor condition the maximum will be limited to 70 mA at 1500 Ohms load the maximum will be limited to 65 mA Type Constant Current maximum output voltage 180 Volts 10 30 Volts Waveform Asymmetrical rectangular bi phasic with zero DC current Selectable pulse width 50 uS 450 LS 2 accuracy Pulse Rate selection in the continuous mode 2 200 Hz 2 accuracy Mode Continuous Burst or Modulated Burst mode Bursts of 9 pulses 200 uS at 150 Hz or 185 Hz over 2 seconds Modulation mode 6 second cycle of concurrent width modulation and pulse repetition rate modulation Low Battery Indicator If the battery goes below 6 9 volts 0 2 volts the battery symbol will flash on off once every second Ifthe battery voltage is below 6 6 0 2 volts the unit will not turn on Open Electrode Detect If an open circuit
14. 2 or 21 22 or 21 23 or 19 25 or 54 22 or 54 23 or 54 21 23 Rectal Scrotal Vaginal or Saddle Area 24 25 or 44 45 or 18 24 19 25 47 34 Phantom Limb Pain Lower Extremity 18 20 or 20 26 or 18 24 or 18 55 24 20 48 y L4 AN L5 34 NeuroTrac Multi TENS Operation Manual Shoulder and Upper Extremity Pain 8 51or1 30or8 140or 8 53 Phantom Limb Pain Upper Extremity 8 51or8 140or 8 14 3 54 Mastectomy Pain 15 10 or9 120r8 140r 15 9 10 12 Abdominal Pain 17 11 0r16 10 or 16 17 10 or 17 18 11 19 c6 C7 Lower Back Pain 18 19 or 20 21 or 54 55 or 18 55 19 54 or 18 20 19 21 Low Back and Bilateral Leg Pain 48 20 19 lt 21 or 18 24 19 gt 25 18 20 19 21 NeuroTrac Multi TENS Operation Manual Clinical References Conventional TENS Bates JAV Nathan PW 1980 Transcutaneous electrical nerve stimulation for chronic pain Anaesthesia 35 817 22 Ellis B 1995 Transcutaneous electrical nerve stimulators outpatient response to a temporary home loan programme Br J The Rehabil 2 8 419 23 Frampton V Bowesher D eds Pain Management by Physiotherapy Butterworth Heinemann London 115 39 Hosobuchi Y Adams J E Linchitz R 1977 Pain relief by electrical stimula tion of the central gray matter in humans and its reversal by naloxone Science 197 183 186 Lundberg TMD Et al 1984 Physiotherapy Vol 70 No
15. ctrode Placement TENS The placement of electrodes is one of the most important parameters in achieving effective pain relief using TENS This is best left to your Physiotherapist or Doctor to advise as to which location is most appropriate It may transpire that various positions need to be experimented with before the user finds the most effective positioning The positioning may be via the contiguous dermatome myotome motor trigger or acupuncture points Dermatomes amp Myotomes These are areas of the body enervated by a single nerve root via the spinal cord Each nerve root serves a known area of the skin The dermatomes are named after the nerve root which serves it For details of dermatome sites refer to diagrams on pages 33 amp 34 Contiguous Placement This form of electrode placement is the most common method used It involves placing the red lead proximal alongside the spine where the dermatome on which your pain lies enters and exists The black lead distal is normally placed over or near to the pain site Your Physiotherapist or Doctor may direct the current to cross through the pain area or using the bracket system allow the current to flow on either side of the pain site through the nerve branches that supply the pain location Acupuncture Points The placement of the red and black electrodes on the skin forms the electrical circuit for TENS It is the skin itself that creates the highest electrical resista
16. dhere to conductive gel rendering the electrodes ineffective 24 NeuroTrac Multi TENS Operation Manual Electrode life can be considerably reduced by i The type and condition of the skin Deep seated moisturisers or make up x For the Best Results Before each use cleanse the skin After each use stick the pads on the shiny insert card and store in a cool and dry place such as the fridge not freezer Caution Static electricity may damage this product NOTE Only Verity Medical Ltd or appointed distributors importers are approved to undertake servicing 25 NeuroTrac Multi TENS Operation Manual Conditions that respond to TENS Pain associated with Arthritis Post Operative Pain Lumbago Pain due to Sports injury Phantom Limb Pain following Amputation Skeletal Pains Neuralgia Whiplash Pain associated with Rheumatoid and Osteo Arthritis Period Pain Cancer Pain Back Pain General Pain Sciatica Muscular Shoulder Aches Tension Conditions that respond to STIM Sports Injuries Continence Prevents disuse atrophy Odema Stroke Increases muscle strength 20 As a warm up prior to exercise Maintains and improves movement Increases and improves the blood supply to the muscle in cases of intermittent claudication NeuroTrac Multi TENS Operation Manual D d LA L LOMU EEERGEE CELTIC OT 4 Information regarding Electromagnetic compatibility and interf
