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SA7972 Infiniti Rehab Suite Manual

1. 80 Static Range of Motion Assessment ee eee eee eee eee eee ee ee eese sesesesesscsscsceseces DS OVERVIEW e 83 CLINIC AL GUIDE REFERENCE 2 is di audio an A an dd Eon un dda ido non E 83 CENERAC PROCEDURE E X OS 83 Preparing the IMSthUIMe MAU ON MR TERRENT 83 PLS AS ONG PEE mm 85 erri E 9 e p MR Y FY FNAN NY i eae EN FN DU EN Y NR HF EN 86 Dynamic Range of Motion Assessment eee eee eee eee eee ee eee eee e eee eseoecss OO OVERVIEW Me 88 CLINIC AL GUIDE FREE EIN Baas Se weet ew cee tects Se eet ete eee ewe eect 88 Rehab ProComp amp FlexComp Infiniti Rehab Suite V ez iz Meli 88 siis MS SS SION FYN Tm mr 88 Wier MM Y oe 89 Reviewing the SESSIOll assteendeasenssdtasoceusectusesntteaxdenesdasddanecesetectuseetcndeanien soesadde dU iU LS YY A UU FO Y AY OF 89 Crise TO ER TCC 91 PROCEDURE FOR LUMBAR SPINE ASSESSMENT 522a a oua a Lo RR Yu aa RR ANRAAAREDNRWENRNUNENEnRASARnUAARURRWNRREGWRAN RAN AA RNRnARHNRNUNRnUD 91 eis BIS Beli TEE Emm 91 Mea Urin EDW EF TE NA
2. o Ue 2 From Categories select Pro Flex Rehab Suite Muscle Fatigue 3 From Clients select a name Clients Rehab ProComp amp FlexComp Infiniti Rehab Suite 54 4 From Favorites select Muscle Fatigue Favorites Monitoring 5 Click OK Muscle Fatigue Monitoring with 2 EMG Measuring e Click the Start button al You can view each screen by clicking on the numerical buttons on the toolbar at the top 1 2 Es 4 5 e Tostop the session click the Stop button gl Muscle Fatigue Monitoring on A amp B OAPEMG WV 122 11234 5 For each signal RMS EMG and median frequency are plotted on the same line graph Video can also be recorded BioGr ph Y Muscle Fatigue Monitoring on A A EMG nV 1 23 4 5 This screen is similar to the one above but only displays channel A CoioGraph J Report Review 2Ch 2 Line Graphs 236 85 293 44 12 3 45 0 85 111 24 The two RMS EMG signals are displayed on line graphs Statistics are also available BioGraph Review screen The same screens are used for review All these screens are accessible from Start Open Display Session in the channel set SEMG Assessment with 2 EMG Rehab ProComp amp FlexComp Infiniti Rehab Suite 55 SEMG Biofeedback OVERVIEW This section suggests several training screens that will enhance and speed up rehabilitation thanks to SEMG
3. e Press a key to go to the next screen In the next screen verify that the signal is free of artifacts and the sensors properly placed Verify the signal and press a key to continue BioGr ph Y e Press the zero button of the inclinometer once to mark the neutral position e Before going to the next screen and starting to record instruct the examinee to perform the motion slowly until they feel restriction tightness or discomfort Measuring 1 Before performing the motion the examinee stays in neutral position and relaxes their muscles during 10 seconds Pre baseline Relax BioGr ph Y 2 Then the voice prompt asks the examinee to perform the motion three times Rehab ProComp amp FlexComp Infiniti Rehab Suite 98 Step down Hold your position BioGraph 3 Atthe end of the exercise the examinee is asked to stay in neutral position and relax their muscles during 10 seconds Post baseline Relax BioGraph Y When the session ends a series of message prompts guides you through the process of saving data adding notes to the session file and switching to reviewing mode so that you can generate a session report Reviewing the session In review mode a screen similar to this will appear Knee Assessment Minimum Maximum Mean Variability 4 61 5 80 4 93 0 04 1 85 3 06 2 15 0 08 E Angle nnnn a nnnn31 nnnn3a nnnn3R nnnn3a nnnn3a BioGr ph Y The review allows you to v
4. LeftRotation easure 1 Final Result 1 Left R otation 2 Right Rotation degrees The report shows the 6 measures and which ones are selected Measures are considered as valid if they are within 5 or YES Cervical Spine FlexionlExtension Movement ty pe select 1 Flexion 2 Extension degrees 1096 of the average of the three It takes the three last consecutive valid measures Rehab ProComp amp FlexComp Infiniti Rehab Suite 30 26 Right Rotation 30 35 368 1149 It then compares these to AMA Norms and shows the 96 of norm and the deviation from the norm If the result is less than the norm you see the result in green and the deviation from the norm in red If the result is greater than the norm you see the norm in green and the deviation from the norm in yellow so the result is green yellow 86 User s fields Position You can select the examinee s position there is a different list for each protocol Position type it here or select ztype it here or select gt Standing bending forward I mesum vani Or you can enter a different one sit Involved Side for the extremities only You can select the involved side Side lt select gt lt se ect gt TT Left Used Right Movement Type You can select the movement type lt select gt v Passive Movement type 1 Left Rotation 2
5. Software Manual 7m Thought Technology Ltd 8205 Montreal Toronto Blvd Suite 223 Montreal West QC H4X 1N1 Canada For use with BioGraph version 5 1 or later Tel 1 800 361 3651 1 514 489 8251 Fax 1 514 489 8255 E mail mail thoughttechnology com Webpage http www thoughttechnology com Rehab ProComp amp FlexComp Infiniti Rehab Suite CLASSIFICATION N CAUTION WARNING ATTENTION Type BF Equipment Internally powered equipment Continuous operation Read Instruction Manual US Federal Law restricts this device to sale by or on order of licensed health care practitioners Do not operate active sensor within 10 feet 8m of an operating cellular phone similar radio transmitting device other powerful radio interference producing sources such as arc welders radio thermal treatment equipment x ray machines or any other equipment that produces electrical Sparks All encoders are totally isolated from line 110 or 220VAC power due to battery operation and fiber optic connections to computers However many hospitals and the FDA require that computers printers and any other equipment used with medical devices be electrically isolated from line voltage to UL or CSA medical safety standards Do not connect inputs or outputs of the encoder or sensors to line powered devices except through the fiber optic cable The PC used with the encoder must be placed outside the patient client environment more
6. D ROM General Dynamic ROM Assessment with 2 5 Click OK D ROM General Dynamic ROM Assessment with 4 D ROMO1 Cervical Spine Flexion Re extension D ROMO2 Cervical Spine L R Lateral Flexion D ROMO3 Cervical Spine Left Right Rotation D ROMO4 Lumbar Spine Flexion Re extension D ROMO5 Lumbar Spine L R Lateral Flexion D ROMO6 knee Assessment Measuring e Click the Start button gt i Ed Reviewing mode Open Display session Client Biodex System Calibration Screen General Purpose 2Ch General Dy Be Session Screens Edk Options View Hep ID Min Max ii mitt 3 ay Dynamic ROM Assessment hfran23 nenn 5 MNP ffr 24 hif f 1 nnn 33 fnn 36 e r dud AMANNA annoa NENA NNNNA MNN ANNA nnnn 3 nnnn s nnnn 7 nens nnnn31 nnon33 nn nn 35 KZ o i oR Open session 00 00 50 100 pen session 00 00 37 100 D ROM General Dynamic ROM Assessment with 2 D ROM General Dynamic ROM Assessment with 4 EMG EMG The Multi line graph will display the EMG signal of 2 The two Multi line graph will display the EMG signal of 2 channels A and B along with the angle in red There channels simultaneously respectively A and B C and are statistics available as well D along with the angle in red There are statistics available as well Press the zero button of the inclinometer once to mark the neutral position Mark the different stages of the movement with event makers events can be marke
7. Eguilibration 10Ch Postural Training Cervical amp Thoracic amp Lumbar Spine 1 2 3 4 5 Scale dependent Threshold dependent M Other The 10 muscle sites are as indicated Cerivcal thoracic and lumbar The difference between each pair of muscles at the site should be less than 35 The red light will be on to indicate that the difference is greater than 35 Eguilibration 10Ch Postural Training Cervical amp Thoracic amp Lumbar Spine 2 1 2 3 4 5 Scale dependent O Threshold dependent M Other The 10 muscle sites are as indicated Cerivcal thoracic and lumbar The difference between each pair of muscles at the site should be less than 35 The red light will be on to indicate that the difference is greater than 35 Rehab ProComp amp FlexComp Infiniti Rehab Suite Reviewing mode Open Display session Client INCREDIBLE Bulk Screen Equili Fie Sesion Sowes Edt Options View Heb A RMS Can you keep the red light turned YY mmx Be Screens Edit Mw 3 bh 13 amp Union ig df when Can you keep the red light turned off Reviewing mode Open Display session Client INCREDIBLE Bulk Screen Equili a Yen ep Lg E ER 9 17 11 8 Revie le Open Display session Client INCREDIBLE Bulk Screen Equill EJ Help Reviewing mode e m B Options View 68 Reviewing mode Open Display session Client INCREDIBLE Bulk Screen E
8. Reviewing an Display Client INCREDIBLE Bulk Screen Traini 1 234 5 O Scale dependent M Threshold dependent O Other Four filled line graphs display the four channels with a color change at the threshold Rehab ProComp amp FlexComp Infiniti Rehab Suite 70 Training 4Ch Line Bar Graphs Reviewing mode Open Display session Client INCREDIBLE Bulk Screen Traini E4 Ble Session Screens Ed Options View Heb 1234 B Stay above the thresholds 1 e 3 4 B to hear the tones O Scale dependent M Threshold dependent O Other The four channels are displayed on a line graph and a bar graph UNSTABLE SHOULDER If you are going use a webcam to make a video recording of this session connect your webcam to a USB port of your computer and turn it on e Connect the sensors to the encoder as follows o MyoScan MyoScan Z sensor to channel A Infraspinatus and B Lower Trapezius e urn the encoder on 1 Click Quick Start 2 From Categories select one of the Categories categories starting with Pro Flex Rehab Suite SEMG Biofeedback Unstable Shoulder Pro Rehab Suite SEMG Biofeedback Unst Should Clients Full Name ID Number Wood Chuck 3 From Clients select a name 4 From Favorites select the Unstable Favorites Shoulder Protocol Description 5 Click OK USO1 Unstable Shoulder e Click the Start button 3 and read the instru
9. Riaht Rotation dearees Summary and Follow up notes You can enter notes in the summary follow up notes boxes Summarv Notes e n Excel 2000 and Excel 2003 place your cursor in the text box and start typing ry e In Excel 2007 place your cursor in the text box Marked improvement 1 Right click the mouse button AS Edit T 2 Select Edit text leet 3 Start typing Comparing to uninvolved side Some reports allow you to compare the results with the uninvolved side M Report Within Patient Analysis Report e x AiteiChanacw A Sa I l ye gt Select the sheet Within Patient Analysis Report Type the results of the uninvolved side in the corresponding column Rehab ProComp amp FlexComp Infiniti Rehab Suite 97 Dynamic Range of Motion Assessment OVERVIEW Similarly to Dynamic SEMG Dynamic ROM assesses muscle tension through various movements by combining EMG with inclinometry In addition to general protocols the system provides three assessment protocols for the cervical spine CP SCM or Traps and two for the lumbar spine It also provides one assessment protocol for the anterior knee VMO and VL This logo on a screen in a protocol indicates that you can use an optional webcam with the screen to record video of the session You need only connect your webcam to a USB port of your computer and turn it on before you start the session Note Your computer system must be connected
10. Skin Conductance amp Temperature Assessment Review The screen was designed for the review of the session The screen shows a line graph of the raw signals of SC and Temp and a trend graph of epoch means Drag the time marker vertical red line over the raw signal and see the value for any data point as a number in the center of the screen To see the whole session mean drag the time marker completely to the end of the session Qoo All these screens are accessible from Start Open Display Session in the channel set Biofeedback with Skin Conductance and Temperature Rehab ProComp amp FlexComp Infiniti Rehab Suite 82 Static Range of Motion Assessment OVERVIEW Range of Motion ROM assessment evaluates the ability of the examinee to achieve the full range of movement for a given part of the body A dual inclinometer is used for measuring the angle between the neutral position and the maximum range of motion position that the examinee can achieve until they feel restriction tightness or discomfort The protocols are based on AMA guides 6 edition 2007 Protocols use the world standard Neutral Zero Reference method This method defines the 0 angle as referring to the neutral position of the joint The measurement is repeated 6 times as a validity check The measures are compared to AMA normative data CLINICAL GUIDE REFERENCE The clinical guide gives general guidelines and recommendations for the ac
11. This setting stays in effect unless you change it Database Start Session Help Force Units d Celsius Show Hide File names Notch Filters Compact Fash Options Database Start Session Temperature Units Gograms ShowHde Frames gt PEZ Notch Filters Compact Flash Options U L T I Optionally enable the Confidential setting This helps protect the privacy of your clients by masking their names in the client database e Click Database to open the Main Database window e From the Settings menu select Confidential The check mark indicates that the setting is enabled e f you need to disable the Confidential setting repeat these steps to remove the Main Database Inactivity Period w Confidential Clents check mark Clients Full Mame Ballance T ara 1 Florimnnd Dorian 4 D armond Florian b Physiology Jane 4 With the Confidential setting disabled ENTERING KEY CODES Full Mame Bam 1 a m iit Lie UN BT Pass m Ca Hjern M iru q a With the Confidential setting enabled The first time you start to record a session with BioGraph Infiniti the software will check for the key codes and ask you to enter them You will also be asked to enter key codes if you have uninstalled and reinstalled the software or if this is the first time you are using your encoder with your existing installation There are three ways to start recording a session They are des
12. and if you suspect a problem with electromagnetic interference contact Thought Technology for a technical note on identification and remediation MAINTENANCE AND CALIBRATION e Wipe encoder with a clean cloth e Factory testing and calibration ensure equipment accuracy and frequency response The user may invoke a self calibration function that will recalibrate certain device parameters see the section Self Calibration on page Error Bookmark not defined of this manual Contact Thought Technology for factory recalibration if necessary STORAGE e Store in its original case at up to 90 humidity 85 F 30 C TRANSPORTATION e Transport in its original case Guidance and manufacturer s declaration electromagnetic emissions The Infiniti system is intended for use in the electromagnetic environment specified below The customer or the user of the Infiniti system should assure that it is used in such an environment Compliance Electromagnetic environment guidance The Infiniti system uses RF energy only for its HF emissions Group 1 internal function Therefore its RF emissions are CISPR 11 very low and are not likely to cause any interference in nearby electronic equipment pe eens Class B The Infiniti system is suitable for use in all CISPR 11 Emo GG establishments including domestic establishments IEC 61000 3 2 Not applicable and those directly connected to the public low Volt Uc DAD vmm voltage power supply ne
13. biofeedback This logo on a screen in a protocol indicates that you can use an optional webcam with the screen to record video of the session You need only connect your webcam to a USB port of your computer and turn it on before you start the session Note Your computer system must be connected to a video capture device such as a webcam and the proper software installed in order to use this function The clinical guide gives general guidelines and recommendations for the accurate use of Clinical Guide the instrumentation It also explains several biofeedback training techniques Physical Rehabilitation c frt Chapter SEMG BIOFEEDBACK TRAINING p E Also recommended _ INTRODUCTION TO SURFACE ELECTROMYOGRAPHY e SKELETAL MUSCLE PROPERTIES GENERAL PROCEDURE Starting the Session If you are going use a webcam to make a video recording of this session connect your webcam to a USB port of your computer and turn it on e Connect the sensors to the encoder as follows o MyoScan MyoScan Z sensor to channel A o Optional MyoScan MyoScan Z sensors to channel B to D and channels E to J for FlexComp Infiniti Myo Myo Myo Myo Myo Myo Myo Myo Myo Myo optional optional optional optional for optional for optional for optional for optional for optional for FlexComp FlexComp FlexComp FlexComp FlexComp FlexComp e urn the encoder on 1 Click Quick Start lt a Quick Start 2 From Categor
14. press any key Io st recording The recording starts with 5 seconds of Work followed by 5 seconds of rest The sequence repeats 3 times AI the Work prompt exer the clinician and at the r 2 Verify signal 3 Rest Work G SEMG03 ENDURANCE ASSESSMENT This protocol assesses a sustained contraction The patient contracts as strongly as they can during an extended period about 20 seconds This monitors the recruitment of the slow twitch fibers muscle endurance The contraction should be performed against static resistance isometric contraction 1 Instructions The protocol is divided into 5 steps 1 Read instructions Gives you an overview of what to expect no data is recorded press any key when you are done 2 Verify signal Take the time to make sure the sensor and cables are connected properly No data is recorded Pressing any key on your keyboard allows you to advance to the next activity Pre Baseline The patient must relax 4 Contract and Hold The patient contracts as strongly as they can during an extended period about 20 seconds 5 Post Baseline Comparison of resting levels pre post assesses the ability to recover Rehab ProComp amp FlexComp Infiniti Rehab Suite 29 Replaying mode Script session Client TTL TTL Screen Instructions Enduran X Recording mode Script session Client TTL TTL Screen Training 1Ch Line Gr E3 Replaying mode Script session Client TTL
15. you must verify the Force units If you use imperial units press the ForceTrac algometer against a hard surface until it reaches at least 100 Lbs inch PSI If you are unable to reach this value it means the Force unit is not properly set Note 1 Lbs inclf 1 PSI e If you can t reach Lbs inch PSI change the force unit to Pounds 1 Todothis first end the session and return to the Main Menu screen of BioGraph Infiniti 2 Open the Options menu and select Force Units The active force unit is the one with the check mark beside it 3 Tochange to Pounds select it 4 Then start a new session Agmety unt verfication ActMEy 1 Cycle 1 Step Z If you use metric units press the ForceTrac algometer against a hard surface If you are able to reach at least 14 Kg cm it means the Force unit is not properly set and the red light will turn on e If the red light turns on change the force unit to Kilograms 1 Todo this first end the session and return to the Main Menu screen of BioGraph Infiniti 2 Open the Options menu and select Force Units The active force unit is the one with the check mark beside it 3 Tochange to Kilograms select it 4 Then start a new session e Ifthe red light does NOT turn on press the pedal to continue Note pressing the pedal allows you to go to the next screen only if the maximum applied pressure is greater than 3 Kg cm and less than 14 Kg cm Rehab
16. 15 sec w ervical Spine Assessment Minimum Maximum Mean Variability CHALA 4 26 3050 2 861 11 1 40 CHB Righ 376 474 84 27 39 1 72 CHC Lef 445 182 11 13 79 1 69 CHDRigh 4 44 69 62 4 63 1 65 Current CHE Angle 2 08 CHA Left 32 60 CHB Right 12 57 cHC Left 4 49 CHD Right 2 415 100 50 nnon 3 nnnn 4 nnnn s nnan s nnnn 7 nnan a nnnn a ANMANN nannai nnnna gt AANA anmnme34 NANI NAIA nnm37 100 50 E E nnna 3 nannn 4 nnnn s nnan 6 NINANI nnan es nnnn a nean 3n NANA ANNA MANA annnm 34 nna 35 annn3s ANNA BioGraph Open session 00 00 37 100 The review allows you to verify that the motion has been properly performed by the examinee at the right time when prompted You can also check the consistency from trial to trial Generating a report e After the review screen opens you can generate a Dynamic ROM Assessment report This is a Text report Rehab ProComp amp FlexComp Infiniti Rehab Suite 96 1 Click the Session Report icon um in the tool bar 2 Select Generate Text Report select report components in the Session Report window and click Generate Report Microsoft WORD opens and displays your report You can print or save the report using WORD s Print and Save functions PROCEDURE FOR ANTERIOR KNEE ASSESSMENT Starting the Session If you are going use a webcam to make a video recording of this session connect your webcam to a USB port of your computer and turn it on e Connec
17. 3 Flexion Re extension 30 00 0 00 0 00 4 Post baseline 10 00 0 00 0 00 This is the Statistics window for a script session The Statistics window for an open display session is similar but does not display a list of rejection durations for individual activities Generating Session Reports In review mode BioGraph Infiniti 5 1 can generate two types of session report Excel reports have been predefined and customized especially for the Rehab Suite protocols An Excel report transfers session statistics from the session data file into a Microsoft Excel workbook and subjects them to further analysis Excel reports can be saved or printed using the Excel functions Excel reports have not been defined for open display sessions The protocol chapters contain detailed information about their respective Excel reports Text reports include general information about the session as well as optional information session notes statistics markers that you select A text report can be generated from any screen which includes line graphs or trend graphs Text reports are generated from Microsoft Word templates and can be saved or printed using the Word functions Text reports are preferred for open display sessions but they can also be generated for script sessions To generate a session report enter review mode either immediately after recording a session see Stopping a Review Report see Reviewing a Session on page 19 Select review screen
18. 46 ii A 1 2 3 4 Hil The two line graphs on the top display the raw EMG of A and B General Purpose 2Ch A amp B General Purpose The power spectrum displays A on the left and B on the right P NE The graph at the bottom displays the median frequency of both channels General Purpose 2Ch Line Bar Graphs 1 2 3 4 The two RMS EMG signals are displayed on line graphs and bar graphs Statistics are also displayed G SEMGO7 SEMG Assessment with 4 EMG FlexComp Infiniti only General Purpose 4 EMG RMS with video 1 2 3 4 4 RMS EMG signals are displayed on 4 line graphs and bar graphs General Purpose 4 raw EMG with video 1 2 3 4 4 raw EMG signals are displayed on 4 line graphs The bar graphs and digital displays show RMS EMG These screens are also used for review Rehab ProComp amp FlexComp Infiniti Rehab Suite G SEMG08 SEMG Assessment with 6 EMG FlexComp Infiniti only General Purpose 6 EMG RMS with video 1 2 3 4 6 RMS ENG signals are displayed on 6 line graphs and bar graphs General Purpose 6 raw EMG with video 1 2 3 4 6 raw EMG signals are displayed on 6 line graphs The bar graphs and digital displays show RMS EMG These screens are also used for review G SEMG09 SEMG Assessment with 10 EMG FlexComp Infiniti only General Purpose 10 EMG RMS with video 1 2 3 4 10 RMS ENG signals are displayed on 5 line graphs General Purpose 10 raw EMG w
19. CONTROL mmm HI RR 63 CATEGORY PRO FLEX SUITE SEMG BIOFEEDBACK EQUILIBRATION ccccccccceceeeeeeeeeeeeeeeeeeeeeeeees 65 CATEGORY PRO FLEX SUITE SEMG BIOFEEDBACK TRAINING ILL LL HH 69 UNSTABLE SHOULDER T e a aa ca ene a Sa pn a Sea ween a see See cee ee esate eee tee 71 MOTOR FUNCTION RESTORATION GG dva rada educi a Uwd NO dada GA UNO OA FM Gw Ydd da wd Odi 72 Respiration Training FT lt Y RR Y RR NAF a J OVERVIEW R TN WT FY RH HR TN HR HN HR FR ae A NF aa EY RH RT RY ER NF NN 74 CLINICAL GUIDE REFERENCE uc iu a Nan O I aa O iau OE iiia idis OS a ON O Odo 74 PROCEDURE t 74 Heart Rate Monitoring and HRV eee e eee eee ee ee ee eee eese eese eoeccececeseseseseses 7 7 OVERVIEW FE 77 eB e meilan lizuzli lec 77 PROCEDURE arcs ud dud ese wh swe ces st NS pet OR EN O CO ET ete 77 Skin Conductance and Temperature Biofeedback 80 OVERVIEW 80 S BI eiMclilnlididide S 80 PROCEDURE
20. Canada H4X 1N1 For international e Package must be marked Broker Livingston International 133461 e Ship insured to Thought Technology Ltd 8205 Montreal Toronto Blvd Suite 223 Montreal West Quebec Canada H4X 1N1 Rehab ProComp amp FlexComp Infiniti Rehab Suite 120 Repair Return Form Be sure to call for authorization before returning any equipment Copy and complete this form and include it with the unit s Include a copy of original invoice and return to the address in the Returning Equipment section Name Company Address Phone No Fax No Date Purchased From Whom Model Name Serial No Problem Rehab ProComp amp FlexComp Infiniti Rehab Suite 121 Rehab ProComp amp FlexComp Infiniti Rehab Suite
