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Forte CPS Series

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1. PRODUCT 200 STIM 200 COMBO 400 STIM 400 COMBO Channels 2 2 amp Ultrasound 4 4 8 Ultrasound Interferential Channels1 amp 2 Channels182 Channels 18 2 0r3 8 4 Channels 1 amp 2 0r3 amp 4 Premod Channels 1 amp 2 Channels18 2 Channels 1 2 3 4 Channels 1 2 3 4 Russian Channels 1 amp 2 Channels18 2 Channels 1 2 3 4 Channels 1 2 3 4 Microcurrent Channels1 amp 2 Channels1 amp 2 Channels 1 2 3 4 Channels 1 2 3 4 VMS Channels 1 amp 2 Channels18 2 Channels 1 2 3 4 Channels 1 2 3 4 Hivolt Channels 1 amp 2 Channels18 2 Channels 1 2 3 4 Channels 1 2 3 4 Ultrasound Not Available 1 amp 3 3 MHz Not Available 1 amp 3 3 MHz Combination Not Available Available Not Available Available NOTE The above features are not available on all units Please note the type of Forte CPS system you are operating and reference those sections of this user manual that are applicable Liability Disclaimer Before administering any treatment to a patient you should become acquainted with the operating procedures for each mode of treatment available as well as the indications contraindications warnings and precautions Consult other resources for additional information regarding the application of electrotherapy Precautionary Instructions As CAUTION AX CAUTION Ay WARNING Ay WARNING AN CAUTION AN CAUTION Read understand and practice the precautionary and operating instruction
2. 21 PREMOD Premodulated Sine Wave e Introduction e Quick Start e Setup Procedure Modifying Power up Presets Parameters e Preparation for Treatment e Detailed Treatment Procedures Treatment Cautions e Modifying Treatment Parameters e Technical Specifications Introduction to PREMOD Premodulated is a single sine wave that has modulated amplitude This waveform is similar to the beat frequency the pattern created by the interferential current but can be delivered through one Channel In some cases premodulated therapy provides a good alternative for interferential treatment especially when treating small areas of the body where four electrodes could not be utilized Quick Start The following is a quick step by step procedure for using Premodulated stimulation Before proceeding refer to treatment cautions Procedure Comments Turn power on The unit will go through self diagnostics followed by the main menu Prepare treatment site Follow steps in preparation for treatment Position electrodes Secure electrodes around area to be treated Press PREMOD To select Premodulated stimulation Set Intensity Adjusting intensity of the displayed Channel Press Start To begin treatment End treatment Remove electrodes and inspect treatment area 22 Setup procedure PREMOD The following sequence of events is followed to begin a Premod treatment Step 1 Press PREMOD and set in
3. The time in microseconds between the two phases when there is no current flow Lead Zirconate Titanate A synthetic crystal used to create the ultrasound beam by vibrating 1 000 000 1 MHz to 3 300 000 3 3 MHz times per second This type of crystal is both durable and efficient in its func duration is the same Microcurrent A Monophasic square wave whose amplitude is less than 1 mA Positive or negative polarity can be used or a mode where the polarity automatically alternates to reduce a net DC effect Phase Duration Time in microseconds for current to flow in one direction In the VMS Waveform both phases are symmetrical thus equal in time In a Monophasic Waveform the phase duration and pulse Polarity The current flow may be directed in the positive or negative direction in the High Volt and microcurrent waveforms In microcurrent it can also alternate polarity at a rate designated by the alteration time Power A measure of the intensity of the ultrasound delivered to the patient Unit of measure is watts W or w cm Premodulated A single sine wave with modulated amplitude This waveform is similar to the beat frequency the pattern created by the interferential current but can be delivered through one Channel At low frequencies comfortable twitch contractions can be produced Presets Clinical Protocol System A library consisting of 100 preset parameters Pulsed Mode Ultrasound Th
4. Suggestion Some patients may not tolerate parameter changes during a session unless the PAUSE key is used to ramp stimulation down prior to making a change Technical Tip Cycle Time The contraction rest cycle time Options are displayed with the contraction ON time first followed by the rest time A 10 50 cycle time means a 10 second contraction time followed by a 50 second rest time A continuous cycle time may be used when using this waveform for relaxation of muscle spasms Technical Specifications for Russian Current Channels 1 4 Intensity CC 100 mA Peak Intensity CV 100 Volts Peak Carrier Frequency 2500 Hz Burst Frequency 20 100 Hz Duty Cycle 10 to 50 Russian Waveform Sine Wave Bursts 36 Russian Carrier Frequency Ww WW Burst Frequency High Voltage Pulsed Current HVPC Monophasic Twin Peak e Introduction e Quick Start e Setup Procedure Modifying Power up Presets Parameters e Preparation for Treatment e Detailed Treatment Procedures Treatment Cautions e Modifying Treatment Parameters e Technical Specifications Introduction to HVPC HVPC stimulators have outbut ranges between 300 500 volts Knowledge of the voltage alone does not inform the user about the physiological responses attainable The ability to assess peak current can help determine tissue response as too much average current can cause negative effects The Forte CPS HVPC is designed to delive
5. Ramp is an amplitude increase from O to the preset level in one second when alternating polarity is selected The lead wire marked with a dot near the pin is the polarity selected e Treatment Time The time in minutes seconds when using the probe that the stimulation will be delivered Treatment will automatically cease and a tone will sound when this time expires e Amplitude The intensity of the output is measured in microamps In general higher amplitudes are used with larger electrodes The amplitude is adjusted to be subsensory for this application 30 10 To modify treatment parameters prior to starting treatment e Use the up and down arrows located next to the ENTER button to navigate through the parameters available for Microcurrent current e Once you have highlighted a desired parameter press ENTER to display a list of options available for this mode of treatment e Use the arrows once again to highlight a desired option and then press ENTER Set Power Intensity using the controls located on the control panel The amplitude is displayed digitally on the LED adjacent to the intensity control button Press Start to initiate the treatment Main Menu will reappear updated with waveforms and Channels in use as well as elapsed time To modify settings during treatment e Parameters for the current Channel will be displayed on the LCD and LED read outs e To modify waveforms frequency or amplitude e You may w
6. available for this mode of treatment e Use the arrows once again to highlight a desired option and then press ENTER to accept e Use the Treatment Time Control to alter treatment time with the arrows on the control panel e Press START to resume treatment 10 Terminating Treatment When treatment ends a tone will sound and the intensity will ramp to 0 Remove electrodes from patient and inspect area of skin treated Modifying Treatment Parameters Treatment parameters can be modified prior to or during a treatment session To modify Russian or any session parameters the session parameters must be displayed on the LCD and LED respectively Modify LED functions Treatment Time and Output Intensity Select the Channel you wish to modify and Treatment Time and Output will be displayed 2 5 00 00 Channel Min Sec Output POWER T INTENSITY Suggestion Some patients may not tolerate parameter changes during a session unless the PAUSE key is used to ramp stimulation down prior to making a change Modify LCD functions RUSSIAN Prior to or while a session is in progress you can modify any of the LCD waveform parameters as desired The following describes the general progression for changing parameters The left side of the screed lists the parameters that can be modified Move the highlight box to the desired parameter and press ENTER a list of options is displayed on the right side of the screen Mov
7. 0 2 watt to 4 watts 2 cm crystal Output Meter Accuracy 20 for any output above 10 of maximum Temporal Peak Average Intensity Ratio 2 1 20 for 50 Duty Cycle 5 1 20 for 20 Duty Cycle 9 1 20 for 10 Duty Cycle Output Continuous 1 MHz or 3 3 MHz nominal signal that is activated as long as the timer is operating Pulsed 1 MHz or 3 MHz signal modulated 100 by the 100 Hz rectangular wave with the selected Duty Cycle Timer Accuracy 0 2 minute Sound Head Effective Radiating Area 8 5 cm 1 5 cm for the 10 cm crystal 4 0 cm 1 0 cm for the 5 cm crystal 1 8 cm 0 4 0 2 cm for the 2 cm crystal Maximum beam non uniformity ratio lt 5 0 1 Beam type Collimating 52 Description of Ultrasonic Field The spatial distribution of the radiated field is essentially a collimated beam of the ultrasonic energy having a cross sectional area of 8 5 cm for 10 cm sound head when measured at a point 5 mm from the transducer face The energy distribution within the radiated field is 2 4 W cm maximum and it takes a generally conic shape having decreasing intensity at progressively increasing distance from the face of the transducer This field distribution applies for the radiation emitted into the equivalent of an infinite medium of distilled degassed water at 30 C and with the line voltage variations in the range of 10 of the rated line voltage Abbreviations The follow
8. Components The following accessories are included standard with your Forte CPS Item Part Description 1 78047 Applicator Ultrasound 5 cm Combo Only 4264 Ultrasound Gel Combo Only 12213 Lead 120 Red Black 1 amp 2 12214 Lead 120 Red Black 3 amp 4 78022 Patient Control Center 78082 Forte CPS Power Supply 78121 Forte CPS Power Cord 0 YJ O OI AI OJIN 78081 Operator s Manual Patient Control Center PCC This accessory may be used for the following e To alter the patient s perception of interferential stimulation The PCC can only be utilized with Interferential Stimulation and by one patient at a time e The Patient Control Center can also be used as a patient interrupt switch Warranty Registration Complete the warranty registration card and return it to Chattanooga Group within 10 days of purchase The warranty registration card should be filled out complete with the system serial number and serial number of the included ultrasound applicator if applicable Warranty registration will ensure that you will not be billed for services that are covered by the warranty policy Optional Accessories The following is a list of optional accessories available for the Forte CPS Series Item Partf Description 1 78046 Applicator Ultrasound 10 cm 2 78048 Applicator Ultrasound 2 cm 3 79976 Microcurrent Probe Kit 4 79977 HIVOLT Probe Kit 5 10
9. Energy from diathermy shortwave microwave ultrasound and laser can be transferred through the implanted neurostimulation system can cause tissue damage and can result in severe injury or death Injury damage or death can occur during diathermy therapy even if the implanted neurostimulation system is turned off Precautions Precautions should be taken when used e For acute conditions of bursitis and tendonitis that can be exacerbated by the use of ultrasound e Over an area of the spinal cord following a laminectomy i e when major covering tissues have been removed e On patient s with a tendency toward hemorrhaging Handle the ultrasound applicator s with care e Do not drop the sound head on hard surfaces e Do not allow the sound head to reach maximum temperatures repeatedly e Do not cool an overheated sound head with ice water or ice packs e All of these conditions are likely to damage the sound head crystal e Damage resulting from these conditions is not covered under the warranty Electronic Signature Chattanooga Group s electronic signature allows you to interchange sound heads without the need for a lengthy calibration procedure Head Warming Head Warm is a unique feature standard in both the Forte 200 Combo and 400 Combo When activated the applicator head will warm to a comfortable temperature setting slightly above normal skin temperature and maintain that range for as long as it is left on or