17. e the hairs The electrodes conductive material is water based If it becomes saturated e g from perspiration it will lose its adhesive qualities After use leave the electrodes face up overnight to dry out replace on plastic film in the morning At some point the electrodes will become dry Moisten the adhesive surface with a few drops of water and apply onto the plastic film overnight This procedure will increase the electrode life by few more days 19 NeuroTrac Multi TENS Operation Manual Suggested Electrode Placement TENS Red Black Finger Arthritis Knee Arthritis Neuralgia of Trigeninus Cervical 2 Positions 20 NeuroTrac Multi TENS Operation Manual If you are using electrodes on your face we recommend you contact your physiotherapist or clinician for guidance Red Black Cephalalgia Overorbital Mandibular Syndrome Herpes Zoster Phantom Limb 21 NeuroTrac Multi TENS Operation Manual Back Pain Menstrual Pain Lumbar Pain 2 Positions Tooth Ache 22 NeuroTrac Multi TENS Operation Manual Red Black Sciatic Pain 2 Positions Epicondylitis Shoulder Pain Feet Pain Ankle Pain 23 NeuroTrac Multi TENS Operation Manual Care Maintenance Accessories and Disposal WARNING Only medically approved accessories should be used CONTROL UNIT Wipe the surface once a week with a damp cloth
18. erence EMC NeuroTrac products are designed to produce very low levels of radio frequency RF emissions interference to be immune from effects of interference produced by other equipment operating in their vicinity and damage due to electrostatic discharge all when operating in a typical domestic and or clinical environment They are certified to meet the international EMC standard EN60601 1 2 For more information please refer to the tables 201 202 204 and 206 overleaf 27 NeuroTrac Multi TENS Operation Manual Table 201 Guidance and manufacturer s declaration electromagnetic emissions The NeuroTrac product is intended for use in the electromagnetic environment specified below The customer or the user of the NeuroTrac product should ensure that it is used in such an environment Emissions test Compliance Electromagnetic environment guidance RF emissions Group 1 The NeuroTrac product uses RF CISPR 11 energy only for its internal function Therefore its RF emissions are very low and are not likely to cause any interference in nearby electronic equipment RF emissions The NeuroTrac product is suitable CISPR 11 for use in all establishments including domestic establishments Harmonic emissions IEC 61000 3 2 IEC 61000 3 2 and those directly connected to the public low voltage power supply network that supplies buildings used Voltage fluctuations for domestic purposes flicker
19. han the recommended separation distance calculated from the equation applicable to the frequency of the transmitter Conducted Recommended separation distance RF d 1 2 VP 150 kHz to 80 MHz d 1 2 VP 80 MHz to 800 MHz IEC 61000 1150 kHz to d 2 3 VP 800 MHz to 2 5GHz 4 6 where P is the maximum output power rating of the transmitter in watts W Radiated according to the transmitter manufacturer RF and d is the recommended separation IEC 61000 12 5 GHz distance in meters m 4 3 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 gt 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 NeuroTrac product is used exceeds the a