21. E Description 5 Click OK S EMGO1 Para Spinal Scanning e Click the Start button 3 and read the instructions on the screen Do not press the foot pedal yet Rehab ProComp amp FlexComp Infiniti Rehab Suite 34 Be Session o EdR Options Vew Help iO Min Max Thri Th 55ec lt EBBEH Static SEMG Assessment Para Spinal Scanning c2 C6 T2 C4 1 After preparing the skin apply conductive paste to the grey area Trapezius of the EMG electrodes that will be in touch with the skin T4 T6 T8 2 Identify the muscle sites shown in the adjacent figure T10 3 When placing the electrodes at L1 the muscle site apply steady L3 pressure 4 After recording the signal move to the next muscle site For further information please i Press the pedal to continue BioGr ph y condition Instructions Activity 1 Cycle 1 Step 1 ctwity progress aiting for e Put conductive electrode paste or cream on the EMG electrodes grey area only e Position yourself next to the examinee the encoder attached to your belt with the pedal near your foot e Press the foot pedal to go to the next screen Measuring Place the active electrodes positive and negative in alignment with the spine except for trapezius at a distance of 3 cm out from the vertebral ridge and at the site shown on the screen A RMS 3 10 Wait for the signal to settle allow at least 5sec Press the pedal to record Signa
22. Inclinometer 2 MIN 17 17 MIN 34 60 MAX 127 37 MAX 121 45 Inclinometer 1 Minus Inclinometer 2 BioGr ph J All these screens are accessible from Start Open Display Session in the channel set ROM Training with 2 inclinometers Rehab ProComp amp FlexComp Infiniti Rehab Suite 104 Manual Muscle Testing OVERVIEW Manual muscle testing is the assessment of muscles and tendons and their ability to generate force Computerized manual muscle testing improves and enriches a method that has existed and evolved for almost a century by replacing subjective factors with objective data SEMG allows the monitoring of potential muscle substitution Note that muscle testing with ForceTrac is allowed only for grades 4 and 5 The examinee should be monitored closely and tests should be terminated immediately if there is any evidence of pain The system is intended only to capture an objective record of force applied during testing rather than to reduce the risk of injury Therefore the ultimate responsibility for risk of injury rests with the examiner CLINICAL GUIDE REFERENCE The clinical guide gives general guidelines and recommendations for the accurate use of Clinical Guide computerized instruments along with traditional muscle testing It also explains how to FEN QUNM prepare the examinee and the procedure to follow Pc UR Bin v ait nv Chapter MANUAL MUSCLE TESTING T E Also recommended INTRODUCTION TO
23. Infiniti icon on the Desktop MULTIMEDIA BIOFEEDBACK SOFTWARE BioGraph The program always starts O ra D by showing the Main Menu INFINITI screen VERIFYING SETTINGS Enable the Notch Filter Settings e Select Options at the top left of the main screen e Select Notch Filter from the drop down menu e Select EEG EMG and EKG and set Frequency to 50Hz or 60Hz depending on the transmission frequency used in your country 60Hz for North America for instance Then click OK Note These settings remain in effect unless you change them Rehab ProComp amp FlexComp Infiniti Rehab Suite BioGraph iioGraph Infiniti Infiniti Docs amp Editors Technology Ltd Infiniti Software System Application ej Database Start Session Help Temperature Units Force Units Show Hide File names gt Notch Filters Compact Flash Options ULTIMEL AIANrFPeeEe ee a Notch Filter Options EEG EKG EMG Frequency O50 Hz 8 60 Hz Cancel Notch Filter Options Select Temperature Units e Select Options at the top left of the main screen e Select Temperature Units from the drop down menu e Select Fahrenheit or Celsius as appropriate Note This setting stays in effect unless you change it Select Temperature Units e Select Options at the top left of the main screen e Select Force Units from the drop down menu e Select Kilograms or Pounds as appropriate Note
24. Otherwise to select review screens do the following e Click on Select Screens e From the Screen Category drop down list select Report Review Only screens from the selected category will be listed e Select up to 5 screens and click OK to return to Review Replay Session Confirmation e Click OK again to enter review mode Rejecting Artifacts The purpose of rejecting artifacts is to have reliable statistics with the least amount of noise affecting the recording Rejecting artifacts can be performed while reviewing sessions It can be done manually by the person reviewing the data First review the session to determine where the recording is most affected by noise Then place artifact rejection segments at these locations by following these steps 1338 1333 1340 1341 1342 1343 1344 1345 1346 1347 1348 Select the line graph containing the segment to be rejected The selected graph will display a magenta border Press and hold the Control Key Place the cursor over one end of the rejected segment Click and hold the left mouse button You can release the Control key at this point Drag the cursor across the segment to be rejected The selected segment is highlighted in gray 9 pu de w I9 At the end of the segment release the mouse button Note You can place artifact rejection segments only on single line graph instruments If you get an error message you have to select a different screen for reviewing Ca
25. Picture View Please select an Encoder Communication Protocol Please select a Channel Set and then a Screen Category FlexComp Infiniti Show all categories Channel Set Screens I Picture View Description DateModfed J Algometry 6 23 2008 5 40 40 PM Report SC Temp EMG Line Graphs amp Trends 8 4 2008 4 01 19 PM Biofeedback and Neurofeedback Re T raining Report Temp Line Graph amp Trend 8 4 2008 4 02 19 PM Dynamic SEMG Assessment with 2 EMG 9 17 2008 11 55 28 AM Signal Verification EEG 1 Reward 2 Inhibits 8 5 2008 9 50 35 AM Dynamic SEMG Assessment with 4 EMG 9 17 2008 11 54 28 AM Training 1 Reward 2 Inhibits Boat Race 8 5 2008 9 53 29 AM Manual Muscle Testing 2 29 2008 9 47 05 AM Training 1 Reward 2 Inhibits Flower Animation 8 5 2008 10 35 22 AM SEMG Biofeedback Physical Re Training with 2 EMG 9 17 2008 11 55 39 AM Training 1 Reward 2 Inhibits Puzzle Animation 8 5 2008 10 38 18 AM SEMG Biofeedback Physical Re Training with 4 EMG 9 17 2008 11 55 52 AM Training 1 Reward 2 Inhibits Sunrise Animation 8 5 2008 10 39 12 AM Static ROM Assessment 6 2 2008 11 22 41 AM Training Alpha with Respiration 8 5 2008 10 40 30 4M Static SEMG Assessment 5 12 2008 6 22 14 PM Training HRV HR Max Min Giraffe 8 5 2008 10 44 32 AM Stress Response E valuation 7 4 2008 11 08 09 4M Training HRV HR Max Min Puppet 8 5 2008 10 43 26 AM Thermographic and SEMG Assessment 5 12 2008 2 24 23 PM Training HRV Paced Breathing 8 5 2008
26. Puzzle ee O U Me Try to keep A above and B below the threshold for over 5 seconds to bulld the puzzle 1 2 3 4 O Scale dependent v Threshold dependent O Other The signal displayed on channel A must exceed the threshold and channel B must be below the threshold for 5 seconds in order for the puzzle to be revealed Basic statistics are also displayed to give a more detailed picture Strengthening 2Ch Hero Morph Slow my EF DU Me Ue M Tw y s maroot MYD DD z3 5n A cs O Scale dependent v Threshold dependent Other The animation is controlled by both channels A and B and is threshold dependent The signal A goes above its threshold and the signal B stays below its threshold the boy slowly morphs into a superman The complete animation cycle is about 14 seconds An audio tone is heard when the signal A is above the threshold If one of the conditions is not satisfied the animation resets to the beginning The animation can also be reset manually Strengthening 2Ch Car Race 1 2 3 4 Scale dependent M Threshold dependent O Other The aim is to make the blue car channel A pass the finish line the white bar on the far right of each track before the yellow car channel B To meet this goal A must stay above its threshold while B stays below The points for A increment when both channels are in condition and the points for B increment when B is above threshold Rehab ProComp a
27. Screens Set Screen Order Cancel Review Replay Session Confirmation 6 Click on the Start button 3 to replay the session After recording a session you can analyze the data by going into review mode This mode allows you to scroll through the graphs look at statistics and print out a report displaying the data in graphical and or statistical form Review 1 2 3 4 Select Database from the Main Menu screen In the Main Database window select the client whose session you want to review Select the session from the right hand table Click on Review Report at the bottom The Review Replay Session Confirmation window opens Rehab ProComp amp FlexComp Infiniti Rehab Suite 19 Review Replay Session Confirmation Review Replay Session Confirmation Channel Set Options Dynamic SEMG Assessment with 4 EMG Select Script Edit Virtual Channel Settings Channel Set Options Dynamic SEMG Assessment with 4 EMG Select Script Edit Virtual Channel Settings M Screens Report Review 4Ch Cervical Spine Review Screen Screens Report Review 4Ch Cervical Spine Review Screen Select Screens Set Screen Order Select Screens Set Screen Order Cancel Cancel For a Script session For an Open Display session If you are reviewing a session that was recorded using a Favorite then review screens will already be selected by default and you can click OK to enter review mode 5
28. TN RR ED Y 92 Reviewing Uke Se 95 OM FF FFF FR HRN HA NF Y FR RA EA HE A PN FF EF FR 93 riae OO sats RESO YE RYN FFA EFA HYF NEF CH AEN NER YF FFF END FFF 93 PROCEDURE FOR CERVICAL SPINE ASSESSMENT 11 Lese iieeeclieeene innen n auam nasa asas aa suas a asas asas a a sas a anas sana 94 UIC INO SESSION ETC pei MDC MM IMEEM RM MD EW FRYN FERN FFF 94 fusce PEE NT YN 95 Reviewing the Session EE ET 96 Genera P3 10 0 a E 96 PROCEDURE FOR ANTERIOR KNEE ASSESSMENT cccccssseecesseeeeeseeeeeaseeeeaeeseesseeseaseeseaseeeoasseseeasessoaneesoaneesonneeees 97 AO NE OESS Oiee E eee eee E eee 97 ME a ee a FATH FR A EF a E E dace 98 Reviewing 1e SOSSON NETTE TETTE 99 Gonera qi e ol aee EET Em 99 Range of Motion Training 1e eee ee ee ee ee eee ee eee e eee e eee ose e eesesessesesesesss LOT OVERVIEW e 101 CLINIC AE GUIDE FE ERIN eoe Gn AG 101 PROCEDURE C eO7 0 O e 101 ROMTO1 ROM Training with 1 inclinometer sseeessseeeseeeeeeenn nennen nennen 102 ROMTO2 ROM Training with 2 inclinometers eesssssssssssseeseeeeeenen nnne
29. TTL Screen Training 1Ch Line Gr E3 ua Fd Options View Her Fie Se Eat Options View Help Fie Session Edt Options View Heb sion Pre baseline REST Endurance Test Tins script consists of 3 parts 1 Pre baseline Rest for 15 seconds 2 Work Contract and hold for 20 seconds 3 Post baseline Rest for 15 seconds adress cti 1 Cyt Led ADS aatem Gymm wy bey a parat wrfy Sagnal jectwty L Cyde 1 3999 2 1 Instructions _ 2 Verify signal _ 8 Pre baseline Replaying mode Script session Client TTL TTL Screen Training 1Ch Line Gr Replaying mode Script session Client TTL TTL Screen Training 1Ch Line Gr E3 Me Session Edt Cyfoes few Meb Fle Seo Edt Opboss View Heb View Mei Pctri adve mu mu CONTRACT Post baseline REST A EMG 5 Post baseline 4 Contract and Hold G SEMG04 FAST FLICK ASSESSMENT This protocol measures the maximal force of the muscle The maximal force is the highest level of voluntary contraction that a person can achieve without inducing unacceptable pain The protocol is divided into 5 steps 1 Read instructions Gives you an overview of what to expect no data is recorded press any key when you are done 2 Verify signal Take the time to make sure the sensor and cables are connected properly No data is recorded Pressing any key on your keyboard allows you to advance to the next activity 3 Pre Baseline The patien
30. Threshold dependent Other This display assists a patient to differentiate between contracting and relaxing their muscles Set the animation scale to a maximum value that is appropriate for a low sub maximal contraction Set the animation threshold in the middle of this scale As the patient sustains a sub maximal contraction and the EMG activity goes above the threshold the fractal will fill in As the patient releases the contraction and the EMG activity falls below its threshold the fractal will slowly open and a relaxing song is heard The complete animation cycle takes approximately 20 seconds 10 on each side of the threshold F Replaying mode _ Display Client INCREDIBLE Bulk Screen Relaxa Ed Relaxation 1Ch Space Hoops Mn Tei T 13 se ix ute e 91 sa4s n 12 3 4 5 Scale dependent M Threshold dependent Other The animation moves when the channel A signal is below the threshold Relaxation 1Ch DVD 1234 5 Scale dependent v Threshold dependent Other The channel A signal must stay below the bar graph s threshold to keep the DVD screen size constant Rehab ProComp amp FlexComp Infiniti Rehab Suite 99 RELAX03 Relaxation with 2 EMG Relaxation 2Ch Shrinking Heads HI O I 1 2 3 4 O Scale dependent M Threshold dependent Other Music is played when both channels A and B bar graphs on the right are below the threshold The two heads must have the same size whi
31. When ready press the pedal and perform the test at full load Resistance should always be applied gradually not suddenly and in the direction of the motion line of pull of the muscle The break usually happens within 2 or 3 seconds A shorter break time may lead to re injury A longer break time may lead to fatigue The trace of the applied force should appear after few seconds You can repeat the exercise Replaying mode Open Display session Client TTL TTL Screen MMT 01 Manu ame E E Replaying mode Open Dispia x0 Mn Eile Session Screens Edit Options View Help il fie Session Screens Edt Options Wew Hep Max Thri T2 5sec iw 1x v Gere o SE mE 252 45 o 10 Min Max Thr Thre Muscle Testing Training Screen CoioGraph f on nf 5 noa nan mn nn BioGroph Session paused Open session 00 03 04 750 00 03 Open session 00 02 09 812 00 0 Training Screen without SEMG Training Screen with SEMG A Reh ha b ProComp amp FlexComp Infiniti Rehab Suite 106 Unilateral Bilateral Muscle Testing MMT03 amp MMTO4 Note Make sure your ForceTrac is properly calibrated before starting e Click the Start button and read the instructions on the screen Do not press the foot pedal yet Manual Muscle Testing Unilateral Testing For this script 1 Ask the patient to complete the range of motion and stabilize the position 2 Position the ForceTrac between the limb or
32. a Dynamic SEMG Assessment report This is an Excel report Rehab ProComp amp FlexComp Infiniti Rehab Suite 47 1 Click the Session Report icon Ez in the tool bar 2 Select Generate Excel Report Microsoft Excel opens and displays your report as a workbook You can print or save the report using Excel s Print and Save functions Section 1 Graphs Cervical Spine Flexion Re extension Client Dorian Florimond Session Date 30 01 2009 BioGraph Session Time 2 06 46 PM Sites Cervical Paraspinals CP OEMG Left Side BEMG Right Side Full Flexion Re extension Neutral position Post B aseline Sites select BEMG Left Side D EMG Right Side Pre Baseline Flexion Full Flexion Re extension Neutral position Post Baseline The session is graphed as simplified charts For relaxation phases such as baselines neutral position and completed range of motion full flexion full rotation etc the EMG RMS mean is plotted For motion phases such as flexion re extension or rotation the EMG RMS peak is plotted The first graph shows CP The second graph shows the second pair of monitored sites They can be either SCM or traps In order to select the sites you have to click on lt select gt oternocleidomastoid SCM Sites The legend on the next pages will be automatically updated Rehab ProComp amp FlexComp Infiniti Rehab Suite 48 Section 2 Data Limrerence A
33. be used as an indicator of muscle fatigue The following screens were designed for this purpose This logo on a screen in a protocol indicates that you can use an optional webcam with the screen to record video of the session You need only connect your webcam to a USB port of your computer and turn it on before you start the session Note Your computer system must be connected to a video capture device such as a webcam and the proper software installed in order to use this function CLINICAL GUIDE REFERENCE The clinical guide gives general guidelines and recommendations for the accurate use of Clinical Guide the instrumentation It also explains how to prepare the examinee and the procedure to Physical Rehabilitation f O low l Chapter SEMG ASSESSMENT section MUSCLE FATIGUE MONITORING Also recommended e INTRODUCTION TO SURFACE ELECTROMYOGRAPHY e SKELETAL MUSCLE PROPERTIES A Sato iecit Sexy s sten Pv may dee imarat ranri f or Peginitee Marr av Ada Afr gt EC ah 1 GENERAL PROCEDURE Starting the Session If you are going use a webcam to make a video recording of this session connect your webcam to a USB port of your computer and turn it on e Connect the sensors to the encoder as follows o MyoScan MyoScan Z sensor to channels A o Optional MyoScan MyoScan Z sensor to channel B LA B ocj bp E FF e ow i y Myo Myo optional e Turn the encoder on Quick Start t
34. boy morphs into a superman when the channel A signal is toward the upper range of the scale As the signal comes down the scale the superman returns to a boy Control 2Ch Animal Game 1 2 3 4 M Scale dependent O Threshold dependent Other An exercise to control muscle contraction by lining up the cartoon man with the animal in the blue square while the line up of animals constantly changes Channel A is connected to the animation The stronger the contraction the further the man moves to the right To keep the man moving the signal from channel B should remain below its threshold Rehab ProComp amp FlexComp Infiniti Rehab Suite 64 CATEGORY PRO FLEX SUITE SEMG BIOFEEDBACK EQUILIBRATION These screens are designed for equilibration training Equilibration refers to bringing muscles into equilibrium EQULO 1 Equilibration with 2 EMG Equilibration 2Ch Balance Ratio a Try to oo ball in the Contes m 1 2 3 4 Scale dependent O Threshold dependent M Other This two channel ratio screen easily communicates the interplay of two muscles When the muscles are in eguilibrium the weight is in the middle of the balance When the weight is off to one end or the other the muscles are progressively more out of balance The bar graphs are connected to channels A B Eguilibration 2Ch Gorilla Ratio hymn Ty to M09 ball eren behind the gorilla S v 12 3 4 Scale d
35. instruct the examinee to perform the motion slowly until they feel restriction tightness or discomfort Measuring 1 Before performing the motion the examinee stays in neutral position and relaxes their muscles during 10 seconds A VMO 3 Atthe end of the exercise the examinee is asked to stay in neutral position and relax their muscles during 10 seconds When the session ends a series of message prompts guides you through the process of saving data adding notes to the session file and switching to reviewing mode so that you can generate a session report Rehab ProComp amp FlexComp Infiniti Rehab Suite 51 Reviewing the session In review mode a screen similar to this will appear Knee Assessment Minimum Maximum Mean Variability 3 92 2 60 0 28 18 93 0 gt nnnnnn nnns ANNANIN nnnnan BioGr ph Y The review allows you to verify that the motion has been properly performed by the examinee at the right time when prompted You can also check the consistency from trial to trial Generating a report e After the review screen opens you can generate a Dynamic SEMG Assessment report This is an Excel report 1 Click the Session Report icon um in the tool bar 2 Select Generate Excel Report Microsoft Excel opens and displays your report as a workbook You can print or save the report using Excel s Print and Save functions Section 1 Graphs Knee Assessment Clien
36. media such as animations and different graphs that change color when the signals pass their threshold markers Start the Program After making the necessary connections described in the previous chapter turn on your encoder and start the BioGraph Infiniti software Starting a session from a Favorite A Favorite is a predefined session configuration that contains all the settings you need for recording replaying and reviewing a session Depending on the session type script or open display these settings include scripts channel sets and screens statistics for session reports auto rejection settings for review mode and Excel report options Favorites simplify and standardize the process of recording and reviewing sessions Rehab Suite includes a Favorite for every protocol You find them listed in the Favorites table when you click the Quick Start button on the main BioGraph screen To start a session from a Favorite 1 Click the Quick Start button on the main screen 2 Optionally click Add New Client in the Client Data screen enter at least the person s first and last name and click OK Select a name from the list of Clients avori D SEMG 01 Cervical Spine Flexion Re extension D SEMG 02 Cervical Spine L R Lateral Flexion D SEMG 03 Cervical Spine Left Right Rotation D SEMG 04 Lumbar Spine Flexion Re extension D SEMG 05 Lumbar Spine Left Right Lateral Flexion D SEMG 06 Lumbar Spine Left Right Rotation 4 Choose
37. report 1 Click the Session Report icon zm in the tool bar 2 Select Generate Text Report select report components in the Session Report window and click Generate Report Microsoft WORD opens and displays your report You can print or save the report using WORD s Print and Save functions G SEMGO1 BASELINE ASSESSMENT This protocol measures the resting level of the muscle The patient must be asked to totally relax the muscle The protocol script is divided into 3 steps 1 Read instructions Gives you an overview of what to expect no data is recorded press any key when you are done Rehab ProComp amp FlexComp Infiniti Rehab Suite 28 2 Verify signal Take the time to make sure the sensor and cables are connected properly No data is recorded Pressing any key on your keyboard allows you to advance to the next activity 3 Baseline Relax muscles to determine new resting levels duration is 15 seconds Replaying mode Script session Client TTL TTL Screen Instructions Baseline E3 Recording mode Script session Client TTL TTL Screen Relaxation 1Ch lineg E3 Replaying mode Script session Client TTL TTL Screen Relaxation 1Ch lineg X Fie Session Edm Optio View Het File Session Eat Options View Heb File Session Edt Options View Help HE w Hi Tu2 v v Verify the signal and press a key to Keep the music playing by relaxing continue and staying below the thr
38. to a video capture device such as a webcam and the proper software installed in order to use this function CLINICAL GUIDE REFERENCE The clinical guide gives general guidelines and recommendations for the accurate use of Clinical Guide the instrumentation It also explains how to prepare the examinee and the procedure to EM E wd fo O W E Chapter RANGE OF MOTION ASSESSMENT section DYNAMIC RANGE OF MOTION ASSESSMENT Also recommended e INTRODUCTION TO SURFACE ELECTROMYOGRAPHY e SKELETAL MUSCLE PROPERTIES e SEMG ASSESSMENT section DYNAMIC SEMG ASSESSMENT GENERAL PROCEDURE Starting the Session If you are going use a webcam to make a video recording of this session connect your webcam to a USB port of your computer and turn it on e Connect the sensors to the encoder as follows MyoScan MyoScan Z sensors to channels A and B left in A right in B Optional MyoScan MyoScan Z sensors to channels C and D left in C right in D Dual single inclinometer to channel E T Myo optional optional e urn the encoder on O OO 1 Click Quick Start Rehab ProComp amp FlexComp Infiniti Rehab Suite 98 2 From Categories select Pro Flex Rehab Categories Suite Dynamic ROM Assessment Pro Rehab Suite Dynamic ROM Assessment 3 From Clients select a name Wood Chuck 4 From Favorites select the desired Favorites General Dynamic ROM Assessment Protocol Description
39. until 1 Before performing the motion the examinee stays in neutral position and relaxes their muscles during 10 seconds 3 6003 A Letside 10 70 B RightSide 4 28 BioGraph 2 Then the voice prompt asks the examinee to perform the motion three times Rehab ProComp amp FlexComp Infiniti Rehab Suite 42 rd as far as you can 3 Atthe end of the exercise the examinee is asked to stay in neutral position and relax their muscles during 10 seconds BioGraph Reviewing the session When the session ends a series of message prompts guides you through the process of saving data adding notes to the session file and switching to reviewing mode so that you can generate a session report In review mode a screen similar to this will appear a Reviewing mode Script session Client Florimond Dorian Screen Report Review 2Ch Lumbar Spine Review Screen E a Fq Fle Session Screens Edit Options View Help Lumbar Spine Assessment Minimum Maximum Mean Variability CHA Left 96 27 169 57 130 96 0 14 CHB Righ 44 08 111 53 86 26 0 24 Current CH A Left 169 57 CH B Right 108 59 i j i i i 0 4 n 4 4 4 e E nnn nn nan ns nnan1n Annas nnn n nnn 5 nn nn 3n ANS annn sn BioGraph Script 00 00 36 700 The review allows y
40. view the different phases of the motion Scroll through the session by using the scroll bar You can read the value of a given point on the signal by moving the red Time Mark The Time Mark is usually placed at the right end of the graph see picture To move the Time Mark p FAU 1 Place the cursor over the Time Mark 2 Click and hold down the mouse button 3 Drag the Time Mark to the desired position nnn Time Mark Move the mouse cursor over a marker vertical dashed line to display its label such as flexion re extension etc nnnn1R f L Rehab ProComp amp FlexComp Infiniti Rehab Suite 90 If you used a webcam to make a video recording of the session during review the video playback is synchronized to the EMG signal as you move the Time Mark back and forth along the EMG signal line graph This allows you to see lateral deviations in the movement and to observe any antalgic position The review allows you to verify that the motion has been properly performed by the examinee at the right time when prompted You can also check the consistency from trial to trial Generating a report e After the review screen opens you can generate a Dynamic SEMG Assessment report This is a Text report 1 Click the Session Report icon zn in the tool bar 2 Select Generate Text Report select report components in the Session Report window and click Generate Report Microsoft WORD ope
