to the P4 GOLF user manual.
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1. Channel 2 electrodes may be at tached to other thighs in order to treat both thighs FOREARM FEMORAL BICEPS BICEPS Valmed SA Av Tourbillon 34 1950 Sion Switzerland Phone 41 27 2036581 Fax 41 27 2036587 info valmed ch VALMED DELTOID UPPER TRAPEZIUS or TRICEPS LOWER TRAPEZIUS ABDOMINALS Valmed SA Av Tourbillon 34 1950 Sion Switzerland Phone 41 27 2036581 Fax 41 27 2036587 info valmed ch 10 VALMED LUMBAR VERTEBRAE ry NECK BACK Valmed SA Av Tourbillon 34 1950 Sion Switzerland Phone 41 27 2036581 Fax 41 27 2036587 info valmed ch 11 VALMED D Lei Yr IV TECHNICAL SPECIFICATIONS Channels Two fully isolated channels with independent intensity control knob for each channel Output Current Waveform during treatment Asymmetrical biphasic with fast rise and zero net current Voltage Waveform open circuit Low voltage rectangular compensated monophasic impulse Peak Open Circuit Voltage during each Impulse 50 Vp 10 Maximum Output Rating at 500 Ohm Load RMS voltage 5 V volts RMS 10 Peak current intensity during impulse 90 mA milliamperes 10 each Power Supply One 9V alkaline or lithium battery The output and program parameters are stable throughout the life of the battery Controls One knob per channel for continuous intensity control Audible click at the OFF position Safe ON switch Progra2. When a muscle is stimulated by a single stimulus impulse while extended by a moderate load it gradually develops internal tension and subsequently contracts The time of this contraction twitch is approximately 6 10 milliseconds msec for an ocular muscle 20 30 msec for gastrocnemius and from 60 to 100 msec for a soleus leg muscle Different muscles thus have different times of Valmed SA Av Tourbillon 34 1950 Sion Switzerland Phone 41 27 2036581 Fax 41 27 2036587 contraction This is due to the fact that they perform different tasks The ocular muscle for example is able to move the eyes very quickly due to an internal myofibril structure and small size which facilitates very rapid contractions The gastrocnemius muscle serves a locomotion function such as running or walking and as such does not need a special structure for rapid contraction On the other hand locomotion muscles exert greater forces and are able to sustain repeated tensions force over longer periods of time The postural muscle like the soleus in the leg work all the time while we are standing and as such they have a different structure which facilitates their long non fatiguing contractions In general the motor units of the muscle and in particular their respective cells can be categorized as follows 1 Slow twitch type l very high resistance to fatigue 2 Fast twitch type lla non fatiguing 3 Fast twitch type llb rapidly
3. e Only electrodes supplied or purchased from Valmed should be used Other electrodes could be dangerous for the skin or may not stimulate correctly Valmed SA Av Tourbillon 34 1950 Sion Switzerland Phone 41 27 2036581 Fax 41 27 2036587 info valmed ch 2 VALMED D Dm Yr Table of contents GENERAL INFORMATION 2 I Introducing the P4 GOLF 4 ll P4 GOLF User s Guide 5 lll Placement of Electrodes 8 IV TECHNICAL SPECIFICATIONS 12 APPENDIX STIMULATION AND THE HUMAN BODY 13 Official Supplier of Neuromuscular Stimulation Equipment to the European Tour Physiotherapy Unit for 2006 Manufacturer disclaims any and all liability for damages caused by the improper use of this device Valmed SA Av Tourbillon 34 1950 Sion Switzerland Phone 41 27 2036581 Fax 41 27 2036587 info valmed ch 3 VALMED Yr I Introducing the P4 GOLF Congratulations and thank you for purchasing the P4 GOLF Your P4 GOLF will be a true complement to your physical training helping you to optimize your physical training and hence enjoy your favorite sport with even more confidence When you participate in any sport it is important to be physically fit firstly to prevent injuries and secondly to fully enjoy the sport experience without suffering afterwards The P4 GOLF is specifically designed for golf players The stimulation programs have been chosen to meet your needs for example improved endurance and strength of quadriceps