20. ield Romsey Hampshire SO51 0QL United Kingdom Tel 44 0 1794 367 110 44 0 1794 367 451 Fax 44 0 1794 367 890 E mail sales veritymedical co uk Web www veritymedical co uk This product is manufactured by Verity Medical Ltd in compliance with the European Union Medical Device Directive MDD93 42 EEC under the supervision of SGS Notified Body number 0120 C 0120 Verity Medical Ltd is certified by SGS to the following Quality Standards ISO 9001 2008 ISO13485 2003 32 NeuroTrac Multi TENS Operation Manual Dermatome Charts Anterior View Trigeminal Migraine Headache Neuraigia 5 60r1 2and5 6or 6 7or i 1 5 5 430r o 2 6 5 50 or 5 5 52 43 Deep Eye 49 7 42 Pain 43 50 ain C2 Tension Headache C3 1 20r5 500r6 7 Nose Pain As i 43 49 Temporal Mandibular Joint Pain 7 52 C6 Hand Pain 38 40 or 40 41 or 38 39 Knee Pain 30 29 or 30 29 32 31 Ankle and or Foot Pain 35 46 or 34 46 or 31 35 or 47 48 or 33 56 1 33 Posterior View Neck and Bilaterala Shoulder Pain 1 20or3 dor 1 223 27 4 Tension Headaches 1 20r5 50o0r6 7 Cervical Osteoarthritis 4 C6 Herpes Zoster ac use appropriate secments 10 11 or 12 13 or 10 12 11 13 or 10 11 on contralateral side Femoral Pain 27 28 or 36 37 or 8 51 c6 Hand Pain 38 38 40 or fj 40 41 or 38 39 Sciatica 19 21 or H 19 2
21. in In addition to small fibres which allow the sensation of pain to be felt the body is also made up of larger diameter nerve fibres These larger nerve fibres transmit less unpleasant sensations such as touch or warmth assisting us to form an impression of our environment Stimulating the larger nerve fibres using TENS may have the effect of inhibiting the transmission of pain along the smaller nerve fibres to the spinal cord known as the Pain Gate Theory What is STIM Neuromuscular Stimulation has been used for many years to stimulate muscle and nerve fibres to treat a number of muscle and nerve related conditions Over the last 30 years numerous clinical trials and papers have been written Neuromuscular Stimulation is increasingly understood by Therapists and Doctors There is a better understanding of the mechanisms which exist between nerves and muscles that makes it possible to stimulate the neuromuscular system with precise electrical signals The NeuroTrac Multi TENS offers precision giving full control of Pulse Widths Rates Ramp up times Work Rest cycles as well as alternating or synchronous application if two channels are being applied Customer Care We welcome constructive comments regarding our equipment particularly those that might help us to improve existing features add new ones or develop new products for the future NeuroTrac Multi TENS Operation Manual Contra Indications amp Precautions
22. l occur The higher rate TENS settings will increase muscle tension It is not advised to increase the intensity to experience strong muscle contraction 16 NeuroTrac Multi TENS Operation Manual Treatment Modes TENS There are three treatment modes available on the NeuroTrac Multi TENS unit 1 Conventional TENS or normal This mode enables the user to select any rate between 2 Hz 200 Hz and a pulse width between 50 US 300 US This is the most frequently used of the three modes The most common selection is 80 90 Hz with a 200 LS pulse width 2 Burst Mode This mode is comparable to the low rate TENS technique except that each low rate pulse is substituted for by a short BURST of 9 pulses 200 uS at 150 Hz or 185 Hz It is a combination of conventional and low rate TENS The burst mode is often referred to as acupuncture like TENS 3 Modulation TENS this mode was designed to help prevent nerve accommodation that some patient s experience It is achieved by continuously cycling the pulse width and rate How Long Do I Use TENS For This depends on the individual patient s condition accuracy of electrode placement stimulation and the characteristics selected but typically the onset of pain relief starts after 20 30 minutes Generally TENS is used for longer periods of normally 1 hour 30 minutes per session With some patients it can be much longer 17 NeuroTrac Multi TENS Operation Manual Ele