41. 0015 000016 000017 moe WIF 000020 000020 000027 Qood Increase the pressure e gradually at a rate al exactly 14Lbs inch or 10Kg cm or follow the yellow line Remove the algometer at the moment the patient Reference 1 Reference 2 Pressure Threshold Bal Increase the pressure gradually at a rate of exactly 14Lbs inch or 10Kg cm or follow the yellow line Remove the algometer at the moment the patient says now 114 e When the session ends a series of message prompts guides you through the process of saving data adding notes to the session file and switching to reviewing mode so that you can generate a session report Generating a report e After the review screen opens you can generate an Algometry report This is an Excel report 1 Click the Session Report icon za in the tool bar 2 Select Generate Excel Report Microsoft Excel opens and displays your report as a workbook You can print or save the report using Excel s Print and Save functions Client TTLTTL Client TTL TTL Session Date 03 11 2008 Session Date 03 11 2008 Session Time 2 43 12PM Session Time 2 43 12 PM Summary and Follow up pag Measure 1 Kg cm2 Description of site PTM C1 Left Reference 1 Opposite Side Reference 2 Surrounding Reference 1 Reference 2 Pressure Threshold Average di References 1 0 19 0 06 0 06 Measure 2 Kg cm2 PIG C4 rte Go Reference 1 Opposite S
42. 10 54 19 4M Training HRV Total Power 8 5 2008 10 54 54 AM Training Resp Abdominal Amplitude 8 5 2008 10 55 36 AM Training Resp RSA amp Amplitude 8 5 2008 10 55 14 amp M Training SC Animation amp Volume Feedback 8 5 2008 10 57 16 AM Training SC DVD 8 5 2008 10 58 38 4M Training SC Temp EMG Animation amp Yolume Feedback 8 5 2008 10 59 43 AM Training SC Temp EMG DVD 8 5 2008 11 10 20 AM Training Temp Animation amp Volume Feedback 8 5 2008 11 21 18 AM Training Temp DVD 8 5 2008 11 21 56 AM ag om z To see thumbnail images of the screens available for the Channel Set Configuration Back Cancel Seas chosen channel set select Select up to 5 Screens for Open Display Mode Picture View 3 Select FlexComp Infiniti or ProComp Infiniti as the encoder communication protocol from the drop down list at the top 4 Highlight a Channel Set on the left 5 Optionally choose a Screen Category from the drop down list Only the screens belonging to the category will display 6 Choose one to five Screens from the list and click OK To select more than one screen press down the CTRL key while clicking with the left mouse button Rehab ProComp amp FlexComp Infiniti Rehab Suite 16 Note lf this is the first time you are recording a session at this point the system will prompt you to enter key codes See page 4 for more details 7 When the recording screen opens start recording by clicking on the Star
43. 11 33 PM D SEMG 04 00 00 50 000 Val flexi Dorimond Florian amp 003 6 13 2008 1 20 02 PM D SEMG 01 00 00 50 000 Cervical Screens Picture View Physiology Jane 9 004 6 13 2008 1 25 15 PM D SEMR 02 00 01 20 000 Val CP a Trend Sarah 10 005 6 13 2008 1 32 34 PM D SEMG 03 00 01 32 000 Val CP a D SEMG 02 Left and Right Lateral Flex Instructions 6 6 2008 EEG Guy 7 006 6 13 2008 1 38 01 PM D SEMG 03 00 01 32 000 Val CP a D SEMG 03 Left and Right Lateral Flex Training script 6 13 200 EMG Ben 8 007 6 13 2008 1 43 11 PM D SEMG 01 00 00 50 000 Val CP a 6 13 2008 1 47 19PM D SEMG 02 00 01 20 000 Val CP a D SEMG 3 Left and Right Lateral F To see thumbnail images of the Start Keep Virtual Channel Settings Channel Set Configuration Add New Client Select New Script Start Default Settings Define New Session Edit Script Settings screens used in the chosen Start Session script select Picture View To record with a new script 1 Select an existing Client 2 Optionally select a previously recorded script session from the Sessions list 3 Click one of the following New Script options e Define New Session to select a new script e Keep Virtual Channel Settings Select New Script to keep the client s channel set and settings but select a different script The Script Database window opens Rehab ProComp amp FlexComp Infiniti
44. 2cm spacing of silver silver chloride electrodes backed with nickel plated brass snaps to 6 prevent corrosion e v e B T3425 UniGel electrodes for use with the EKG sensor or EMG B in case of sensitive placements on dry skin amp C T3404 Single strip electrodes versatile electrodes can be used A C as strip or separated for wider placements Static EMG electrodes P N SA9327 Standard silver silver chloride re usable electrodes backed with nickel plated brass snaps to prevent corrosion when connected to pre amplifiers for extended od periods Foot Pedal P N SA7551 The Foot Pedal connects to the encoder and allows the user to remotely drive the software initiate the recording Used for PRESS TO CLOSE SWITCH 601 wrcs 47551 C e SEMG para spinal scanning e Thermal scanning e SEMG para spinal scanning with thermographic scanning e Range of Motion assessment e Manual Muscle Testing e Algometry Rehab ProComp amp FlexComp Infiniti Rehab Suite 11 Tele Infiniti CF P N SA9600 Optional The Tele Infiniti CF turns the encoder into a long range monitoring device The unit disappears into the Compact Flash slot leaving only the antenna visible to transmit data up to 300 feet 100 m This accessory is optional Rehab ProComp amp FlexComp Infiniti Rehab Suite 12 Software Overview This chapter provides you with a rapid overview of the main functions of th
45. 6 37 les 1291 D When they are all green the DVD resumes Rehab ProComp amp FlexComp Infiniti Rehab Suite 73 Respiration Training OVERVIEW Respiration training should be considered as part of the rehabilitation program e Proper breathing during effort enhances the efficiency of the contraction and therefore the efficiency of the training e Proper breathing is necessary for overall health and speeds up healing e Respiration training may also help the examinee to relax before therapy reduces anxiety The following biofeedback training screens were designed for this purpose This logo on a screen in a protocol indicates that you can use an optional webcam with the screen to record video of the session You need only connect your webcam to a USB port of your computer and turn it on before you start the session Note Your computer system must be connected to a video capture device such as a webcam and the proper software installed in order to use this function The clinical guide gives general guidelines and recommendations ili i Chapter RESPIRATION TRAINING WITH BIOFEEDBACK PROCEDURE e Connect the sensors to the encoder as follows o Respiration sensor to channel D o MyoScan MyoScan Z to channel A and B optional A e c Dp EJ F A To 4 Myo Myo optional optional e um the encoder on 1 Click Quick Start 2 From Categories select Pro Flex Reh
46. Accuracy HR BVP Flex Pro Sensor SA9308M Length approx Weight Input range Accuracy Respiration Sensor SA9311M Size approx Weight Range ProComp amp FlexComp Infiniti Rehab Suite 37mm x 37mm x 15mm 1 45 x 1 45 x 0 60 25g 1 oz 10GO in parallel with 10pF 0 400uVnus O 1600u Vnus 0 1 UVRMS 20Hz 500Hz 5 0 3uVnwus 152cm 60 10g 0 330z 10 C 45 C 50 F 115 F 1 0 C 1 8 F 20 C 40 C 68 F 104 F 20mm x 34mm x 10mm 0 72 x 1 33 x 0 41 20g 0 66 oz Unit less quantity displayed as 0 10096 5 132cm 52 long 30g 1 0 oz 30 65 117 Rehab Skin Conductance Flex Pro Sensor 8A9309M Size without electrode leads approx Size with electrode leads approx Cable length approx Weight approx Signal input range Accuracy Skin Temperature Sensor 8A9310M Length approx Weight Temperature range Accuracy 3 5 cm 1 4 15 cm 6 0 127 cm 50 25 g 1 oz 0 30 0 uS 5 and 0 2 uS 152cm 60 10g 0 330z 10 C 45 C 50 F 115 F 1 0 C 1 8 F 20 C 40 C 68 F 104 F InclinoTrac Dual InclinoTrac SA7650 SA7655 Dimensions Weight Range Accuracy operated in vertically oriented plane lt 2 0 dual mode angle difference Output gain Output voltage span Power supply Current consumption maximum Link cable Force
47. Connects via extender cables for a single channel hook up Am Used for e Heart Rate Monitoring and HRV Respiration Sensor P N SA9311M f The Respiration Sensor includes a sensitive and reliable girth sensor using an easy fitting high durability latex rubber band fixed with self adhering belt for monitoring respiration rate waveform and amplitude Can be worn either thoracically or abdominally over clothing Used for e Respiration Training e Relaxation e Heart Rate Monitoring and HRV Skin Temperature Sensor P N SA9310M The Temperature sensor measures skin surface temperature between 10 C 45 C 50 F 115 F It is supplied with a self adhering band for easy finger _ placement Used for e Stress Assessment e Relaxation Rehab ProComp amp FlexComp Infiniti Rehab Suite 10 Skin Conductance Sensor P N SA9309M The Skin Conductance sensor measures the conductance across the skin and is normally connected to the fingers or toes Supplied with two finger bands Used for e Stress Assessment e Relaxation EKG Wrist Straps P N SA9325 EKG Wrist Straps come in a kit containing Y A LE m reusable medical grade non latex straps and i replaceable silver silver chloride electrodes N They provide fast convenient placement of electrodes for measuring EKG from the wrists A Y e Y Disposable EKG EMG electrodes A T3402M Triode electrode with standard
48. E SEMG BIOFEEDBACK RELAXATION These screens are designed for muscle deactivation training and ultimately total relaxation RELAXO 1 Relaxation with 1 EMG Relaxation 1Ch Line Graph AT 375 72 CE 12345 Scale dependent M Threshold dependent Other Music is played when the channel A signal stays below the threshold Rehab ProComp amp FlexComp Infiniti Rehab Suite 97 Relaxation 1Ch Relaxation Bar Graph 1 2 3 4 5 Scale dependent v Threshold dependent L Other Music is played when the channel A signal stays below the threshold Relaxation 1Ch Smiley 12 3445 Scale dependent v Threshold dependent O Other The face will smile when the channel A signal is below the threshold Relaxation 1Ch Knee Flexion 12 3 4 5 Scale dependent v Threshold dependent O Other When the signal is below the threshold the leg relaxes when above it straightens Relaxation 1Ch Wrist Flexion 1234 5 Scale dependent v Threshold dependent O Other When the signal is below the threshold the wrist relaxes when above it straightens RELAX02 Relaxation with 1 EMG Relaxation 1Ch Filled Line Bar Graphs 12345 Scale dependent v Threshold dependent Other Music is played when the channel A signal stays below the line graph threshold The signal is displayed in two different views filled line graph and bar graph Rehab ProComp amp FlexComp Infiniti Rehab S
49. G Assessment sccccccccscscscsccccccccscsccccccccscscsesccscccsoscscsecscsososess OO OVERVIEW e SER 38 CLINICAL GUIDE REFERENCE a t 38 CENERALE PROCEDUR E 38 Staring the SOCSSION s sisien apna EE EEE EEE EEEE EEA EEE EEEE I On UC o nA 38 A eS NMA e E FF RY FF E RF FN 39 Reviewing NR clle NT e oa en EE orre GR e y ee eee eee 39 Gener EON ee O E Y Y Y NN 41 PROCEDURE FOR LUMBAR SPINE ASSESSMENT ccccccssseeceeseeecenseeeeaseeseaeeseeaseeseaseeseaasesoaaseseeasessoaseesoaaeesenaeeees 41 AOE e ae E EA E HF HR UN FNF 41 SO MO a a E YF YN OA E E E YF En ET GE eee 42 Reviewing GSC SSIO ERE m m R E a E aE aa 43 Generalno i e o MNT Em t 44 PROCEDURE FOR CERVICAL SPINE ASSESSMENT 11 eeeiieeeclieeenuiee nnn auae nanus sas a a sas u a assa asas sn sas s anas mnnn 45 iria gre SOS ol ON NERONI m RENTRER 45 TS AS d 8 asthe crete E me 46 Reviewing the SS IOI e T L EON 47 OTIS 0o 8 100 TREE ser RFC A O RF AY FE RF FA NEF NF FF NWY 47 PROCEDURE FOR ANTERIOR KNEE ASSESSMENL ieiiinna etse eiu uU onda E VB GWADN ARWR c quA aU GHA DWM aua dX Vu va Dux D c pau ONR 49 Rehab ProComp amp FlexComp Infiniti Rehab Suite iv Starling the SION ce
50. IBLE Bulk Screen Gener E3 Elle Session Screens Edit Options View Help xl Mn Mas 30 sec vi lt 12 amp mamic SEMG Assessment 150 100 5p 62 BioGr ph Y Open session 00 00 51 408 D EMG General Dynamic Assessment with 4 EMG The two Multi line graph will display the EMG signal of 2 channels simultaneously respectively A and B C and D The Bar graphs indicates the Difference between the signals A and B C and D There are statistics available as well Mark the different stages of the movement with event makers events can be marked by hitting the space bar or a key of the keyboard that you would have preliminarily labeled with the name of the event Reviewing the session When the session ends a series of message prompts guides you through the process of saving data adding notes to the session file and switching to reviewing mode so that you can generate a session report A Rehab ProComp amp FlexComp Infiniti Rehab Suite In review mode a screen similar to this will appear General Dynamic SEMG Assessment Minimum Maximum Mean Variability A Left 4 16 1957 4 131 59 2 45 B Right 5 81 1905 2 149 77 2 00 fr 4R aph nnnm 43 nn i BioGr D EMG General Dynamic Assessment with 2 EMG The Multi line graph will display the EMG signal of 2 channels A and B The Bar graph indicates the 96 Difference between the two signals There are statistics avail
51. M or Traps 2 Then the voice prompt ask the examinee to perform the motion three times Rehab ProComp amp FlexComp Infiniti Rehab Suite 46 p nnanin SCM or Traps 3 Atthe end of the exercise the examinee is asked to stay in neutral position and relax their muscles during 10 seconds SCM or Traps 4 BioGr ph Reviewing the session e When the session ends a series of message prompts guides you through the process of saving data adding notes to the session file and switching to reviewing mode so that you can generate a session report In review mode a screen similar to this will appear Cervical Spine Assessment Minimum Maximum Mean Variability mman 3 78 6 42 4 95 0 11 CHB Righ 357 5 61 4 75 0 08 CHC Left 2 78 8 91 4 02 0 32 CHD Right 978 7 83 3 91 0 22 Current CHA Left 4 45 CHB Right 4 85 CHC Left 3 54 CHD Right 3 50 100 f 50 i NANNAN nnn a n 3n nn nn 4n fi an 45 AMANAN 4 nnn 15 L 4 nnnn 5 n n nn Aras 0 nnnntna an an 3n NANNAN nnanns nnnn40 nnnn n fin nn 45 na ann BioGraph The review allows you to verify that the motion has been properly performed by the examinee at the right time when prompted You can also check the consistency from trial to trial Generating a report e After the review screen opens you can generate
52. ProComp amp FlexComp Infiniti Rehab Suite 113 Position yourself next to the examinee with the encoder attached to your belt the pedal near your foot and the ForceTrac in the palm of your hand Measuring Repeat the following sequence three times once for each pressure threshold measure Reference 1 Reference 2 Pressure Threshold e aph y Measure of reference 1 Apply the tip of the algometer over the marked area and perpendicular to the surface of the skin When ready to measure press the foot pedal Reference 1 Reference 2 Pressure Threshold E BioGraph B Measure of Tr 2 Apply the tip of the algometer over the marked area and perpendicular to the surface of the skin When ready to measure UE the foot ee om js mg ms Reference 1 Reference 2 Pressure Threshold s BioGr ph Measure oft pressure e threshold ADD the tip of the algometer over the marked area and perpendicular to the surface of the skin When ready to measure press the foot pedal Pressu siki p tuti AU on Slepe Aivi Rehab ab ProComp amp FlexComp Infiniti Rehab Suite Reference 1 Reference 2 Pressure Threshold a ww como ow mum wa w Ws namo QU Increase the pressure gradually at a rate of exactly 14Lbs inch or 10Kg cm or follow the yellow line Remove the algometer at the moment the patient says now Reference 1 Reference 2 Pressure Threshold 00
53. Protocol for Cervical Spine Description D SEMG General Dynamic Assessment with 2 EMG 9 Click OK D SEMG General Dynamic Assessment with 4 EMG D SEMGO1 Cervical Spine Flexion Re extension D SEMGO2 Cervical Spine L R Lateral Flexion D SEMGO3 Cervical Spine Left Right Rotation D SEMG04 Lumbar Spine Flexion Re extension D SEMGU S Lumbar Spine L R Lateral Flexion D SEMG06 Lumbar Spine Left Right Rotation D SEMGU7 Knee Assessment e Click the Start button zi and read the instructions on the screen Rehab ProComp amp FlexComp Infiniti Rehab Suite 45 First you will see an overview screen Flexion Re extension shown here Flexion Re extension Evaluation edi Bend the head forward and hold at the lowest point until prompted unenvetume to the upright position The motion restarts at the next d forward and is repeated for three times p Placement of electrodes Sub ves Press a key to continue BioGraph e Press a key to go to the next screen In the next screen verify that the signal is free of artifacts and the sensors properly placed ress a key to continue SCM or Traps 4 BioGraph e Before going to the next screen and start recording instruct the examinee to perform the motion slowly until they feel restriction tightness or discomfort Measuring 1 Before performing the motion the examinee stays in neutral position and relaxes their muscles during 10 seconds SC
54. Rehab Suite 14 Script Database x Please select a script Turn encoder s ON and click OK Please select an Encoder Communication Protocol Script Categories FlexComp Infiniti Static SEMG Assessment Description DIM E Channel Set Description Date Modified S EMG 01 Para Spinal Scanning 00 00 24 000 2 Static SEMG Assessment Static SEMG Assessment 8 28 2008 3 49 24 PM Picture View Script Screens Description Categor Date Modified Static SEMG Assessment C6 Verification Static SEMG Assessment 8 12 2008 2 28 22 PM Static SEMG Assessment Instructions Static SEMG Assessment 8 12 2008 2 07 28 PM Static SEMG Assessment L1 Verification Static SEMG Assessment L3 Verification Static SEMG Assessment L5 Verification Static SEMG Assessment Recording Static SEMG Assessment T10 Verification Static SEMG Assessment Static SEMG Assessment Static SEMG Assessment Static SEMG Assessment Static SEMG Assessment 8 12 2008 2 21 06 PM 8 12 2008 12 47 22 PM 8 12 2008 12 47 34 PM 8 12 2008 12 48 03 PM 8 12 2008 12 48 37 PM Static SEMG Assessment T2 Verification Static SEMG Assessment A 0 Am O I i At 8 12 2008 2 24 42 PM gt fu m mmm OO rms Cancel Channel Set Configuration Edit Script Settings Script Database 4 Select FlexComp Infiniti or ProComp Infiniti as the encoder communication protocol from the drop down list at the top 5 Optionally choose a Script Category from the drop down list On
55. SURFACE ELECTROMYOGRAPHY PROCEDURE Starting the Session e Connect the sensors to the encoder as follows o ForceTrac to channel D o Foot pedal to channel C o MyoScan MyoScan Z to channel A and B optional yo E NM NAM G a Optional e Turn the encoder on 1 Click Quick Start 2 From Categories select Pro Flex Rehab Categories Suite Manual Muscle Testing Pro Rehab Suite Manual Muscle Testing Rehab ProComp amp FlexComp Infiniti Rehab Suite 105 3 From Clients select a name Clients V ood Ch uck 4 From Favorites select the desired Favorites Muscle Testing Protocol Description 9 Click OK MMTO1 Manual Muscle Testing Training MMTO2 Manual Muscle Testing Training with EMG MMTO3 Unilateral Muscle Testing MMT04 Bilateral Muscle Testing MMTOS5 Unilateral Muscle Testing with EMG MMT06 Bilateral Muscle Testing with EMG Muscle Testing Training MMTO1 amp MMTO2 These screens were designed for training purposes and for becoming familiar with the procedure and the instrumentation They allow the recording of video so the session can be replayed If you use EMG sensors MMTO2 position them on the muscles of interest Note Make sure your ForceTrac is properly calibrated before starting Click the Start button a Ask the examinee to complete the range of motion and stabilize their position Position the ForceTrac on the examinee
56. Trac SA7600 Dimensions Weight Input range force Safe overload Accuracy Zero level output Full scale output swing Power supply Algometer Attachment Dimensions Weight Material Flat Tester Attachment Dimensions Weight Material Curved Tester Attachment Dimensions Weight Material ProComp amp FlexComp Infiniti Rehab Suite 32mm x 18mm x 71mm 26g 180 lt 1 0 standalone mode 4 44mV degree inclination 2 200 0 8V 7 26V 9 5 mA standalone mode 19 0 mA dual mode RJ 11 2 pairs reversed this is not a standard telephone cable 93mm x 68mm x 25mm 94g 0 100 Ibf 250 Ibf 0 1Ibf 5 of reading 2 048V 1V at 100 lbs load 7 26V 69mm x 11mm diameter 14g Aluminum 9mm x 42mm diameter 39g Neoprene 19mm x 42mm diameter 52g Neoprene 118 Placing Orders Outside USA Tel 1 514 489 8251 Fax 1 514 489 8255 In USA Toll Free Tel 1 800 361 3651 E Mail mail thoughttechnology com Or contact your local authorized distributor Technical Support Outside USA Tel 1 514 489 8251 Fax 1 514 489 8255 In USA Toll Free Tel 1 800 361 3651 E Mail techsupport thoughttechnolo Or contact your local authorized distributor Warranty The hardware encoder and sensors is guaranteed to be free from defects in material and workmanship for 1 year from the date of purchase In the unlikely event that repair is necessary contact Thought Technolog
57. a Category from the drop down list Only the favorites belonging to the category will display 5 Select a Favorite from the list 6 Click OK If there is no problem with your encoder or sensor connection the recording screen will open Add New Client Rehab ProComp amp FlexComp Infiniti Rehab Suite 13 Note lf this is the first time you are recording a session at this point the system will prompt you to enter key codes See page 4 for more details 7 Start recording by clicking on the Start button 3 in the toolbar Starting a Script Session Select Start Script Session from the Main Menu screen This opens the Start Session screen where you go through the process of selecting a client file and script setting up session parameters and launching recording mode Start Session x Please check your preferences switch encoders ON and click Start Channel Set Description Clients Sessions Dynamic SEMG Assessment Full Name ID N Clinic ID DateandTime Script Duration _ Descipi _ Channel Set Description Script Description Wood Chuck 14 6 6 2008 355 04PM D SEMG 05 00 01 32 000 Vallater yne cM ei D SEMG 05 Lumbar Spine Left Right Lateral Flexion 00 01 i Script Description RF ee Ballance Tara 1 001 6 6 2008 4 00 10 PM D SEMG 06 00 01 32 000 Val rotati D SEMG 05 Lumbar Spine Left Right Lateral Flexion BOE Vv Picture View Florimond Dorian 4 002 6 6 2008 4
58. a key to go to the next screen In the next screen verify that the signal is free of artifacts and the sensors properly placed Verify the signal and press a key to continue 0 000000 000003 MOG 000003 000012 MOS 000018 000021 000024 000027 e Press the zero button of the inclinometer once to mark the neutral position e Before going to the next screen and start recording instruct the examinee to perform the motion slowly until they feel restriction tightness or discomfort Measuring 1 Before performing the motion the examinee stays in neutral position and relaxes their muscles during 10 seconds Pre baseline REST 2 Then the voice prompt ask the examinee to perform the motion three times Rehab ProComp amp FlexComp Infiniti Rehab Suite 95 Flexion Bend Forward 200 000013 000016 000019 000022 000025 000028 000031 000034 000037 000040 629 12 270 91 629 12 270 91 3 Atthe end of the exercise the examinee is asked to stay in neutral position and relax their muscles during 10 seconds Post baseline REST Difference a MEN Differ Reviewing the session e When the session ends a series of message prompts guides you through the process of saving data adding notes to the session file and switching to reviewing mode so that you can generate a session report In review mode a screen similar to this will appear Fle Session Screens Edit Options View Heb E I0 Min Max
59. a name Clients Full Name ID Number _ Clinic ID Wood Chuck 4 From Favorites select the desired Favorites Dynamic SEMG Protocol for Lumbar FC Spine Description D SEMG General Dynamic Assessment with 2 EMG 9 Click OK D SEMG General Dynamic Assessment with 4 EMG D SEMGO1 Cervical Spine Flexion Re extension D SEMGO 2 Cervical Spine L R Lateral Flexion D SEMG S3 Cervical Spine Left Right Rotation D SEMGO4 Lumbar Spine Flexion Re extension D SEMGO5 Lumbar Spine L R Lateral Flexion D SEMGO6 Lumbar Spine Left Right Rotation D SEMGO Knee Assessment e Click the Start button 3 and read the instructions on the screen Rehab ProComp amp FlexComp Infiniti Rehab Suite 41 First you will see an overview screen Flexion Re extension shown here West point until prompted to Return to neutra positio motion restarts at the next Bend forward prompt Range of motion mi E Press a key to continue BioGr a e Press a key to go to the next screen In the next screen verify that the signal is free of artifacts and the sensors properly placed ind press a key to 0 000000 000003 000006 000009 000012 000015 000018 000021 000024 000027 000030 EUN 1408 EXE Min ax Mean n Variabiliy 103 98 ioGraph they feel restriction tightness or discomfort Measuring Before going to the next screen and starting to record instruct the examinee to perform the motion slowly