4. Minimum An excellent complement to physical training Use on the quadriceps twice a week before info valmed ch 6 VALMED D Dags ae Yr the season begins and once a week during periods of great activity Instructions for Use Please refer to the instructions Start and End of Treatment Placement of Electrodes Please see Section Ill PROGRAM 4 Relaxation and Maintaining Muscle Tone Type of Stimulation This program has three phases 1 Warm up and massage phase characterized by a frequency modulation varying each second from 45 to 120 i p s duration 5 minutes 2 Active recovery phase which contains a series of 40 muscle contractions alternating with pause periods 30 or active relaxation periods 10 Each contraction lasts 2 5 seconds at tetanic frequencies varying from 40 to 80 i p s Each contraction has a 1 second ramp followed by a contraction of 1 5 seconds at maximum level Each pause lasts 2 5 seconds During the active 12 5 second relaxation period the stimulation is subtetanic with MUAP pattern frequencies varying every second duration 5 minutes 3 Cool down phase which contains a series of 10 muscle contractions alternating with relaxation periods Each contraction lasts 12 seconds at a tetanic frequency of 64 i p s and is made up of a 3 second ramp followed by a 9 second modulated contraction After each contraction there is an active relaxation period lasting for 48 seconds d
5. abdominal and back muscles as well as warm up and post golf active recovery of back muscles Good physical training is achieved above all by physical exercise running stretching bodybuilding etc In practice it is not always possible to do this In fact it is sometimes difficult to combine physical training with work or health problems It is no secret to anyone once you stop working out your muscles fade away very quickly It is at these times among others that your P4 GOLF will help maintain your muscles in condition and accelerate your preparation for physical activity including golf Please Note The training suggestions provided in this manual are given for a person in good health and average physical condition Your age level of physical training or individual objectives must be factored into your personal use of the P4 GOLF The P4 GOLF meets all requirements of the IEC 601 2 10 European Safety Standard and the ANSI AAMI NS4 1985 American National Standard Valmed SA Av Tourbillon 34 1950 Sion Switzerland Phone 41 27 2036581 Fax 41 27 2036587 P4 GOLF Functional Controls 1 7 Dor The P4 GOLF unit has four stimulation program indicator lights 3 a low battery warning light 4 two cable output sockets 6 and two control knobs 5 The program selection button 2 allows you to choose the treatment program The protection cover 1 gives access to the program selection button and the battery
6. once it is completely removed Replace battery when the yellow warning light appears info valmed ch 4 VALMED D pam Yr ll P4 GOLF USER GUIDE A Stimulation Programs Start of Treatment 1 Make sure that the intensity control knobs 5 are in the OFF position 2 Connect the electrodes to each cable 3 Place the electrodes on the motor point s of the muscle s to be treated See Section Ill for placement of electrodes lf the electrodes do not adhere well wet their surface sparingly with warm water 4 Connect the cables to the output sockets 6 of the stimulator 5 Switch on the stimulator by turning the intensity control knobs 5 until you hear a click 6 Select the program by pressing the program selection button 2 If you do not make your selection within the first 5 seconds Program 1 will automatically start 7 Slowly turn the intensity control knobs 5 clockwise until you have reached the desired intensity Remember that to get effective stimulation the muscle has to contract firmly Note Every program consists of several sequences Once a program has started you can automatically go to the next sequence by pressing the program selection button 2 End of Treatment 1 All four treatment programs have preprogrammed time durations Once the stimulation automatically stops turn both intensity control knobs 5 counterclockwise to the OFF position otherwise the battery will dischar
7. reduce any associated pain Use while sitting or prone on stomach as preferred Frequency of use Use this program when you wish to relax or when experiencing pain stiffness in your back muscles info valmed ch 5 VALMED D Dags a Yr Instructions for Use Please refer to the instructions Start and End of Treatment Placement of Electrodes Please see Section Ill PROGRAM 2 Muscle _ Strength and Endurance Type of Stimulation This program has three phases 1 Resistance to fatigue endurance phase characterized by a train of impulses with 0 7 second MUAP pattern frequencies repeating every 5 seconds duration 60 minutes 2 Strength endurance phase that contains a series of 52 muscle contractions alternating with relaxation periods Each contraction lasts 9 seconds at a tetanic frequency of 60 i p s Each contraction has a 3 second period in which the intensity of the stimulation gradually increases from zero to maximum ramp followed by a total contraction of 6 seconds at maximum level After each contraction there is an active relaxation period of 21 seconds During this relaxation period the stimulation is subtetanic at MUAP frequencies reoccurring every second duration 26 minutes 3 Cool down phase that contains the same train of impulses as in Phase 1 but MUAP pattern repeating every 2 seconds duration 4 minutes Duration 90 minutes Application To increase muscle stren