23. lash ON OFF then press the either or button to adjust the time between TENS 30 minutes 1 4 9 hours CON no time limit NMS 30 minutes or 2 hours Press ESC to save the time for the selected programme Setting Custom Programmes l Select PC1 2 or 3 by pressing the PRG 1 button on the front panel Remove the battery lid where you will see two buttons SET and ESC Press the SET button once to customise a single phase Hold the SET button for three seconds to enter advance mode and customise up to 5 phases Press the SET button once to select the next phase Press B to set the phase time Press A to select the phase mode Press B to select the phase mode continuous CON modulated MOD burst BST Neuromuscular stimulation NMS Press A to configure the phases parameters CON continuous TENS mode l Press B to set the frequency Hz between 2Hz and 200Hz Press A to set the Pulse Width Press B to set the pulse width US between SOUS and 450uS NOTE If frequency 105 Hz or higher is set the pulse width will be restricted to 300US maximum for safety Press the SET button to configure the next phase or press the ESC button to save the parameters NeuroTrac Multi TENS Operation Manual MOD modulated TENS mode l Press B to set the low frequency Hz LO between 2Hz and 200Hz Press A to set the high frequency Press B to set the high frequenc
24. lter any parameter such as the programme number and time programme type Constant Burst etc Use this option if you want to keep the same settings through out a course L T This option will allow you to alter all the parameters during the course programme time etc Use this option if you are an advanced user and you are allowed to alter the parameters during the treatment The recorded statistics are the same for both L P and L T options Locking the Unit and recording statistics Remove the battery cover and using the end of the lead wire gently press on the concealed lock button as shown in the diagram on page 7 until you hear a double bleep The lock symbol will appear on the LCD screen and L T or L P will be flashing Your unit will start recording the daily statistics It is very important to set up the timer and calendar correctly see page 15 Displaying Global Statistics To display the global statistics remove the battery cover and using the end of the 2mm dia pin press the concealed switch once and you will hear a single beep On the diagram below the basic global statistics are displayed on the LCD how many days the unit was used number of hours in total the unit was used and the average intensity m A used When you have noted the information press the OFF ON button to bring the unit back to the Home position Total Total Number of Number of Hours in use Days in Use 7 E l HR PILETI LIEN m
25. lti TENS Operation Manual Introduction The NeuroTrac Multi TENS is a dual channel device combining several treatment programmes into one unit The NeuroTrac Multi TENS features Multi TENS mode The front of the unit has two programme buttons allowing the unit to run a separate TENS programme on each channel PRG 1 selects the TENS programme to run on Channel A PRG 2 selects the TENS programme to run on Channel B This allows the therapist to select the best combination of output to more effectively control pain NOTE The unit cannot run a combination of TENS STIM or custom programmes Backlight A clear bright backlight and large LCD allow the display to be read more easily in low light or dark conditions The backlight will automatically turn off after one minute to conserve battery power Comprehensive Statistics Comprehensive statistics backed up by a real time clock record up to 5 sessions daily for 60 days An easy to use menu system allows the therapist to review the statistics to ensure that the patient is using the unit correctly Multi Phase Custom Programmes Up to 5 phases can be configured for each of the three custom programmes The custom programmes feature a simple setup of one phase only or an advanced setup of up to 5 phases What is Pain When we feel pain it is the body s process of informing us that something is wrong To feel pain is important without this feeling abnormal conditions ma
26. nce to stimulation The Physiotherapist or Doctor may consider using acupuncture loci acupoints which offer much lower resistance properties as a more effective site for placing the electrodes Accurately locating an acupuncture point can be difficult please seek advice from you doctor or physiotherapist 18 x NeuroTrac Multi TENS Operation Manual Electrodes Types and Tips Self Adhesive Hypoallergenic electrodes have a typical life span if looked after of 4 6 weeks We recommend cleaning the skin before placing the electrodes After use place the electrodes back onto the plastic film and in the zip tag plastic pouch Store in a cool