10. Ramp 2 sec Display Voltage Time 5 minutes e VMS Preset parameters for VMS stimulation Mode Single Channel Cycle Time 10 30 Frequency 50 pps Ramp 2 sec Phase Duration 200 msec Treatment Time 5 minutes To modify parameter settings prior to starting treatment e Use the up and down arrows located next to the ENTER button to navigate through the parameters available for the selected current e Once you have highlighted a desired parameter press ENTER to display a list of options available for this mode of treatment e Use the arrows once again to highlight a desired option then press ENTER e Highlight Ch Select and press ENTER Ultrasound parameters should be displayed Apply an ultrasound coupling agent to the patient s skin Place the sound head in contact with the patient s body with a firm uniform pressure You must keep the sound head moving during the treatment Failure to keep the sound head moving may result in hazardous exposure to the ultrasound energy Set INTENCITY in the following order Use the POWER INTENCITY controls located on the control panel to set the ultrasound level Keep the sound head moving as you increase the power setting Next press ENTER Set output intensity of the selected waveform and press START Press START to initiate the treatment timer To modify settings during treatment It is recommended that you Pause the treatment ses
11. Select the Channel you wish to modify and Treatment Time and Output will be displayed 2 15 00 00 Channel Min Sec Output o POWER es T INTENSITY Suggestion Some patients may not tolerate parameter changes during a session unless the PAUSE key is used to ramp stimulation down prior to making a change Modify LCD functions PREMOD Prior to or while a session is in progress you can modify any of the LCD waveform parameters as desired The following describes the general progression for changing parameters The left side of the screed lists the parameters that can be modified Move the highlight box to the desired parameter and press ENTER a list of options is displayed on the right side of the screen Move the highlight box to the desired option and press ENTER If no list of options is displayed this indicates that there are less than four choices and you may select them by continuing to press ENTER Premod Parameter Options Cycle time Continuous or 5 5 Beat Freq 1 10 Hz 80 150 Hz 1 150 Hz Variable or Fixed Current CC or CV Default Ch tz Premod Channel 1 Cycle Time Continuous Beat Freq 80 150 Hz CC CV CV Enter Modify Feature Start Begin Treatment Variable Beat Frequency options Beat Low 1 150 Hz Beat High 1 150 Hz Fixed Beat Frequency options 0 200 Hz Suggestion Some patients may not tolerate parameter changes during a session unless the PAUSE key
12. its set current amplitude level as prescribed by the clinician If resistance increases during a treatment the unit will automatically increase the voltage to maintain the current amplitude The CC setting is commonly used when a goal of the selected waveform is to elicit a muscle contraction When CC is selected the clinician needs to monitor the skin and be sure good electrode contact is made throughout the course of therapy as any change in electrode contact or the conducting medium will cause the voltage and current density to increase Self adhesive electrodes are recommended when CC is selected Constant Voltage CV If the output waveform encounters resistance the set voltage remains the same causing the current amplitude to decrease The CV setting is commonly used when a goal of therapy is traditional pain management or sensory level stimulation With Constant Voltage as changes in electrode contact or levels of impedance increase during the course of therapy the output level can decrease potentially limiting the desired physiologic effect Clinical Protocol System e Select Clinical Protocol button to access the internal library of over 100 preset parameters e Presets are grouped by pain management muscle contraction or ultrasound e Use the up or down arrow keys to navigate through the preset library Output Pause Control e Select this prompt to pause a treatment session Output Stop Control e Select this prompt to stop a tr
13. lead wire and place on the patient in an area near the treatment site oP eck Change method from Pads preset to probes Use the up and down arrows located next to the ENTER button to navigate through the parameters available for HVPC Once you have highlighted a desired parameter press ENTER to display a list of options available for this mode of treatment Use the arrows once again to highlight a desired option and then press ENTER 6 Set POWER INTENCITY using the controls located on the control panel The amplitude is displayed digitally on the LED adjacent to the intensity control button 7 Press START to initiate the treatment LED treatment timer will begin to display elapsed time and Main Menu will reappear updated with waveform Channels in use and available as well as elapsed time 41 8 To modify settings during treatment e Refer to modify settings during treatment described earlier in this section 9 Terminating Treatment e When treatment ends a tone will sound and the intensity will ramp to 0 e Remove electrodes from patient and inspect area of skin treated Technical Specifications for High Voltage Pulsed Current HVPC Description The output is a fast rising twin peak pulse with approximately 75 microseconds spacing between peaks Pulse duration The first peak is 5 microseconds at one half pulse height and second peak is 8 microseconds at one half pulse height The
14. pain is suppressed that would otherwise serve as a protective mechanism e Electronic monitoring equipment such as ECG monitors and ECG alarms may not operate properly when electrical stimulation is being utilized Precautions e Isolated cases of skin rash may occur at the site of electrode placement following long term applications The irritation can usually be reduced by use of an alternate conductive medium or an alternative electrode placement e Effectiveness of this treatment is dependent upon patient selection Adverse Effects e Skin irritation and burns beneath the electrodes has been reported with the use of transcutaneous nerve stimulation The microamperage current levels of this device may minimize this possibility 15 Hand Held Probes Optional Microcurrent Probes Active Probe with switch e Plug the Microcurrent probe with switch into the port marked Microcurrent Probe e To deliver Microcurrent to the patient hold the active probe as you would hold a pencil press the button near the tip of the probe to start delivery of current e You must also use a reference probe or a reference electrode the Channel One Black lead wire as described below e The active probe should touch the patient s skin at the treatment site and the reference probe should touch the patient s skin elsewhere to complete the circuit e Once you press and release the button current will be delivered for the treatment time which
15. provides fine tuning of interferential output amplitude balance D Thumbwheel provides fine tuning of interferential output amplitude balance E Manually position interferential amplitude balance Interferential Quandrand Balance functions to change the percent of maximum set amplitude levels determined by the position of the control lever Below is a close up schematic of the actual quandrand control lever and diagram of percentage levels The percentage change will range from 100 to 60 61 Maintenance Instructions To fully maintain compliance with Federal Regulation Title 21 21 CFR this unit must be recalibrated annually It is recommended that all Chattanooga Group ultrasound products be returned to the factory or an authorized servicing dealer for repairs or recalibration It is also recommended after the replacement or repair of any major component The following items should be checked at least monthly to ensure proper operation of this unit e Power cord and plug Check to make sure the cord is not frayed kinked or does not have torn or cut insulation e Sound head cable Check to make sure the cable is flexible free of kinks not frayed and the insulation is intact e Sound head face Check to see that there is no build up of gel or foreign material on the aluminum face e Lead Wires Check that the cables are not frayed kinked or do not have torn or cut insulation Screen Prompts The followi
16. the affected area so treatment is through the affected area If attended therapy is preferred you can use the microcurrent probes for hands on treatment Probes are used to treat very small areas or treat a number of different areas in succession This therapy utilizes an active treating probe and a reference probe If desired a ground electrode may be substituted for the reference probe 26 Quick Start The following is a quick step procedure for using Microcurrent stimulation Before proceeding refer to treatment cautions Procedure Comment Turn power on The unit will go through self diagnostics followed by the main menu Prepare treatment site Follow steps in preparation for treatment Position electrodes Secure electrodes in the around area to be treated Press MICRO To select Microcurrent stimulation Set Intensity Set intensity of selected Channel Press Start To begin treatment End treatment Remove electrodes and inspect treatment area Setup procedure MICROCURRENT The following sequence of events are followed to begin Microcurrent treatment using electrodes Step 1 Press MICRO and set intensity of displayed Channel Ch 1 Microcurrent Channel 1 Method Pads waveform Positive Freq Step Fine Frequency 1 0 Hz Enter Modify Feature Start Begin Treatment Step 2 Press Start to begin treatment Modifying Power up Preset Parameters With
17. the unit powered down Head warm is fully activated after it is turned on from the ultrasound parameter screen and the user returns to the Main Menu At the Main Menu you will see WARM adjacent to the Ultrasound Channel Additionally you will notice the LED output displaying 2 watts of output to rapidly warm the applicator to slightly above skin temp Output will drop to a minimal maintenance level to keep applicator head warm 49 Detailed Treatment Procedures 1 2 10 11 Connect sound head to ultrasound by pressing cable plug into the receptacle marked US Place the power switch in the ON position The display screen will indicate the machine is going through its power up procedures and system checks When completed the main menu will appear on the screen Select Ultrasound from the control panel View and verify the preset parameters for Ultrasound Preset parameters for ultrasound Frequency 1 MHz Duty Cycle Continuous Display w cm Head Warm Off To modify parameter settings prior to starting treatment Use the up and down arrows located next to the ENTER button to navigate through the parameters available for Ultrasound Once you have highlighted a desired parameter press ENTER to display a list of options available for this mode of treatment Use the arrows once again to highlight a desired option and then press ENTER Prepare the area to be treated by applying an ultrasound co
18. those specified herein may result in hazardous exposure to ultrasonic energy This unit generates uses and can radiate radio frequency energy and if not installed and used in accordance with the instructions may cause harmful interference to other devices in the vicinity However there is no guarantee that interference will not occur in a particular installation Harmful interference to other devices can be determined by turning this unit on and off or trying to correct the interference using one or more of the following Reorient or relocate the receiving device increase the separation between the equipment connect the unit to an outlet on a different circuit from that to which the other device s are connected and or consult the factory field service technician for help DO NOT use sharp objects such as a pencil point or ballpoint pen to operate the buttons on the control panel as damage may result Explosion hazard if used in the presence of flammable anesthetics The warning symbol for this hazard is prominently displayed on the cabinet For continued protection against fire hazard replace fuses only with ones of the same type and rating Make certain that the unit is electrically grounded by connecting only to a grounded electrical service receptacle conforming to the applicable national and local electrical codes This device should be kept out of the reach of children Dispose of all products in accordance with local and nationa
