TU-00000 TSE Manual.cdr
Contents
1. Need Help If you need advice about any aspect of your Acticare device please email us at UK and Europe uk acticare com Australia and NZ aus acticare com or consult our website www acticare com for support telephone numbers Calls may be recorded for quality control purposes Common problems are listed in the troubleshooting guide in section 10 acticare E Acticare TSE is manufactured by Bioinduction Limited 178 180 Hotwell Road Bristol BS8 4RP United Kingdom Tel 44 870 241 9071 Website www acticare com Email info acticare com Document REF TU 00000 TSE Manual 5 0 Part code C00201 Year of manufacture 2009 Acticare TSE and the Acticare logo are registered trademarks of Bioinduction Ltd The Acticare TSE device is protected by patents and patents pending This manual is copyright Bioinduction Limited 2004 2007 Key to Symbols used in this Manual A Contra indications These notes describe situations where you should not use Acticare TSE Warnings and Cautions Make sure you understand these before using Acticare TSE Important Note This symbol appears next to key points of note A Warranty information Bioinduction Ltd warrants Acticare TSE and its fast charge cradle free from defects in workmanship and materials for one year from the date of invoice Electrodes batteries carry cases lead wires and other accessories are2. OFF 50mS 20uS 20uS SAZ 1Hz 10Hz 1kHz 2kHz Quick Reference The Acticare TSE device has 4 buttons Plus button on off GD GD O Timer button button Minus button To turn the device on press To turn the device off press and hold for one second To adjust the treatment timer Press the to gEEMODE mmp enter timer d HR M setting mode l i Use amp to adjust time Press and hold for one second to save your new time To start treatment press the button Each press increases intensity by 1 Hold the button down to increase quickly The treatment intensity is displayed as a percentage highlighted in red in the diagram below TSE MODE 4 TED WER HR MIN 75 na Intensity Level Set the treatment intensity at the level at which you first feel a slight tingle or 100 To increase or decrease treatment intensity during treatment press the or buttons Each press changes intensity by 1 Hold the button down to change quickly To stop treatment press and hold the button to quickly reduce intensity When the treatment level reaches 0 the treatment stops automatically Alternately you can stop treatment by turning the device off To check therapy mode turn the device on using the C key The mode is displayed at the top of the screen at all times highlighted in red in the diagram below TSEMODE A SHEM
3. Check power socket Allow device to cool batteries must be less than 40C to fast charge Push fully home until it stops beeping Fit new batteries Check that battery positive terminal alternates as illustrated illustrated the symbols inside the battery case indicate correct placement The positive end of the battery is the one with the pip and marked with a If none of the above resolves your problem you can email us at support acticare com visit our website at www acticare com or call our customer service line Technical Information Specifications Parameter Average current limit Maximum charge per pulse Waveform type Treatment Timer Pulse width Output frequency Power source Electrical protection rating Weight Dimensions Environmental Ambient Operating Conditions Temperature Relative humidity Atmospheric pressure Shipping and Storage Conditions Temperature Relative humidity Atmospheric pressure Specification 20mA 250VDC bus 25uC per pulse under normal operation 754C with single component failure Biphasic monophasic or twin peak square wave 10 mins to 3 hours 0 5uS to 100S 1Hz to 500kHz Four AA batteries rechargeable NiMH 1 2V or alkaline 1 5V Type BF equipment Do not attempt to connect to mains power except through approved charger stand 235gms 100x72x38mm 10C to 50C battery charging 10C to 40C 30 75 non condensing
4. 4 pads Lead wire Features of the Acticare TSE unit Electrode connector Operating light User display Battery cover Battery catch On Off button 4 lt P Belt clip _ Minus button af Timer button Charger connector Front View Back View Your Acticare TSE Display Symbols and Their Meaning Mode I ndication Shows which treatment and the number of the preset mode the device is using Battery TSE Transcutaneous Spinal Electroanalgesia gt i Indicates the amount of TENS Standard and high frequency TENS charge left in the batteries RF Pulsed radio frequency 5 ADV Advanced ahode Scans when charging TENS MODE A LLL Example Screen Intensity setting Shows the intensity voltage setting as a percentage from 0 off to 100 max Treatment timer Shows the remaining treatment time in hours and minutes and in seconds for Flashes when power output the last minute of treatment js at maximum Safety limit Charging Batteries Installing the batteries Charging the batteries Your device is supplied with four AA The supplied fast charge cradle provides a full rechargeable Nickel Metal Hydride NiMH charge in 2 2 hours To charge batteries batteries which must be installed before use plug the device into the charger stand as shown below Make sure you push the device 1 Open the battery cover by squeezing the
5. blue catch into the belt clip as shown fully into the cradle to ensure proper contact E An intermittent beeping means that the device is not pushed completely in 2 Insert four new AA batteries making sure the polarity is correct The correct polarity is The battery symbol will scan to indicate that indicated by symbols in the battery the battery is charging If the battery is not compartment charging check to make sure the charger is plugged in and the socket is switched on When the batteries are fully charged the battery symbol shows full CD Battery Battery Low Full Acticare TSE cannot be used for treatment when it is on the charger stand Placing Acticare TSE on the 3 Close the battery cover Check that it is secure Ifthe batteries are correctly installed the battery symbol H___ will be displayed on the screen charger stand during a treatment causes the device to switch off Battery Lifetime Under typical operating conditions freshly charged batteries should last for 1 2 hours The amount of charge left in the batteries is shown on the battery indicator when the device is switched on Typically NiMH batteries need replacing after 6 months of continuous use although you may need to replace them sooner if you are experiencing poor performance Using Non Rechargeable Batteries Acticare TSE can be used with AA sized alkaline batteries You may find this useful if travelling a