environment Skin Electrode Types Available SHAPE CODE DESCRIPTION VS 4040 40 x 40 mm square max 53mA VS 5050 50 x 50 mm square recommended for general use CT VS 9040 90 x 40 mm rectangular CT VS 9050 90 x 50 mm rectangular _J VS 10050 100 x 50 mm rectangular 30 mm diameter round VS VS 50 150 mm diameter round IMPORTANT Don t use VS 4040 at more than 53mA and VS3030 at more than 46 mA ew Good Tips Self Adhesive Electrodes AF x If you find the electrodes will not stick due to oily skin cleanse the skin with soap and water then rinse and dry the area around the electrode site If this does not work try cleansing the skin with a swab impregnated with alcohol Clip away hairy skin using scissors don t use a razor to remov
27. next patient or treatment After you deleted the statistics the timer and calendar is displayed and can be adjusted please make sure it is up to date see the next chapter of how to set it Timer calendar reviewing and setting The NeuroTrac Multi TENS has a built in real time clock to track unit usage and statistics The time and date settings will be lost if the unit has the battery removed for more than ten minutes so it is important to check the timer and calendar whenever you insert the new battery or lock the unit To review or set the real time clock hold the PRG 1 button for ten seconds until the LCD will start flashing the first parameter hour Press A to select the next parameter Hour Minutes Day Month Year Press B and B to adjust the parameter p D Year EI rime NeuroTrac Multi TENS Operation Manual Using the NeuroTrac Multi TENS Unit in TENS mode RATE Hz or pulses per second The RATE to be selected depends primarily on the electrode placement on the patient s body If one uses contiguous and dermatome the electrodes alongside or over the area of pain electrode placement a higher rate of 80 Hz 100 Hz is desirable The patient should experience steady continuous stimulation It has been found that an optimal setting of 80 or 90 Hz with a pulse width of 200 uS has good effect for most patients and is a good first choice for pain gating Patients using Trigger
28. onditions However it is known that TENS does work in up to 70 of cases How can I have a better chance of success using TENS Seeking professional advice from your Physiotherapist or Doctor on how to best apply TENS is the best answer we can give to this question Are there circumstances in which TENS should not be used Yes For undiagnosed pain When using a cardiac pace maker During pregnancy and other instances as fully detailed in this manual on page 5 How long will I have to use the TENS stimulator Some long term chronic pain sufferers may have to use a stimulator for extended periods of time even years Other conditions may only need a short period of treatment lasting weeks If I have any medical or product queries how can I get help Any clinical advice on the TENS stimulator should be provided by your Physiotherapist or Doctor 38 NeuroTrac Multi TENS Operation Manual Notes 39 Not for sale or use in the USA Distributor WIN HEALTH Win Health Ltd Brockhirst Oxnam Road Jedburgh Roxburghshire TD8 6QN Tel 01835 864866 Fax 01835 863238 E mail info win health co uk Website www win health co uk ISO 9001 REGISTERED FIRM Revised Issue Date 10 10 2011 Document Number VM C6V350 OM001 2
29. pplicable RF compliance level above the N euroTrac Jus product should be observed to verify normal operation If abnormal performance is observed additional measures may be necessary such as reorienting or relocating the N euroTrac on product b Over the frequency range 150 kHzto 80 MHz field strengths should be less than 3 V m 29 NeuroTrac Multi TENS Operation Manual Table 206 Recommended separation distances between portable and mobile RF communications equipment and NeuroTrac product The NeuroTrac product is intended for use in an electromagnetic environment in which radiated RF disturbances are controlled The customer or the user of the NeuroT rac product can help prevent electromagnetic interference by maintaining a minimum distance between portable and mobile RF communications equipment transmitters and the NeuroT rac product as recommended below according to the maximum output power of the communications equipment Rated maximum output Separation distance according to frequency of power of transmitter transmitter W 150 kHz to 80 MHz to 800 800 MHz to 2 5 80 MHz MHz GHz d 1 2VP d 1 2VP d 2 3VP 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