8. VALMEDS S A User Manual P4 Golf Neuromuscular Stimulator V 5 0 P4 GO V50 EN V10 Valmed SA Av Tourbillon 34 1950 Sion Switzerland Phone 41 27 2036581 Fax 41 27 2036587 info valmed ch 1 VALMED D ne Yr General Information The P4 Golf is manufactured distributed by VALMED SA Sion Switzerland The P4 Golf is manufactured in accordance with the requirements of European Safety Standards EN 60601 1 EN 60601 2 10 and meets requirements of the American Standards for Transcutaneous Stimulators ANSI AAMI NS4 1985 The P4 Golf is a Class Il Medical Device and conforms to the requirements of European Directive CEE 93 42 and holds certificate number 0535 Read this Manual Before Using the P4 Golf Indications The P4 GOLF offers optimal stimulation for e increasing blood flow e muscle relaxation pain relief e maintenance and strengthening of muscles e increasing resistance to fatigue endurance Contraindications The use of the P4 GOLF is contraindicated in the following cases e Persons with cardiac pacemakers e Persons with cancer Warnings e Safety of electrostimulation during pregnancy is not established e Obtain medical advice in cases of suspected heart problems or epilepsy e Do not stimulate frontal or laryngeal neck region or temporal lobes e Do not apply trans thoracically e Keep stimulator out of the reach of children e Do not to wet the stimulator
9. brain If muscles are not regularly exercised their performance diminishes a condition known as muscle atrophy Stimulation with your P4 GOLF can compensate for lack of physical activity and maintain muscle conditioning Moreover the P4 GOLF can improve your physical condition It is therefore a valuable complement to physical training and should be used in combination with regular exercise Neuromuscular stimulation improves muscle functions just like physical exercise It affects particularly the muscle mechanical properties such as strength endurance size muscle flexibility and muscle cell metabolic functions The results are similar to physical exercise results This occurs since the P4 GOLF emulates the brain by sending analogous electrical signals to the muscles via the motor nerves These signals are in the form of impulses Valmed SA Av Tourbillon 34 1950 Sion Switzerland Phone 41 27 2036581 Fax 41 27 2036587 which are transmitted to the muscles through the skin by means of electrodes To further demonstrate the capabilities of the P4 GOLF the physiological principles on which it is based as well as research results showing effectiveness of neuromuscular stimulation is discussed below Muscle Structure and Physiology All muscles of the human body have a common structure but they are different in size and function Each muscle is made up of several thousand muscle fibers attached at each end to
10. c or vice versa Stimulating Muscles Muscles receive their stimulation signals from the brain via motor nerves neurones While it would be ideal to ap such neurones in order to deliver a muscle stimulation signal from an external stimulator it is not practical as these nerves are not exposed but buried rather deeply under the skin The most convenient least invasive method is to transmit electrical stimulation impulses to motor nerves through the skin This is done by using transcutaneous electrodes placed on the skin surface The use of transcutaneous electrodes for electrostimulation however includes the following trade offs 1 Stimulation energy and the issue of cardiac safety 2 Correct placement of electrodes 3 Interface between the skin and the electrodes and skin safety 4 Electrical resistance of subcutaneous tissues 5 Voltage values and waveforms used for stimulation 6 Pain sensation on the skin the skin and Valmed SA Av Tourbillon 34 1950 Sion Switzerland Phone 41 27 2036581 Fax 41 27 2036587 These tradeoffs are now discussed 1 Stimulation Energy and the Issue of Cardiac Safety The brain stimulates muscles with very low energy levels This is because the molecular mechanisms of nerve conduction and of muscle excitation are extremely efficient For transcutaneous stimulation however much higher energy levels must be used in order to overcome the resistances that exist between