6. harmful interactions or side effects and is complimentary to physiotherapy osteopathy and acupuncture TSE has also been Clinically proven to improve mood and aid relaxation Introduction How Does TSE differ from TENS Transcutaneous Electrical Nerve Stimulation TENS is a popular and successful treatment for the relief of common aches and pains There are however a few limitations to its use Effectiveness may reduce over a period of time and the period of post stimulation relief tends to be brief Also TENS electrodes must be placed over the painful region and correct placement often requires experimentation One benefit of TSE is that the electrode locations are standardised Two surface electrodes are always placed over the spinal cord wherever the painful regions are Because the spinal cord is the body s conduit for pain signals TSE can relieve multiple pains in different parts of the body at once Furthermore the effect of TSE tends to be cumulative over time in about 50 of patients In order to penetrate deep tissues TSE pulses are of higher voltage and higher power than TENS But because of their very short duration TSE pulses produce less stimulation of the peripheral nerves and therefore little or no tingling sensation which some patients find uncomfortable The Acticare TSE device looks very similar in size and shape to a regular TENS device but its size is deceptive under typical treatment conditions i
7. st l POWER 5 You should always check you are in the desired mode when you turn on Acticare TSE prior to treatment The default mode is TSE1 To restore factory settings Start with the device off and hold down the timer O key while you turn the unit on with the on off key The device should display all segments followed by the software revision number before starting up normally Quick Reference To change therapy mode hold down the TIMER button and momentarily press the plus button at the same time The display should flash MODE MENU as confirmation TSE MODE MEER Ix 48 MOTE MEN WUC VICI If you see the TIMER setting screen this means you did not press both keys together Press to exit and try again Press or to select the mode you wish to use Each press of causes the menu to cycle through the available modes in this order 3 TSE modes TSE1 TSE3 Page 9 8 TENS modes TEN1 TEN8 Page 15 2 RF modes RF1 RF2 Page 9 e Advanced settings mode ADV Page 21 TSE MODE J SEER PA PODE TSEg ese Press and hold TIMER for 1 second to exit and save settings Quick Reference Before first use please read the warnings and contraindications contained in section 2 Key Features of Your TSE Device Electrode connector Operating light User display a Plus button On Off button Minus button T
8. 0 86 1 06 hPa 40C to 70C 10 100 non condensing 0 50 1 06 hPa All electrical specifications are 10 into a 500 ohm load Specification Charger Cradle Parameter Input voltage Europe UK Australian Versions North American Version Output voltage Specification 230 240VAC 50 60Hz 115VAC 60Hz 6V 1000mA 25 Technical Information Standard TSE and TENS Therapy Mode Parameters Mode TSEL TSE2 TSE3 TENS1 TENS2 TENS3 TENS4 TENS5 TENS6 TENS7 TENS8 RF1 RF2 See page 22 for diagrams of Waveform shapes and Burst parameters Modulation modes produce a linear variation of pulse width between 10 and 50uS over the specified period Waveform Frequency FRQ 2 5kHz 10kHz 250Hz 100Hz 5Hz 100Hz 100Hz 100Hz 100Hz 500Hz 500Hz 500kHz 250kHz Waveform Pulse Type WAVE B B B B B B B B B B B B iphasi iphasi iphasi iphasi iphasi iphasi iphasi iphasi iphasi iphasi iphasi iphasi B phasi IC Cc E E Width Spacing PULS SPAC 1 5uS 200uS 0 5uS 0 5uS 4us 2000S 50uS OS 2004S OuS 100uS OuS 100uS OuS 10 504S Ous 10 50uS Ous 20uS Ous 20uS OuS 0 5uS 0 5uS 0 5uS 1 5yuS TSE and TENS modes Peak Output into 5000hms Pulse width 0 5 2uS 3 5uS 6 10uS 20uS 50uS 100uS Peak Voltage 250V 200V 160V 130V 90V 70V 26 Interpulse Burst Time BT OFF OFF OFF OFF OFF 100mS 500ms 3 sec modulation 6 sec modulation
9. COM ON OFF For clinician use Controls serial communications port Buzzer BUZ ON OFF Controls buzzer disables end of treatment alarm 19 Replacing electrodes Electrodes typically have a lifetime of 30 uses This means that they should be replaced every month if used once per day With heavy use or if used with oily or hairy skin electrodes may need replacing sooner Because of the higher current level with TSE standard carbon rubber TENS electrodes are not suitable Always use the recommended electrodes available direct from us These have an integral metallic conductor for superior current distribution Care of electrodes Always store electrodes on their backing sheet in their sealed bag between treatments When not in use do not leave electrodes exposed to the air even if on their backing sheet This may cause them to dry out prematurely To prevent cross contamination do not share electrodes Electrode life is considerably shortened by use on dirty or oily skin it is best to clean the electrode application area with soap and water then rinse and thoroughly dry before each session Dry electrodes may be re moistened by rubbing a few drops of water into the sticky surface Cleaning Your Acticare TSE Unit Clean the outside of the unit as required with a damp cloth Do not use strong detergents or immerse the unit lead wires or electrodes in any liquid Be careful not to force any liquid i