19. treatment or two electrodes You may choose to modify the frequency polarity and intensity e VMS Symmetrical Biphasic Square waveform Symmetrical biphasic rectangular pulse with interphase interval between the positive and negative phase This waveform can be administered in Single Reciprocal or Co Contraction cycle times Convenient presets can easily be altered for each patient need e US Ultrasound Therapy Combo units only The Forte CPS gives you the choice of 1 or 3 3 MHz frequency output Ultrasound applicators are available in 2 cm 5 cm and 10 cm and include the Electronic Signature feature Duty cycle may be set at 10 20 50 or Continuous e COMBO Combination Therapy Combo units only This option allows you to combine ultrasound therapy with Premodulated Interferential VMS or High Volt stimulation The ultrasound head becomes one half of the electrical circuit You can also select from the available options for both modalities used during a given treatment 10 11 12 13 14 Constant Current CC or Constant Voltage CV Output is available on Premod VMS VMS Burst CPS equilivants and Russian current only These waveforms are commonly used to elicit a muscle contraction and clinically one may wish for current output to be in either format High Volt and IFC are set on CV and Microcurrent on CC without the ability to change this setting Constant Current CC The output waveform maintains
20. two steps you are ready to start therapy Select Waveform Set Intensity Select Start Programmable Start Up Presets All power up presets can be individually customized to meet the needs of the clinician Foreword This manual has been written for the owners and operators of the Forte CPS It contains general instructions for operation precautionary instructions and maintenance recommendations In order to obtain maximum life and efficiency from your Forte CPS and to assist in the proper operation of the unit read and understand this manual thoroughly and become familiar with the controls on the panel as well as the various accessories that come with the unit before operating it This manual includes operator information and instructions for the Forte CPS Stim and or Forte CPS Combo systems The sections that discuss ultrasound and combination treatments apply only to the Forte CPS Combo unit All other sections in this manual apply to both the Stim and Combo devices To inquire about upgrading options of the Forte CPS product line consult your Chattanooga Group representative or call 1 800 592 7329 The specifications put forth in this manual were in effect at the time of publication However owing to Chattanooga Group s policy of continuous improvement changes to these specifications may be made at any time without obligation on the part of Chattanooga Group Forte CPS Series Product Matrix
21. 2 reciprocal or co contraction e Channels 3 amp 4 reciprocal or co contraction e Ultrasound sound output High Voltage Pulsed Current HVPC e Channel 1 2 3 or 4 probes or pads e Ultrasound sound output VMS e Channel 1 2 3 or 4 single e Channels 1 amp 2 reciprocal or co contraction e Channels 3 amp 4 reciprocal or co contraction e Ultrasound sound output US Ultrasound e In combination with interferential Premodulated VMS or HVPC e As a stand alone treatment 58 Clinical Protocols e Introduction e Setup procedure Introduction Clinical Protocols provides the clinician with a library of general application presets To access the Clinical Protocols press the Clinical Protocol button Select the desired preset from the provided list and press ENTER The user is given the opportunity to alter the preset parameters to the patient s needs to prior to initiating treatment The protocols contained in this section are to be used only as guidelines Each patient should be individually assessed to determine the appropriateness of the parameter settings prior to use Setup Procedure Navigation example Press Clinical Protocol button to access the library Choose Anatomical Location press ENTER Choose Indication or Modallity press ENTER Make a selection from on screen choices press ENTER Set Intensity press START button OEI Ea All parameters can sti
22. 832 Strap Nylatex Long 2 x 48 6 10648 Strap Nylatex Medium 2 2 x 24 7 10828 Strap Nylatex Short 2 2 x 18 8 4264 Ultrasound Gel 9 76910 Service Manual System Operation Prior to operating the Forte CPS become familiar with the following e Control Panel LCD and LED displays Modes of operation Modes of Treatment Available e Indications Contraindications for treatment Specific instructions for performing each treatment Clinical Protocols e System Components Patient Control Center PCC Probes Ultrasound Applicator e Accessories Operator Interface The operator interface consists of an illustrated control panel with light emitting diodes LED and a liquid crystal display LCD The operator is able to view parameter options on the LED and LCD readouts and make selections by touching the designated area of the control panel The displays will provide continual information during the treatments concerning amplitude and elapsed time Ultrasound and stimulation intensities are adjusted with control panel buttons adjacent to the corresponding LED display The stimulation ultrasound output can be stopped by pressing the PAUSE or STOP buttons located at the bottom of the control panel or using the Patient Control Center PCC Control Panel The Forte 200 Stim and 400 Stim do not include Ultrasound or Combo To upgrade to Ultrasound and Combo please see your Chattanooga Group repr
23. Amplitude 600 yA Load 500 ohm Frequency 2 Hz Alternate 2 5 sec Ramp 1 sec Amplitude 600 yA Load 500 ohm RUSSIAN Interrupted Sine Wave e Introduction e Quick Start e Setup Procedure Modifying Power up Presets Parameters e Preparation for Treatment e Detailed Treatment Procedures Treatment Cautions e Modifying Treatment Parameters e Technical Specifications Introduction to RUSSIAN The Russian current is a 2 500 Hz sinusoidal carrier wave interrupted to create pulse trains or bursts The number of bursts per second is set by the burst frequency and the length of the burst is determined by the duty cycle Russian stimulation currents produce strong muscle contractions Three modes of treatment are available including single Channel reciprocal and co contraction You have the option to choose from a wide variety of parameters to selectively generate the level of contraction s specific for your patient s needs Adjustable parameters include Mode single Channel reciprocal or co contract Cycle Time Frequency Ramp and Duty Cycle 32 Quick Start The following is a quick step by step procedure for using Russian stimulation Before proceeding refer to treatment cautions Procedure Comment Turn power on The unit will go through self diagnostics followed by the main menu Prepare treatment site Follow steps in preparation for treatment Position electrodes Secure electrodes around
24. Forte CPS Series 200 STIM 200 COMBO 400 STIM 400 COMBO ee A DIVISION OF encore b 13485 GROUP Table of Contents Introduction ra A Pee AA A eee es Aah aed Pie ad Oe as 1 Features of the Forte CPS Electotherapy System ooo 1 FOTSWOrd at vas ve Son cti notices amp ate AO Phe AAA Gee Bs apd Bea oy en Aaa ce eR aes Seek A 1 Forte GPS Series Product Matrix vv dla bra Ye Rt acme Sena a Dh ate econ 2 liability Disclaime k aaao da og ake BN eee tig tke is ibe anA E i a aaa eaii 2 Precautionary MStruUctionss iain abit et te Ua te Y e dh de Deo do qe aed dl A A el dl aaa na T 2 Principles Of Operation wr dd tlt ke re 3 Initial Setup Instructions sree ee toe ales Seino Sabie hs Bre Ee thie teh tee da 3 System COMPONENTS Hits Satan erat ae e Se ag Aare betes de da 4 RatientsControl Genter POGI sso i202 on a Ae Bodh ons Malai WI A Magn eda RDA ant 4 Optional ACCESSOMES cu ta e in eh ole Seared oh et aloha ah oe tl etl he eae alata 4 System Operation a ii hey wanted abad 5 Operator Interface sarta hee ed a A A A A E ch ia EG Se te 5 ComtroliPanely 00040 eL teas Be Mabe E i od sd le idad en AN etc de ceo healt ohn der di A E 6 Indications Contraindications Adverse Effects for Electrical Stimulation o o ooooooo o 12 Interterential CU du rd e da EA E A bap ee AE TA ERA OY hoch 12 PremodulatedsC ure nt a a E A A A Sta had on Panda 13 VMS RUSSIA TINO ese ox a a Ad emia au ana x EA is EA 14 Microamperage Pulsed Curren
25. LOMIDTS gt a A A A A A A A A AS 62 Glossae aaa a A aa n O le a aca 64 Introduction e Welcome to the Forte CPS e Features of the Forte CPS e Foreword e Forte CPS Series Product Matrix e Liability Disclaimer e Precautionary Instructions Welcome to the Forte CPS The Forte CPS designed and manufactured by Chattanooga Group offers a new dimension in electrotherapy combination and ultrasound treatments This technology is made possible by advanced software design and digital signal processing The result is a series of products with extraordinary versatility based on simplicity of operation A clinical electrotherapy system should not be self limiting in any price range as your needs as a Clinician change so can your Forte CPS Features of the Forte CPS Electrotherapy System Clinical Protocol System An efficient approach for setting up a treatment using preset parameters The Clinical Protocol library includes over 100 presets for pain management muscle contraction or Ultrasound Upgradeable The world s only system that can be upgraded from two to four Channels or to which ultrasound can be added after purchase Electronic Signature Combo Systems only Automatically calibrates the system to any size Forte sound head Patient Control Center A unique method of Interferential stimulation control allowing the patient to pinpoint their stimulation needs throughout the treatment session Easy as One Two Go In
26. T INTENSITY Modify LCD functions INTERFERENTIAL Prior to or while a session is in progress you can modify any of the LCD waveform parameters as desired The following describes the general progression for changing parameters The left side of the screen lists the parameters that can be modified Move the highlight box to the desired parameter and press ENTER a list of options is displayed on the right side of the screen Move the highlight box to the desired option and press ENTER If no list of options is displayed this indicates that there are less than four choices and you may select them by continuing to press ENTER Interferential Parameter Options Ch Select Both Channels Channel 1 or Channel 2 Amp Mod Quad Balance 40 Scan 100 Scan or Static Beat Frea 1 10 Hz 80 150 Hz 1 150 Hz Variable or Fixed Ch 1 2 IFC Ch Select Both Ch Amp Mod 40 Scan Beat Freq 80 150 Hz Enter Modify Feature Start Begin Treatment Variable Beat Frequency options Beat Low 1 150 Hz Beat High 1 150 Hz Fixed Beat Frequency options 0 200 Hz 20 Suggestion Some patients may not tolerate parameter changes during a session unless the PAUSE key is used to ramp stimulation down prior to making a change Technical Tip Quad Bal Quadrant Balance A unique and proprietary balance control system This allows you to define the patient s area of stimulation in continuous fashion prior t