11. fatiguing All muscles in the body are a mix of these fast and slow cells and the proportion of each fiber type in a given muscle determines the properties of this entire muscle i e speed of contraction and its ability to withstand fatigue Muscle contraction force depends primarily on the size and volume of the muscle but is also dependent on the types of muscle fibers in the muscle Muscles with a predominance of fast fibers type Ilb are able to exert higher forces than muscles of the same size but with a predominance of slow fibers The predominance of fiber types is predetermined genetically but can be also changed by exercise and or electrostimulation info valmed ch 14 VALMED DN Ft Yr Modifying Muscle Properties Muscle properties are partially due to heritage genetics but are not static and can be modified through physical training or by electrical stimulation It is a well known medical fact that these changes in muscle properties are caused by the type of stimulation patterns transmitted by the brain to a particular muscle motor unit By imposing on a muscle different patterns of activity either by training or stimulation P4 GOLF one can therefore change the properties of the muscle These changes include increasing the speed of muscle contraction increasing muscle force and endurance increasing muscle mass and vascularization as well as changes in muscle cell metabolism from anerobic to aerobi
12. fore stimulation or by stimulation itself The P4 GOLF increases blood flow in the stimulated area within 5 to 15 minutes during any stimulation program Finally the P4 GOLF impulse waveforms have a very high content of high frequencies thus penetrating human tissue with much less difficulty than impulse waveforms of competitive stimulators 5 Voltage Values and Waveforms The P4 GOLF delivers stimulation impulses with a voltage waveform that is very similar to the action potential waveform in human motor neurons P4 GOLF impulse waveforms due to this similarity are more easily recognized info valmed ch 16 VALMED D Dags Yr by the neuromuscular system and have lower stimulation thresholds The P4 GOLF therefore provides effective stimulation with lower impulse energy 6 Pain Sensation on the Skin Our skin pain receptors are activated by external stimuli Nerves carrying pain signals from these receptors are slightly different in diameter and conduction speed from motor neurons Nevertheless they can be activated by electric impulses if the stimulation threshold is exceeded Truly effective stimulation maximizes results without undue pain The waveforms of the P4 GOLF and the low impulse energy make such stimulation possible In contrast to many competitive stimulators the P4 GOLF stimulation session constitutes a virtually painless and rather pleasant experience With the P4 GOLF virtually no pain receptors in
13. ge Should you forget an audible beep will be heard 2 Remove the electrodes from the skin 3 Disconnect the electrodes from the cables and place in the hermetically sealed bag Valmed SA Av Tourbillon 34 1950 Sion Switzerland Phone 41 27 2036581 Fax 41 27 2036587 Troubleshooting If the P4 GOLF does not work please check the following points 1 Has the battery been inserted correctly 2 Have the cable plugs been properly pushed into the output sockets of the stimulator 3 Are there two electrodes at the end of each cable 4 Are the electrodes no longer sticking well If so wet electrode surfaces sparingly with water PROGRAM 1 Relaxation of Back Muscles Type of Stimulation This program contains four phases 1 Relaxation which delivers a train of impulses with varying frequencies between 45 and 120 impulses per second i 0 S and variation pattern repeating every second duration 5 minutes 2 Endorphinic phase pain control which consists of continuous stimulation at a low frequency of 4 i p s duration 6 minutes 3 Cool down phase characterized by a train of impulses at MUAP frequencies varying from 4 to 83 i p s with an average of 10 i p s duration 7 minutes 4 Analgesic phase for pain control with a train of continuous impulses bursts at a frequency of 80 i p s duration 2 minutes Duration 20 minutes Application Allow tight stiff back muscles to relax and