10. been established Drowsiness This device can cause drowsiness or light headedness During use or after use if feeling drowsy never operate potentially dangerous machinery such as power tools automobiles etc Symptomatic treatment This device may suppress sensations of pain that would otherwise serve as a protection mechanism Keep out of reach of children This device is not recommended for use on children except under clinical guidance Metallic Implants Consult a clinician before using TSE if you have a metallic implant in your spine or neck Not recommended for use by persons with metallic rods in the spine where these rods lie between electrode locations Tumours Use only under the guidance of a Clinician Neurological damage Use only under the guidance of a clinician for persons with neurological conditions such as MS stroke and cognitive defects Electronic equipment Electronic monitoring equipment such as cardiac alarms may not function properly if used simultaneously with this device External use Only for external use Not for internal use Warnings A Spinal Cord Stimulators This device is not recommended for use in persons with an implanted spinal cord stimulator High frequency Surgical Equipment Simultaneous connection of a patient to high frequency surgical equipment may cause burns at the site of electrodes and possible damage to the device Microwave or Radio frequency sources Ope
11. drying out Always stick the electrodes to the correct side of the backing sheet as marked If the message CHECK LEADS AND PADS is displayed check that the electrodes and lead wires are correctly connected to the device Check also that the electrodes are properly stuck to the skin Once electrodes have been properly connected you can increase the power to the desired level See section 10 Troubleshooting for more information Treating Yourself with TSE Adjusting the treatment timer Whenever you start a treatment the Timer automatically uses the last treatment time You can however adjust the Timer at any time before or during a treatment See page 9 for advice about deciding your treatment time To change the treatment timer press the TIMER button to display the Timer screen TSE MODE A CD HR MIN TIMER O30 Timer Setting Screen Press or to increase or decrease the timer to your desired time You can select times between 10 minutes and 3 hours or timer off If the timer is set to OFF the treatment will run until stopped manually Press the TIMER button for 1 second to confirm your setting Acticare TSE will go back to the Running screen with your new treatment time shown 14 Treating Yourself with TENS STEP 1 Select the TENS mode to use Acticare TSE has eight different TENS therapy modes as summarised in the table below If you are using T
12. safety feature that ensures that excess current does not flow even if your skin resistance is low Message Symptom Possible causes Troubleshooting Solution Device appears to be operating but no output Lead wire connection Mode with no sensation Check connectors are fully pushed home This is normal it is common not to feel any sensation with pulse widths less than a few microseconds Device in charger cradle but not charging amp or beeping continuously Very low battery Batteries too hot Device not fully home Batteries do not retain charge or battery meter goes straight from full to empty Old or damaged batteries Resetting Acticare TSE Some faults may be resolved by restoring factory settings and resetting Acticare TSE 1 Restore factory settings Start with the device off and hold the TIMER key while pressing the ON OFF key The device should display all segments followed by the software revision before starting up normally 2 Reset Acticare TSE Open the battery cover by squeezing the blue catch in the belt clip refer to page 7 for detailed instructions Remove one battery After five seconds replace the battery If the batteries are correctly installed the battery symbol Sm will be displayed on the screen If not check that the batteries are inserted with the positive terminals correct as Mains not connected Leave overnight to slow charge
13. CD HR MIN 15 STEP 2 Setup your treatment Follow the instructions for Treating Yourself with TSE in section 5 with the following exceptions 1 Treatment Time There is no one TENS treatment time suitable for everybody so it is recommended that your first treatment time is kept short approximately 20 minutes Once you become familiar with your response to TENS try increasing treatment periods up to 1 hour in length 2 Treatment I ntensity Unlike TSE treatments TENS treatments can produce a strong tingling sensation When setting up your TENS treatment increase the intensity until you feel a strong but comfortable level of sensation You may need to increase the intensity during treatment to maintain the same level of sensation as your body becomes tolerant to the TENS stimulation After TENS treatments you may feel a tingling sensation or numbness around the area of the electrodes This is normal 3 Care of electrodes Electrode life is considerably shortened by use on dirty or oily skin it is best to clean the electrode application area with soap and water then rinse and thoroughly dry before each session Treating Yourself with TENS 4 Electrode Positioning With TENS treatments it is important to place the electrodes in the correct position depending on where you are experiencing pain Choosing the correct electrode positioning for TENS often requires experimentati
14. ENS for the first time it is recommended that you start with TENS1 Name TENS1 TENS2 TENS3 TENS5 TENS6 TENS7 TENS8 Type and Sensation Technical Description Constant tingling Constant pulsing Burst mode tapping Burst mode gripping Modulated fast wave Modulated slow wave High frequency tingling High frequency tingling and pulsing The current therapy mode is displayed at the top of the screen 100Hz 50uS pulse width 5Hz 200uS pulse width 100Hz 1004S pulse width 0 1 sec bursts five times per second 100Hz 100uS pulse width 0 5 sec bursts once per second 100Hz 50uS pulse width 3 sec modulation period 100Hz 50uS pulse width 6 sec modulation period 500Hz 20US pulse width 500Hz 20uS pulse width 0 05 sec bursts ten times per second To change between therapy modes Follow the instructions on page 10 Recommended For Most types of chronic and acute pain For chronic pains such as back pain and arthritis Don t use on damaged muscles For chronic pains such as back pain and arthritis Don t use on damaged muscles For chronic pains such as back pain and arthritis Don t use on damaged muscles Most types of chronic and acute pain Most types of chronic and acute pain Severe acute and chronic pains Severe acute and chronic pains You should always check you are in the desired mode prior to treatment POWER 0 UdU MODE 4