27. ability in connection with the sale of the Product Any representative or agreement not contained in the warranty shall be void and of no effect 60 System Utilities Adjust Screen Contrast LCD Intensity Press and hold the MAIN MENU ESCAPE button Use the POWER INTENCITY up or down arrow keys to adjust contrast Modifying Power up Preset Parameters With the exception of output intensity all power up preset parameters can be modified using the following sequence of steps 1 Select and change the desired parameter setting then press ENTER 2 Next press and hold the PAUSE button then press the ENTER button Interferential Quad Balance Control amp Unit Patient Interrupt Switch The Patient Control Center is configured such that the patient can press either of the buttons A amp B to stop a treatment session It is important to note that when either of these buttons are pressed all active Channels of stimulation output will be ramped to zero and elapsed treatment times will be paused The Patient Control Center is also used as a balance control for interferential stimulation When selected for use the Quad Balance function will impact the percentage of set amplitude of the active electrodes A Patient Interrupt Switch When pressed this will stop stimulation output in all operating Channels B Patient Interrupt Switch When pressed this will stop stimulation output in all operating Channels C Thumbwheel
28. ae ao are Aare an Stew a 46 US Ultrasound coh Oe Vente a den oo head E wen ne A Agee doe aoe as 47 QUICK Start ra easan ah td id a a ads 48 TA oh aot Ba wae Eno artes ete dace takes qt arner ished aa a aG 48 Contralndications saad tet ay Do AOL dre Deo Ay Don Fall o de aches dle hint od ih Ashok hal he Miah hd es 49 PECAUTIONS 1 Mk Cubed AA A A oealhs aA ak A Da 49 Detailed Treatment Procedures sarei es oho ais dae sie ee eee eles Ste es io nies ben SS ed 50 Modifying Treatment Parameters rirnan u eee eee ees 51 USsParameterQptlons ri A Ran e ety Ae A GE ae SPEER al da ere 51 TechniGal SPSCITIGAtONS iia a es 52 COMBO Combination Therapy 0 000 tee 53 TOUCH uso crate ov Ba wae knot ean we dake Raa aries a a aba eae ear 53 PUT Starts 2h Moa ths II Oh end td hse A Ball death dA aana eal otis Addon Dd A od 54 Detaled Treatment Procedures i tents sah Ao eee hd han Oke oar SL BR dy a ne BR E 55 setting Upsa Second Meat A ee A Gan beeen 57 QUICK States ok Sass Sect aed shox said A Bee ds Fasten ss eh a aera on Ans GUN da ai hotest 57 Elihical PEOtOCO Sera phe aruda ee aod A Moda otek as Snes saben O gt ES anata Ailes 59 APPENOIX A aa Di ee a Pa ee 59 Forte CPS Two Year Limited Warranty 00000 cee 60 System WtllteScs arios oh Mtro onlay ue se eth ay oa tall Lin tdo Wh ioe Biche baled le te ea A nal Md old 61 Patient Control Center en n dl A E a Taa hain E A lt Sled 61 Maintenance Instructions van ad dada 62 Screen P
29. ain e Management of pain associated with post traumatic or postoperative conditions Contraindications e This device should not be used for symptomatic pain relief unless etiology is established or unless a pain syndrome has been diagnosed e This device should not be used on patients with demand type cardiac pacemakers e This device should not be used over cancerous lesions e Electrode placements must be avoided that apply current to the carotid sinus region anterior neck or transcereberally through the head Warnings e The long term effects of chronic electrical stimulation are unknown e Safety has not been established for the use of therapeutic electrical stimulation during pregnancy e Adequate precautions should be taken when treating individuals with suspected or diagnosed heart problems or epilepsy e Benefits of Interferential stimulation have not been established for pain of central origin e This device is to be used as a symptomatic treatment for pain and has no curative value Patients should be cautioned and their activities regulated if pain is suppressed that would otherwise serve as a protective mechanism e Electronic monitoring equipment such as ECG monitors and ECG alarms may not operate properly when electrical stimulation is being utilized Precautions e Isolated cases of skin rash may occur at the site of electrode placement following long term applications The irritation may be reduced by use of an altern
30. and Treatment Time and Output will be displayed 2 15 00 00 Channel Min Sec Output POWER T INTENSITY Modify LCD functions MICRO Prior to or while a session is in progress you can modify any of the LCD waveform parameters as desired The following describes the general progression for changing parameters The left side of the screed lists the parameters that can be modified Move the highlight box to the desired parameter and press ENTER a list of options is displayed on the right side of the screen Move the highlight box to the desired option and press ENTER If no list of options is displayed this indicates that there are less than four choices and you may select them by continuing to press ENTER Microcurrent Parameter Options Method Pads or Probes Waveform Negative Positive or Bipolar Freq Step Fine or Coarse Frequency 1 1000 Hz 29 Ch ts Microcurrent Channel 1 Method Pads Waveform Positive Freq Step 1 0 Hz Frequency Enter Modify Feature Start Begin Treatment Technical Tip Waveform options The current flow may be directed in either a positive negative or alternating Bipolar direction Bipolar Alternating through a Positive and Negative direction Technical Tip Frequency Step Options are Fine and Coarse This is a parameter convenience that allows you to scroll through your frequency options with fine sensitivity or course sensitivity Us
31. ange the desired parameter setting then press ENTER 2 Next press and hold the PAUSE button then press the ENTER button Preparation for Treatment Refer to section three to become familiar with the following Indications Contraindications Warnings Precautions and Adverse Effects for Interferential current Detailed Treatment Procedures Remember that most patients are unfamiliar with electrical stimulation and may be anxious or apprehensive during the initial sensation of current If the patient is extremely apprehensive either discontinue the treatment or set the Output Intensity at a level where the patient just feels the current Allow the individual to become accustomed to the current before increasing the intensity Treatment Cautions e Never turn the power on or off while the unit is connected to the individual e Stop the treatment before removing or attaching electrodes or leads e Never use leads or electrodes that are damaged or worn this may result in injury to the patient e Consult published sources for electrode placements settings and treatment duration e Make sure all electrodes make full contact with the patient s skin 1 Place the power switch in the ON position The display screen will indicate the machine is going through its power up procedures and system checks When completed the main menu will appear on the screen N Connect electrodes to lead wires and plug into jacks for Channels selec
32. ant to choose Pause to interrupt treatment or lower the intensity prior to making changes in treatment parameters to prevent an undesirable sensation of current by you patient e From the Main menu select the Channel to be altered e Use the up and down arrows located next to the ENTER button to navigate through the parameters available for Microcurrent e Once you have highlighted a desired parameter press ENTER to display a list of options available for this mode of treatment e Use the arrows once again to highlight a desired option and then press ENTER to accept e Use the Treatment Time Control to alter treatment time e Press START to resume treatment Terminating Treatment e When treatment ends a tone will sound and the intensity will ramp to 0 e Remove electrodes from patient and inspect area of skin treated Technical Specifications for Microcurrent Channel 1 amp 2 only in the Forte CPS 200 Stim and Combo Channels 1 2 3 amp 4 in the Forte CPS 400 Stim and Combo Probe Channel 1 Only Current 0 995 microamperes CC Compliance Voltage 60 Volts Frequency 0 1 1000 Hz Polarity Either Positive Negative or Alternating selectable as follows Negative rectangular wave output or Positive rectangular wave output Alternating 2 5 Seconds in each polarity 31 Microcurrent one cycle 4 V 0 Volt y Frequency 2 Hz Alternate 2 5 sec Ramp O sec
33. area to be treated Press Russian To select Russian stimulation Set Intensity Set the output intensity for the selected Channel Press Start To begin treatment End Treatment Remove electrodes and inspect treatment area Setup procedure RUSSIAN Follow this sequence of events to begin single Channel Russian stimulation Step 1 Press RUSSIAN and set intensity of displayed Channel Ch 1 Russian Channel 1 Mode __ i Single Cycle Time 10 50 Frequency 50 bps Ramp 2 sec Duty Cycle 50 CC CV cc Enter Modify Feature Start Begin Treatment Step 2 Press START to begin treatment Modifying Power up Preset Parameters With the exception of output intensity all power up preset parameters can be modified using the following sequence of steps 1 Select and change the desired parameter setting then press ENTER 2 Next press and hold the PAUSE button then press the ENTER button Preparation for Treatment Refer to section three to become familiar with the following Indications Contraindications Warnings Precautions and Adverse Effects for Russian current 33 Detailed Treatment Procedures Remember that most patients are unfamiliar with electrical stimulation and may be anxious or apprehensive during the initial sensation of current If the patient is extremely fearful either discontinue the treatment or set the Amplitude at a level where the patient just feels th
34. ate conductive medium or an alternative electrode placement e Effectiveness of this treatment is dependent upon patient selection Adverse Effects e Skin irritation and burns beneath the electrodes have been reported with the use of therapeutic electrical stimulation Premodulated Current Indications e Symptomatic relief of chronic intractable pain e Management of pain associated with post traumatic or post operative conditions Contraindications e This device should not be used for symptomatic pain relief unless etiology is established or unless a pain syndrome has been diagnosed e This device should not be used on patients with demand type cardiac pacemakers e This device should not be used over cancerous lesions e Electrode placements must be avoided that apply current to the carotid sinus region anterior neck or transcereberally through the head Warnings e Long term effects of chronic electrical stimulation are unknown e Safety has not been established for the use of therapeutic electrical stimulation during pregnancy e Adequate precautions should be taken when treating individuals with suspected or diagnosed heart problems or epilepsy e Benefits of Premodulated stimulation have not been established for pain of central origin e This device is to be used as a symptomatic treatment for pain and has no curative value Patients should be cautioned and their activities regulated if pain is suppressed that would ot
35. cuit with the lead marked with a dot from Channel 2 Constant Current CC The output waveform maintains its set current amplitude level as prescribed by the clinician If resistance increases during a treatment the unit will automatically increase the voltage to maintain the current amplitude The CC setting is commonly used when a goal of the selected waveform is to elicit a muscle contraction Constant Voltage CV If the output waveform encounters resistance the set voltage remains the same causing the current amplitude to decrease The CV setting is commonly used when a goal of therapy is traditional pain management or sensory level stimulation Continuous Mode Ultrasound The output of the ultrasound is not interrupted during the treatment time This mode imparts the most energy to the tissues and is used when a maximal thermal effect is desired See Duty Cycle Contract The time amplitude is held at its maximum in the muscle contraction mode This is the time that will be most fatiguing to the muscle Coupling Media An agent used to insure that the ultrasound is transmitted from the sound head to the tissue to be treated Gels or lotions labeled for therapeutic ultrasound use is recommended Duty Cycle This is the ratio of the On time to Total time of the cycle expressed as a percentage The duty cycle describes the burst on time in the Russian Waveform and the pulsed modes of ultrasound The lower th