60. ab Categories Suite Respiration Training Pro Rehab Suite Respiration Training Rehab ProComp amp FlexComp Infiniti Rehab Suite 74 3 From Clients select a name Clients 4 From Favorites select the training Favorites protocol Description 5 Click OK Respiration Training e Click the Start button You can view each screen by clicking on the numerical buttons on the toolbar at the top af oE e Tostop the session click the Stop button gl Training Abdominal Respiration Training 12345 This screen was designed to train abdominal breathing The line graph at the bottom displays the respiration amplitude The two line graphs on the right display the EMG of the associated muscles If the EMG of one channel is above its threshold music will be heard och Training Abdominal Respiration Training Windmill 1 2 3 4 5 This screen was designed to train abdominal breathing The greater is the abdominal respiration amplitude the faster the windmill turns The line graph at the bottom displays the respiration amplitude The two line graphs on the right display the EMG of the associated muscles If the EMG of one channel is above its threshold the windmill will stop turning and music will be heard Training Relaxation Training 1 2 3 4 5 This screen was designed for relaxation The line graph displays the respiration amplitude The examinee must follow the pink dot This will le
61. able as well Select the desired display time window on the screen by using the dropdown list It is recommended to select first Size to session for a global view of the session and then Size to activity to view the different phases of the motion Scroll through the session by using the scroll bar You can read the value of a given point on the signal by moving the red Time Mark The Time Mark is usually placed at the right end of the graph see picture To move the Time Mark 1 Place the cursor over the Time Mark 2 Click and hold down the mouse button 3 Drag the Time Mark to the desired position Move the mouse cursor over a marker vertical dashed line to display its label such as flexion re extension etc Rehab ProComp amp FlexComp Infiniti Rehab Suite General Dynamic SEMG Assessment Minimum Maximum Mean Variability A Left 1 54 150 16 14 05 2 63 B Right 4 46 155 84 16 81 2 13 C Left 2 10 70 12 9 02 1 77 D Right 4 10 1252 1 175 12 2 02 BioGraph D EMG General Dynamic Assessment with 4 EMG The two Multi line graph will display the EMG signal of 2 channels simultaneously respectively A and B C and D The Bar graphs indicates the Difference between the signals A and B C and D There are statistics available as well Size to session size to activity ls amm R gt ht 108 59 nn an Time Mark ANNA f L E 40 If you used a webcam to make a video re
62. ad them to a slow breathing rate around 6 breath min EioGr phY pen session 00 02 25 000 00 0 Re hob ProComp amp FlexComp Infiniti Rehab Suite 75 Training Respiration During Exercise 1 during exercise 12 3 4 5 The screen was designed to help the examinee to breath properly during an exercise It has a line graph displaying the respiration amplitude and a video camera A tone proportional to the respiration amplitude can be heard Review screen Report Review Respiration and EMG Review Screen The screen was designed for the review of the session Respiration and EMG Review Screen It shows the respiration amplitude and the EMG activity along with 4e the video Mt t t rinde Resp Amplitude A RMS EMG n 0 0x B RMS EMG Resp Amplitude Max All these screens are accessible from Start Open Display Session in the channel set Respiration Training Reha b ProComp amp FlexComp Infiniti Rehab Suite 76 UITE Heart Rate Monitoring and HRV OVERVIEW The system allows the therapist to monitor rapid changes in the heart rate It gives the choice of gathering the heart rate from EKG electrocardiogram or BVP Blood Volume Pulse The following screens allow the monitoring of heart rate from BVP or EKG respiration and EMG 2 sites This logo on a screen in a protocol indicates that you can use an optional webcam with the screen to record video of the session You need only c
63. al training They will reinforce good posture with visual assistance Equilibration 4Ch Postural Training Cervical amp Thoracic Spine 1 2 3 4 5 Scale dependent O Threshold dependent M Other The light will turn red when the difference between the two muscles at the site is greater than 3596 The mirrored bar graphs assist the comparison at the site Eguilibration 4Ch Postural Training Cervical amp Lumbar Spine 1 2 3 4 5 Scale dependent O Threshold dependent M Other The light will turn red when the difference between the two muscles at the site is greater than 35 The mirrored bar graphs assist the comparison at the site Equilibration 4Ch Postural Training Thoracic amp Lumbar Spine 1 2 3 4 5 Scale dependent O Threshold dependent M Other The light turns red when the difference is greater than 35 Both signals are also displayed in the same line graph and bars for comparison EGUL04 Postural Training with 6 EMG FlexComp Infiniti only Eguilibration 6Ch Bi Lateral Video 1 2 34 5 Scale dependent O Threshold dependent M Other Comparing 6 muscle sites the difference between each two muscle site should be less than 359e The red light will be on to indicate the difference is greater than 3590 Rehab ProComp amp FlexComp Infiniti Rehab Suite Ble Session Sgews Ed Options Mew tip ne Max Sorc Y A RMS 4 02 Et D RMS 24 19 The light
64. an select the muscle test type different list for unilateral bilateral test Type it here or select I Type it here or select gt Scapular Abduction and Upward Rotation COCH Scapular Elevation MUSCLE TEST Result Max Scapular Adduction Scapular Depression and Adduction 30 329 Scapular Adduction and Downward Rotation 32 815 Shoulder Flexion Trial 3 235 777 Shoulder Extension v Or you can enter your own test MUSCLE TEST Ce i Rehab ProComp amp FlexComp Infiniti Rehab Suite 110 Involved bilateral testing only You can select the involved side right left Select Select LEFT RIG INVOLVED Uninvolved Grade You can select the grade GRADE sSelect Summary and Follow up notes You can enter notes in the summary follow up notes boxes Summary Notes Marked improvement Rehab ProComp amp FlexComp Infiniti Rehab Suite e n Excel 2007 place your cursor in the text box 1 Right click the mouse button 2 Select Edit text 3 Start typing e n Excel 2000 and Excel 2003 place your cursor in the text box and start typing 111 Algometry OVERVIEW Algometry measures Pressure Threshold PTM It quantifies the sensitivity of para spinal tissues and their tenderness CLINICAL GUIDE REFERENCE The clinical guide gives general guidelines and recommendations for the accurate use of Clinical Guide the i
65. and D left in C right in D _ o B 9l PI IU 9 Un Myo Myo Myo optional optional e Turn the encoder on Rehab ProComp amp FlexComp Infiniti Rehab Suite 38 1 Click Quick Start 2 From Categories select Pro Flex Rehab Suite Dynamic SEMG Assessment 3 From Clients select a name Categories Wood Chuck 4 From Favorites select the desired General Dynamic Assessment Protocol 5 Click OK Measuring e Click the Start button gt i Favorites Description D SEMG General Dynamic Assessment with 2 EMG D SEMG General Dynamic Assessment with 4 EMG D SEMGO1 Cervical Spine Flexion Re extension D SEMGO2 Cervical Spine L R Lateral Flexion D SEMGU S3 Cervical Spine Left Right Rotation D SEMGO4 Lumbar Spine Flexion Re extension D SEMGU S Lumbar Spine L R Lateral Flexion D SEMG06 Lumbar Spine Left Right Rotation D SEMGU7 Knee Assessment File Session Screens Edit Options View Help L 9 01 3 Mex 20 Msec wj S gt 1 eB inamic SEMG Assessment Sert 00 00 46 170 D EMG General Dynamic Assessment with 2 EMG The Multi line graph will display the EMG signal of 2 channels A and B The Bar graph indicates the 96 Difference between the two signals There are statistics available as well Reviewing mode Script session Client INCREDIBLE Bulk Screen General Purp E3 KL c Reviewing mode Open Display session Client INCRED
66. ategories starting with Pro Flex Rehab Suite Motor Function Restoration 3 From Clients select a name Wood Chuck 4 From Favorites select the desired Motor Favorites Function Restoration Protocol 5 Click OK MFRO1 Motor Function Restoration with 4 SEMG e Click the Start button You can view each screen by clicking on the numerical buttons on the toolbar at the top mj Blas Rehab ProComp amp FlexComp Infiniti Rehab Suite 72 All the screens under this category are based on the same principle Only the number of channels and their assignment to a group uptrain downtrain vary The feedback is given on the ensemble of the signals The patient gets a reward only if all the muscles simultaneously follow their correct activation pattern The muscles and their corresponding signals are sorted into two groups the up trained and the down trained The up trained muscles are the ones that will be encouraged to fire The down trained muscles are the ones that will be discouraged to fire When the EMG of the up trained muscles goes above a threshold and the EMG of the down trained muscles goes below a threshold the DVD resumes All the uptrain signals are on the left while all the downtrain ce signals are on the right When a signal is not in the right state above threshold for uptrain below for downtrain the corresponding bar is red and green otherwise hb b Up train Ed Down train B 15
67. baseline REST OY Ge Tr rrrrrrrrrrrerereresss tinet 90 09 18 AIT OF 3 Pre baseline Replaying mode Script session Client TTL TTL Screen Training 1Ch Line Gr E He Session Ed Options View pip D i wi na mm CONTRACT AND HOLD 6 Endurance SEMG ASSESSMENT GENERAL PURPOSE G SEMG06 and up This section regroups generic display screens designed for SEMG Assessment As opposed to the protocols above here there is no seguence of actions and limitation of time G SEMG06 SEMG Assessment with 2 EMG General Purpose 1Ch A General Purpose me ci E 1 2 3 4 wr One channel display of signal The line graph is to display the RMS EMG It displays the power spectrum and median freguency as well as statistics Rehab ProComp amp FlexComp Infiniti Rehab Suite A RMS 47 35 Median Frequency amp Power Spectrum A Max MF 131 00 A Min MF 22 00 A MF 66 00 BioGr ph y J coal 901 92 31 General Purpose 1Ch B General Purpose Se n un xl id 213 B RMS i Power Spectrum 1 2 3 4 One channel display of signal The line graph is to display the RMS EMG It displays the power spectrum and median PARERES frequency as well as statistics Eo Nit B Min MF 38 00 B MF 88 00 U Reviewing mode Open Display session Client INCREDIBLE Bulk Screen Gener E3 Ble Sesion Soeens Edt Options View twp o gt Mae ve 4 gt 2 1 s A RMS 53 84 Wis Rus 68
68. body part where the resistance will be applied and the hand applying the resistance 3 Apply resistance gradually and in the direction of the motion The exercise is repeated 4 times For more information on how to position the ForceTrac please read your BioGraph Waiting for condition e Position yourself next to the examinee with the encoder attached to your belt the pedal near your foot and the ForceTrac in the palm of your hand e Press the foot pedal to go to the next screen e Position and stabilize the examinee in neutral position e Ask the examinee to complete the range of motion and stabilize their position e Position the ForceTrac on the examinee and perform a trial at 50 load do not press the pedal Prior to the test 1 Instruct the patient on how to perform the exercise 2 Perform test trial at 50 of the resistance Press the Pedal to continue 0 m 000030 000031 MOR 000033 000034 000035 000036 000037 000038 000033 000040 BioGraph Test Run Activity 2 Cycle 1 Step 1 Activity progress Waiting for condition e Press the foot pedal to go to the next screen The examinee should be monitored closely and tests should be terminated immediately if there is any evidence of pain Measuring 1 Askthe examinee to complete the range of motion and stabilize their position Rehab ProComp amp FlexComp Infiniti Rehab Suite 107 screens Edit Options View Hel Thri 1 Ask
69. c as indicated in the clinical guide Start the range of motion as shown in the video example when prompted Hold the bend at the lowest point until prompted to Return to neutral position returning to the upright position The motion restarts at the next Bend forward prompt Press a key to continue BioGr ph Y e Press a key to go to the next screen In the next screen verify that the signal is free of artifacts and the sensors properly placed Verify the signal and press a key to continue 20 000030 000033 000036 000039 000042 000045 000048 00005 Moe 000057 000100 e Press the zero button of the inclinometer once to mark the neutral position e Before going to the next screen and starting to record instruct the examinee to perform the motion slowly until they feel restriction tightness or discomfort Measuring 1 Before performing the motion the examinee stays in neutral position and relaxes their muscles during 10 Seconds Pre baseline REST 2 Then the voice prompt asks the examinee to perform the motion three times Rehab ProComp amp FlexComp Infiniti Rehab Suite 92 Re extension Back to Neutral 3 Atthe end of the exercise the examinee is asked to stay in neutral position and relax their muscles during 10 seconds Post baseline REST 200 000055 000058 00010 0001094 000107 000110 000113 000116 000119 000122 000125 Reviewing the session When the session ends a se
70. c cO ARR E REE NR EEEa d redde 21 TOOL BAR Re IIO c X X X A 22 Rehab ProComp amp FlexComp Infiniti Rehab Suite iii Toggling Between ScreenS EIE TT 22 Adjusting Scales and Threshold ET S 22 USING A WEB CAMERA ees E EE E E E E AAAA AAA EAA 23 USING A qr spe RFY 23 SENSOR CALIBRATION AND ZEROING ua aain RR IEEE Deb De ELE MOR NR EUER ER QUAE De cav OO oed Ear EON EER ROED FERN RG MS OR eq 23 INPEDANCE CHECI em 25 General SEMG Assessment ccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccs 27 OVERVIEW isis wa sis ra tee aa a a ei ea Se a ae ae ae E desde ace sce sh cen ede esate dees ees 27 eB e mc iizEigz ieum u DR 27 GENEBHALPRHOCEDUBE uu a ie RE HERE ERES EEUU E RLAEESIRE IEEE EE 27 SANNE SOS SI OM PN TTE TET 27 IS AS NIG PECH T H 28 Reviewing the session RE ERE 28 EEE Ee HC o el R dM wd ddd E A WU E eee ee 28 G SEMGOT BASELINE ASSESSMENT sessin EE EEE 28 G SEMG02 MAXIMAL FORCE ASSESSMENT ccccccesseeeesneeeeeneeeeeaseeseeneeseeasseceaaeeseaaseeseasessoaaeesonaseseosessoaneesonneeses 29 G SEMGUS ENDUR ANCE ASSESSMENT au GG GG GY de O GOG GO Go
71. ch means both signals must be at the same level Channel B could be connected to the healthy site in order to use it as a model for the unhealthy site Ej sasn Relaxation 2Ch Relaxation with DVD mee uem fa e A BO E 1 2 3 4 Scale dependent M Threshold dependent Other The DVD will resume playing when both channels A and B are below the threshold CATEGORY PRO FLEX SUITE SEMG BIOFEEDBACK STRENGTHENING These screens are designed for muscle activation training and ultimately strengthening The scale should be adjusted according to the maximal force and the threshold to the training goal STRNO1 Strengthening with 1 EMG The three screens show a classic view of the signal with bar graphs and line graphs Strengthening 1Ch Bar Graph 1 2 3 4 Scale dependent M Threshold dependent Other This screen graphs the channel A signal on a bar graph and also displays statistics A sound plays when the signal goes above the threshold Replaying mode Open Display session Client INCREDIBLE Bulk Screen Streng Ble Session Screens Eat Options View Heb Max T Pe mL mmm Keep the music playing by sil x Replaying mode Open Display session Client INCREDIBLE Bulk Screen Streng Die Session Sowers Edt Qoo Wew Hep Strengthening 1Ch Filled Line Graph I ONU MONEO ee eae 1 2 3 4 Scale dependent M Threshold dependent Other The signal changes color and bolero music pla
72. cording of the session during review the video playback is synchronized to the EMG signal as you move the Time Mark back and forth along the EMG signal line graph This allows you to see lateral deviations in the movement and to observe any antalgic position The review allows you to verify that the motion has been properly performed by the examinee at the right time when prompted You can also check the consistency from trial to trial Generating a report e After the review screen opens you can generate a Dynamic SEMG Assessment report This is a Text report 1 Click the Session Report icon zn in the tool bar 2 Select Generate Text Report select report components in the Session Report window and click Generate Report Microsoft WORD opens and displays your report You can print or save the report using WORD s Print and Save functions PROCEDURE FOR LUMBAR SPINE ASSESSMENT Starting the Session If you are going use a webcam to make a video recording of this session connect your webcam to a USB port of your computer and turn it on e Connect the MyoScan MyoScan Z EMG sensors to the encoder in channels A and B left in A right in B pA B ocj p E F e Aw M Myo Myo left right e Turn the encoder on 1 Click Quick Start Ir 2 From Categories select Pro Flex Rehab Categories Suite Dynamic SEMG Assessment Pro Rehab Suite Dynamic SEMG Assessment 3 From Clients select
73. cribed fully in the chapter Software Overview beginning on page 13 e Quick Start Click this option to record a Favorite session page 13 This is the preferred method for recording sessions p Ar RN Y Quick Start e Start Open Display Session Click this option to record an unscripted AR session using your own selection of feedback screens page 16 e Start Script Session Click this option to record a script session page 14 Start Open Display Session t eie S NE ITE eE eee 1 Click Quick Start select a name from the Clients list and a protocol from the Favorites list and then click OK 2 The Encoder Key Codes dialog box opens Rehab ProComp amp FlexComp Infiniti Rehab Suite 3 Click to highlight your units serial number in the left table in this example DA1002 this is the same number as on the back of the unit Please select an encoder serial number and enter a Key Code for it Expected physical channel configuration Mi A E Key Code Configuration T able EAUX Clear gt FlexC i Infiniti DA1002 The serial number is found on the back of the encoder Cancel Return to entenhg encoder ETT TS BITIBETS 4 Enter the Encoder Key Code found inside the encoder battery compartment in the Key Code text box Click gt to move the serial number from the left table to the right table The serial number s
74. ctions on the screen You can view each screen by clicking on the numerical buttons on the toolbar at the top aJ Bias Rehab ProComp amp FlexComp Infiniti Rehab Suite 71 Unstable Shoulder 2Ch Unstable Shoulder Overview Screen eme Seen oiplay sesion client TTL TTL Screen Unstable E mage iz n 1 e j E 5 elow shows briefly what motions the patient is expected to do Mect screen 2 from the Too bar or the Screens menu Scale dependent sal Ranges of Motion Threshold dependent O Other This screen will demonstrate videos of reguired ranges of motion that the patient is reguired to perform Unstable Shoulder 2Ch Unstable Shoulder Training Screen 1 2 3 4 5 Scale dependent M Threshold dependent Two filled line graphs represent Infraspinatus muscle Ch A and Lower Trapezius Ch B Both channels have to be above threshold Two different alarms will play when the signals A amp B are above or below threshold MOTOR FUNCTION RESTORATION e Connect the sensors to the encoder as follows o MyoScan MyoScan Z sensor to channels A to D o Optional MyoScan MyoScan Z sensors to channels E to J for FlexComp Infiniti Myo Myo Myo Myo Myo Myo Myo optional for optional for optional for optional for optional for optional for FlexComp FlexComp FlexComp FlexComp FlexComp FlexComp e urn the encoder on 1 Click Quick Start 2 From Categories select one of the c
75. curate use of Clinical Guide the instrumentation It also explains how to prepare the examinee and the procedure to Physical Rehabilitation f O low Chapter RANGE OF MOTION ASSESSMENT section STATIC RANGE OF MOTION ASSESSMENT As vh nen a rery ace stis Hu aa tarar pho Y diene ybu leer Div Ate F 4 E t Te yE Hn ML NW GENERAL PROCEDURE Preparing the instrumentation e Connect the sensors to the encoder as follows o Dual single inclinometer to channel E o Foot pedal to channel C e urn the encoder on 1 Click Quick Start 2 From Categories select Pro Flex Static Categories a Pro Rehab Suite Static ROM Assessment 3 From Clients select a name Clients Full Name ID Number _ Clinic 1D Wood Chuck Rehab ProComp amp FlexComp Infiniti Rehab Suite 83 Favorites 4 From Favorites select the desired Static ROM Protocol Description 5 Click OK S ROM 01 Cervical Spine Flexion Extension S ROM 02 Cervical Spine L R Lateral Flexion S ROM 03 Cervical Spine Left Right Rotation S ROM 04 Thoracic Spine Flexion Extension S ROM 05 Thoracic Spine Left Right Rotation S ROM 06 Lumbar Spine Flexion Extension S ROM 07 Lumbar Spine L R Lateral Flexion S ROM 08 Shoulder Flexion Extension S ROM 09 Shoulder Abduction Adduction in 309 5 ROM 10 Shoulder External Internal Rotation S ROM 11 Elbow Flexion Extension S ROM 12 Forearm S
76. d DO OIN GO 29 OG EMG04 FAST FLICK ASSESSMENT ua AAG GWR GWNA NWYN dambU van RNA DRENAU WW AUAN AA GHANA AN UON RAW NU FN WNAF 30 G SEMG05 GLOBAL SEMG ASSESSMENT 1 MUSCLE 1 elles iieeecliieenuiee ene SHALL LLW LL Lu a naa sanas sanas anna 31 SEMG ASSESSMENT GENERAL PURPOSE G SEMGO6 and up eeeeeeeeeeeeeeeee e HNN AEE E EDD NN NY EE nn 31 G SEMG06 SEMG Assessment with 2 EMG ssssesssssssssssseseeee nennen nennen nnn nnnnnn nnn nnns sna aan nnn resa n aa 31 G SEMGO7 SEMG Assessment with 4 EMG FlexComp Infiniti only 32 G SEMG08 SEMG Assessment with 6 EMG FlexComp Infiniti ON y cccceccsseeceeeeeeeeeeeeeeeeeeeeeseeeeeeeesaeeeeees 33 G SEMGO9 SEMG Assessment with 10 EMG FlexComp Infiniti only 33 Static SEMG Assessment ccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccces OA SAA E tM A mu Y _ Y RE RR A RR A YR Y Y CH A Y CE NN Y RY Y YR RR CE YN IC E Y Y ER Y Y RR Y Y RHY FO YN WY 34 CLINICAL GUIDE HEFEBHENGE ui Y E Su DE GR wg GWY DU Du DNE do IR YND OR EE OA AN OG WD GA GO END Dd M Dad Tu DU 34 PROCEDURE UG es ce ase seca cg CONOR GOD EFE DYFAN 34 Sauna Meness fennel ery E NN AF FY CE EF Y DIM RY CC NC CR HR YF HE HY RS YN 34 PES tic eM P A 35 Y lt r LL es E g aan nee ne E E ree tec om 36 Dynamic SEM
77. d by hitting the space bar or a keyboard key that was previously assigned the name of the event Reviewing the session When the session ends a series of message prompts guides you through the process of saving data adding notes to the session file and switching to reviewing mode so that you can generate a session report Rehab ProComp amp FlexComp Infiniti Rehab Suite 89 In review mode a screen similar to this will appear General Dynamic ROM Assessment General Dynamic ROM Assessment Minimum Maximum Mean Variability Minimum Maximum Mean Variability A Left 1 35 70 33 12 47 1 18 1 26 3050 2 861 11 1 40 B Right 2 10 103 71 25 81 0 88 3 76 474 84 27 39 1 72 4 15 182 11 13 79 1 69 1 44 69 62 4 63 1 65 A Lof 69 58 B Right 63 41 E Angle BioGraph BioGraph D ROM General Dynamic ROM Assessment with 2 _ D ROM General Dynamic ROM Assessment with 4 EMG EMG The Multi line graph will display the EMG signal of 2 The two Multi line graph will display the EMG signal of channels A and B along with the angle in red There 2 channels simultaneously respectively A and B C and are statistics available as well D along with the angle in red There are statistics available as well Select the desired display time window on the screen by using Options View Help the dropdown list It is recommended to select first Size to session for a global view of the session and then Size to activity to
78. e 8 5 2006 2 31 52 PM Day s until next calibration Gam Olfset In the screen shot above for example For the sensor connected to Channel A calibration and zeroing schemes exist and calibration and zeroing have both been performed For the sensor connected to Channel B no calibration scheme exists A zeroing scheme exists and zeroing has been performed For the sensor connected to Channel C no calibration scheme exists A zeroing scheme exists but zeroing has not yet been performed Sensors have not been connected to the other channels The command buttons are in a row at the bottom of the window Depending on whether you are calibrating or zeroing the sensor some button labels will change Calibrate now Click this button to open the Calibration Wizard which provides step by step instructions leading you through the calibration procedure The wizard opens the right pane of the window When the Zeroing Wizard is active this button is disabled Zero now Click this button to open the Zeroing Wizard which provides step by step instructions leading you through the zeroing procedure The wizard opens the right pane of the window When the Calibration Wizard is active this button is disabled Note Ifa sensor requires both calibration and zeroing calibrate the sensor before you zero it Rehab ProComp amp FlexComp Infiniti Rehab Suite 24 TE Sensor Calibration amp Zeroing Show Legend S
79. e BioGraph Infiniti software Refer to the on line help manual for a more detailed description of all the functions and features of the program To open the on line help press the F1 function key on your keyboard from any dialog box in the program Because the on line help manual is designed to provide contextual information it will automatically open at the section that discusses the dialog box from which the help was called The information in this chapter is of a general nature Each protocol chapter explains how to record review and report upon data using that particular protocol RECORDING SESSIONS With the BioGraph Infiniti software two types of sessions can be recorded Open Display and Script sessions Both types of session can be recorded with BioGraph Infiniti e Scripts are predefined protocols that group together varied types of activities with specific display screens They are used for evaluation and assessments because they produce statistics that can be used to determine the type of exercise and or practice that is needed by the patient These statistics can be trended across sessions to reflect patient progress e Open Display sessions are used for biofeedback training when flexibility is important and you need to be able to rapidly change the session parameters depending on the client s reactions The kinds of feedback include various types of audio such as music tones sounds and voice prompts There are also visual