15. Placement with any TENS mode Only use with TSE at a level at which a tingling sensation is very mild or just perceptible Treating Yourself with TSE STEP 3 Turn Acticare TSE on Once you have placed the electrodes in the correct place you are now ready to turn Acticare TSE on and begin treatment Press and release the ON OFF button to turn on the device If using TSE for the first time we recommend TSE 1 Always check that the correct mode is set when you switch on this is displayed at the top of the screen CD TSE MODE A es POWER d STEP 4 Commence treatment When prompted by the message PRESS TO BEGIN TREATMENT press the plus key to increase the treatment intensity until you feel a light tingling sensation or reach 100 Each press of the key increases the intensity by just 1 holding the key down causes the intensity to increase gradually without the need for repeated presses Typical intensity settings are 50 with electrodes on the neck and 100 with electrodes on the back in the default mode TSE 1 The orange light on the top of the unit will turn on to show that the treatment has begun The last used treatment time or factory default of 30 mins is also shown The intensity is displayed as a percentage from 0 100 at the bottom left of the screen anni If the POWER bar flashes this indicates the device is providing full current which may happen a
16. ake only place electrodes either side of the neck as sure that the electrodes are directly over the shown There should be a hands width gap spine If you are using TSE 3 for low mood between the electrodes Remove any metallic always use the spinal placement necklaces when using the neck placement Spinal Neck Alternate Neck Placement Placement If you find the basic neck placement uncomfortable try this alternate neck placement with the pads on the top of the shoulders as shown Placement Peripheral electrode placement If you have a recent or acute injury particularly if it is localized you may find that you get best results with the electrodes placed so that they span the painful area rather than using the standardized neck or back placements described above For instance if the pain is in your arm or leg place one electrode directly over the point of pain and the second electrode further up the limb and on the other side so that current flows through the tissues Use the high power TSE2 or RF modes as they cause little or no sensation while blocking pain signals If you are unsure about where to place the pads you can also use TSE and RF modes with the pad placements indicated in the TENS section on pages 16 18 Never apply the electrodes across the head or chest or to the front of the neck since this can cause breathing difficulty if the stimulation is strong enough to cause muscle contraction Never use the Neck
17. broad but you should note that with the high power TSE modes alkaline batteries may be exhausted in a couple of hours Storing Acticare TSE If you plan to store your unit for a period of longer than a month we recommend that you remove the batteries from the unit This Charging Batteries Never attempt to recharge standard alkaline batteries Do not plug anything into the base of Acticare TSE except for the dedicated Acticare charger stand Treating Yourself with TSE Getting started with TSE Getting started with TSE is easier than TENS since there are only two electrode placements to consider Correct electrode placement is one of the major reasons that users of TENS experience difficulties in early use To get started follow the steps summarised in the flowchart below and described in detail over the next few pages While treating yourself with TSE you can continue to go about your daily routine but because TSE can sometimes cause drowsiness we recommend that you do not drive if affected Plug the lead wire into the top of the device and connect to two electrodes Stick the electrodes on your skin in one of the two positions shown on page 12 depending on where your pain is Turn on Acticare TSE by pressing and releasing the ON OFF button Commence treatment by pressing and holding down the button to increase the treatment intensity until you feel a light tingling sensation or reac
18. ce swelling or redness If affected discontinue use and seek medical advice Limitation of Liability To the maximum extent permitted by law Bioinduction Ltd its subsidiaries suppliers or resellers collectively Bioinduction accepts no liability for any damages arising from the use of or inability to use the product including but not limited to indirect incidental or consequential damages In any event Bioinduction s entire liability shall not exceed the purchase price of the product with the sole exception of death or personal injury caused by the negligence of Bioinduction but only to the extent that applicable law prohibits the limitation of damages in such cases The purchaser indemnifies Bioinduction from all claims arising from third parties Bioinduction will not be held liable for any loss resulting from incorrect information provided by its personnel errors or omissions in this manual and other documentation By using the product the purchaser agrees to be bound by these terms otherwise purchasers should return the product unused within 14 days of receipt requesting a refund Your Acticare TSE Identifying the components of Acticare TSE a bag Po _ Acticare TSE Device Charging cradle User manual N m To protect your Acticare TSE during transport we recommend that you pack the device and charger in Rechargeable the pockets in the bag as batteries x4 illustrated Pack of