30. rgeable batteries into the battery compartment 2 Insert lead wire s to channel A and B if both channels are to be used 3 Switch on the unit by pressing the Power button 4 Press the PRG 1 Programme button to select POI P13 for preset TENS programmes Channel A only P14 P17 for preset STIM programmes Channel A and B PCI PC3 for custom programmes Channel A and B 5 To start press channel A and B button if you are using both channels increase the stimulation to the desired level 6 To stop the programme press the ON OFF button which will turn the unit off LCD Display Channel A Programme Channel B Frequency Time Frequency Pul a Width 3 Pulse 7 Width De W Lock Statistics A Symbol Channel A PET s F E Channel B Programme a Programme Mode Number Home Screen Mode Number Running Programme Channel A Channel B Channel A amp B Low battery programme saat paused indicator PO Poy Pot T PE POL rir hy rir PLA at VLIL CON CON CON CON Channel A Channel B Channel A Channel B milliamps milliamps disconnected disconnected electrode electrode P IL g p 4 oe STIM only programme both channels fixed to ma o a one programme 605 L CI 23 Oe Of 8 NeuroTrac Multi TENS Operation Manual Setting Time in Pre set Programmes Select POI P17 using the PRG 1 button Press the SET button and the Clock symbol will f
31. same dual conductor lead wire one electrode to the black connector and another to red connector Check if both electrodes are making a sticky contact on your skin some electrode edges could not be stuck due to electrode wear amp tear but the electrode should be sticking with at least 80 of it s field You may have lots of grease after long term use try new electrodes You may have dry gel on electrodes try to make it more sticky by dropping a small amount of water on the black conductive side of the electrode and leave for an hour for the gel to absorb Don t use wet electrodes Try some fresh electrodes as electrodes loose conductivity proportionally to the use time due to grease and gel getting drier This is the most frequent reason check if the dual conductor leadwire cable is not broken as it might be bent or pulled out too much which results in no conductivity try another cable To check if the cable is good cross the red and black pin and increase mA on the unit If the cable conducts the electricity the mA will go above 10mA and you would feel the stimulation mild tickling in your fingers which holds the crossed pins If you feel a mild electrical current this means the problem is with surface skin electrodes 37 NeuroTrac Multi TENS Operation Manual Commonly Asked Questions Does TENS work for all pain conditions and on all patients There is significant variation between patients with similar pain c
32. time FILM m Ho Su PU i Pu Channel A Channel B Channel A Channel B Average Average program program if Milliamps Milliamps different from A A then SET then A to see the calendar da Press A to select the Day press SET then A to see the calendar date of the selected Day the date and time should be set correctly when you lock the unit NOTE Additional sessions are added to the fifth session if a patient uses the device more than 5 times a day Sessions less than two minutes are not recorded 14 NeuroTrac Multi TENS Operation Manual Unlocking the unit If you see the LOCK symbol on the LCD your unit is locked To unlock the unit press the concealed button then PRG 1 for 10 seconds The LOCK symbol will disappear You need to unlock the unit to change the treatment parameters if it was locked as L P stop the statistics recording the statistics will still be there in the memory be able to delete the statistics see next chapter for how to delete the Statistics Deleting the statistics The statistics are not automatically deleted when the unit is unlocked To delete the statistics completely make sure the unit is unlocked then press the concealed button The L P or L T is flashing now press the following buttons one after another SET then A then A then B then B 5 beeps will sound and all the records will be deleted Now your unit can be used again for the