80. e of Clinical Guide biofeedback for ROM therapy It also explains how to prepare the examinee and the TM HD procedure to follow MU Chapter ROM THERAPY WITH BIOFEEDBACK e ree I Atlas ro AA Th 3 ju t 1 PROCEDURE e Connect the sensors to the encoder as follows o A single inclinometer unit InclinoTrac to channel C o Optionally the second InclinoTrac unit can be used as a single inclinometer and connected to channel E e urn the encoder on 1 Click Quick Start 2 From Categories select Pro Flex Rehab Categories Suite ROM Trainin g Pro Rehab Suite ROM Training 3 From Clients select a name Clients Wood Chuck Rehab ProComp amp FlexComp Infiniti Rehab Suite 101 4 From Favorites select the desired Favorites training protocol l Description 9 Click OK ROMTO1 ROM Training with 1 inclinometer ROMTO2 ROM Training with 2 inclinometers e Click the Start button gt You can view each screen by clicking on the numerical buttons on the toolbar at the top 1 e B 4 5 e Tostop the session click the Stop button ul ROMTO1 ROM Training with 1 inclinometer Neutral Position Training Gorilla Animation 0 95 12345 In Neutral Position In this screen the examinee is being trained to keep his joint in neutral position by keeping the ball centered behind the EY AS ae 2 rice MAX 14 0 monkey s neck When he is successful the green l
81. e of relaxation These physiological measures can also be used to assess the level of stress of the examinee during the examination The following biofeedback screens were designed for that purpose This logo on a screen in a protocol indicates that you can use an optional webcam with the screen to record video of the session You need only connect your webcam to a USB port of your computer and turn it on before you start the session Note Your computer system must be connected to a video capture device such as a webcam and the proper software installed in order to use this function The clinical guide gives general guidelines and recommendations meia in Chapter SKIN CONDUCTANCE AND PERIPHERAL TEMPERATURE BIOFEEDBACK Assessment Biofeedback ieee Diem nono y race s sten Puce Tam dewey Dus 2a r ar AU vee Tay MI clans ad luyna Th hl Hi 1 Also recommended e RESPIRATION TRAINING WITH BIOFEEDBACK e HEART RATE MONITORING amp HRV niece Hiram Gwy Abe E PROCEDURE e Connect the sensors to the encoder as follows o Temperature sensor to channel C o Skin Conductance sensor to channel E e urn the encoder on 1 Click Quick Start Quick Start 2 From Categories select Pro Flex Rehab Suite Skin Conductance and Temperature 3 From Clients select a name Wood Chuck Rehab ProComp amp FlexComp Infiniti Rehab Suite 80 4 From Favorites select Biofeedback Favorit
82. ected video capture device and activates it automatically A preliminary testing window will pop up in order to adjust the camera The video will be recorded with the session and can be reviewed or replayed If you have more than one video capture device connected to your system and want to use a specific one place the cursor on the video image and click the right mouse button then select the device from the list Video capture devices yw ATI Rage Theater Video Capture Logitech QuickCam Pro USB USING A DVD When you see this logo on a screen in the manual it means a DVD can be used with this screen You only need to insert the DVD in the DVD player of your computer When the option Start DVD but Pause session is selected you can launch a DVD access the DVD menu and start a movie while the program waits in Pause When you are ready to start recording data click the Pause button Recording will begin Note Your computer system must include a functioning DVD drive in order to use this function SENSOR CALIBRATION AND ZEROING The ForceTrac and Dual InclinoTrac sensors may require calibration or zeroing You do this in the Recording Screen before starting to run the protocol From the Options menu of the Recording Screen select Sensor Calibration This opens the Sensor Calibration amp Zeroing window Here you can run a Wizard to zero or calibrate your sensor m Recording mode Script session Client ProComplnf Biof Channe
83. el report 1 Click the Session Report icon E in the tool bar 2 Select Generate Excel Report Microsoft Excel opens and displays your report as a workbook You can print or save the report using Excel s Print and Save functions Rehab ProComp amp FlexComp Infiniti Rehab Suite 36 Client Bulk INCREDIBLE Session Date 28 08 2008 Session Time 13 38 45 AM O ID HT W o Mn Lh st y E o m wmm WLI TT S TT TIE i x E T m mm m m Ul imali ES Summary amp Follow up Notes Name and Signature Normative Data are shown with a T on the graph gei Sp The report shows the difference between left and right in 96 for each site The formula is Max left right Min left right Max left right The report rates the level of activation of each site Ll green orange red T yelow ed Summary and Follow up notes You can enter notes in the summary follow up notes boxes Summary Notes e n Excel 2000 and Excel 2003 place your cursor in the text box and start typing ry e In Excel 2007 place your cursor in the text box Marked improvement 1 Right click the mouse button 2 Select Edit text 3 Start typing Rehab ProComp amp FlexComp Infiniti Rehab Suite 37 Dynamic SEMG Assessment Dynamic SEMG assesses muscle tension through various movements such as flexion extension lateral flexion or rotation In addition to general protoco
84. en if there is less than 1596 between two consecutive trials and if the overall variation coefficient of variation between the selected trials is also less than 1596 The test requires at least 3 selected trials to be valid Only the selected trials are plotted on the graph Uninvolved Side Involved Side Jue RENE Trials Result Max Used Resuit Max Used 47 254 Tmas AO LL kJ U Trial 4 35 218 26 022 El Piai 3029 a 027 O rial 998 28215 m Am Trials Bilateral testing with only 3 trials selected for the Unilateral testing with all trials selected involved side Trial 1 is discarded Final Result Uninvolved Involved Mean 33 53 25 71 HUM 249 086 Deficit N Ig a The final result computes the mean and standard deviation of the selected trials For the bilateral test the percentage of deficit is also computed This is the difference in percent between the final result of the uninvolved side reference and the involved side Soto od P RP B 6 Uninvolved Side Involved Side ror the protocols with EMG Side A EMG Side B EMG Side A EMG Side B SEMG the EMG peak EMG Max EMG F EMG Max EMG F EMG Max EMGIF EMG Max EMGI F intensity as well as the 140411 1051 5585 1057 32366 0 53 107305 088 EMG to Force ratios are d 94885 0909 238211 1137 93068 1186 41895 0951 computed User s fields Muscle Test You c
85. enerating o SOO NM NR CYNT EFA Y ERFYN ET FCA NE A YR FF ees 115 Rehab ProComp amp FlexComp Infiniti Rehab Suite vi Hardware Specifications eee e e eee eee ee eee eee eee eee sese seesesesesesesesesesecess 17 Returning Equipment for Repair c ee ee ee ee ee ee ee eee ee ee ee ee eese eesesesesesecccs ILO Ropair Roturn Form oorr o4 AS ERE ERES Y EU Rehab ProComp amp FlexComp Infiniti Rehab Suite vii Rehab ProComp amp FlexComp Infiniti Rehab Suite Introduction Welcome to the user manual for Rehab Suite This manual provides information intended to help you get the most out of your system The manual is organized into chapters as follows e Installation and System Requirements lists the computer requirements recommended for running the software e First Time Run explains how to start the software and verify its settings prior to using it for the first time e Hardware Set up provides general information about the encoder sensors and accessories included in the system It also shows how to connect the hardware elements e Software Overview introduces the main functions of the BioGraph Infiniti software recording replaying and reviewing sessions It discusses the analytical processes of artifact rejection statistics calculation and report generation In addition this section explains how to use a web camera with the software how to calibrate and zero sensors and how to r
86. ensor Input value 2 0953 Kg o Sensor S M E ForceTracO04l Sensor type 18 FarceTrac Encoder S N D 1023 Physical channel index 0 Channel 4 Unit type 17 Kilogram Force Zeroing date q X X X x x X X Calibration date Ae sensor information and then click ext Calibration due date D ag s untill next c alibrstion User Entry Kg Apply Click this button to save changes to the settings Abort calibration In the Calibration Wizard click this button to exit the wizard without saving changes Abort zeroing In the Zeroing Wizard click this button to exit the wizard without saving changes Next After completing each step click this button to proceed to the next step Close At any step click this button to discard any changes to the settings and close the wizard You will be prompted to confirm that you want to discard the changes Sensor Status Details The list in the middle panes of the window shows specific values for the sensor on the selected channel For a description of these values press F1 to consult the on line help IMPEDANCE CHECK It may be necessary to check impedance values for MyoScan Z sensors These values indicate the quality of contact between the electrodes and the skin You do this in the Recording Screen before starting to run the protocol From the Options menu of the Recording Screen select Impedance Chec
87. ependent Ll Threshold dependent M Other This two channel ratio screen easily communicates the interplay of two muscles When the muscles are in eguilibrium the ball is balanced on the gorilla s shoulders When the ball is off to one end or the other the muscles are progressively more out of balance The bar graphs are connected to channels A B Eguilibration 2Ch Bi Lateral Bar Video ML r Br lfibnomparison 1 23 4 Can you keep the red light turned off ight is o fee ere as eas san 25 w Scale dependent O Threshold dependent M Other The light turns red when the difference is greater than 35 Both signals are also displayed in the same line graph and mirrored bars for comparison Equilibration 2Ch Bi Lateral Bar Video 2 a RR E o ui Y 1 2 3 4 Can you keep the red light turned off Scale dependent O Threshold dependent M Other The light turns red when the difference is greater than 35 Both signals are also displayed in the same line graph and bars for comparison BioGroph y 48 Open sessen 00 01 48 000 Rehab ProComp amp FlexComp Infiniti Rehab Suite 65 EQULO2 Equilibration with 4 EMG Eguilibration 4Ch Balance Ratio uw n o Try to keep the ball in the center 1 2 3 4 Scale dependent Ll Threshold dependent M Other This four channel ratio screen easily communicates the interplay of four muscles When the muscles are in
88. eps to record with a new script Rehab ProComp amp FlexComp Infiniti Rehab Suite 15 Starting an Open Display Session Select Start Open Display Session from the Main Menu screen This opens the Start Session screen where you go through the process of selecting a client file and channel set setting up session parameters and launching recording mode Start Session x Please check your preferences switch encoders ON and click Start Clients Sessions Cremada Duaion Desipi Charest Desorption 10 29 2008 12 5 Biofeedback and Neu 00 02 01 HE FC Cet Ome a HAW FullName IDN CinielD Wood Chuck 14 Ballance Tara 1 001 10 29 2008 12 5 Biofeedback and Neu 00 01 46 Florimond Dorian Dorimond Florian amp 003 Screens JV Picture View Physiology Jane 9 004 Trend Sarah 10 005 EEG Guy 006 EMG Ben 8 007 Training SC DVD 4 sj Start Keep Virtual Channel Settings Channel Set Configuration Add New Client Select New Screens Start Default Settings Define New Session Start Session To record a new session 1 Create a new client as described above or select an existing client from the list 2 Select Define New Session to open the window The Select up to 5 Screens for Open Display Mode window opens Select up to 5 Screens for Open Display mode x Please select a Channel Set and up to 5 screens Tum encoder s ON and click OK Screens Iv
89. equilibrium the weight is in the middle of the balance When the weight is off to one end or the other the muscles are progressively more out of balance The bar graphs will be connected to channels A B C D Equilibration 4Ch Gorilla Ratio Em o ae Try to keep the ball balanced behind the gorilla s head 1 2 3 4 Ll Scale dependent O Threshold dependent M Other This four channel ratio screen easily communicates the interplay of four muscles When the muscles are in equilibrium the ball is balanced on the gorilla s shoulders When the ball is off to one end or the other the muscles are progressively more out of balance The bar graphs will be connected to channels A B C D Equilibration 4Ch Bi Lateral Bar Video Dci MEC E Bi Lateral comparison FS Can you keep the red light turned off 1 2 3 4 Ll Scale dependent O Threshold dependent M Other The light turns red when the difference is greater than 359e Both signals are also displayed in the same line graph and mirrored bars for comparison Eguilibration 4Ch Bi Lateral Bar Video 2 lt a oe e Bi Lateral comparison 1 2 3 4 O Scale dependent Ll Threshold dependent M Other The light turns red when the difference is greater than 359e Both signals are also displayed in the same line graph and bars for comparison Rehab ProComp amp FlexComp Infiniti Rehab Suite 66 EQULOS Postural Training with 4 EMG The next three screens are specified for postur
90. erify that the motion has been properly performed by the examinee at the right time when prompted You can also check the consistency from trial to trial Generating a report e After the review screen opens you can generate a Dynamic ROM Assessment report This is a Text report Rehab ProComp amp FlexComp Infiniti Rehab Suite 99 1 Click the Session Report icon Ez in the tool bar 2 Select Generate Text Report select report components in the Session Report window and click Generate Report Microsoft WORD opens and displays your report You can print or save the report using WORD s Print and Save functions Rehab ProComp amp FlexComp Infiniti Rehab Suite 100 Range of Motion Training OVERVIEW Range of motion therapy usually consists of simple exercises to increase the range of motion flexibility strength endurance and control over the movement The following biofeedback training screens were designed for this purpose This logo on a screen in a protocol indicates that you can use an optional webcam with the screen to record video of the session You need only connect your webcam to a USB port of your computer and turn it on before you start the session Note Your computer system must be connected to a video capture device such as a webcam and the proper software installed in order to use this function CLINICAL GUIDE REFERENCE The clinical guide gives general guidelines and recommendations for the us
91. es with Skin Conductance and Temperature Description 5 Click OK Biofeedback with Skin Conductance and Temperature e Click the Start button gt i You can view each screen by clicking on the numerical buttons on the toolbar at the top 1 2 ES 4 5 e To stop the session click the Stop button Bl Training Biofeedback on Skin Conductance 1234 5 The screen shows a bar graph of the skin conductance and plays a song and an animation when the SC value dips below the threshold The threshold is set to automatically follow the signal to allow for instantaneous feedback of any change of direction Training Biofeedback on Temperature 1 2 3 4 5 The screen shows a bar graph of the temperature signal and plays a song and an animation when the signal value moves over the threshold The threshold is set to automatically follow the signal to allow for instantaneous feedback of any change of direction Assessment amp Review Skin Conductance amp Temperature 1 2 3 4 5 The screen was designed for assessment The screen shows a line graph of the raw signals of SC and Temp and a trend graph of epoch means It also has a video audio instrument so you can record the examination Events can be marked by hitting the space bar or a key of the keyboard that you would have preliminarily labeled with the name of the event A Re hab ProComp amp FlexComp Infiniti Rehab Suite 81 Review replay screen
92. eshold D mo Keep the music playing by refaxing and staying below the threshold Recording Baseline RELAX an evaluation of the muscle at rest ignal in the next frame press any key to start lO M 4507 M 500 N Ciz 2 Verify signal 3 Baseline G SEMG02 MAXIMAL FORCE ASSESSMENT This protocol measures the maximal force of the muscle The maximal force is the highest level of voluntary contraction that a person can achieve without inducing unacceptable pain 1 Instructions The protocol is divided into 3 steps 1 Read instructions Gives you an overview of what to expect no data is recorded press any key when you are done 2 Verify signal Take the time to make sure the sensor and cables are connected properly No data is recorded Pressing any key on your keyboard allows you to advance to the next activity 3 Rest work cycle The patient relaxes and contracts muscles for 5 seconds three times Replaying mode Script session Client TTL TTL Screen Instructions Maximal EJ Recording mode Script session Client TTL TTL Screen Training 1Ch Line Gr EJ Replaying mode Script session Client TTL TTL Screen Training 1Ch Line Gr EJ Fie Sesion bt Opos View Help Fie Session Ex O p Fie Session Edt toss Wem Hep dt Options View Hol owe P mn Verify the signal and press a key to continue Maximal Force After verifying the signal in the next frame
93. he sensor and or encoders use anti static mats or sprays in your working area A humidifier may also be used to help prevent static environments by conditioning hot dry air Not for diagnostic purposes Not defibrillator proof Not for critical patient monitoring To prevent voiding warranty by breaking connector pins carefully align white guiding dot on sensor plug with slot on sensor input Sharp bends or winding the fiber optic cable in a loop smaller than 4 inches 10cm may destroy the cable A fiber optic cable not fully pushed into its receptacle may cause the unit not to operate make sure that both ends of the cable are fully inserted into their receptive jacks and the nuts are tightened firmly Make sure to remove electrodes from sensor snaps immediately after use Apply conductive gel only to electrodes never put gel directly on sensor snaps Always use electrodes between the subject and the sensor Sharp bends or winding the fiber optic cable in a loop smaller than 4 inches 10cm may destroy the cable Rehab ProComp amp FlexComp Infiniti Rehab Suite e A fiber optic cable not fully pushed into its receptacle may cause the unit not to operate make sure that both ends of the cable are fully inserted into their receptive jacks and the nut is tightened firmly e Do not plug third party sensors directly into instrument inputs Plug only Thought Technology active sensor cable connectors into instrument inputs All EMG electrode
94. he threshold is also indicated by the Tarantella tune and can be set on the bar graph instrument Replaying mode Open Display session Client INCREDIBLE Bulk Screen Streng E Strengthening 1Ch Flower Puzzle ha ret x See what happens when you hold the contraction above the threshold for more than 5 seconds 1 2 3 4 Scale dependent v Threshold dependent Other The puzzle will fill when the contraction on channel A has been held above the threshold for more than 5 seconds If the contraction dips below the threshold then the timer will reset The threshold is also indicated by a jazz tune and set on the bar graph Rehab ProComp amp FlexComp Infiniti Rehab Suite 61 Strengthening 1Ch Dolphin Puzzle Ua a I EEE uw Trt Tel w Gate oc Can you complete the puzzle by s e than 10 econds 1 2 3 4 O Scale dependent v Threshold dependent Other The puzzle will fill when the contraction on channel A has been held above the threshold for more than 10 seconds If the contraction dips below the threshold then the timer will reset The threshold is also indicated by a harpsichord sound and can be set on the bar graph instrument STRNO3 Uptrain A Downtrain B with 2 EMG The four next screens are more challenging involving two muscles Channel A is used for the muscle that must be activated while channel B is used for the muscle that must not be activated Strengthening 2Ch Tomato
95. hould now appear in the Configuration Table 6 When done click OK en 7 Now the Application Key Code dialog box opens Application Key Code 8 Enterthe Application Key Code Please enter the Application Key Code This number is found in the battery compartment with the encoder key code 9 When done click OK Cancel Note Even if you are using more than one encoder you need to enter only one Application Key Code If the key codes have been entered properly and there is no problem with your encoder setup or your sensor connections the recording screen will open Rehab ProComp amp FlexComp Infiniti Rehab Suite 5 Hardware Set up Before you can start recording a session you have to set up your hardware The following section describes how to connect a FlexComp Infiniti encoder but the process is similar when using ProComp Infiniti and ProCompb Infiniti For more information on using your particular encoder please refer to the device s hardware manual The Encoder Connecting TT USB and the encoder Insert one end of the fiber optic cable carefully into the fiber optic port on the encoder Tighten the nut gently so that the cable won t slip out Do the same with the other end of the fiber optic cable and the fiber optic port of the TT USB interface unit Insert the small connector of the USB cable into the USB port on the TT USB interface device Insert the large connector of the USB cable
96. i Trial 1 Apply resistance gradually Script 00 00 04 812 00 00 24 000 Potential substitute muscles being monitored with SEMG during the test A tone can be heard when the SEMG goes above a threshold Generating a report After the review screen opens you can generate an MMT report This is an Excel report 1 Click the Session Report icon m in the tool bar 2 Select Generate Excel Report Microsoft Excel opens and displays your report as a workbook You can print or save the report using Excel s Print and Save functions Manual Muscle Testing Manual Muscle Testinc Unilateral Testing Bilateral Testing Client Bulk INCREDIBLE Session Date 15 08 2008 Client Bulk INCREDIBLE Session Date 15 08 2008 Session Time 3 18 49 PM Session Time 4 35 53 PM MUSCLE TEST Scapular Abduction and Upward Rotation Ue 8 313 lt Select gt Uninvolved Side ed Side Trials arc m Tinis Uninvolved Involved i Result Max Rent ia Used Mean 5209 34 RIINENE C NN D HUM 249 invalid mal 285 E2 mm O mai Sm M am 5 LTral4 35218 m 002 O 55043 L m4 sw GRADE Select Name and Signature Unilateral Testing lame and Signature Bilateral Testing Rehab ProComp amp FlexComp Infiniti Rehab Suite 109 Validity Check of the Trials The important data is the peak load before the break maximum force Trials are selected wh
97. ide Reference 2 Opposite Side Average of Difference Between PT Reference 2 Pressure Threshold References GRIDS antca References 0056 0050 0 056 0056 000 Measure 3 Kg cm2 Description of site Follow up notes UT TT UT Follow up notes Reference 1 Opposite Side Reference 2 Surrounding Average of Difference Between PT Reference 2 Pressure Threshold CIUS 0056 ano nxeierences 005 0 056 0 056 000 Measure 1 Measure 2 Measure 3 Name and Signature Page 1 Page 2 For each measure first select the area cervical thoracic lumbar or sacral If the measure is not used select Not used Then select the PTM site Reference 1 I5 and the side Rehab ProComp amp FlexComp Infiniti Rehab Suite 115 Then select the reference sites opposite side or surrounding muscle PTM C3 Reference 1 select v T m Opposite Side Surrounding Opposite Side Reference 2 lt select _ lt select gt Reference 1 Opposite Side Surrounding You can also add a description of the location of the site Description of site one inch from the spine PM C3 ef Opposite Side Data table NEA C RE 1 79 33 72 87 7610 BU 08 06 The data table shows the three measures the average of the references and the difference between the references and the
98. ies select one of the Categories categories starting with Pro Flex Rehab Suite SEMG Biofeedback c Pro Rehab Suite SEMG Biofeedback F Rehab ProComp amp FlexComp Infiniti Rehab Suite 96 3 From Clients select a name Clients Wood Chuck 14 4 From Favorites select the desired Favorites SEMG Biofeedback Protocol mum 5 Click OK RELAXO1 Relaxation RFI AX 1 Relaxation e Click the Start button HI You can view each screen by clicking on the numerical buttons on the toolbar at the top aj Bias e If the feedback is scale dependent you can adjust the sensitivity of the animation or graph as follow 150 100 7 Min Max 180 gt l e 4x Select the animation by clicking on it A thin red Type the desired EMG scale in Min and Max Then frame will appear around it click anywhere on the screen e fthe feedback is threshold dependent The threshold line on a bar graph line graph and animation can be adjusted in the same way as the vertical scale The text box labeled Thr1 is for single threshold graphs while Thr2 is for double threshold graphs like the multi line graph that can have up to two guidelines Max100 Thri10 Th mouse cursor on the threshold line pressing and holding the 20 You can also directly move the threshold by placing the mouse left button and moving the cursor up and down 0 e To stop the session click the Stop button nj CATEGORY PRO FLEX SUIT