19. e electrodes and try again If none of the above works disable Pad Detect in settings section 7 Low Batt __ Batteries are flat Recharge batteries Blank screen Batteries are flat or not correctly inserted Recharge batteries and check orientation Error 01 02 then shutdown Error 03 04 05 06 08 then shutdown Device is too warm to operate above 60C Internal error Allow device to cool before use Turn device off then on If error persists reset device see instructions opposite Error 07 then shutdown Output shorted i e leads or electrodes touching or safety limit reached Check output lead or pads are not touching Turn device off then on If error persists reset device Non responsive or locked up display Display does not come on even though batteries Internal fault Weak or dead batteries Batteries installed the Follow instructions opposite for device reset Recharge batteries Check that batteries are inserted the are inserted wrong way around right way around Electrodes Poor adhesion with skin Check electrodes are not peeling away become hot during use Power set too high Reduce power level by 25 Power bar flashing The device is operating at its current limit 23 This is sometimes caused by electrodes being close together Otherwise there is no action required The current limit is a
20. form of TSE where the pulses are delivered in short bursts rather than individually and is similar in concept to pulsed radio frequency treatment used widely in pain clinics The History of TSE and Acticare Electrical stimulation of the spinal cord for pain relief dates back to 1967 when electrodes were implanted in the spinal cord to block the sensation of pain This technique is called Spinal Cord Stimulation SCS Spinal Cord Stimulation is often effective against longstanding pain but has the disadvantage that surgery is required to implant the electrodes In 1991 inspired by the success of SCS Drs Alex Macdonald and Tim Coates discovered Transcutaneous Spinal Electroanalgesia TSE They were granted patents on the technology in 1995 and 1997 TSE uses very short electrical pulses applied to the spinal cord via the skin These pulses are only a few millionths of a second in duration but of relatively high voltage The pulses pass through the skin and tissues to the spinal cord They are too short to cause any more than a very mild tingling sensation in nerves under the skin so the therapy is well tolerated by most people TSE has been used as a form of electrical pain relief since its discovery in 1991 No serious side effect or interaction with medication has been reported despite being used in over 100 NHS hospitals and by thousands of patients in their homes TSE will work alongside drug therapy without
21. h 100 Typical settings are 50 with electrodes on the neck and 100 with electrodes on the back in TSE 1 the default mode Treatment ends when the timer finishes counting down and the message Treatment Complete is displayed TSE modes Acticare TSE has three standard TSE therapy modes and two burst TSE modes called RF First time users should use TSE 1 therapy mode for pain relief Acticare TSE comes set in TSE 1 mode as standard so you should not need to change these settings on first use When the device is switched on the set mode is displayed on the screen for one second to change TSE mode see opposite Name Therapy Recommended For TSE1 Normal TSE All first time users all conditions TSE 2 Powerful TSE Severe or long lasting conditions where TSE 1 has not helped TSE 3 Long pulse Low mood fatigue SE and conditions where TSE 1 amp 2 have not helped RF 1 2 Burst mode Acute pain and WISE conditions where regular TSE has not helped Selecting treatment time and intensity With TSE there is no one treatment time appropriate for everybody and every condition Because the effects of TSE tend to accumulate over time we recommended that you use the therapy every day for two weeks before assessing the degree of relief First time use Start off with a 30 minute treatment using the default TSE mode called TSE 1 Set the treatment intensity so that you feel a mild tingling at first which wil
22. hile they are still on the backing sheet 3 Connect the lead wire to the Acticare TSE device Note that the connector can only be inserted into the device in one orientation For the right orientation match up the key shape of the connector with the key shaped hole in the device 4 When you are ready to begin treatment peel the electrodes off the backing sheet using the electrode material not the lead wire Pulling on the lead wire can reduce the lifetime of your electrodes Electrode life is considerably shortened by use on dirty or oily skin it is best to clean the electrode application area with soap and water then rinse and thoroughly dry before each session Do not use worn out self adhesive electrodes as this can cause weak stimulation and skin irritation With normal use one treatment per day electrodes begin to lose their stickiness after one month Replace with new electrodes when this occurs Treating Yourself with TSE STEP 2 Place the electrodes on your skin Place the electrodes in the locations described below depending on the site of your pain For pains in both areas of the body alternate the electrode placements between treatments For all pains below the shoulders For pains in the head neck upper chest Spinal Placement Place one electrode at the and arms base of the neck Place the other electrode in Neck Placement For TSE 1 and 2 and RF modes the middle of the lower back as shown M