33. y Hz HI between 2Hz and 200Hz Press A to set the low pulse width Press B to set the low pulse width US LO between SOUS and 4SOUS NOTE If a frequency of 105 Hz or higher is set the pulse width will be restricted to 300US maximum for safety Press A to set the high pulse width Press B to set the high pulse width LS HI between SOUS and 450uS NOTE If a frequency of 105 Hz or higher is set the pulse width will be restricted to 300US maximum for safety Press A to set the milliamp modulation adjustment Press B to set a milliamp modulation ADJ between 50 and 100 100 is no milliamp modulation Press A to set the modulation time Press B to set the modulation TME time between 3 and 60 seconds Press the SET button to configure the next phase or press the ESC button to save the parameters BST BURST TENS mode l Press B to set the frequency Hz between 35Hz and 200Hz Press A to set the Pulse Width Press B to set the pulse width US between SOUS and 200uS Press A to set the number of bursts per second Press B to set the frequency FRQ of bursts per second between 2 and 9 Press the SET button to configure the next phase or press the ESC button to save the parameters 10 NeuroTrac Multi TENS Operation Manual NMS Neuromuscular STIM mode l 10 Press B to set the frequency Hz between 2Hz and 200Hz Press A to set
34. y go undetected creating damage or injury to critical parts of the body Although pain is essential in warning our body of trauma or malfunction nature may have gone too far in its design Continued long term chronic pain has no useful value apart from its importance in diagnosis Pain begins when a coded signal travels to the brain where it is decoded and analysed The pain message travels from the injured area of the body along small diameter nerves leading to the spinal cord At this point the message is switched to a different kind of nerve that travels up the spinal cord to the brain area The brain then analyses the pain message refers it back and the pain is felt NeuroTrac Multi TENS Operation Manual What is TENS Transcutaneous Electrical Nerve Stimulation TENS uses a small battery operated unit to provide a non invasive drug free method of controlling acute and principally long term intractable pain It can also be used as an adjunctive treatment in the management of post surgical traumatic pain problems In TENS mild electrical impulses are transmitted through the skin via surface electrodes to modify the body s pain perception TENS does not cure problematic physiological conditions it only helps to control the pain perception TENS will not work for every user Please seek advice from your Doctor There are millions of small nerve fibres throughout the body and it only requires a few impulses to produce chronic pa
35. y result in burns at the site of the stimulator electrodes and possible damage to the stimulator di This device can deliver current densities in excess of 2mA cm2 when used at a high intensity with small electrodes See page 19 for more detail No modification of this equipment is allowed Symbols on the rear cabinet of NeuroTrac Multi TENS explained Caution Type BF output Equipment TYPE BF Follow Do not dispose in normal ll instructions dustbin see page 30 for for use mms the disposal instructions NeuroTrac Multi TENS Operation Manual Contents Contents Page Warnings 2 Introduction 4 What is Pain 4 What is TENS 4 What is STIM 5 Contra Indications amp Precautions 6 Description of Unit amp Functions 7 Quick Start Instructions 8 Setting Custom Programmes 9 Programmes 12 Home Compliance 13 Using the NeuroTrac Multi TENS Unit in TENS mode 16 Treatment Modes 17 How Long do I Use TENS For 17 Electrode Placement 18 Dermatomes amp Myotomes 18 Contiguous Placement 18 Acupuncture Points 18 Electrode Types amp Tips 19 Suggested Electrode Placement TENS 20 Care Maintenance Accessories and Disposal 24 Conditions that Respond to TENS 26 Conditions that Respond to STIM 26 Information regarding Electromagnetic compatibility and interference EMC 2 Specifications 31 Warranty 32 Dermatome Charts 33 Clinical References 35 Troubleshooting 37 Commonly asked Questions FAQ 38 NeuroTrac Mu

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