36. e Fine sensitivity when frequencies between 0 01 and 1 0 Hz are desired Use the Coarse sensitivity setting to make increases in frequency of greater magnitude Hand Held Probes Optional application of Microcurrent 1 Place the power switch in the ON position The display screen will indicate the machine is going through its power up procedures and system check When completed the main menu will appear on the screen Plug in probes Plug the active probe with the start switch into the multiple pin jack labeled Probe The reference probe without start switch should be plugged into Channel 1 black lead wire You may also use a reference electrode adhered to the patient s body instead of the probe This electrode is connected to the black lead wire pin plugged into Channel 1 Press MICRO for Microcurrent current Refer to the information on indications and contraindications in section three View and verify the preset parameters for microcurrent current probe therapy Preset parameters for Microcurrent Probe Therapy Method Pads Waveform Bipolar Frequency Steps Fine Frequency 0 1 Hz Specific parameters for Microcurrent Waveform include e Frequency The number of cycles delivered per second The waveform is pulsed at a 50 duty cycle so the lower frequency the longer the pulse duration e Polarity The current flow may be directed in either a positive negative or alternating Bipolar direction The
37. e Modulation The amplitude of one Channel is automatically reduced by a selected amount of set amplitude and then brought back to the set point in the time designated This mode is also called Scan When two Channels are used they alternate moving from maximum to minimum The effect is that the stimulation scans the painful area to be treated Beam Non uniformity Ratio By nature an ultrasound beam is not homogeneous The BNR is a ratio of the highest intensity found in the beam field to the average intensity as indicated on the output display of the unit This measure may not exceed 5 0 1 Because of the areas of increased intensity the sound head is moved continuously during the treatment Beat Frequency Refers to frequency created when two interferential sine waves cross in the body It is equal to the difference between the frequencies of the two original waves Burst Frequency A burst is created when a train of pulses or cycles is interrupted The burst frequency is the number of bursts that occur per second Carrier Frequency The original frequency of the interferential sine wave entering the skin One Channel will be this value and the other will be equal to the carrier frequency plus the beat frequency Combo This term refers to Combination Therapy The sound head emits ultrasound and acts as a moving electrode to simultaneously deliver electrical stimulation to the area The sound head completes the electrical cir
38. e current Allow the individual to become accustomed to the current before increasing the intensity Treatment cautions e Never turn the power on or off while the unit is connected to the individual e Stop the treatment before removing or attaching electrodes or leads e Leads and electrodes should be applied to the patient before a treatment is initiated e Never use leads or electrodes that are damaged or worn this may result in injury to the patient e Consult published sources for electrode placements settings and treatment duration e Make sure all electrodes make full contact with the patient s skin 1 Place the power switch in the ON position The display screen will indicate the machine is going through its power up procedures and system checks When completed the main menu will appear on the screen 2 Connect electrodes to lead wires and plug into jacks for Channels selected Certain Channels are designated for specific modes of treatment 3 Adhere electrodes to the location to be treated Refer to guidelines under preparation for treatment earlier in this section 4 Press Russian for Russian current Refer to the information on indications and contraindications in section three 5 View and verify the preset parameters for Russian current Preset parameters for Russian current Mode Single Channel Cycle Time 10 50 Frequency 50bps Ramp 2 sec Duty Cycle 50 6 To modify treatment parameters prior to s
39. e output of the ultrasound is automatically interrupted during the treat ment time This limits the amount of energy delivered to the tissues and is used primarily for the minimizing of the thermal effects of ultrasound See Duty Cycle Ramp Up The time it takes for the amplitude to go from O to set value in the muscle contraction mode and any time the stimulation is initiated or resumed This improves the comfort of the stimulation Ramp Down The time it takes for the amplitude to go from set value to 0 Rest The time amplitude is at O in the muscle contraction mode It provides for muscle recovery in between contractions An adequate rest time minimizes fatigue A good rule of thumb is three or four times longer than the contraction time Russian An interrupted sine wave used for maximal motor recruitment Strong muscle contractions can be generated with better tolerance due to the parasthesia created by the carrier frequency Scan A term used in the interferential and other pain management waveforms that refers to an amplitude modulation mode Sound Head Applicator The applicator used for delivery of ultrasound to the patient An aluminum face contracts the patient s skin lt covers a transducer mechanism that converts electrical energy to mechanical energy in the form of a vibrating crystal 65 Sweep A term used in the interferential and other pain management waveforms that refers to a frequency modulation m
40. e percentage the lower temporal average intensity 100 is continuous ultrasound Effective Radiating Area ERA A measure of the ultrasound beam made underwater 5 mm from the radiating surface of the sound head The ERA is always smaller than the geometric area of the sound head but should be as close as possible This measurement is used to calculate the ultrasound intensity in w cm Frequency Stimulation The number of pulses delivered per second pps or cycles per second Hz Frequency Ultrasound Selectable to 1 or 3 3 MHz with the 5 cm sound head The lower the frequency the longer the wavelength the deeper the penetration of ultrasound 64 High Voltage Pulsed Current HVPC Monophasic pulse type with a double peak shape High Volt is designed to deliver very short duration pulses which are very low in charge or power output Treatment can be administered using either Pads electrodes or probes and intensity displays are in Volts or Peak Current Twin Peak High Volt current is available from Channel 2 on the Forte 200 Series and Channel 2 or 4 on the 400 Series Interferential Two sine waves 2 Channels of different frequencies are used Electrodes typically surround the area of pain in a criss cross manner An interference pattern is created where the two Channels cross treating the tissue with a third frequency the difference between the two original frequencies called the Beat Frequency Interphase Interval
41. e proceeding refer to treatment cautions Procedure Comments Turn power on The unit will go through self diagnostics followed by the main menu Apply ultrasound gel Follow steps in preparation for treatment Press US To select Ultrasound Set Intensity Set desired intensity for your treatment Press Start To begin treatment End Treatment Clean skin area of residual gel Setup procedure ULTRASOUND Follow this sequence of events to begin a 1 MHz Ultrasound application Step 1 Press US for ultrasound Set ultrasound output intensity Ultrasound 5cm Ultrasound 1 MHz Duty Cycle Continuous Display W cm Head Warm OFF Enter Modify Feature Start Begin Treatment Step 2 Press START to begin treatment Modifying Power up Preset Parameters With the exception of output intensity all power up preset parameters can be modified using the following sequence of steps 1 Select and change the desired parameter setting then press ENTER 2 Next press and hold the PAUSE button then press the ENTER button Indications Ultrasound for use in applying deep heat can be used for treatment of selected medical conditions such as the relief of pain muscle spasms and joint contractures These conditions may be associated with adhesive capsulitis bursitis with slight calcification myositis and soft tissue injuries The Forte CPS Combo can provide therape
42. e product must be filled out and returned to the Chattanooga Group by the original owner within 10 business days of purchase This warranty does not cover Replacement parts or labor furnished by anyone other than the Company the dealer or an approved Company service agent Defects or damage caused by labor furnished by someone other than Company the dealer or an approved Company service agent Any malfunction or failure in the Product while it is in the possession of the owner during the warranty period if the malfunction of failure is not caused by a defect in material or workmanship or if the malfunction or failure is caused by unreasonable use applications in which the product was not intended or the failure to prove reasonable and necessary maintenance To Obtain Service From Company or the selling dealer under this warranty the owner must do or abide by the following e A written claim must be made within the warranty period to Company or the selling dealer e f the claim is made to the Company the written claim should be sent to 4717 Adams Rd P O Box 489 Hixson TN 37343 Phone 800 592 7329 outside the US 1 423 870 2281 e The Product must be returned to Company or the selling dealer by the owner This warranty gives you specific legal rights and you may also have other rights which vary from state to state The Company does not authorize any person or representative to create for it any other obligation or li
43. e the highlight box to the desired option and press ENTER If no list of options is displayed this indicates that there are less than four choices and you may select them by continuing to press ENTER 35 Russian Parameter Options Mode Single Reciprocal or CoContract Cycle Time 5 5 10 10 10 20 4 12 10 30 10 50 or Continuous Frequency 20 100 bps Ramp 0 5 1 2 or 5 sec Duty Cycle 10 20 30 40 or 50 Russian Channel 1 Mode __ i Single Cycle Time 10 50 Frequency 50 bps Ramp 2 sec Duty Cycle 50 CC CV cc Enter Modify Feature Start Begin Treatment Note Ch Select is available only when Reciprocal or CoContract is selected This allows amplitude adjustment of each Channel independently if desired To make this selection follow these commands With the highlight bar positioned over Ch Select press Enter This will change output intensity of Channel 1 At this point raise the intensity of Channel 1 using the Power Intensity keys When at desired levels press Enter to set Channel 2 The intensity level of Channel 1 will remain on as Channel 2 intensity level is being set Technical Tip Single Channel One Channel two electrodes positioned to stimulate a muscle or muscle group Reciprocal Two Channels four electrodes positioned to stimulate the same or opposing muscle groups CoContract Two Channels four electrodes positioned to stimulate the opposing muscle groups simultaneously
44. eatment When treatment time has expired a tone will sound e Wipe excess coupling media from patient s skin and ultrasound head e Press the STOP button to end treatment early 50 Modifying Treatment Parameters Treatment parameters can be modified prior to or during a treatment session Modify LED functions Treatment Time and Output Intensity Select the Channel you wish to modify and Treatment Time and Output will be displayed 2 500 00 Channel Min Sec Output POWER gt T INTENSITY Modify LCD functions ULTRASOUND Prior to or while a session is in progress you can modify any of the LCD waveform parameters as desired The following describes the general progression for changing parameters The left side of the screed lists the parameters that can be modified Move the highlight box to the desired parameter and press ENTER a list of options is displayed on the right side of the screen If no list of options is displayed this indicates that there are less than four choices and you may select them by continuing to press ENTER Ultrasound Parameter Options Frequency 1 MHz or 3 3 MHz Duty Cycle 10 20 50 or Continuous Display W cm or Watts Head Warm Off or On Ch U Ultrasound 5cm Ultrasound Frequency 1 MHz Duty Cycle Continuous Display W cm Head Warm OFF Enter Modify Feature Start Begin Treatment Technical Tip Frequency The ul