99. ifference between left and right either in uV or in 96 The formula for uV difference is right left The formula for percentage difference is Max left right Min left right Max left right Rehab ProComp amp FlexComp Infiniti Rehab Suite 44 Section 3 Summary and Follow up notes You can enter notes in the summary follow up notes boxes Summarv Notes e n Excel 2000 and Excel 2003 place your cursor in the text box and start typing ry i e In Excel 2007 place your cursor in the text box 1 Right click the mouse button 2 Select Edit text 3 Start typing PROCEDURE FOR CERVICAL SPINE ASSESSMENT Starting the Session Marked improvement If you are going use a webcam to make a video recording of this session connect your webcam to a USB port of your computer and turn it on e Connect the sensors to the encoder as follows o MyoScan MyoScan Z sensors positioned on the CPs to channels A and B left in A right in B o MyoScan MyoScan Z sensors positioned on the SCMs or Traps to channels C and D left in C right in D pA B p E F fw sf y Myo Myo Myo Myo left CP right CP leftSCM right SCM or Traps or Traps e Turn the encoder on 1 Click Quick Start 2 From Categories select Pro Flex Rehab Categories Suite Dynamic SEMG Assessment 3 From Clients select a name Wood Chuck 4 From Favorites select the desired Dynamic iouis SEMG
100. ight turns MIN 15 4 on Threshold based Training Bowling Animation Points 1 2 3 4 5 This is a threshold based exercise The examinee must perform the motion until a threshold is crossed When this happens the animation starts and the bowl is thrown The examinee must hold the position during 5 seconds to do a strike and get a point They must then go back to neutral position to restart In Neutral Position BHL c o 5uoc n a ces So Neutral Position and ROM Training Dial Animation 12 3445 In Neutral Position This is a stretching exercise The examinee is told to reach a given color on the rainbow When they return to neutral Eee position the light turns on MIN 20 5 Rehab ProComp amp FlexComp Infiniti Rehab Suite 102 ROM Training Tube Game mum This screen is similar to the Dial Animation This time the MAX 0 92 examinee has to move the ball up and down MIN 8 64 ROM Training Animal Game 1234 5 Here the examinee has to align the character with the animal appearing in the left box by moving his limb D BioGraph Y Review screen ROM Training Review i 1 C The screen was designed for reviewing the session e uu MAX 0 53 It shows the ROM amplitude along with the video BioGraph All these screens are accessible from Start Open Display Session in the channel set ROM Training with 1 inclinometer ROMTO2 ROM Training wi
101. inee to go back to neutral position Do not press the Zero button again e Repeat the exercise 6 times e Then repeat it another 6 times for the antagonistic movement e When the session ends a series of message prompts guides you through the process of saving data adding notes to the session file and switching to reviewing mode so that you can generate a session report Rehab Pro omp amp FlexComp Infiniti Rehab Suite 85 Generating a report e After the review screen opens you can generate a ROM Assessment report This is an Excel report 1 Click the Session Report icon in the tool bar 2 Select Generate Excel Report Microsoft Excel opens and displays your report as a workbook You can print or save the report using Excel s Print and Save functions Static Range of Motion Inclinometry Client Bulk INCREDIBLE Session Date 15 08 2008 Session Time 3 30 38 PM Position exio Measure 1 type it here or select Measure 2 Measure 3 Measure 4 Measure 1 538 YES Measure 2 532 YES Measure 3 53 1 YES Measure 4 528 YES Measure 5 50 1 YES Measure 6 Follow up Notes Validity Check of the Trials Valid Measre5 238 YES WM Measue 247 YES M Measue1 368 YES O Measue2 329 YES O Measue3 38 YES O Measue5 30 YES W Measue6 341 YES WM
102. into the USB port of your PC USB ports on a PC are generally located at the back of the base unit You may also find a USB port at the front of your base unit you can connect the other end of the USB cable to it On a laptop USB ports are usually located at the side or the back of the laptop It is recommended to always use the same USB port for connecting the TT USB to your computer Battery Placement Opening the Compartment Looking at the underside of the encoder you will see a long door gt in the plastic enclosure Holding the encoder with the connectors facing you and with the door up push lightly down and back with your thumbs on the door to slide it open Attention The internal workings of the encoder are not intended to be opened for repair except by qualified service personnel The tamper evident seal under the batteries in the battery compartment should not be removed or broken Thought Technology may refuse to honour the unit s warranty if the seal is broken Rehab ProComp amp FlexComp Infiniti Rehab Suite 6 Polarity When the compartment cover has been slid out place four AA batteries in the slots observing the correct battery polarity as embossed on the inside surface of the compartment Closing the Compartment Slide the door back into the encoder case gently pushing it in until you feel the click of the locking mechanism Keeping an Eye on the Battery Level Since each se
103. is off when there is less than 35 difference between muscle site pairs ing mode Op DISD sion CI Bie Session Screens Edt Options View Help 8 Wn LI ton amp A RMS 4 02 The light is off when there is less than 35 difference between muscle site D RMS 24 19 Ele Session Screens o Ortioes Wew Bep ow E A e The light is off when there is less than 35 difference between muscle site Can you keep the red light turned ff B RMS 4 02 5 Reviewing mode Open Display session Client INCREDIBLE Bulk Screen Equili EJ Ele Session Sgmem Edt Options View Helo ow LES t i tie a The light is off when Can you keep the red light turned off 67 Eguilibration 6Ch Postural Training Cervical amp Thoracic amp Lumbar Spine 1 2 3 4 5 Scale dependent Threshold dependent M Other The 6 muscle sites are as indicated Cervical thoracic and lumbar The difference between each pair of muscles at the site should be less than 35 The red light will be on to indicate that the difference is greater than 35 EQULO5 Postural Training with 10 EMG FlexComp Infiniti only Equilibration 10Ch Bi Lateral Video 1 2 3 4 5 Scale dependent O Threshold dependent M Other Comparing 10 muscle sites the difference between each two muscle site should be less than 359e The red light will be on to indicate the difference is greater than 35
104. ith video 1 2 3 4 10 raw EMG signals are displayed on 10 line graphs The digital displays show RMS EMG These screens are also used for review Rehab ProComp amp FlexComp Infiniti Rehab Suite 33 Static SEMG Assessment OVERVIEW Static SEMG Scanning assesses the resting level of the muscles surrounding the spine in static position The protocol scans 12 sites x 2 left right from C2 to L5 CLINICAL GUIDE REFERENCE The clinical guide gives general guidelines and recommendations for the accurate use of Clinical Guide the instrumentation It also explains how to prepare the examinee and the procedure to Physical Rehabilitation f O low Issessment 2 Biofeedback Saxe afte Puci IS SI Neer Pey Att tuaran raini luge J A iyw emu Chapter SEMG ASSESSMENT section STATIC SEMG ASSESSMENT Also recommended e INTRODUCTION TO SURFACE ELECTROMYOGRAPHY e Atlas zat ju t i PROCEDURE Starting the Session e Connect the sensors to the encoder as follows o MyoScan or MyoScan Z sensors to channels A and B left in A right in B o Foot pedal to channel C LA amp p E F n J Myo Myo Pedal left right e Turn the encoder on 1 Click Quick Start 2 From Categories select Pro Flex Rehab Suite Static SEMG Assessment 3 From Clients select a name Wood Chuck 4 From Favorites select S EMGO1 Para Favorites Spinal Scanning
105. ity Therefore they are very sensitive to electromagnetic fields generated by other devices in the exam room such as radio transmitting devices computer monitors medical devices for example x ray machines and fluorescent halogen or neon lights These devices should be turned off if they are not needed for the examination If the situation arises keep the instrumentation 10 feet away from radio transmitting devices and 3 feet away from electronic devices including monitors and fluorescent halogen or neon lights Disconnect all the unused sensors from the encoder If not connected to the examinee they may act as antennas and capture unwanted signals that would corrupt the signal Electrostatic discharges To prevent static discharge from damaging the sensor and or encoder use anti static mats or sprays in your working area A humidifier may also be used to help prevent static environments by conditioning hot dry air Rehab ProComp amp FlexComp Infiniti Rehab Suite 7 Connecting the sensors When connecting a sensor to the encoder make sure to properly line up the guiding dot on the top of the plug with the notch in the device s input socket Guiding dot w Forcing the plug into the jack in any other position may damage your eguipment Correct orientation of sensors For some sensors such as the temperature and skin conductance sensors either the connection cable or the electrode cable forms a permanent part of the i
106. k This opens the Impedance Check window Impedance Check Then trigger impedance checking from your encoder To do this e Ensure that the encoder s power light is on e Press and hold down the power button for about 3 seconds or until the power light starts blinking When the power light begins to blinK mpedance checking mode is active Rehab ProComp amp FlexComp Infiniti Rehab Suite 25 The graphic display shows the impedance values of the selected sensor in green orange or red e Green indicates a low value e Orange indicates a medium value e Red indicates a high value Ideally all three measurements should display in green For more information about impedance checking press F1 to consult the on line help Electrode Colors 9 is blue is yellow ground is black is blue is white ground is black Calculation Type Resistive C Total Representation Type Individual Pairs Both Thresholds kOhms Individual Pairs 50 100 Knee 15 30 amr 0 49 To exit impedance checking mode press the power button down for about 3 seconds or until the power light stops blinking Rehab ProComp amp FlexComp Infiniti Rehab Suite 26 General SEMG Assessment OVERVIEW The following protocols are very common SEMG assessment techniques They can be performed at the beginning of each visit They allow you to quickly assess the examinee s muscle condition and de
107. l Set Configuration Edit Me View Help Graph Mode d Bsec Time Frame d Sensor Calibration Max Rehab ProComp amp FlexComp Infiniti Rehab Suite 23 Encoder Channels and Sensors The left pane of the window identifies the specific encoder by its serial number in this case DA1029 lists the channels for the encoder and indicates the calibration and zeroing status of the sensor attached to each channel If a sensor has previously been zeroed or calibrated the value entered in Sensor S N displays beside its channel identifier Click Show Legend to open a window explaining the symbols used to indicate sensor status Sensor calibration and zeroing legend X Sensor disconnected o Encader serial number Calibration Status i Calibration done i Calibration due i Calibration was never performed i Mn calibration scheme defined Zerning status E Zeroing done b Zeroing was never performed D Mo zeroing scheme defined Command Buttons JE Sensor Calibration amp Zeroing EW 9 DA1023 Sensor S N D Channel Force Tract0d A Channel B ltrac002 Sensor type 18 FarceT rac lp Channel C InclinoO07 X Channel D Encoder S M DA1023 P Channel E Se Channel F Physical channel index 0 Channel 4 a Unit type 17 Kilogram Force A Channel Zeroing date 7 26 2006 2 31 52 PM 2X Channel Calibration date 25 2006 2 31 52 PM Calibration due dat
108. l Verification A Raw Signal Verification B Raw 20 MANR nnnn anms MAANA armi MNANE nnnnn MANARA NANA Ain BioGraph Position your hands so that the electrodes remain stable and do not move as shown in the picture below Apply gentle pressure on the sensor so that the 3 electrodes make good contact with the skin Ask the examinee to relax their muscles Rehab ProComp amp FlexComp Infiniti Rehab Suite 35 Wait for the signal to settle allow at least 5 seconds before recording the data But do not wait more than 30 seconds the signal will not settle more and you risk creating movement artifacts by holding the electrodes too long Press the foot pedal to record E mode Script session Client INCREDIBLE Bulk Screen Static SEMG A EJ File Session Edit Options View Help ii x10 Mn Mex Thr ma RECORDING 3 01 Wait for the signal to settle allow at least 5sec Press the pedal to record Signal Verification A Raw nenmeag nnnn na neanin nont Anant Signal Verfication Activity 2 Cyde 1 Step 5 Activty progress Repeat steps 1 to 6 for sites from C2 to L5 When the session ends a series of message prompts guides you through the process of saving data adding notes to the session file and switching to reviewing mode so that you can generate a session report Generating a report After the review screen opens you can generate a SEMG Assessment report This is an Exc
109. lculating Statistics e ocalculate statistics for a session click the Calculate Statistics button B in the tool bar A message confirms that the program is processing session data and then the Statistics window opens e Click Close to close the window Rehab ProComp amp FlexComp Infiniti Rehab Suite 20 Activity Description Step Description Statistic Description Vale 4 1 Activity 2 CO CO CO CO CO CO WM PO PO PO PO PO Ph Pre baseline Pre baseline Pre baseline Pre baseline Pre baseline Pre baseline Pre baseline Pre baseline Flexion R e estension Flexion Re extension Flexion Re extension Flexion Re extension Flexion Re extension Flexion Re extension Flexion Re extension NO NOL Nf at j Pre baseline Pre baseline Pre baseline Pre baseline Pre baseline Pre baseline Pre baseline Pre baseline Flexion Start Flexion Start Flexion Start Flexion Start Flexion Flexion Flexion A Mean B Mean C Mean D Mean A Variability B Variability C Variability D Variability A Rise Time seconds B Rise Time seconds C Rise Time seconds D Rise Time seconds A Max B Max C Max Rejection Durations 313 73 1464 33 285 20 2222 02 0 33 0 14 0 73 0 12 0 04 0 00 0 06 0 00 361 89 1406 37 402 78 Note Activity Activity Description Activity Duration Rejection Durations sec Rejection Durations Z E Pre baseline 10 00 0 00 0 00
110. lexComp FlexComp FlexComp FlexComp FlexComp FlexComp e um the encoder on 1 Click Quick Start r 2 From Categories select Pro Flex Rehab Categories Suite General SEMG Assessment Pro Rehab Suite General SEMG Assessment Rehab ProComp amp FlexComp Infiniti Rehab Suite 27 3 From Clients select a name Clients Wood Chuck 4 From Favorites select the desired Favorites Assessment Protocol 5 Click OK G SEMG0O1 Baseline G SEMGO2 Maximal Force G SEMGO3 Endurance G SEMGO4 Fast Flick G SEMGO5 Global SEMG Assessment 1 Muscle G SEMG06 General SFMG Assessment with FMG Measuring e Click the Start button gt i Reviewing the session When the session ends a series of message prompts guides you through the process of saving data adding notes to the session file and switching to reviewing mode so that you can generate a session report In review mode a screen similar to this will appear A EMG 2 70 B EMG Max 125 35 Max Min 1 07 Min Mean 17 00 Mean Maximum 82 52 BioGraph BioGraph If you used a webcam to make a video recording of the session during review the video playback is synchronized to the EMG signal as you move the Time Mark back and forth along the EMG signal line graph Generating a report e After the review screen opens you can generate a Dynamic SEMG Assessment report This is a Text
111. ls the system provides three assessment protocols for the cervical spine CP SCM or Traps and for the lumbar spine e Flexion Extension e Left Right Lateral Flexion e Left Right Rotation It also provides one assessment protocol for the anterior knee VMO and VL This logo on a screen in a protocol indicates that you can use an optional webcam with the screen to record video of the session You need only connect your webcam to a USB port of your computer and turn it on before you start the session Note Your computer system must be connected to a video capture device such as a webcam and the proper software installed in order to use this function CLINICAL GUIDE REFERENCE The clinical guide gives general guidelines and recommendations for the accurate use of Clinical Guide the instrumentation It also explains how to prepare the examinee and the procedure to Physical Rehabilitation fol low 3 Chapter SEMG ASSESSMENT section DYNAMIC SEMG ASSESSMENT Also recommended e INTRODUCTION TO SURFACE ELECTROMYOGRAPHY e SKELETAL MUSCLE PROPERTIES niece leur Day al GENERAL PROCEDURE Starting the Session If you are going use a webcam to make a video recording of this session connect your webcam to a USB port of your computer and turn it on e Connect the sensors to the encoder as follows o MyoScan MyoScan Z sensors to channels A and B left in A right in B o Optional MyoScan MyoScan Z sensors to channels C
112. ly the scripts belonging to the category will display 6 Selecta script from the list and click OK Note lf this is the first time you are recording a session at this point the system will prompt you to enter key codes See page 4 for more details 7 When the recording screen opens start the script by clicking on the Start button and follow the on screen instructions To record with a previously recorded script T 2 Select an existing Client Select a previously recorded script session from the Sessions list Click one of the following Start options e Start to rapidly start a new session with the same display screens and script settings as the selected session These include any changes you made to the client settings e Start Default Settings to start a new session with the default channel set settings instead of any changes you made to the client settings for the selected session Note lf this is the first time you are recording a session at this point the system will prompt you to enter key codes See page 4 for more details When the recording screen opens start the script by clicking on the Start button and follow the on screen instructions To record with a new client 1 Click Add New Client in the Client Data screen enter at least the person s first and last name and click OK 2 Select the new Client from the list 3 Click Define New Session and when the Script Database opens follow the remaining st
113. me as screen time frame Note Microsoft Word and Microsoft Excel must be installed on your system v idi Renecsnessssensenscssecsesensonsenecueeeeed for these functions to work T C Span by span Eu Ua m np oe o d n Bisram am da 4 B ga at prie 258 IAS bal ct dd O _ NES Cervical Spine FlexionlExtension Client Bulk INCREDIBLE Session Date 15 08 2008 Session Time 3 30 38 PM Movement type mee f p 1 Flexion 2 Extension degrees ils rum turk a BAR guo fgg Gu Excel generated session report TOOL BAR OPTIONS While recording replaying or reviewing an open display session there are certain options that are available on a tool bar found near the top of the display screen To learn more about the tool bar refer to the online help by pressing F1 Word generated session report Toggling Between Screens If you have chosen more than one screen you can view each one by clicking on the numerical buttons on the toolbar at the top Up to five screens can be viewed in the example below there are four where the third screen is currently on display Adjusting Scales and Threshold By clicking on a graph instrument you can enable any of the scale and threshold options on the toolbar shown below 4 xo Mn 0 zb wo amp Amel 3 10 sec 20 e Vertical scale The minimum and maximum scale values can be changed by clicking on
114. mp FlexComp Infiniti Rehab Suite 62 Strengthening 2Ch Conditional DVD A se 12 3 4 5 Scale dependent v Threshold dependent O Other The DVD stays on when the channel A signal is above its threshold and channel B signal stays below If either condition is not met the DVD stops playing STRNO4 Uptrain A Downtrain B Specific with 2 EMG The two next screens are specific to a given joint Replaying mode u Client INCREDIBLE Bulk Screen Streng Strengthening 2Ch Knee Flexion Se n ren a mes er 8a Contrac both mus CH athe the threshol left leg extend forward cT mm 7344 1 2 34 5 Scale dependent v Threshold dependent O Other Control over both channels during the movement is reguired to move the animation The threshold can be set on the bar graphs to make it progressively easier or harder to trigger the animation Strengthening 2Ch Wrist Flexion mr Client INCREDIBLE Bulk Screen Streng To move the right p dom nw ards keep n an TTT dB 1 i J 4 n above the threshold Scale dependent v Threshold dependent O Other Control over both channels during the movement is required to move the animation The threshold can be set on the bar graphs to make it progressively easier or harder to trigger the animation CATEGORY PRO FLEX SUITE SEMG BIOFEEDBACK CONTROL These screens are designed for muscle control training The scale should be adjusted acco
115. mplified surface electromyography sensor for use on low sampling rate inputs of the ProComp5 and ProComp Infiniti and designed to measure RMS SEMG Used for e SEMG Assessment e SEMG Biofeedback InclinoTrac Dual InclinoTrac P N T7650 T7655 ForceTrac P N T7640 Rehab ProComp amp FlexComp Infiniti Rehab Suite The Dual InclinoTrac is a dual inclinometer that measures relative angle between back and head for instance Used for e Static Range of Motion Assessment e Dynamic Range of Motion Assessment e Range of Motion Training The ForceTrac can be used as an algometer when used with its rod attachment ForceTrac can be used as a manual muscle tester when used with its rubber coated probes a flat one and a curved one Used for e Manual Muscle Testing e Algometry Accessories to the ForceTrac are from left to right e Rod attachment e Curved muscle testing probe e Flat muscle testing probe HR BVP Sensor P N SA9308M The HR BVP sensor is a blood volume pulse BVP detection sensor also known as a photoplethysmography PPG sensor housed in a small finger worn package to measure heart rate HR and provide BVP amplitude BVP waveform HR and heart rate variability HRV feedback Used for e Heart Rate Monitoring and HRV EKG Z Sensor P N SA9306M The EKG sensor is a pre amplified electrocardiograph sensor for directly measuring the heart s electrical activity
116. n Rehab ProComp amp FlexComp Infiniti Rehab Suite 49 1 Click Quick Start 2 From Categories select Pro Flex Rehab Suite Dynamic SEMG Assessment 3 From Clients select a name Wood Chuck 4 From Favorites select the desired Dynamic Favorites SEMG Protocol for Knee Assessment me Description 9 Click OK D SEMG General Dynamic Assessment with 2 EMG D SEMG General Dynamic Assessment with 4 EMG D SEMGO1 Cervical Spine Flexion Re extension D SEMGO2 Cervical Spine L R Lateral Flexion D SEMGO3 Cervical Spine Left Right Rotation D SEMGO4 Lumbar Spine Flexion Re extension D SEMGOS Lumbar Spine L R Lateral Flexion D SEMGO6 Lumbar Spine Left Right Rotation D SEMGO Knee Assessment e Click the Start button gt and read the instructions on the screen First you will see an overview screen Knee Assessment atec Start the range of motion as shown in the video example when position With Bcth legs on the block until prompted to Step down returning to ting position The motion restarts at the next Step up prompt Press a key to continue BioGraph e Press a key to go to the next screen In the next screen verify that the signal is free of artifacts and the sensors properly placed and press a key to Max E Mean Variabilly 043 MM MET Rehob ProComp amp FlexComp Infiniti Rehab Suite 50 e Before going to the next screen and starting to record
117. n compressed format but Sessions i i a uox uro EE unless your hard drive has very little space available or you do not need to review the saved sessions we recommend that you always Save which uses non compressed format Do Mot Save Save Compressed Compressed files can t be replayed reviewed or trended until they have been decompressed Rehab ProComp amp FlexComp Infiniti Rehab Suite 17 2 Enter Session Notes Here you can enter if you want a treatment code a session description and some notes Click OK to continue Session Notes X Training Code Description Notes Cancel Review or replay the session Din you want to reviewreplay this session now You have the option to analyze the session data at this point You can switch to review mode or replay mode Yes switch to After you review the data and close the viewing screen ED the program displays the next message prompt Record another session with the same settings i If you selected No at the previous message the Do you want to record another session for the same dient with program asks if you want to record another session the same configuration with the same settings e lf you select Yes at this point the recording screen will reopen Turn off your encoder Infiniti Software System If you selected No at the previous message the program prompts you to turn your enco der O ff A Remember to tur
118. n your encoder s off Click OK to return to the Main Menu screen You can also manually stop recording a script session by clicking the Stop button m In this case you are prompted to confirm the command Infiniti Sofiaan ee If you select No the script continues recording normally The Script is not finished Session data will not be saved Do you want to stop recording If you select Yes no data is saved for the session and you are prompted to record another session with the same settings message 4 above REPLAYING SESSIONS Replaying a session allows you to play back a recorded session like a movie This is useful if you have recorded video data You can replay the session from any point in time and skip to event markers or script activities and steps 1 2 3 4 Select Database from the Main Menu screen In the Main Database window select the client whose session you want to replay Select the session from the right hand table Click on Replay Session at the bottom Rehab ProComp amp FlexComp Infiniti Rehab Suite 18 Main Database x Settings Options Clients Sessions FulName ID Num Clinic 1D Date and Time Scrpt ChannelSet Type Duration Description State Wood Chuck 14 10 29 2008 2 07 52 PM D SEMG 01 Cervical S Script 00 00 50 000 Ballance Tara 1 001 D SEMG 01 Cervical 5 Script 00 00 50 000 Florimond Dorian 4 002 Biofeedback and Ne