23. ice to be configured to provide a wide range of stimulation modalities such as Neuromuscular Stimulation and Electro Acupuncture at frequencies from 1Hz to 500 000Hz There are three basic forms of wave generated by Acticare L MN ulse amplitude The maximum voltage produced by Acticare TSE is 250V but this is reduced as the programmed pulse width increases to prevent excessive levels of stimulation at longer pulse widths The peak voltage at 100 output into 500ohms is indicated in the table 1 Biphasic a square waveform with equal positive and negative pulses 2 Monophasic a square waveform with single positive pulses 3 Twin peak a square waveform with two repeated positive peaks Pulse width Peak Voltage 0 5 2uS 250V 3 5uS 200V 6 10uS 160V 20uS 130V 50yuS 90V 100 200uS 70V Only for use by doctors and therapists experienced in electrotherapy The instantaneous output charge in normal Operation is limited to 25uC per pulse to prevent dangerous shock The maximum average current is also limited to 20mA These limits are not changeable by the user To Setup an Advanced Waveform 21 1 Enter the Therapy Mode menu by holding down the TIMER button and momentarily pressing the plus button at the same time The display will flash MODE MENU as confirmation 2 Select advanced mode ADV using the and keys 3 Press TIMER to scroll through the wavefor
24. imer button Electrode Placements for TSE For all pains below the shoulders Place one electrode at _ the base of the neck Place the other electrode in the middle of your lower back as shown Quick reference continued inside back cover To treat yourself with Acticare TSE Plug the lead wire into the top of the device and connect to two electrodes Stick the electrodes on your skin in one of the two positions shown in the photos depending on where your pain is Turn on Acticare TSE by pressing and releasing the ON OFF button Commence treatment by pressing and holding down the button to increase the treatment intensity until you feel a light tingling sensation or reach 100 Typical settings are 50 with electrodes on the neck and 100 with electrodes on the back in TSE 1 the default mode Treatment ends when the timer finishes counting down and the message Treatment Complete is displayed For pains in the head neck upper chest and arms Place electrodes either side of the back of the neck as shown A Do not use this placement in TENS mode or any mode with a strong tingling sensation www acticare com
25. l usually dissipate as the treatment progresses If at the end of this first treatment you have not experienced any relief immediately restart the treatment for another 30 minutes using a higher intensity with a continuous tingling sensation Many people find that they experience relief after 30 60 minutes with one or two sessions per day However you can use TSE for as long as you need to gain relief it is not possible to overdose Finding the best treatment time Pain relief with TSE is often cumulative so in regular use it is possible for users to experiment with gradually reducing the length of repeated treatments However if you do not have relief during a session either increase the length of treatment by up to 30 minutes or increase the intensity After following the above guidelines for two weeks you should settle on a treatment time that is both effective and convenient Long term use A typical user experiences relief with TSE using 30 minute treatments Some only need 20 minute treatments whereas others with long standing and severe pains may require 3 hour treatments If there is no relief even using 3 hour treatments repeat the two week schedule using the more powerful TSE mode TSE 2 If TSE 2 is ineffective try TSE 3 or either of the RF modes TSE 3 produces a quite strong tingling sensation because of its longer pulses and may also be applied peripherally over the area of pain
26. like a high powered TENS machine Treating Yourself with TSE Changing Therapy Modes As supplied the Acticare device is set in TSE Mode 1 You can change it to any one of three TSE six standard TENS two High Frequency TENS HFT modes two pulsed radio frequency RF modes or the advanced mode ADV by following the steps below A full list of preset modes is shown on page 26 Turn on Acticare by pressing and releasing the on off button Hold down the TIMER button and momentarily press the plus button at the same time The display flashes MODE MENU as confirmation If you see the timer screen instead of the mode menu you did TSEMODE TD MAT MENU B iy together Press Y ogo to exit amp try again TENDE E CD rN MOJE ote Press and hold the TIMER button for one second to exit and save the new setting Use the or keys to cycle through the available modes 10 Treating Yourself with TSE STEP 1 Connect the electrodes and lead wire Connect a pair of self adhesive electrodes to the device using the lead wire as described below 1 Before connecting the lead wire for the first time pull the wires apart so that the electrodes can be positioned someway apart from one another To do this slide down the clear plastic sheath on the lead wire and pull apart the pins as shown in the picture 2 Connect the metal pins to the electrodes w
27. m parameters Use the and keys to set values for each of the parameters available parameters are shown in the table opposite 4 Exit the Therapy Mode menu and save your selection by pressing and holding the TIMER button If the message INVALID is displayed when you exit this means the waveform specified is not possible for Acticare TSE to produce This may occur for one of three reasons i The sum of the pulse width PULS and inter pulse space SPAC you have specified is longer than the time available at your desired frequency FRQ You should reduce the pulse width PULS or decrease the frequency FRQ ii The burst time BT you have specified is too long for the burst frequency BF You should reduce the burst time or decrease the burst frequency iii You are attempting to use waveform frequencies below 100Hz in Burst mode this is not possible with Acticare TSE Advanced Therapy Mode Basic Waveform Parameters Burst Parameters Pulse Waveform RE Width Even Burst y i Time Pulse oy ot Amplitude Inter pulse Spacing Available Parameters Each parameter may be independently set to produce any desired waveform For example a 50uS Biphasic TENS pulse repeated at 250Hz with bursts of 1 sec on and 1 sec off would require the following parameters MODE BIPH PULS 50S SPAC OuS FRQ 250Hz BT 1000mS BF 0 5Hz Pulse Interpulse Waveform Burst Burst Warning Only u