45. eatment session Output Start Control e Select this prompt to begin a treatment session General Setup Steps The unique design of the front panel allows you to setup a treatment faster than ever Careful grouping of treatment options allows you to easily identify and select from the appropriate option Two simple steps are all that is needed prior to pressing START and initiating treatment Quick Start The following is a general quick step by step procedure for using the Forte CPS Before proceeding refer to the cautions related to the mode of use selected Procedure Comments Turn power on The unit will go through self diagnostics followed by the main menu Prepare treatment site Follow steps in preparation for treatment Position electrodes or apply Ultrasound gel Secure electrodes in the area to be treated Select Mode of use Select Waveform Ultrasound or Combo Set Intensity Set intensity of the Channel s selected Press Start To begin treatment End treatment Turn power off and remove electrodes and inspect treatment area or remove residual gel Screen Layout There are three types of screen displays Main Menu Active Parameter Display and Parameter Change screens Each of these screens is formatted for easy navigation 1 Main Menu The Main Menu serves as the opening screen when the unit is first powered up It will display available Channels as well as basic text help at the bott
46. edures and system checks When completed the main menu will appear on the screen 2 Select COMBO from the control panel 3 Select one of the combo preset waveforms PREMOD Preset IFC HIVOLT or VMS e After selecting a waveform view the electrical stim summary screen to confirm your selection Channel 2 will automatically be selected for COMBO but you will also use Channel 1 if you choose Interferential e Attach the electrode Red 2 lead wire to the patient It may be placed in the treatment area if it is similar in size to the sound head surface area bipolar technique or in a non treatment area if it is larger than the sound head and acts to disperse the current monopolar technique 55 4 View and verify the preset parameters for Combination treatments al o e Ultrasound Ultrasound preset parameters used in Combo mode Frequency 1 MHz Duty Cycle Continuous Display W cm Head Warm Off Treatment Time 5 minutes e Premodulated Premodulated preset parameters used in Combo mode Channel used Ch 2 Beat Frequency 80 150 Hz Treatment time 5 minutes e Interferential Interferential preset parameters used in Combo mode Amplitude modulation 40 Scan Beat Frequency 80 150 Hz Treatment Time 5 minutes e HIVOLT Preset parameters for single Channel High Volt current Method Pads Polarity Positive Cycle Time Continuous Sweep Continuous Frequency 50 pps
47. elect a mode of treatment the Main Menu will be displayed on the LCD screen to let you know if this mode is available and which Channel s to use Once you have chosen a waveform and have plugged the lead wires into the appropriate Channels follow the quick start instructions below or you may want to refer to the designated section in this manual for the current selected for more details concerning setting up your patient Quick Start The following is a quick step by step procedure for setting up a second treatment Before proceeding refer to the treatment cautions of the selected treatment Procedure Comments Prepare treatment site Follow steps in preparation for treatment Position electrodes Secure electrodes around area to be treated Set Intensity Adjust amplitude for the Channel selected Press Start To begin treatment End Treatment Remove electrodes clean and inspect treatment area To modify treatment parameters prior to starting treatment e Use the up and down arrows located next to the ENTER button to navigate through the parameters available for the selected current e Once you have highlighted a desired parameter press ENTER to display a list of options available for this mode of treatment e Use the arrows once again to highlight a desired option then press ENTER Stop One Treatment e f you press the STOP button on the control panel the treatment hig
48. ent Preset parameters for VMS stimulation Mode Single Channel Cycle Time 10 30 Frequency 50 pps Ramp 2 sec Phase Duration 200 mSec 6 To modify treatment parameters prior to starting treatment e Use the up and down arrows located next to the ENTER button to navigate through the parameters available for VMS current e Once you have highlighted a desired parameter press ENTER to display a list of options available for this mode of treatment e Use the arrows once again to highlight a desired option and then press ENTER 7 Set POWER INTENCITY using the controls located on the control panel The amplitude is displayed digitally on the LED adjacent the intensity control button 8 Press START to initiate the treatment VMS stimulation will ramp up to set output values The Main Menu will reappear displaying Channel s waveform s in use with elapsed time 44 9 To modify settings during treatment It is recommended that you Pause the treatment session prior to implementing a parameter change e Select the Channel to modify from the Main Menu e Press ENTER to display parameters of that Channel on both the LCD and LED displays e You may want to choose PAUSE to interrupt treatment or lower the intensity prior to making changes in treatment parameters to prevent the possibility of undesirable sensation that could be perceived with a change in parameters e Once you have
49. esentative or call 1 800 592 7329 or 423 870 2281 Parameter Display Channel Min Sec Output 9 Operating Controls 1 LCD Screen Display e Provides visual display of parameters selected during all phases of treatment set up e Main Menu provides a constant update of available Channels as well as treatments and time remaining for Channels in use 2 LED Channel Indicator displayed continuously e Displays the current Channel selected e Information presented on the screen display as well as treatment time and power intensity as related to the specific Channel selected 3 LED Treatment Time Remaining displayed continuously e Displays the amount of time remaining for the Channel selected 4 Amplitude Output Level displayed continuously e Displays output intensity of the selected Channel ENTER Parameter Selection Control e Select this prompt to change a treatment parameter to a value other than the default setting Preset treatment parameters will be displayed on the screen use the up or down arrow to highlight a parameter and press ENTER Use the up and down arrows to navigate through the list of options and press ENTER to accept e When using Clinical Protocols use the selection control to navigate through the options Main Menu Escape e Select this prompt to return to the Main Menu or escape from a pop up menu Treatment Time Controls e Select this prompt to set or modify treatment time in minute
50. has been set in the Microcurrent parameter change screen When the time has elapsed a tone will sound and the device will return to the GSR mode default e The active treating Microcurrent probe senses skin impedance levels when not delivering stimulation This method of skin impedance sensing is referred to as the GSR mode When low levels of impedance are found the number of audible tones per second will increase Reference Probe e The purpose of the reference probe is to complete the circuit allowing flow of current through patient tissue The reference probe should touch the patient s skin away from the location of the active probe e Attach the Black wire from Channel One to the reference probe or you may use an electrode as a reference NOTE Place the reference device as close to the treatment site as possible where it will not interfere with placement of the active treating electrode for example do not place the reference electrode on the leg if you are treating the arm e Use the end of a moistened cotton swab inserted into the ends of both the active treating probe and the reference probe The cotton must touch the probe s metal ring use water to wet the cotton swab before starting the treatment HIGH VOLT Probe The High Volt probe is used to deliver stimulation manually Select the High Volt Waveform then simply plug the Red lead wire into the connector of the Probe The Black lead wire from the same Channel should be at
51. he electrical conductive medium The irritations can usually be reduced by the use of an alternate conductive medium or alternative electrode placement Adverse Effects e Skin irritation and burns beneath the electrodes have been reported with the use of therapeutic electrical stimulation 14 Microamperage Pulsed Current Microcurrent Indications e Symptomatic relief of chronic intractable pain e Management of pain associated with post traumatic or postoperative conditions Contraindications e This device should not be used for symptomatic pain relief unless etiology is established or unless a pain syndrome has been diagnosed e This device should not be used on patients with demand type cardiac pacemakers e This device should not be used over cancerous lesions e Electrode placements must be avoided that apply current to the carotid sinus region anterior neck or transcereberally through the head Warnings e Long term effects of chronic electrical stimulation are unknown e Safety has not been established for the use of transcutaneous nerve stimulation during pregnancy e Adequate precautions should be taken when treating individuals with suspected or diagnosed heart problems or epilepsy e Benefits of microcurrent have not been established for pain of central origin e This device is to be used as a symptomatic treatment for pain and has no curative value Patients should be cautioned and their activities regulated if
52. herwise serve as a protective mechanism e Electronic monitoring equipment such as ECG monitors and ECG alarms may not operate properly when electrical stimulation is being utilized Precautions e Isolated cases of skin rash may occur at the site of electrode placement following long term applications The irritation can usually be reduced by use of an alternate conductive medium or an alternative electrode placement e Effectiveness of this treatment is dependent upon patient selection Adverse Effects e Skin irritation and burns beneath the electrodes have been reported with the use of therapeutic electrical stimulation 13 VMS Russian HIVOLT Indications e Relaxation of muscle spasms e Prevention or retardation of disuse atrophy e Increasing local blood circulation e Muscle re education e Maintaining or increasing range of motion e Immediate postsurgical stimulation of calf muscles to prevent venous thrombosis Contraindications e This device should not be used on patients with demand type cardiac pacemakers e This device should not be used on cancer patients Warnings e The long term effects of chronic electrical stimulation are unknown e Safety has not been established for the use of therapeutic electrical stimulation during pregnancy e Adequate precautions should be taken when treating individuals with suspected or diagnosed heart problems e Adequate precautions should be taken in the cases of perso
53. highlighted a desired parameter press ENTER to display a list of options available for this mode of treatment e Use the arrows once again to highlight a desired option and then press ENTER to accept e Use the Treatment Time Control to alter treatment time with the arrows on the control panel e Press START to resume treatment 10 Terminating Treatment When treatment ends a tone will sound and the intensity will ramp to O Remove electrodes from patient and inspect area of skin treated Modifying Treatment Parameters Treatment parameters can be modified prior to or during a treatment session To modify VMS M or any session parameters the session parameters must be displayed on the LCD and LED respectively Modify LED functions Treatment Time and Output Intensity Select the Channel you wish to modify and Treatment Time and Output will be displayed digitally on the display LEDs 2 5 00 00 Channel Min Sec Output POWER T INTENSITY Suggestion Some patients may not tolerate parameter changes during a session unless the PAUSE key is used to ramp stimulation down prior to making a change Modify LCD functions VMS Prior to or while a session is in progress you can modify any of the LCD waveform parameters as desired The following describes the general progression for changing parameters The left side of the screed lists the parameters that can be modified Move the hig