119. ne REST 5 Post baseline 4 Rapid Contractions Rehab ProComp amp FlexComp Infiniti Rehab Suite 30 G SEMG05 GLOBAL SEMG ASSESSMENT 1 MUSCLE This is a complete assessment of the muscle with 5 activities pre baseline fast flicks rapid contractions work rest maximal force endurance and post baseline Replaying mode Script session Client TTL TTL Screen Instructions 1Ch EMG j Fie Session Edt Optom View Heb wt Um EMG Assessment This script consists of 5 parts 1 Instructions Replaying mode Script session Client TTL TTL Screen Training 1Ch Line Gr E He Session Eat Qetoe y Hep aw em REST 4 BioGr TT 4 Fast flicks Verify the signal and press a key to continue erty Signal Acta L Cytbe 1 Recording mode Script session Client TTL TTL Screen Training 1Ch Line Gr E3 Fio Session Eat Options View Hep 2 Signal Verification Replaying mode Script session Client TTL TTL Screen Training 1Ch Line Gr E Fe Sesuon Ed Qom Wem Hp 5 Work Rest Replaying mode Script session Client TTL TTL Screen Training 1Ch Line Gr E3 Fle Seo Edt Optoss Vew Heb mya Pet mu Post baseline REST Variab ty 4 BioGraph Y 7 Post baseline Replaying mode Script session Client TTL TTL Screen Training 1Ch Line Gr Ed He Sessions Ed Options No Hep y na mu Pre
120. nnn nene nnns 103 Manual Muscle Tostilg ooose eo eoo rure aa oe ER Ere aF REN FER NV ETE PPS a Vas s o seas aea eg asses evesesosssso see 105 OVERVIEW asec ca seve n 105 CLINIC AL GUIDE REFERENCE anon E dina GWN O WYD d Ed cd nb uncia nn did i Wiw WRN UU 105 PROCEDURE EFFECT 105 Ty EMI Rit del gt c 1 OM FEN Y EO ooo 105 Muscle Testing Training MMTO1 amp MMTO2 essssssssssseseeseeeeeennnnnennn nnne nn nn hnn nnn ern NEL E ELEN ELE nnne 106 Unilateral Bilateral Muscle Testing MMTOS3 amp MMT O4 seeeeeseeeeeeeeeennnnn mnn 107 Deere 4 d a o RED CU 107 Unilateral Bilateral Muscle Testing with EMG MMTO5 amp MMT06 ccccccssseeeeeeeeeeeeeeeseeeeeeeseeeeeeeeseaeeeeeeeeas 109 erar mcus E1 9 9 EY _ v wvFnm z TWF c c 109 AL PERROS EERTE y OVERVIEW 112 CLINIC AL GUIDE REFERENCE acen GY Y Y YO EEE pense CCD CED E TUE 112 PO BPE e ORG 112 orari 40 Sells Y DU GU GY NUS E RU SM EPA ME Ed MM M MUI EMEN RUD EE PUEDE 112 YS zc NG y NE CORYN REN Y YN RE NN TRW 114 G
121. ns and displays your report You can print or save the report using WORD s Print and Save functions PROCEDURE FOR LUMBAR SPINE ASSESSMENT Starting the Session If you are going use a webcam to make a video recording of this session connect your webcam to a USB port of your computer and turn it on e Connect the MyoScan MyoScan Z EMG sensors to the encoder in channels A and B left in A right in B e Dual inclinometer to channel E PA B c p E F a i s Myo Myo INC left right e Turn the encoder on 1 Click Quick Start 2 From Categories select Pro Flex Rehab Suite Dynamic ROM Assessment 3 From Clients select a name Wood Chuck 4 From Favorites select the desired Favorites Dynamic ROM Protocol for Lumbar Spine Description l D ROM General Dynamic ROM Assessment with 2 5 Click OK D ROM General Dynamic ROM Assessment with 4 D ROMO1 Cervical Spine Flexion Re extension D ROMO2 Cervical Spine L R Lateral Flexion D ROMO3 Cervical Spine Left Right Rotation D ROMO4 Lumbar Spine Flexion Re extension D ROMOS5 Lumbar Spine L R Lateral Flexion D ROMO6 knee Assessment e Click the Start button 3 and read the instructions on the screen Rehab ProComp amp FlexComp Infiniti Rehab Suite 91 First you will see an overview screen Flexion Re extension shown here Lumbar Spine Flexion Re extension Evaluation Place the electrodes and the inclinotra
122. nsnneessssons 7 Electromagnetic interferenceS 99 u irr YY LLLL YR LY YR HL ELLI LL LL LLE nnne L LLE R YL L LLE E LLE LEE LL LLEN sns sse aras EEEE EEEE Eneee 7 Electrostatic discharges NNI UE FR YE ee Pm T o AEE S REI 8 Correct oremtation Of Sensors ccna scccceecocactesceorectiionndadisucdenmiecadeanpoeddceblondaaieionesumtsqodeaetauddeabdacdsctigiowedsen E EEEE 8 MyoScan MyoScan Z EMG Sensor P N SAQ503M SAQ503Z ccccccccsseeseeeeeeeeeeaeeeeeeeeeeeaeeceeeeeeeessaaeeeeeeeeesags 9 MyoScan Pro EMG P N SA9401M 60 or SA9401M 50 sssssssssssssseeeeeenennnnnn nnne nnne nennen nnns n nares nnn 9 InclinoTrac Dual InclinoTrac P N T7650 T 7655 ccccccsssceccesececceseeeceaseecceseecsegeeeseaseeeseeeessaseeessueessseseeessags 9 ORGS WAG duni MEET MH 9 HR BYP Sensor sions NT OO 10 EKGZ SONS Gr P N SA9306M MM CTK 10 Respiration Sensor P N SAQ311M ccccccccccccseseseeeeeeeeeeeeeececeeeseeeeeeeeeeeessaeeeseeeeeesssaeeseeeeeeseseeeeeeeeeessseaaeeeeeeees 10 Skin Temperature Sensor P N SAQ310M aerieni anneni a O E Ea a i 10 Skin Conductance Sensor P N SAQ309M cccccccsssseeeeeceeeeeeeeeeeceeesesaeeeeeeeeeeeeeeeeeseeeeeeeseseeeeeeeeeesseaaaeeeeeeeeseaas 11 EKG Wrist Straps P N SA0 G25 sen 0 aud eU gUn TR COG Nnw NS GAD Cb SD Gn 11 Disposable EKG EMG electrodes seeeesessssss
123. nsor draws a small amount of power from the batteries when connected to the encoder it is better to connect only the sensors that are going to be used for a session before you start recording this will ensure maximal battery life Most Thought Technology software applications will display a battery power indicator we recommend that you replace the batteries as soon as this indicator falls below about 5096 of the battery power Caring For the Fiber Optic Cable A fiber optic FO cable is used for transmitting the sensor data to the computer Although this technology provides maximal electrical isolation signal fidelity and freedom of movement some care has to be taken when handling the fiber optic cable as it is much less flexible than a regular electric wire Be careful not to bend it sharply or wind it in a loop smaller than 4 inches in diameter Electromagnetic Electrical Interference When performing a biofeedback session it is best to avoid placing the encoder near the computer display monitor or any other electrical device where it can be exposed to electromagnetic fields Sensors and Accessories The instrumentation system includes a group of sensors used for the various protocols Before a session can be recorded the correct sensors must be connected to the encoder Electromagnetic interferences The SEMG and EKG sensors are capable of detecting very tiny electrical signals millionths of a Volt generated by muscle activ
124. nstrument It also explains how to prepare the examinee and the procedure to follow Chapter ALGOMETRY h i Assessment 2 Biofeedback SUNY Tiere ur y ace serie Picy Tam Dicet AFIACH D Dan tuaran Yr uyanan J PROCEDURE Starting the Session e Connect the sensors to the encoder as follows o ForceTrac with rod attachment to channel D o Foot pedal to channel C pA B oO FE Fo e i 4 j Pe a rmej J e urn the encoder on 1 Click Quick Start 2 From Categories select Pro Flex Rehab Categories Suite Algometry 3 From Clients select a name Clients Wood Chuck 4 From Favorites select the Algometry Favorites Protocol um 5 Click OK P EEEE Algometry Lbs inch2 or PSI Note The force unit kgs cm or Ibs in depends on whether you have selected Pounds or Kilogram units in the menu Options gt Force Units Re hab Proc omp amp FlexComp Infiniti Rehab Suite 112 Note Make sure your ForceTrac is properly calibrated before starting e Click the Start button mi and read the instructions on the screen Do not press the foot pedal yet A TA ab UE C CIE RIDE ER E E E epl cc H 2 File Sessor Edt Options View Help w Swe Algomet Posractions activins 1 Ced L Stem i Actety precress e Press the foot pedal to go to the next screen e Hold the ForceTrac in your hand Force Unit Verification screen Before you can proceed
125. onnect your webcam to a USB port of your computer and turn it on before you start the session Note Your computer system must be connected to a video capture device such as a webcam and the proper software installed in order to use this function The clinical guide gives general guidelines and recommendations eio Aie Chapter HEART RATE MONITORING amp HRV Ei egre Also recommended e INTRODUCTION TO SURFACE ELECTROMYOGRAPHY e RESPIRATION TRAINING WITH BIOFEEDBACK s Arauca ro Wi 3 i PROCEDURE e Connect the sensors to the encoder as follows BVP or EKG sensor to channel C o Respiration sensor to channel D o MyoScan MyoScan Z to channel A and B optional O e urn the encoder on 1 Click Quick Start IL Quick Start 2 From Categories select Pro Flex Rehab Suite Heart Rate Monitoring 3 From Clients select a name Clients Wood Chuck Rehab ProComp amp FlexComp Infiniti Rehab Suite 17 4 From Favorites select the training protocol with EKG or BVP 5 Click OK e Click the Start button HI Favorites Description Heart Rate Monitoring with BVP Heart Rate Monitoring with EKG You can view each screen by clicking on the numerical buttons on the toolbar at the top ij 3 e To stop the session click the Stop button B Heart Rate amp EMG Monitoring with webcam 1 2 3 4 This screen displays the respiration amplitude and the hea
126. ositioned on the SCMs or Traps to channels C and D left in C right in D o Dualinclinometer to channel E Myo Myo Myo Myo left CP right CP left SCM right SCM or Traps or Traps e um the encoder on 1 Click Quick Start 2 From Categories select Pro Flex Rehab Categories Suite Dynamic ROM Assessment 3 From Clients select a name Wood Chuck 4 From Favorites select the desired Dynamic ENS ROM Protocol for Cervical Spine nmm 5 Click OK D ROM General Dynamic ROM Assessment with 2 D ROM General Dynamic ROM Assessment with 4 D ROMO1 Cervical Spine Flexion Re extension D ROMO2 Cervical Spine L R Lateral Flexion D ROMO3 Cervical Spine Left Right Rotation D ROMO4 Lumbar Spine Flexion Re extension D ROMO5 Lumbar Spine L R Lateral Flexion D ROMUOG Knee Assessment e Click the Start button 3 and read the instructions on the screen Rehab ProComp amp FlexComp Infiniti Rehab Suite 94 First you will see an overview screen Flexion Re extension shown here Cervical Spine Flexion Re extension Evaluation Place the electrodes and the inclinotrac as indicated in the clinical guide Bend the head forward and hold at ine lowest point until prompted to Return to neutral position then return to the upright position The motion restarts at the next Bend forward prompt and is repeated for three times Press a key to continue BioGraph e Press
127. ou to verify that the motion has been properly performed by the examinee at the right time when prompted You can also check the consistency from trial to trial Rehab ProComp amp FlexComp Infiniti Rehab Suite 43 Generating a report After the review screen opens you can generate a Dynamic SEMG Assessment report This is an Excel report 1 Click the Session Report icon in the tool bar 2 Select Generate Excel Report Microsoft Excel opens and displays your report as a workbook You can print or save the report using Excel s Print and Save functions Section 1 Graphs Lumbar Spine Flexion Re extension Client TTL TTL Session Date 23 10 2008 BioG raph Session Time 4 44 24 PM INFINITI OEMG Left Side BEMG Right Side Pre baseline Flexion Full fiexion Re extension Neutral position Post baseline The session is graphed as a simplified chart For relaxation phases such as baselines neutral position and completed range of motion full flexion full rotation etc the EMG RMS mean is plotted For motion phases such as flexion re extension or rotation the EMG RMS peak is plotted Section 2 Data Flexion re extension peaks ratios Pre post baselines difference uv TEMPORAL ANALYSIS Left Right Right Lefi Time to flexion peak seconds Pre baseline variability Post baseline variability The data are grouped in order to facilitate the analysis The report computes the d
128. pressure threshold According to the literature the following conditions are considered a positive finding e he difference between the PTM and the opposite side or surrounding muscle in the same patient exceeds 2 kg cm 28 5 Lbs inch e The PTM is less than 3 kg cm 42 7 Lbs inch Summary and Follow up notes You can enter notes in the summary follow up notes boxes Summarv Notes e n Excel 2000 and Excel 2003 place your cursor in the text box and start typing ry e n Excel 2007 place your cursor in the text box Marked improvement 1 Right click the mouse button j Edit Te 2 Select Edit text a Oe 3 Start typing El gt Rehab ProComp amp FlexComp Infiniti Rehab Suite 116 Hardware Specifications MyoScan MyoScan Z EMG Sensors SA9503M SA9503Z Size approx Weight Input impedance Input range Sensitivity CMRR Channel bandwidth Signal output range Input output gain Supply voltage Current consumption Accuracy 37mm x 37mm x 12mm 1 45 x 1 45 x 0 45 15g 0 5 oz gt 10GO in parallel with 10pF 0 2000u VRMS lt 0 1uVRMS gt 130dB 10Hz 1kHz 0 1 0VRMS 500 7 26V 0 02V 0 7mA 0 25mA 0 3uVRMS 4 of reading 25 C to 30 C MyoScan Pro EMG Sensor SA9401M 60 or SA9401M 50 Size Approx Weight Input Impedance Input Range Sensitivity Bandwidth Accuracy EKG Sensor SA9306M Length approx Weight Temperature range
129. quili EJ Ple Session Sgems EGR Option Wem Hep Equilibration 10Ch Postural Training Thoracic amp Lumbar Spine oe 1 2 3 4 O Scale dependent Threshold dependent M Other The 10 muscle sites are as indicated Thoracic and lumbar The difference between each pair of muscles at the site should be less than 359e The red light will be on to indicate that the difference is greater than 3590 CATEGORY PRO FLEX SUITE SEMG BIOFEEDBACK TRAINING These screens are for general training involving more complex or various exercises TRNGO1 Training with 2 EMG Training 2Ch Line Graph Grow Box Reviewing mode Open Display session Client INCREDIBLE Bulk Screen Traini Ed Ble Session Screens Edt Qolons View Hep 12345 M Scale dependent M Threshold dependent Other A proportional sound is played when the square expands past the limit red line The left square is for channel A and the right square for channel B The signals are also displayed on a line graph Training 2Ch Bar Graphs 1 2 3 4 5 O Scale dependent M Threshold dependent Other A simple and easy to understand display for two channels of EMG A song is played in two parts If both channels are below the threshold then the music stops If one or both channels are above the threshold then progressively more layers of music are added Training 2Ch Filled Line Graphs oe nally n 12 3445 Scale dependent M Thre
130. rating systems Microsoft Windows 7 Home Premium Business Ultimate or Enterprise Microsoft Windows Vista Home Basic Home Premium Business Ultimate or Enterprise with Service Pack 2 Microsoft Windows XP Professional or Home Edition with Service Pack 3 DirectX 9c or later if this is missing it will be installed with BioGraph Infiniti 50 60 gigabytes hard disk space for video recording and processing The software needs 2 5 gigabytes to install and run Minimum RAM 1 GB Windows XP or 2 GB Windows Vista or Windows 7 CD ROM or DVD drive Video Card minimum XGA 1 024 x 768 monitor resolution 32 bit compatible sound card amp speakers 1 USB port Mouse or compatible pointing device Microsoft Office with Word and Excel for report generation and printing Webcam 30 frames per second for video purposes only Internet access for updating software and receiving technical support PLEASE NOTE Rehab When using Windows 7 Home Basic or Business or Windows Vista Home Basic or Business additional codecs must be installed to view camera and DVD Low speed CPUs 1 8 GB or less may be sluggish when running screens with multiple instruments ProComp amp FlexComp Infiniti Rehab Suite 2 First Time Run Once the software is installed you have to configure your system This takes only a few minutes STARTING THE PROGRAM To start the program simply double click on the BioGraph
131. rding to the maximal force Channel B is used to train the patient not to activate a second muscle while activating the first one The threshold of channel B should be set at a small value above the resting baseline CTRL01 Control with 1 EMG Control 1Ch Tubes m 1 23 4 5 v Scale dependent O Threshold dependent O Other The animation represents channel A and is dependent on the scale on the left The ball climbs the tubes when the signal goes up Instruct your patient to move the ball to a given tube color k Rehab ProComp amp FlexComp Infiniti Rehab Suite 63 Control 1Ch Tension Discrimination Training Level 1 1 2 3 4 Control 1Ch Tension Discrimination Training Level 2 1 2 3 4 Control 1Ch Tension Discrimination Training Level 3 1 2 3 4 M Scale dependent O Threshold dependent Other Each screen contains a template to follow Three levels of difficulty are available You can also adjust the level of difficulty by adjusting the graph scale These screens are designed for tension discrimination training and for muscle contraction control CTRLO2 Control with 2 EMG Reviewing mode Open Display session Client INCREDIBLE Bulk Screen Contr Db ie Screen DN Que Whew tb tj Control 2Ch Hero Morph Fast CI 1 2 3 4 M Scale dependent Ll Threshold dependent Other The animation represents channel A and is dependent on the scale on the left The
132. ries of message prompts guides you through the process of saving data adding notes to the session file and switching to reviewing mode so that you can generate a session report In review mode a screen similar to this will appear Lumbar Spine Assessment Minimum Maximum Mean Variability Ae 1 35 70 33 11 34 1 25 B Right 2 10 103 71 24 53 0 90 A Left 10 01 inen 25 80 BioGr ph Y The review allows you to verify that the motion has been properly performed by the examinee at the right time when prompted You can also check the consistency from trial to trial Generating a report e After the review screen opens you can generate a Dynamic ROM Assessment report This is a Text report 1 Click the Session Report icon zm in the tool bar 2 Select Generate Text Report select report components in the Session Report window and click Generate Report Rehab ProComp amp FlexComp Infiniti Rehab Suite 93 Microsoft WORD opens and displays your report You can print or save the report using WORD s Print and Save functions PROCEDURE FOR CERVICAL SPINE ASSESSMENT Starting the Session If you are going use a webcam to make a video recording of this session connect your webcam to a USB port of your computer and turn it on e Connect the sensors to the encoder as follows o MyoScan MyoScan Z sensors positioned on the CPs to channels A and B left in A right in B o MyoScan MyoScan Z sensors p
133. rt rate on the same line graph It plots the 2 channels of EMG The HRV measure HR Max HR Min is also displayed Video can be recorded Heart Rate amp EMG Monitoring 1 2 3 4 This screen is similar to the one above but without webcam Heart Rate amp Monitoring 1 2 3 4 This screen is similar to the ones above but shows only the heart rate and respiration Verification Screen 12 3 4 This is a signal verification screen It shows raw BVP or EKG with heart rate as well as raw EMG Rehab ProComp amp FlexComp Infiniti Rehab Suite 78 Review screen The screen was designed for the review of the session It shows the respiration amplitude and rate the raw BVP or EKG heart rate and Heart Rate Variability HRV and the EMG activity along with the video BioGraph X All these screens are accessible from Start Open Display Session in the channel set Heart Rate Monitoring with BVP and EMG or Heart Rate Monitoring with EKG and EMG Rehab ProComp amp FlexComp Infiniti Rehab Suite 79 Skin Conductance and Temperature Biofeedback OVERVIEW Skin conductance and peripheral temperature biofeedback is useful when training of overall physiology is desired as it incorporates two modalities with simple correlations to relaxation skin conductance lower and temperature raise When these physiological measures meet the biofeedback conditions the subject is in a general stat
134. s and then follow these steps 1 Session on page 17 or from the Database window by selecting the session from the database and clicking on If this is an open display session from the Options menu select Set Open Display Statistics and choose the channels for which statistics should be calculated If necessary perform artifact rejection on the recorded data Click the Calculate Statistics icon in the tool bar to recalculate the statistics If you have loaded more than one screen open the screen from which you want to generate the report Different screens can generate different reports Click the Session Report icon m in the tool bar and select the type of report that you want to generate amp ll Generate Text Report 3 Generate Excel Report e f you select Generate Excel Report Microsoft Excel opens and displays your report as a workbook You can print or save the report using Excel s Print and Save functions Rehab ProComp amp FlexComp Infiniti Rehab Suite 21 e Ifyou select Generate Text Report the Session Report window opens and you must continue to the next step E o s M Session Notes Select report components by placing a check mark in the desired boxes IV Session Statistics M Session Markers Click Generate Report to generate the report Word opens and displays your F7 Soting Instumenie report as a document You can print or save the report using Word s Print and IV Screen Graphs n C Sa
135. s and third party sensors must be connected to active sensors either directly or through an adapter e Remove batteries when the device is not being used for extended period of time Please dispose of battery following national regulations INTENDED PURPOSE e Biofeedback relaxation and muscle re education purposes CONTRAINDICATIONS e Patients with limited or impaired physical and mental capacity NOTE e No preventative inspections required maintenance must be performed by qualified personnel e The supplier will make available upon request circuit diagrams component parts lists and description or other information required for the repair of product by qualified personnel e If a fiber optic or patient cable is damaged or breaks please replace it e Due to the essential performance and intended use of the device testing for immunity to electromagnetic disturbances was not required and was not performed The device may be susceptible at levels below IEC60601 1 2 immunity test levels e The operator must be familiar with typical characteristics of signals acquired by this equipment and be able to detect anomalies in the acquired signal that could interfere with treatment effectiveness Depending on the importance of signal integrity it may be advisable to continuously monitor the raw signals in time and or frequency domain while the device is being used for biofeedback or other purposes If anomalies are observed on acquired signals
136. shold dependent Other Two filled line graphs display the two channels with a color change at the threshold Each channel controls a different part of the same song Rehab ProComp amp FlexComp Infiniti Rehab Suite 69 Training z 2Ch Line Bar Graphs e Client INCREDIBLE Bulk Screen Traini E3 LI gt 123 5 Stay above the thresholds to h the tones 1 2 3 4 5 ee Ll Scale dependent M Threshold dependent Other Both channels are displayed on a line graph and a bar graph Training 1Ch Motor Copy Training iim oem ER Mies Ve Motor Copy Training 123 4 5 O Scale dependent O Threshold dependent M Other This screen is used for the motor copy training technique It can also be used to train the patient to consistently repeat the same contraction without a template Do the first repetition and then wait for the new signal to appear in the top graph below before doing the next repetition The movement detection threshold is set to 20uV If you want to modify this value from the Edit menu select Edit VC Settings select V210 and edit the Input 2 Constant Value TRNGO2 Training with 4 EMG Training 4Ch Bar Graphs Reviewing mode Open Display session Cliant INCREDIBLE Bulk Sereen Tank EJ Mm 1 2 3 4 Scale dependent M Threshold dependent Other Four bar graphs representing 4 EMG channels with a color change above threshold Training 4 C h Fi le d L i ne G ra p h S
137. sor is not detected 1 sensor or replace it with the right one 1D not in Channel Set EKG Pro Flex Click Repeat to check the sensor connections again until the system no longer detects a wrong sensor type The program will not allow you to record a session with the wrong sensors Channels that are not included in the selected Channel Set will not be recorded OK Cancel Note Ifthe Wrong Sensor Type column is empty the correct sensor has been connected If you do not connect all the sensors that are required for the selected channel set the message Sensor is not detected appears in the Wrong Sensor Type column When a sensor is not connected the program replaces its signal value by a constant value of 1 You can record a session when some sensors are missing but the corresponding signal will be a flat line Any calculations based on that signal will not reflect real physiological changes STOPPING A SESSION No duration is set for an Open Display session It must be stopped manually by clicking the Stop button m The duration of a Script session is set at the time the script is defined When the script reaches its end recording will automatically stop When the session ends the following series of message prompts will appear and guide you through the process of saving data adding notes to the session file and optionally reviewing the data or recording another session 1 Save session data You can save the session i