28. nto the gaps where the buttons meet the outer casing 20 Maintenance and Care Replacing batteries The rechargeable Nickel Metal Hydride NiMH batteries installed in Acticare TSE may need replacement if the time between charges has decreased considerably Because batteries are chemical products performance deteriorates not only with use but also during prolonged storage Normally the batteries will last around 6 months or 250 cycles if used under proper conditions Disposing of a battery in fire can cause the battery to rupture Replace with good quality AA size NiMH batteries of at least 1600mA hour capacity Never use the charger stand with non rechargeable batteries installed Spares Service The following spares are available from our helpline or our website www acticare com Item Order Code Electrode Pads pack of 4 C00207 Blue Electrode Pads for C00220 sensitive skin pack of 4 Rechargeable batteries Cc00200 pack of 4 AA size Lead wire C00206 Long lead wire C00251 Acticare TSE carry bag C00208 Acticare TSE user manual C00201 Charger cradle UK Version A00007 European Version A00008 North American Version A00009 Australian Version A00010 ED Advanced Therapy Mode Advanced Mode allows the user to control the type of the waveform generated by Acticare TSE by programming a series of parameters that describe the wave shape and frequency This mode is very flexible it allows the dev
29. on to get a good result and you may require professional advice from your doctor physiotherapist or TENS nurse Otherwise refer to the maps on the following pages as a starting point Never apply the electrodes across your head or chest when using TENS stimulation Electrode Placements for TENS Lower Back Pain Place electrodes either side of the spine slightly above the position of the pain 16 Electrode Placements for TENS cont Hip Pain Place electrodes so that the painful area is between them a Knee Pain Place electrodes either side of the knee For best results avoid placing the electrodes on the knee cap Treating Yourself with TENS 17 Shoulder Pain Apply electrodes to the front and back of the painful shoulder Neck Pain Place electrodes on the back of the neck no higher up than the nape of the neck Ail A N Never place TENS electrodes on the side or front of the neck Treating Yourself with TENS Electrode Placements for TENS cont Arthritis of fingers and hands Elbow Pain Place one electrode on the top of the hand Place electrodes either side of the elbow one and the second close to your elbow on the slightly above and one slightly below the joint inside of the forearm Menstrual Pain Nausea and Travel Sickness Place the electrodes over the tummy area or Place electrodes on the front and back of one across the lower back forearm just above the
30. ration close less than 1m to sources of short wave radio or microwave equipment is not recommended Damage from liquids Do not allow Acticare to come into contact with water or other liquids Do not use in the bathroom Flammable atmospheres Do not use this device in the presence of flammable gases or liquids such as when refueling an automobile Connections Do not connect Acticare TSE to anything other than the approved charger cradle and electrode lead wires Uncomfortable stimulation Do not operate at a level at which the stimulation is uncomfortable reduce the intensity to a comfortable level No curative value This device is effective for the treatment of chronic pain but has no curative value Long term effects The long term effects of of electrical stimulation have not been established Adverse reactions Important Information A Skin irritation under electrodes This usually resolves itself within a few days A hypo allergenic electrode material is available for sensitive skin Electrode reactions can arise from high intensity stimulation or mono phasic currents that are available in advanced modes Use the default biphasic modes and or reduce stimulation level Adverse reactions to electrotherapy are rare but reported cases include the following general malaise nausea vomiting dizziness fainting migraine or headache epileptic seizure eczema tinnitus numbness loss of muscle tone and balan
31. se Width Spacing Frequency Time Freq the Monophasic and PULS SPAC FRQ BT BF Twin Peak waveforms 0 5uS 0 0uS 1Hz Eo off 0 25Hz with medical advice 1 0uS 0 5uS 5Hz i g 104S 0 5Hz These waveforms IESUS 1 0uS 10Hz 20uS 1Hz result in a net flow of 2uS IESUS 25hz 3 2 ims 2Hz current from one 3uS 2us 50Hz2 Z2 2mS 5Hz electrode to the other 4us 3yuS 100Hz 5ms 10Hz electrode The result 5uS 4us 250Hz 10ms 20Hz may be reddening or 6yuS 5uS 500Hz 20mS 50Hz in severe cases burns 8uS 6uS 750Hz 50mS 100Hz under the electrodes 10uS 8uS 1kHz 100mS 250Hz due to ionic transport 20uS 10uS 2 5kHz 250mS 500Hz A 50uS 204S 5kHz 500mS kHz Scientific Notation 1004S 50uS 10kHz 1000mS 2kHz Hz Hertz 200uS 100uS 20kHz 2000ms ane bie 200uS 50kHz nal u icroseconds 1mS 100kHz a e mS Milliseconds 2mS 200kHz Ce LEG DIET eI uC Micro coulombs 500kHz unit of charge Waveform time in uS 1 000 000 Waveform frequency FRQ Waveform frequencies of 50Hz and below are not available for burst modes 22 Troubleshooting Message Symptom Possible causes Solution Check Leads and Pads on display The electrodes are not properly stuck to the skin Badly connected lead wire Very hairy skin Make sure that the lead wire is properly connected to both the device and the electrodes Ensure that the electrodes are firmly stuck to the skin Replace electrodes if required If skin is very hairy cut short underneath th
32. t delivers ten times the power Contraindications Important Information Indications Acticare TSE is intended to be used for the symptomatic relief of chronic pains of all types to help improve mood and aid natural sleep A Cardiac pacemakers Not to be used by persons fitted with a cardiac pacemaker Epilepsy Not to be used by persons who suffer from an epileptic condition Transthoracic Stimulation Chest Do not apply the electrodes across the chest This can cause electrical current to enter the chest and may lead to irregularities in heart beat Cranial Stimulation Head Do not apply the electrodes across the head Skin and vascular problems Do not apply the electrodes over infected areas of skin skin eruptions dermatological conditions open wounds or damaged or broken skin or on areas of the body where there is a loss of normal skin sensation Unknown Cause Do not use to relieve undiagnosed pains until cause has been established by a clinician Carotid Sinus Neck Stimulation Avoid using any electrode placement that stimulates the carotid sinus region at the front of the neck In rare cases spasm of the laryngeal and pharyngeal muscles may occur when the electrodes are placed across the neck or mouth This may be strong enough to cut off the airway causing breathing difficulty Warnings Pregnancy The safety of using electrotherapy at anytime during pregnancy or birth has not