54. hlight box to the desired parameter and press ENTER a list of options is displayed on the right side of the screen If no list of options is displayed this indicates that there are less than four choices and you may select them by continuing to press ENTER 45 VMS Parameter Options Mode Single Reciprocal or CoContract Cycle Time 5 5 10 10 10 20 4 12 10 30 10 50 or Continuous Frequency 5 200 pps Ramp 0 5 1 2 or 5 sec Phase Dur 20 300 msec Ch 1 VMS Channel 1 Mode Single Cycle Time 10 50 Frequency 50 pps Ramp 2 sec Phase Dur 200 uSec CC CV cC Enter Modify Feature Start Begin Treatment Technical Tip Single Channel One Channel two electrodes positioned to stimulate a muscle or muscle group Reciprocal Two Channels four electrodes positioned to stimulate the same or opposing muscle groups CoContract Two Channels four electrodes positioned to stimulate the opposing muscle groups simultaneously Suggestion Some patients may not tolerate parameter changes during a session unless the PAUSE key is used to ramp stimulation down prior to making a change Technical Tip Cycle Time The contraction rest cycle time Options are displayed with the contraction ON time first followed by the rest cycle A 10 30 cycle time means a 10 second contraction time followed by a 30 second rest time A continuous cycle time may be used when using this waveform for relaxa
55. hlighted on the Main Menu will be stopped immediately If you want to stop a specific treatment allowing the other treatments to continue then perform the following Select the specific treatment from the Main Menu Press STOP to discontinue the selected treatment 57 Simultaneous Treatments The Forte CPS Stim and Combo allows you to perform a variety of simultaneous treatments Simultaneous treatments should not be mistaken for combination treatments Combination treatments blend ultrasound with Premodulated Interferential VMS or High Voltage Pulesed Current HVPC into a single treatment Simultaneous treatments are separate and independent which may be delivered to one or more patients at the same time As many as 5 different treatments may be performed at the same time when using the 400 Combo and 3 when using the 200 combo Simultaneous treatments available through the Forte CPS are listed below Note Any reference to Channel 3 or 4 is associated with the Forte CPS Stim or Combo 400 reference to Ultrasound is associated with the Forte CPS Combo 200 or 400 unit IFC Interferential e Channels 1 amp 2 e Channels 3 amp 4 e Ultrasound sound output PREMOD Premodulated e Channel 1 2 3 or 4 e Ultrasound sound output MICRO Microcurrent e Channel 1 2 3 or 4 pads Probes available on Channel 1 only e Ultrasound sound output RUSSIAN e Channel 1 2 3 or 4 single e Channels 1 amp
56. ing Electrodes 1 Place the power switch in the On position The display screen will indicate the machine is going through its power up procedures and system checks When completed the main menu will appear on the screen Adhere electrodes to the location to be treated Refer to guidelines under preparation for treatment earlier in this section The Red lead wire is the Treating Active electrode Example If the polarity is set on Positive the Red lead wire is Positive and if the polarity is set on Negative then the Red lead wire now has a Negative polarity Press HIVOLT for HVPC Refer to the information on indications and contraindications in section three View and verify the preset parameters for HVPC Preset parameters for single channel HVPC Method Pads Polarity Positive Cycle Time Continuous Sweep Continuous Frequency 50 pps Ramp 2 sec Display Voltage To modify treatment parameters prior to starting treatment e Use the up and down arrows located next to the ENTER button to navigate through the parameters available for HVPC e Once you have highlighted a desired parameter press ENTER to display a list of options available for this mode of treatment e Use the arrows once again to highlight a desired option and then press ENTER Set POWER INTENSITY using the controls located on the control panel The amplitude is displayed digitally on the LED adjacent the intensity cont
57. ing abbreviations are used on the sound head of the Forte CPS ultrasound Area Effective Radiating Area Coll Collimating BNR Beam Non Uniformity Ratio Freq Frequency COMBO Combination Therapy e Introduction e Quick Start e Indications Contraindications e Warnings Precautions e Preparation for Treatment e Detailed Treatment Procedures e Modify Treatment Parameters e Setting Up a Second Treatment Quick Start e Simultaneous Treatments Introduction to COMBO The Combo mode of treatment includes an ultrasound treatment combined with Premodulated PREMOD Interferential IFC High Voltage Pulsed Current HIVOLT or VMS In this treatment the aluminum face of the ultrasound head becomes one half of the electrical circuit The circuit is com pleted by an electrode attached to the red lead wire plugged into Channel 2 53 Quick Start The following is a quick step by step procedure for using Combo with PREMOD stimulation Before proceeding refer to treatment cautions Procedure Comments Turn power on The unit will go through self diagnostics followed by the main menu Prepare treatment site Follow steps in preparation for treatment Position electrodes Secure electrodes around area to be treated Channel 2 Red lead wire Press Combo To select Combination mode Set Waveform Preset to Premod on Channel 2 Coupling Agent Apply Ultrasound gel to the area to be
58. ions for descriptions of preset treatment parameters Change the presets to match your own most common treatment protocols or utilize the internal library of Clinical Protocols Refer to Clinical Protocol section for more information concerning Clinical Protocols Parameter adjustment ranges for pain modulation modes of stimulation Interferential Premodulated Microcurrent Function Electrodes Electrodes Electrodes Probes Carrier Frequency 5000 Hz 5000 Hz N A Beat Frequency 0 200 Hz 0 200 Hz 0 1 1000 Hz Scan Mode On Off N A N A Scan Time 15 sec N A N A Sweep Time 15 sec 15 sec N A Quadrant Balance Patient Control Center N A N A Duty Cycle N A Continuous 5 5 N A Ramp Up Down N A N A 1 sec only Cycle Time 15 sec Continuous 5 5 N A Alternating Time in Polarity N A N A 2 5 sec Polarity N A N A gt 4 Intensity CC N A 0 50 mA Peak 0 995 uA Intensity CV 0 50 Volts Peak 0 50 Volts Peak N A Treatment Time 1 to 60 min 1 to 60 min 1 to 60 min N A Not Applicable Parameter adjustment ranges for muscle contraction modes of stimulation Russian HIVOLT VMS Function Electrodes Electrodes Probes Electrodes Mode Single Reciprocal Single Reciprocal Single Reciprocal Co Contraction Co Contraction Co Contraction Carrier Frequency 2500 Hz N A N A Pulse Frequency N A 0 120 pps 5 200 pps Burst Frequency 20 100 Hz N A N A Phase Du
59. is no ultrasound sound head currently plugged in Corrective Action Attach correct sound head and fully seat the cable plug in the sound head connector Channels needed for this Mode are Busy The output Channels needed for this waveform are occupied with another treatment The user just pressed a stim button from the main screen but all stim Channels are currently running Corrective Action lt is not possible to select Channels which are already selected One Wire Device Failure Not communicating with the ultrasound applicator Corrective Action Check connection of the ultrasound applicator to the unit or the ultrasound applicator head may need service No Head Detected No ultrasound applicator head is connected or applicator head is damaged Corrective Action Check the connection quality of the ultrasound jack to the unit or ultrasound applicator head needs service HHH displayed on the output LED The temperature of the ultrasound head has exceeded 140 F The ultrasound output ceases and treatment time freezes until the head cools off and START button is pressed Corrective Action Stop ultrasound application and let applicator head cool Setting Up Channel Please Wait Selected electrotherapy session preparing to start Corrective Action None required Reading Calibration Data System is reading the ultrasound applicator head calibration Corrective Action None required 63 Glossary Amplitud
60. is used to ramp stimulation down prior to making a change 25 Technical Specifications for Premodulated Current Channels 1 4 Intensity CC 0 50 mA Peak Intensity CV 0 50 Volts Peak Carrier Frequency 5000 Hz Beat Frequency 0 200 Hz Maximum RMS Current Density 3 x 5 Electrode 5 2 mA mm 2 Diameter Electrode 24 7 mA mm Maximum Power Density 3 x 5 Electrode 365 mw mm 2 Diameter Electrode 1 74 mw mm Area of Conductive Surface 3 x 5 Electrode 15 in2 9 677 mm 1 5 8 x 2 Electrode 3 25 in2 2 096 mm 2 Diameter Electrode 3 14 in2 2 026 mm Premodulated WWW MICRO Microcurrent Microamperage Pulsed Current e Introduction e Quick Start e Setup Procedure Modifying Power up Presets Parameters e Preparation for Treatment e Detailed Treatment Procedures Treatment Cautions e Modifying Treatment Parameters e Technical Specifications Introduction to MICROCURRENT Monophasic rectangular wave with selectable or alternating polarity 50 duty cycle is fixed so pulse duration is inversely affected by changes in frequency Some clinicians prefer microcurrent because of the low current utilized With such low current the individual feels no discomfort and quite often feels no sensation at all during the treatment You can provide attended or unattended microcurrent therapy Use electrodes for longer unattended therapy sessions pads are usually placed on opposite sides of
61. ite Follow steps in preparation for treatment Position electrodes Secure electrodes in a criss cross fashion around area to be treated Press VMS To select VMS stimulation Set Intensity Set the output intensity for the selected channel Press Start To begin treatment End Treatment Remove electrodes and inspect treatment area Setup procedure VMS Follow this sequence of events to begin single channel VMS stimulation Step 1 Press VMS and set intensity of displayed Channel Ch Ws VMS Channel 1 Mode Single Cycle Time 10 50 Frequency 50 pps Ramp 2 sec Phase Dur 200 uSec CC CV CC Enter Modify Feature Start Begin Treatment Step 2 Press START to begin treatment Modifying Power up Preset Parameters With the exception of output intensity all power up preset parameters can be modified using the following sequence of steps 1 Select and change desired parameter setting next press ENTER 2 Next press and hold the PAUSE button then press the ENTER button 43 Preparation for Treatment Refer to section three to become familiar with the following Indications Contraindications Warnings Precautions and Adverse Effects for High Voltage Pulsed Current HVPC Detailed Treatment Procedures Remember that most patients are unfamiliar with electrical stimulation and may be anxious or apprehensive during the initial sensati
62. l regulations and codes Patients with an implanted neurostimulation device must not be treated with or be in close proximity to any shortwave diathermy microwave diathermy therapeutic ultrasound diathermy or laser diathermy anywhere on their body Energy from diathermy shortwave microwave ultrasound and laser can be transferred through the implanted neurostimulation system can cause tissue damage and can result in severe injury or death Injury damage or death can occur during diathermy therapy even if the implanted neurostimulation system is turned off Principles of Operation e Initial Setup Instructions e System Components Patient Control Center e Warranty Registration e Optional Accessories e System Operation Operating Controls Quick Start General Setup Steps Screen Layout Initial Setup Instructions Remove the Forte CPS unit and any additional items ordered from the carton and inspect for damage that may have occurred during shipment Check the voltage rating on the serial decal located on the bottom of the unit Plug the system power supply in to a 100 Volt to 220 240 Volt AC outlet as required DO NOT attempt to use Direct Current DC DO NOT attempt to use the unit if it is not properly grounded DO NOT place unit in a location where the power cord could be tripped over or pulled out during treatment Follow the procedures listed in the precautionary instructions located later in this section System