14. gth and endurance Frequency of Use Minimum Use on the quadriceps twice a week before Valmed SA Av Tourbillon 34 1950 Sion Switzerland Phone 41 27 2036581 Fax 41 27 2036587 the season begins and once a week during periods of great activity Instructions for Use Please refer to the instructions Start and End of Treatment Placement of Electrodes Please see Section IIl PROGRAM 3 Muscle Strength and Power Type of Stimulation This program has three phases 1 the warm up phase characterized by a train of impulses with varying stimulation frequencies with MUAP pattern and repeating every 5 seconds duration 25 5 minutes 2 the strength power intensive phase which contains a series of 22 muscle contractions alternating with relaxation periods Each contraction lasts 15 seconds at a tetanic frequency varying from 40 to 62 5 i p s Each contraction has a 3 second ramp followed by a total contraction of 12 seconds at maximum level After each contraction there is an active relaxation period which lasts 39 seconds During the relaxation period the stimulation is subtetanic with MAUP pattern of frequencies which reoccur every second duration 9 5 minutes 3 the cool down phase which has the same train of impulses as in Phase 1 duration 25 minutes Duration 60 minutes Application Increase muscle strength and power Also use Phase 1 for warm up prior to golfing Frequency of use
15. ing pain from overworked muscles Your P 4 GOLF The Most Effective Neuromuscular Stimulator Most stimulators sold for electrostimulation are capable of delivering only the first component of a brain signal i e a stimulus to the muscle to contract mechanically This is due to the fact that these stimulators deliver stimulation at fixed frequencies for periods of contraction and deliver no zero stimulation for periods of rest While such stimulation is adequate to cause the mechanical movement of a muscle it carries little information to effect trophic desired changes in a muscle cell It is a well known fact that in order to transmit information modulation is needed in the carrier signal The fixed frequency stimulation constitutes a carrier signal but it lacks modulation which carries the information content What is unique about the P4 GOLF is that it contains the carrier fixed frequency signal as well as the modulation just like brain signals The P4 GOLF is thus capable of transmitting complete information to the muscle in order to effectively change its trophicity and in effect train the muscle to obtain desired performance Your P4 GOLF is an extremely effective complement to exercise in order to help you improve muscle performance warm up prior to physical activity such as golf and to allow your muscles to rapidly recover after intensive exercise or activity such as golf info valmed ch 17
16. m selection button Indicators Two green output intensity lights four program lights one low battery warning light Standard Accessories Set of four non polar reusable self adhesive electrodes one 9V alkaline battery 2 cables One instruction manual and one storage case Size and Weight Size 10 x 7 x 3 cm weight 175 g net with battery Valmed SA Av Tourbillon 34 1950 Sion Switzerland Phone 41 27 2036581 Fax 41 27 2036587 Warranty Two years free replacement accessories and shipping charges except Standard Accessories A set of four non polar self adhesive reusable electrodes one alkaline 9V battery two cables and one instruction manual info valmed ch 12 VALMED D ne Yr Appendix Stimulation and the Human Body Human Muscles Almost all functions of the human body involve muscular activity These include physical movements of the body functions of the cardiovascular system peristaltic movements and bladder control Three muscles types are responsible for these activities skeletal muscles the cardiac muscle and smooth muscles all of which have some characteristics in common but differ significantly in function and performance The P4 GOLF neuromuscular stimulator interacts only with skeletal muscles These skeletal muscles are responsible for the movements of different parts of the body The action of these muscles is caused and controlled by nerve impulses transmitted by the
17. muscle tendons When the brain sends impulses via motor nerves muscle fibers contract and the force of contraction is transmitted to the bones by the tendons On a microscopic scale some several thousand fibers in each muscle are grouped into a single motor unit Each motor unit is connected to a single motor nerve neuron that stimulates the motor unit with the impulses transmitted by the brain Such stimulation causes simultaneous that is synchronous contraction of all fibers in a given motor unit The contraction of an entire muscle is the result of the summation of the contractions of individual motor units of this muscle The contractions of several individual motor units are usually not simultaneous thus giving the brain