33. t less than 100 intensity if your skin resistance is low This is not a problem but there is no need to increase the intensity level beyond this setting Most people do not feel any sensation with TSE 2 so it is fine to increase the output level to 100 You are likely to feel a light tingling sensation using TSE 1 and TSE 3 If the sensation becomes uncomfortable press the key until it is comfortable again Treatment mode TSEMODE A SEER POWER HR MIN Treatment Timer Intensity Level Typical Running Screen With TSE treatments we recommend that you set the intensity level to a light tingling sensation or 100 if there is no sensation Caution With TSE 1 and TSE 2 especially the electrodes may get warm and or there may be some reddening of the skin during treatment If this happens check that they are properly stuck to your skin and reduce the intensity by about 25 STEP 5 Completion of treatment Your treatment has ended when the timer has finished counting down and the message TREATMENT COMPLETE is displayed The device will bleep to let you know when treatment is over You can end a treatment before the timer has finished by turning off the device To turn off the device hold down the ON OFF button for 1 second After every treatment we recommend that you return the electrodes to their backing sheet and store them in the sealable bag to prevent them from
34. ularly for at least a week preferably two before you assess your level of relief Although TSE may reduce pain in many cases it does not completely eliminate pain Acticare TSE should only be used to treat diagnosed pains If you have any new symptoms always consult your doctor Also do not vary your intake of any prescribed medication without consulting your doctor TSE is safe to use in the home but should not be used if you are epileptic pregnant or have a cardiac pacemaker Many people find that by using TSE they have good relief from pain for the first time in many years which leads to a recovery of mobility If this is your experience please take care not to overdo it but instead ease yourself gradually back into a more active lifestyle About TSE TENS and RF Acticare TSE can deliver two different types of electrotherapy called TSE TENS and RF TSE stands for Transcutaneous through the skin Spinal Electroanalgesia electrical pain relief TSE is a unique and powerful form of electrotherapy available only on Acticare devices TENS stands for Transcutaneous through the skin Electrical Nerve Stimulation TENS is a commonly available form of electrotherapy used widely by physiotherapists and doctors TENS treatments normally produce a tingling sensation and work by stimulating the peripheral nerves RF stands for Radio Frequency This is a
35. warranted to be free from defects in workmanship or materials at the time of delivery Bioinduction Ltd will repair or replace at its discretion any product found to be defective within the warranty period This warranty does not apply to any product which has been damaged due to misuse or that was repaired or altered other than by the manufacturer 2 actica rcf Introduction Important Information gt Your Acticare TSE Charging Batteries Treating Yourself with TSE Treating Yourself with TENS i Settings Menu Maintenance and Care Ge Advanced Therapy Modes Troubleshooting KO Technical Information Quick Reference Introduction Welcome to Acticare TSE Congratulations you have invested in an Acticare TSE device to help manage your pain without increasing your intake of drugs If you are eager to get started you only need follow the instructions on the enclosed Quick Start Guide Acticare TSE provides effective relief from persistent pains anywhere on the body Ina January 2005 study of 150 patients who used Acticare TSE for a period of two months more than 3 out of 4 said that they had 50 or more pain relief despite an average duration pain of 9 years In addition to providing pain relief TSE improves mood relieves stress and can aid natural sleep TSE is an accumulative therapy and therefore it is important that you treat yourself reg
36. wrist 18 Settings Menu To enter the Settings menu Hold down the TIMER button and momentarily press the minus button at the same time The display flashes SETT MENU for one second To make changes Press the TIMER button to advance through the options until the parameter you want to change is displayed Press or to set the value of the parameter to your desired setting To exit Settings and save your changes Press and hold the TIMER button for 1 second To exit Settings without saving Press the and TIMER buttons together The following parameters can be changed in the Settings Menu Parameter Screen Valid Description Name Options Language iL English French Allows selection of language for help messages German Pad Detect PAD ON OFF Disables detection of disconnection of leads and pads This is useful for patients with hairy skin who experience false disconnect messages Clock CLK ON OFF Controls time and date display when the device is switched off Year YEAR 2004 2034 Sets year Month MONTH Jan Dec Sets month Date DATE 1 31 Sets day of month Hour HOUR 0 23 Sets current time hours Minute MIN 0 59 Sets current time minutes Pain diary DIARY ON OFF For clinician use Allows level of relief to be recorded using Visual Analogue Scale VAS scoring which can be uploaded for analysis Consult www acticare com for details Serial port
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