138. sssssseessseseenne nenne nennen nennen Ek a eii ENE rAd rin 11 oialic EMG electrodes P N SA9927 uu uu uu uu aquae a aeneo opo Uu e UUN Dur te cc Re tare ceu adu Su butane FD M S E GO 11 gosu ocibiyh re ON c HR 11 Tele Infiniti CF P N SA9600 Optional seeeeeessesseseeeeennnnnnnnnnnnnn nnne nnn nnne nnn nnns 12 Software Overview eee eee eee eee ee eee ee ee ee see see seescescesceseesceseeseeseesceseeseess IO RECORDING SESSIONS c UU 13 RE URIS ROO ii IEEE 13 Starting a session from a FAVOTILC cccccccccsseseecceeeecseeeeeeeeeeeeeeaeeeseeeeeeeseeeeeeceeeeesseeeseeeeeeesseeaeeeeeeesssaeeeeeeeeeesaas 13 FAN SC MMO oe Sol OM PERITO mmm 14 Starting an Open Display S SSION ccccccccsseseecceceeceeeeeeeeeeeeeeeaeeseeceeeeeseeeeeeceeeesesseaseeeeeeesssaeaeeeeeeeesseaaeeeeeeeeeaaas 16 SON ON ON ETE TT em 17 SIOPPING A SESSION FRYN FN FIR HR EE AIFF PY YE RR RR FY Y FF HF CYH CREF NEF FN HE RTH Y CH YN RF NN 17 REPLAYING SESSIONS reese Sak ca aes em HN I RH Y RR RH O I FR I RI RY Y REF YF EF 18 i imbekRzollenlm c o S 19 mid MEI 19 mij leo AU LAC TEE ee cm 20 elei elici e ENTRO T Oo Tom 20 Generating Session Reports e eceecceceocesesese deser nea usas cOO sa baaa OODU RN R Ra E Pa
139. ste m rPAEUERUIRE FMCIPRODN NDA EIU A FE AD EYFLE NUN ONR RUTH RIEN NIAI FUIMUS SINUS 49 sis 0 9 EESE EEE A t T T ERREUR 51 Reviewing the SessSiON NER TR RW ET FA YNN FN TN NA Y RE FR WE ner E Ea Eiran iak Eiaeai 52 Generating f gt ole FF _ eC cm 52 Muscle Fatigue Monitoring eee e eee eee ee ee eere eere eere eee eee sesesesesesesesesesesese DA OVERVIEW t O OO I FFF PH 54 CLINIC AL GUIDE REFERENCE 5 i1nitesii ini cuddiu ad uud tua dun dua quud ipi oodd ina BARA ANNA da daga du ud ope cud dana ARA Liza daa Ego doa da Ro deni dua adu diedie 54 el z 751 1e ez 0 54 TMC MS SS SION ae cece neste EL ER TETTE 54 Wi AS UN elas se NF FN FFAN NFYFC FD 55 SEMG Biofeedbactk use e duD du UO Yn G GDG nU DUO U DW OUd wu Oedd donio D OVERVIEW c 56 CLINIC A GUIDE REFERENCE O OG O E A De csse UE EF OAODN 56 GENER AL PROCEDURE 56 Sila ale OO 6 ea Fu Em es 56 CATEGORY PRO FLEX SUITE SEMG BIOFEEDBACK RELAXATION emHH HH 57 CATEGORY PRO FLEX SUITE SEMG BIOFEEDBACK STRENGTHENING mmmHMM 60 CATEGORY PRO FLEX SUITE SEMG BIOFEEDBACK
140. t Dorian Florimond Session Date 30 01 2009 BioGraph y Session Time 2 23 45 PM Involved Right D EMG VMO B EMG V Pre Baseline Step up Leg up Step down Leg down Post Baseline The session is graphed as a simplified chart For relaxation phases such as baselines and neutral position leg up and leg down the EMG RMS mean is plotted For motion phases step up and step down the EMG RMS peak is plotted In order to select the involved side you have to click on Involved Rehab ProComp amp FlexComp Infiniti Rehab Suite 52 Involved E EMG VMO Section 2 Data PARALLEL SYMMETRY ANALYSIS VMO yuV VL uW Pre baseline average Step up Legup Step down Leg down Post baseline average Pre post baselines difference jV During Step up During Step down The data are grouped in order to facilitate the analysis The report computes the difference between pre and post baselines and the ratio VMO VL EMG peaks during the motion phases Section 3 Summary and Follow up notes You can enter notes in the summary follow up notes boxes Summarv Notes e n Excel 2000 and Excel 2003 place your cursor in the text box and start typing ry e n Excel 2007 place your cursor in the text box 1 Right click the mouse button 2 Select Edit text 3 Start typing Marked improvement Rehab ProComp amp FlexComp Infiniti Rehab Suite 53 Muscle Fatigue Monitoring OVERVIEW SEMG can
141. t button mH Sensor Connections If there are problems with your sensor connections the M program will report them prior to accessing the recording screen If for example you have sensors that are connected but are not required for this channel set you will get a warning message 1 D EKG Pro Flex The following physical channels are not included in the selected Channel Set and will not be recorded TEM You can remove the sensor if you want or continue Y anon recording by clicking Yes Keep in mind that no data is recorded for sensors that are not defined in the channel set Note If there are sensor connection problems in addition to extra sensors this information won t appear as a separate message It will display in the Sensor Connections window If you have connected wrong sensor types you will see the Sensor Con nections window All the Sensors that Physical Channel Set of 1 FlexComp Infiniti encoders with FlexComp Infiniti Communication Protocol are expected Will be listed in the Expected Sensor Channel Description Expected Sensor Wrong Sensor Typel Replacement Signal Value 1 A EMG MyoScan Flex column 1B B EMG i enfia EEGZ TE C EEG EEG Z 1 TRE E Tem Temp Pro Flex Sensor is not detected 1 The Wrong Sensor Type column shows which Sensor 1F F RATE ES ELE Sensor HE 1 type was actually detected You can remove the wrong 1G BSC SCPro Flex i 1H H BYP HR BVP Pro Flex Sen
142. t must relax 4 Rapid Contractions the patient repetitively contracts as quickly and strongly as they can 5 Post Baseline Comparison of resting levels pre post assesses the ability to recover Replaying mode Script session Client TTL TTL Screen Instructions 1Ch Fast Ed tenes me session Client TTL TTL Screen Training 1Ch Line Gr Replaying mode Script session Client TTL TTL Screen Training 1Ch Line Gr Ed Mile Session Ect Opos View Web Fie Season Edt Options View Help Be Session Edt Options Yww tip u een oD a bi gt w T LE Tw he Um LN tes tt Ted Fast Flick Assessment Verify the signal and press a key to continue Pre baseline REST This scrip consists of 3 parts 1 Pre baseline Rest for 15 seconds 2 Quick Contractions Start with 1 to 3 quick contractons during 6 seconds and rest for 4 seconds Cycles 3 times 3 Post baseline Rest for 15 seconds Press a key to continue Acti progpegs fremt ony tay 1o camma wrfy 2498 Acty L Cyta Stap 2 awt pregrene Frees ayy tey to continue menenie pe O O OS Joys 02 09 14 8 1 Instructions 2 Verify signal 3 Pre baseline Replaying mode Script session Client TTL TTL Screen Training 1Ch Line Gr E Replaying mode Script session Client TTL TTL Screen Training 1Ch Line Gr E3 Fie Session EO Ortors Vow Help Fle a Edt Opboss Wee Het Contract quickly 1 to 3 times Post baseli
143. t the MyoScan MyoScan Z EMG sensors to the encoder in channels A and B A for VMO B for VL e Dual inclinometer to channel E pA B p FE F fw sf Myo Myo INC left right e Turn the encoder on 1 Click Quick Start 2 From Categories select Pro Flex Rehab Categories Suite Dynamic ROM Assessment Pro Rehab Suite Dynamic ROM Assessment 3 From Clients select a name Wood Chuck 4 From Favorites select the Dynamic ROM Favorites Protocol for Knee Assessment Description 5 Click OK D ROM General Dynamic ROM Assessment with 2 D ROM General Dynamic ROM Assessment with 4 D ROMO1 Cervical Spine Flexion Re extension D ROMO 2 Cervical Spine L R Lateral Flexion D ROMO3 Cervical Spine Left Right Rotation D ROMO4 Lumbar Spine Flexion Re extension D ROMO5 Lumbar Spine L R Lateral Flexion D ROMO6 Knee Assessment e Click the Start button 3 and read the instructions on the screen Rehab ProComp amp FlexComp Infiniti Rehab Suite 97 First you will see an overview screen Knee Assessment Place the electrodes and the inclinotrac as indicated in the clinical guide Start the range of motion as shown in the video example when prompted Hold the position with both legs on the block until prompted to Step down retuming to the starting position The motion restarts at the next Step up prompt Press a key to continue BioGr ph Y
144. tem Connect to electrodes Other sensors for example the push button switch have removable cables but only a single input entrance This makes it impossible to connect these sensors in the wrong orientation to the encoder Certain sensors however have removable cables and two input entrances It is important to orient these sensors to the encoder correctly so that the physiological signal is properly received These sensors include the EKG EEG and EMG sensors all of which are shaped like the illustration at the right Such a sensor is correctly oriented to the encoder when the cable joining them is connected to the bottom entrance of the sensor If an extender cable with electrodes needs to be attached to such a sensor it should be connected to the top entrance of Connect to encoder the sensor The following is an overview of the sensors electrodes and accessories used with the system Rehab ProComp amp FlexComp Infiniti Rehab Suite 8 MyoScan MyoScan Z EMG Sensor P N SA9503M SA9503Z The MyoScan is a pre amplified surface electromyography sensor sensing raw SEMG MyoScan Z also allows impedance check e Input Range O 2000 uV e Bandwidth 20 Hz 500Hz Used for e SEMG Assessment e Muscle Fatigue Monitoring e SEMG Biofeedback e Dynamic Range of Motion e Respiration Training e Manual Muscle Testing MyoScan Pro EMG P N SA9401M 60 or SA9401M 50 ci 5 Ld The MyoScan Pro is a pre a
145. termine the training parameters of the day since an examinee s condition can change over time This logo on a screen in a protocol indicates that you can use an optional webcam with the screen to record video of the session You need only connect your webcam to a USB port of your computer and turn it on before you start the session Note Your computer system must be connected to a video capture device such as a webcam and the proper software installed in order to use this function CLINICAL GUIDE REFERENCE The clinical guide gives general guidelines and recommendations for the accurate use of Clinical Guide the instrumentation It also explains how to prepare the examinee and the procedure to Mcr follow 3 Chapter SEMG ASSESSMENT section SEMG SIGNAL ANALYSIS GENERAL x CONCEPTS Also recommended e INTRODUCTION TO SURFACE ELECTROMYOGRAPHY e SKELETAL MUSCLE PROPERTIES GENERAL PROCEDURE Starting the Session If you are going use a webcam to make a video recording of this session connect your webcam to a USB port of your computer and turn it on e Connect the sensors to the encoder as follows o MyoScan MyoScan Z sensor to channel A o Optional MyoScan MyoScan Z sensors to channel B and channels C to J for FlexComp Infiniti Myo Myo Myo Myo Myo Myo Myo Myo Myo Myo optional optional for optional for optional for optional for optional for optional for optional for optional for FlexComp FlexComp F
146. th 2 inclinometers The second unit of the dual InclinoTrac can also be used as a single unit You can use both units together either for working on the three dimensions or bilateral training ROM Training Balance Animation 12345 For this screen the inclinometers are positioned at the back and the left of the head or the trunk The examinee can train to keep his head trunk straight line in the center of the lissajous graph the balls in the middle of the balance and the green lights turned on He can also roll his head around his neck and see where his ROM is limited 4 BioGraph Rehab ProComp amp FlexComp Infiniti Rehab Suite 103 ROM Training Motor Copy 1 2 3 4 5 Here the inclinometers are attached to the arms or legs The examinee has to elevate both limbs in the same time to keep the ball centered on the balance The line on the rainbow gives the averaged angle between the two sides ROM Training Review 12 3445 The screen was designed for reviewing the session but can be used to monitor the motion It shows the ROM amplitudes along with the video Review Screen ROM Training Review The screen was designed for reviewing the session It shows the ROM amplitudes along with the video y MIN 17 17 MIN LEFT RIGHT E Inclinometer 2 34 60 121 45 C Inclinometer 1 MAX 127 37 MAX Inclinometer 1 Minus Inclinometer 2 BioGr ph J C Inclinometer 1 E
147. than 3 meters or 10 feet or the PC must comply with EN60601 1 1 system safety After use the disposable electrodes may be a potential biohazard Handle and when applicable dispose of these materials in accordance with accepted medical practice and any applicable local state and federal laws and regulations To diminish the risk of spreading communicable diseases always use good hygiene practices with reusable EMG electrodes particularly if abrasive substances are used In all cases refer to your facility s infection control procedure Do not use in the presence of a flammable anesthetic mixture with air or with Oxygen or Nitrous Oxide Not to be immersed in water Take care in arranging patient and sensor cables to avoid risk of patient entanglement or strangulation The operator is responsible for ensuring the safety of any devices controlled or triggered by Infiniti equipment or software or by any software or hardware receiving data from Infiniti equipment Infiniti equipment must not be configured or connected in such a way that failure in its data acquisition processing or control functions can trigger patient feedback stimulus that poses an unacceptable level of risk Use of any equipment in a biofeedback context should be immediately terminated upon any sign of treatment related distress or discomfort Not to be connected to a patient undergoing MRI Electro surgery or defibrillation To prevent static discharge from damaging t
148. the patient to complete the desired ROM and hold the position 2 Place the Force Trac where applicable to measure the desired muscle activity Press the pedal when ready Instruction Trial 1 Activity 2 Cycle 1 Step 3 Activity progress Waiting for condition 2 When ready press the pedal and perform the test at full load Apply resistance gradually BioGraph RR Script 00 00 05 812 b 000000 000001 00000 000003 000004 000005 000005 000007 moc 000009 000010 Resistance should always be applied gradually not suddenly and in the direction of the motion line of pull of the muscle The break usually happens within 2 or 3 seconds A shorter break time may lead to re injury A longer break time may lead to fatigue e Repeat the exercise 4 times e Then repeat it 4 times for the opposite side if you are performing bilateral testing e When the session ends a series of message prompts guides you through the process of saving data adding notes to the session file and switching to reviewing mode so that you can generate a session report Rehab ProComp amp FlexComp Infiniti Rehab Suite 108 SUITE Unilateral Bilateral Muscle Testing with EMG MMTO5 amp MMTO6 The procedure is very similar to the one described above The only difference is that the EMG sensors must be positioned on the muscles of interest and that EMG activity will be recorded creen dr Options View Bao Te
149. the up and down arrows to the right of the text boxes labeled with Max and Min Rehab ProComp amp FlexComp Infiniti Rehab Suite 22 The numbers increase or decrease by 0 1 but when you click on the button xio the numbers change by 1 You can also type the desired value into the text box and then click anywhere on the screen to save the change e Multi line graph Y1 and Y2 axes toggle The multiple line graph has a left and a right vertical scale that can be adjusted independently of each other by clicking on the toggle button Left vertical scale enabled Right vertical scale enabled e Threshold The threshold line on a bar graph line graph and animation scale can be adjusted in the same way as the vertical scale The text box labeled Thr is for single threshold graphs while Thr2 is for double threshold graphs like the multi line graph that can have up to two guidelines e Time scale The default time for all the screens is 30 seconds You can select a new time scale by clicking on the drop down menu USING A WEB CAMERA When you see this logo on a screen in the manual it means you can use a webcam with this screen You only need to connect your webcam to a USB port of your computer and turn it on before you start the session Note Your computer system must be connected to a video capture device such as a webcam and the proper software installed in order to use this function The software searches for a conn
150. twork that supplies bo Sd eager Not applicable buildings used for domestic purposes Manual No SA7972 Revision 5 1 Rehab ProComp amp FlexComp Infiniti Rehab Suite ii TABLE OF CONTENTS Ttg UL Lu POON YR CEIR Y HE RR Y RWYN Installation and System Requirements eee eee eee ee ee ee ee ee eee e eoe e e e eseess 2 FESTE TInio RUE SE UE RE E E 9909999000998 63 9E 09 Y D STARTING THE PROGF AM inii i Ieu 3 VERIFYING o 0 ia LC IN REF 3 ENTERING KEY CODES FFF DRI EF HF FREE FA FO HD HE FF HE FN FFY Eae aaea FFF DYU 4 Hardware Sel Up Y Ye ON H TRE FO FY YRR 0 TNE ENCOUGI Y ER YR M 6 Connecting TT USB and the encoder eeeei ir enia aE SEN AREENA nsns aa aas nnn nsa nnn 6 BVI TY dud tel FNS QR PEE 6 Caring For the Fiber Optic Cable cccccccccsssseecceceeceeeeeeceeeeeeeaeeeeeeeeeeeesaeeeeeeeeeesseeaeeeeeeeeseseaeeseeeeeessseaaeeeeeeeessaas 7 Electromagnetic Electrical Interference cccccccccsseeeccseeeceeseecceeeecseueeecsuueecseueeecsaueeessueeeesaueeessaseeessueeessanseeseaes 7 Sensors and Accessories cccceceeeeeeeeeeeeeeeeeneeeeeeeeeeeeaseeeeeeeeeasaaeeeeseeeeasaaeeeeeeeeeasaaeeeeeeeoessaaseeeseegensaeeeeeeeaanssaeeseseeoe
151. uite Ble Session Screens Edt Options Wew Help ww tne mi Tw ym vw maronad ONE 0 Relax muscles below the threshold to keep the music playing a Reclawine a M s c LEE PRISES BLE Bulk eze a E4 Ble Sesion Sgtens Eck Options Yew Hep Doom we E me m s ur mm a 5mm ig your muscles and staying below the Rel ia am ode Open Di 5i SSSI Chien t INCRED BLE Bulk ree Rel 3 EJ E3 Ble Seion Sgems Edt Optms Yew Bep l nw me Y 5 S MBO OM 12348 playing by staying below the threshold Replaying mode Open Display session Client INCREDIBLE Bulk Screen Relaxa j Die Semion Sgems Eck Options yew Help we Ma wi w im vii vwiaweon w WD 2345 n Replaying mode Open Display session Client INCREDIBLE Bulk Screen Relaxa Edl Ble saon ptem Eck Options Wew Help i Doo ue o m Tmi t t Gwg Apre N Open Display se oa Client TT IBLE Bulk Ser ee a E3 58 Relaxation 1 Ch Parrot Puzzle FAU CA Ty pep E E EE UE 1 2 3 4 5 O Scale dependent M Threshold dependent Ll Other If the EMG reading is below the threshold for 10 seconds then the puzzle starts to fill in If the signal goes above pieces will disappear Reviewing mode Open Display session Client INCREDIBLE Bulk Screen Relaxa j Ble Sessio Help e Sesion Sogwes Eck Options Yew Relaxation 1Ch Growing Fractal 12 3445 Scale dependent M
152. un an impedance check The next chapters explain the protocols run by the system These are General SEMG Assessment Static SEMG Assessment Dynamic SEMG Assessment Muscle Fatigue Monitoring SEMG Biofeedback Respiration Training Heart Rate Monitoring and HRV Skin Conductance amp Temperature Biofeedback Static Range of Motion Assessment Dynamic Range of Motion Assessment Range of Motion Training Manual Muscle Testing Algometry Each protocol chapter presents the general principles of one specific protocol It lists relevant references in the clinical guide It provides step by step instructions for running the protocol Finally it describes how to generate a report The remaining sections of the manual provide a list of Hardware Specifications and information about the Warranty obtaining Technical Support and Returning Equipment for repair if necessary Rehab Note Important safety information about operating the equipment is provided in the front matter of the manual starting on page i ProComp amp FlexComp Infiniti Rehab Suite 1 Installation and System Requirements If BioGraph Infiniti is not already set up on your computer please follow the Installation Instructions provided to install the program Make sure that your computer meets the following requirements before you install the BioGraph Infiniti software Desktop or laptop with two monitor capacity CPU 1 8GHz dual core processor or faster Ope
153. upination Pronation S ROM 13 Wrist Flexion Extension S ROM 14 Wrist Radial Ulnar Deviation S ROM 15 Hip Flexion Extension S ROM 16 Hip Abduction Adduction S ROM 17 Hip External Internal Rotation 5 ROM 18 Knee Flexion Hyper Extension S ROM 19 Ankle Flexion Extension e Click the Start button 3 and read the instructions on the screen Do not press the foot pedal yet gt el VICA in this protoco use the dua BioGr Gh E e Position yourself next to the examinee with the encoder attached to your belt and the pedal near your foot e Press the foot pedal to go to the next screen e Position and stabilize the examinee in neutral position e lf the patient cannot reach the neutral position right click on the purple box on the screen enter the neutral zero reference angle displayed when zero button is pressed and click Apply Local Constant Value Apply Activitv nroaress e Position the dual inclinometer on the examinee and press the Zero button on the primary or secondary whichever is more convenient for you Rehab ProComp amp FlexComp Infiniti Rehab Suite 84 Measuring 1 Instruct the examinee to perform the motion slowly until they feel restriction tightness or discomfort Make sure the inclinometer does not move against the body part during the motion 2 When the position is stabilized press the pedal to record the measure 3 Instruct the exam
154. ur Open 00 00 09 313 RENT Dorimond Florian 6 003 Biofeedback and Neur Open 00 02 01 750 Physiology Jane 3 004 10 23 2008 12 55 23 PM Biofeedback and Neur Open 00 01 46 500 Trend Sarah 10 005 EEG Guy 7 O06 EMG Ben 8 oo z M Client Options Session Options Add New Client Edit Client Data Delete Client s Trend Report Delete Session s Session Notes Espot Data Review Report Replay Session R k Delete video Compress estore Client s Archive Client s Import Client s Export Client s data if any Import Session s Esport Session s Decompress Close Main Database 5 The next step depends on whether you selected a Script session or an Open Display session to replay e f you selected a Script session the window Edit Channel Set Setting for Current Client opens Click Close to enter replaying mode e f you selected an Open Display session the window Review Replay Session Confirmation opens Channel Set Options Biofeedback and Neurofeedback Re Training To replay the session using different screens from those ue ero en used to record it click Select Screens to open the a Select Screens window Select up to 5 screens and Helge luere click OK to return to Review Replay Session r Screens Co nfi rmatio n Signal Verification EEG 1 Reward 2 Inhibits Click OK to enter replay mode Training Alpha with Respiration Select
155. verage PARALLEL SYMMETRY ANALYSIS Left side Right side Right Left Difference MV MV MV 36 52 52 X 00 00896 169 155 14 8 0696 3 aM 25 6o WITHIN MOTION ANALYSIS Right side Flexion re extension peaks ratios 1 24 Pre post baselines difference uV 0 02 1 57 0 15 0 08 0 07 Pre baseline average Full Flexion average Neutral position average Post baseline average The data are grouped in order to facilitate the analysis The report computes the difference between left and right either in uV or in 96 The formula for uV difference is right left The formula for percentage difference is Max left right Min left right Max left right Section 3 Summary and Follow up notes You can enter notes in the summary follow up notes boxes Summary Notes e n Excel 2000 and Excel 2003 place your cursor in the text box and start typing ry e n Excel 2007 place your cursor in the text box 1 Right click the mouse button 2 Select Edit text 3 Start typing PROCEDURE FOR ANTERIOR KNEE ASSESSMENT Starting the Session Marked improvement If you are going use a webcam to make a video recording of this session connect your webcam to a USB port of your computer and turn it on e Connect the MyoScan MyoScan Z EMG sensors to the encoder in channels A and B A for VMO B for VL pA B oO E F e Myo Myo left right e um the encoder o
156. y Ltd to receive a Return Authorization number Then send the unit back by a traceable method Thought Technology will not be responsible for items not received We will repair or replace your unit s that are still under warranty free of charge This warranty does not apply to damage incurred through accident alteration or abuse This warranty does not cover damage to the Infiniti encoder or the sensors caused by obvious mechanical mistreatment of the system Rehab ProComp amp FlexComp Infiniti Rehab Suite 119 Returning Equipment for Repair Before returning the equipment please contact first our service department and get an authorization number RA number S 4 Canada and International 41 514 489 8251 S 4 USA 1 800 361 3651 mm service thoughttechnology com Then fill in the return form the form can be found at the end of the manual You must provide a detailed description of the problem you are experiencing and your telephone fax number and e mail The unit s must be sent postage prepaid and insured with proof of purchase to one of the addresses below All customs and duties charges will be billed to the customer if incurred by sending the unit to the wrong address In the USA ship insured to Thought Technology Ltd Cimetra LLC 8396 State Route 9 West Chazy New York 12992 USA In Canada ship insured to Thought Technology Ltd 8205 Montreal Toronto Blvd Suite 223 Montreal West Quebec
157. ys when channel A goes above the threshold Rehab ProComp amp FlexComp Infiniti Rehab Suite 60 Strengthening 1Ch Filled Line Bar Graphs HP m m mm 2bssa4s5n 1 2 3 4 Scale dependent M Threshold dependent O Other The signal changes color and music plays when channel A goes above the line graph threshold 38 19 149 00 59 72 The bar graph also displays the EMG levels in real time STRNO2 Contract and Hold with 1 EMG The four next screens provide the patient with more interesting feedback Each screen requires the patient to hold the contraction for a longer period of time Strengthening 1Ch Smiley LN r Tw wa Sew x manero E WE TM 17134586 nh Keep the face smiling by staying above the threshold 1 2 3 4 Scale dependent v Threshold dependent Other The face will continue smiling as long as the contraction on channel A is being held above threshold Replaying mode Open Display session Client INCREDIBLE Bulk Screen Streng J Strengthening 1Ch Rooster Puzzle Be ea Mrs Et ew t Un te Tw 2 5 a x a 4510 Try to hold the contraction above the threshold for more than 3 seconds 1 2 3 4 O Scale dependent v Threshold dependent O Other The puzzle will fill when the contraction on channel A has been held above the threshold for more than 3 seconds If the contraction dips below the threshold then the timer will reset T

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