the ability to produce gradual contractions of the entire muscle resulting in perfectly controlled and smooth movements Muscle fiber cells contain myofibrils These myofibrils shorten their length by overlapping their actin and myosin protein molecules using an electrical impulse called the action potential This action potential is triggered by a nerve signal that reaches the neuromuscular junction point between the motor nerve and the muscle motor unit As a result of this impulse a neurotransmitter compound called acetylcholine is released making the muscle fiber membrane permeable to sodium ions info valmed ch 13 VALMED D m The influx of sodium ions creates a local electrical current fl
18. on This interface is an obstacle resistance between the stimulation signals and the muscle motor points Resistance is normally reduced by moistening the skin with water or by using conductive gels Valmed SA Av Tourbillon 34 1950 Sion Switzerland Phone 41 27 2036581 Fax 41 27 2036587 Effective and efficient stimulation requires electrodes with minimal and uniformly distributed resistance Your P4 GOLF is designed to be compatible only with electrodes of this type A second P4 GOLF feature is automatic control of the stimulation current This unique feature prevents excessive current density and ensures skin comfort and safety The low internal resistance of the P4 GOLF also reduces energy consumption and results in longer more efficient operations 4 Skin Subcutaneous Tissue Resistance Dry skin has very high specific impedance resistance as does subcutaneous fat tissue Dry skin impedance can be reduced by proper skin preparation and or the use of conductive gels Dry skin should be well moistened beforehand and kept moist during the stimulation session Skin and subcutaneous tissue impedances can also be reduced by increasing subcutaneous blood circulation before and during the stimulation session Blood is a relatively good conductor and increased blood flow will result in better more efficient stimulation Increases in subcutaneous blood flow can be accomplished by a hot bath or radiant heat application be
19. or nerves are obstacles resistance for effective stimulation If this distance is too great no muscle stimulation may be possible at safe energy levels Muscles typically have several hundred to thousands of motor nerves entering as a bundle at the motor point These motor points are usually close to the skin surface Motor points are the optimal locations for external stimulation since muscle stimulation at the motor points requires several times less electrical energy than stimulation at any other location on the muscle Hence electrodes should be placed on the skin directly over a motor point The best approach is to cover the largest possible skin surface with electrodes in order to ensure that all desired motor points are covered This is easiest to do with large electrodes The P4 GOLF electrical signal output is specially tuned to deliver effective stimulation with the largest electrodes available on the market It is therefore possible to cover more than one motor point and effectively stimulate a group of muscles In summary the larger the electrode surface the more effective is the stimulation There are very few stimulators like the P4 GOLF that supply effective muscle stimulation with large electrodes The P4 requires less user skill for electrode placement and as such is simpler and easier to use 3 The Skin Electrode Interface Skin surface electrode contact the Interface is the pathway for external stimulati
20. ow that initiates an action potential traveling in both directions on the membrane of a muscle fiber This action potential causes a contraction of the myofibril that travels in the muscle fiber at a velocity of approximately 5 meters per second Therefore when a 10 cm long muscle fiber is stimulated in the middle the action potential will reach both ends of the fiber in approximately 1 100 second The action potential thus excites and contracts the entire fiber in a very short time In this example the action potential travel time also limits the stimulation frequency to a maximum effective value of 100 impulses per second 100 Hz The maximum effective stimulation frequency therefore depends on the conduction velocity of the action potential and the length of muscle fibers Mechanical Properties of Muscles A relaxed resting muscle is elastic and stretches easily The force needed to stretch a muscle increases as the muscle is stretched The tension developed in the muscle as a consequence of stretching does not increase linearly with elongation but increases exponentially as the muscle is stretched beyond its resting length This is due to the internal molecular structure of myosin actin filaments in a myofibril These filaments slide and bind to each other in rapid and non linear fashion This rapid exponential growth of internal muscle tension explains why muscle injuries are often caused by overstretching or overloading
21. the skin are activated However if stimulation is done at maximum intensity and for a long time some latent muscular pain can occur due to the intense exercise This is a healthy sign proving that the stimulation session was equivalent to vigorous physical training Stimulation as a Complement to Physical Training While regular and moderately intense exercise is undoubtedly most beneficial for the human body it is not be always possible As a result during relatively short periods of inactivity a few days or weeks the muscles in the human body lose their force and resistance to fatigue If a physical exercise is not intense enough or not regularly performed the muscles lose their mass strength and endurance This is particularly noticeable in the largest muscles responsible for locomotion such as the quadriceps or gluteus buttocks and in postural muscles such as the abdominal or paravertebral back muscles Therefore it is essential to exercise or stimulate muscles regularly to keep them in good form Valmed SA Av Tourbillon 34 1950 Sion Switzerland Phone 41 27 2036581 Fax 41 27 2036587 The P4 GOLF is the best way to retain physical condition during periods of little activity or physical training Electrostimulation for Pain Electrostimulation allows muscle fibers to relax relief from soreness effects which is beneficial after physical exercise This effect can also be antalgic pain relief by decreas
22. the stimulator and the muscle In the human body there are organs which can be stimulated with electric energy notably the heart and the brain In order to avoid stimulation of these organs energy safety limits for transcutaneous stimulation of muscles and nerves have been established In the EC the standard IEC 601 2 10 for unattended home use of stimulators is an effective current output less than 10 mA rms on 500 ohm load which corresponds to a very low effective voltage of 5 V In the United States in addition to this limit there is a limit AAMI ANSI NS4 85 for each stimulating impulse electrical charge which is not to exceed 25 uC microcoulomb microampersecond for transchest stimulation and 75 uC for non transchest application These energy safety limits were established in order to avoid the risk of cardiac rhythm disturbance The P4 GOLF design delivers the most effective stimulation with the best safety margin for the user The P4 GOLF is one of the very few stimulators on the market that uses minimal energy for stimulation P4 GOLF stimulation is effective with as little as 1 V rms and 5 uC which is 5 times below the above stated safety margins This is due to the unique design which enables the P4 GOLF to reduce resistances between the stimulator motor nerves and muscles info valmed ch 15 VALMED D Yr 2 Correct Electrode Placement Physical distances between electrodes and mot
23. uring which the stimulation is subtetanic with MUAP pattern frequencies varying every second duration 10 minutes Duration 20 minutes Valmed SA Av Tourbillon 34 1950 Sion Switzerland Phone 41 27 2036581 Fax 41 27 2036587 Application To relieve pain increase blood circulation and keep muscles toned Frequency of use Use this program to recover after golfing or after physical exercise Instructions for use Please refer to the instructions Start and End of Treatment Position of Electrodes Please see Section Ill info valmed ch 7 VALMED lll Placement of Electrodes The P4 Golf should only be used with the recommended electrodes Use oval 3 by 5 electrodes for large areas e g leg muscles and round 3 electrodes for smaller areas such as forearm muscles Do not use smaller electrodes than recommended above Leads for Channel 1 are depicted in RED and leads for Channel 2 in BLUE Where only one set of electrodes is shown Channel 1 is depicted but Channel 2 may be used instead Channels may be reversed if desired from that indicated in the following photos QUADRICEPS On both legs On one leg TIBIA Channel 2 electrodes may be attached to other leg in order to treat both legs CALVES Valmed SA Av Tourbillon 34 1950 Sion Switzerland Phone 41 27 2036581 Fax 41 27 2036587 info valmed ch 8 VALMED FEMORAL BICEPS AND CALVES THIGHS d
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