63. ll be changed before or during a treatment Appendix e Warranty e System Utilities e System Trouble Shooting e Maintenance e Screen Prompts 59 Forte CPS Two Year Limited Warranty The Chattanooga Group Company warrants that the Forte CPS Model 200 or 400 series Product excluding accessories is free of defects in material and workmanship This warranty shall remain in effect for two 2 years from the date of the original consumer purchase of this and extends to any owner of the product during the warranty period Accessories that are included as standard with the product as listed in the users manual are warranted for 90 days Ultrasound applicators 2 cm 5 cm or 10 cm as included with the Combo Combination units are warranted for one 1 year If this product fails to function during the two year warranty period because of a defect in material or workmanship the company or the selling dealer will replace or repair this product without charge within a period of 30 days from the date on which the defective product is returned to the company or the dealer The company or the dealer will ship the replacement or the repaired product to the owner All repairs must be performed by a service center authorized by the Chattanooga Group Any modifications or repairs performed by unauthorized centers or groups will void this warranty To participate in warranty coverage the products warranty registration card included with th
64. meters must be displayed on the LCD and LED respectively Modify LED functions Treatment Time and Output Intensity Select the channel you wish to modify and Treatment Time and Output will be displayed digitally on the display LEDs 1 B Channel Min Sec Output o POWER T INTENSITY Suggestion Some patients may not tolerate parameter changes during a session unless the PAUSE key is used to ramp stimulation down prior to making a change Modify LCD functions HVPC Prior to or while a session is in progress you can modify any of the LCD waveform parameters as desired The following describes the general progression for changing parameters The left side of the screed lists the parameters that can be modified Move the highlight box to the desired parameter and press ENTER a list of options is displayed on the right side of the screen Move the highlight box to the desired option and press ENTER If no list of options is displayed this indicates that there are less than four choices and you may select them by continuing to press ENTER HVPC Parameter Options Method Pads Probes Polarity Positive or Negative Cycle Time 5 5 10 10 10 20 4 12 10 30 10 50 or Continuous Sweep Continuous 1 10 Hz 80 150 Hz or 1 150 Hz Frequency 0 120 pps Ramp 0 5 1 2 or 5 sec Display Voltage or Peak Current 40 Eh 23 HIVOLT Channel Method Pads Polarity Positive Cycle Time Conti
65. ng messages are displayed in the middle of the screen called the OK Window The screen message is displayed as seen below the corrective action message presented in this section will help you to correct the situation Overcurrent on Channel An excessive change in the current has occurred This means that the change between current values has exceeded the Forte preset limit When this prompt occurs the Channel and all associated Channels on this run are stopped Corrective Action Check electrodes and leads Replace if defective Ultrasound overcurrent fault An overcurrent fault has occurred on the ultrasound This means that the current has exceeded the built in limits of the Forte System for that particular sound head size When this error occurs the Channel and all associated Channels on this run are stopped Corrective Action Restart unit using lower intensity Patient Terminated Treatment The patient has pushed the patient safety switch This immediately stops all active Channels Corrective Action Attend to patient Check operation of unit If malfunctioning return for repair 62 Ultrasound already active The user just pressed the US ultrasound button from the main screen but the ultrasound is already running Corrective Action Only one ultrasound treatment at a time is possible Sound head not connected The user just pressed the US ultrasound button from the main screen but there
66. ns with suspected or diagnosed epilepsy e DO NOT stimulate over the carotid sinus nerve especially in persons with a known sensitivity to the carotid sinus reflex e Severe spasm of the laryngeal and pharyngeal muscles may occur if the electrodes are placed over the neck or mouth The contractions may be strong enough to cause breathing difficulty or even close the airway e DO NOT perform therapeutic electrical stimulation transcerebrally through the head e Therapeutic electrical stimulation should not be applied over swollen infected or inflamed areas of skin eruptions e g phlebitis thrombophlebitis and varicose veins e Use extreme caution in transthoracic application of therapeutic electrical stimulation introduction of electrical current into the heart may cause arrhythmia e This device should only be used under medical supervision for adjunctive therapy for the treatment of medical diseases and conditions e This device should be kept out of the reach of children Precautions should be observed in the presence of the following e Following recent surgical procedures especially when muscle contractions could disrupt the healing process e Where sensory nerve damage is present by a loss of normal skin sensation e When there is a tendency to hemorrhage following acute trauma or fracture e Over the menstruating uterus e Some patients may experience skin irritation or hypersensitivity due to the electrical stimulation or t
67. ntrol Center for easy location of the treatment site and delivery of the full interferential beat where it is needed You can choose the high frequency range the low frequency range or both along with Scan when you want to deliver the therapeutic current over a more general area Quick Start The following is a quick step by step procedure for using interferential stimulation Before proceeding refer to treatment cautions Procedure Comments Turn power on The unit will go through self diagnosis followed by the main menu Prepare treatment site Follow steps in preparation for treatment Position electrodes Secure electrodes around area to be treated Press IFC To select interferential stimulation Set Intensity Set intensity level for both Channels Press Start To begin treatment End Treatment Remove electrodes and inspect treatment area 17 Setup Procedure INTERFERENTIAL IFC The following sequence of events are followed to begin an Interferential treatment Step 1 Press IFC and set intensity of both Channels Gh T 2 IFC T Ch Select Both Ch Amp Mod 40 Scan Beat Freq 80 150 Hz Enter Modify Feature Start Begin Treatment Step 2 Press START to begin treatment Modifying Power up Preset Parameters With the exception of output intensity all power up preset parameters can be modified using the following sequence of steps 1 Select and ch
68. ntrol button 8 Press Start to initiate the treatment The stimulation will ramp up to the set values and the Main Menu will reappear displaying the Channels and waveforms in use as well as the treatment time remaining for each Channel 9 To modify settings during treatment It is recommended that you Pause the treatment session prior to implementing a parameter change e Select the Channel to modify from the Main Menu e Press ENTER to display parameters of that Channel on both the LCD and LED displays e You may want to choose PAUSE to interrupt treatment or lower the intensity prior to making changes in treatment parameters to prevent the possibility of undesirable sensation that could be perceived with a change in parameters e Once you have highlighted a desired parameter press ENTER to display a list of options available for this mode of treatment e Use the arrows once again to highlight a desired option and then press ENTER to accept e Press START to resume treatment 10 Terminating Treatment When treatment ends a tone will sound and the intensity will ramp to 0 Remove electrodes from patient and inspect area of skin treated Modifying Treatment Parameters Treatment parameters can be modified prior to or during a treatment session To modify Premod or any session parameters the session parameters must be displayed on the LCD and LED respectively 24 Modify LED functions Treatment Time and Output Intensity
69. nuous Sweep Continuous Frequency 100 pps Ramp 2 sec Display Voltage Enter Modify Feature Start Begin Treatment Technical Tip Polarity You can set the polarity of the red active lead wire in relation to the black reference lead wire The red active lead wire delivers the treatment current while the black reference lead wire completes the patient circuit Suggestions Some patients may not tolerate parameter changes during a session unless the PAUSE key is used to ramp stimulation down prior to making a change Technical Tip Cycle Time The contraction rest cycle time Options are displayed with the contraction ON time first followed by the rest cycle The continuous cycle time option gives continuous stimulation output A 10 50 cycle time means a 10 second contraction time followed by a 50 second rest time Sweep The system automatically changes the frequency with in a selected range Display A unique feature that will display output as Voltage or Peak Current High Voltage Pulsed Current HVPC Application with Hand Held Probes Optional 1 Place the power switch in the On position The display screen will indicate the machine is going through its power up procedures and system checks When completed the main menu will appear on the screen Press HIVOLT as the desired treatment from the control panel Attach the probe to the red lead wire from active channel Apply an electrode to the black
70. o and during a treatment session Note The option of Quad Balance will only appear in the parameter change box if it is properly mounted on the back of the unit Setting Channel Output The power up preset delivers stimulation from both Channels simultaneously This can be modified so stimulation can be set one Channel at a time if so desired To make this selection follow these commands With the highlight bar positioned over Ch Select parameter press Enter This will change output intensity settings to Channel 1 At this point raise the intensity of Channel 1 using the Power Intensity keys When at desired levels press Enter to set Channel 2 The intensity level of Channel 1 will remain on as Channel 2 intensity level is being set Technical Specifications for Interferential Current Output Channels 1 4 Intensity CV 0 50 Volts Peak Carrier Frequency 5000 Hz Channels 1 2 for CPS 200 Series 1 2 3 and 4 for CPS 400 Series Beat Frequencies 0 200 Hz Maximum RMS Current Density 3 x 5 Electrode 5 2 mA mm 2 Diameter Electrode 24 7 mA mm Maximum Power Density 3 x 5 Electrode 365 mw mm 2 Diameter Electrode 1 74 mw mm Area of Conductive Surface 3 x 5 Electrode 15 in2 9 677 mm 1 5 8 x 2 Electrode 3 25 in2 2 096 mm 2 Diameter Electrode 3 14 in2 2 026 mm Interferential Channel 1 DAAADADAADA Interferential Channel 2 AAN Interferential WANNA
71. o using the combination set up Warnings Precautions e Do not use combination therapy for underwater treatments Placing active electrodes underwater poses a serious hazard to the patient e Just as with therapeutic electrical stimulation treatments current travels between the two electrodes In the case of combination stim sound the ultrasound head becomes one of the active electrodes As a result the ground or dispersive electrode should not be placed in a location that will cause current to travel through a contraindicated area e Make sure the sound head is making contact with the patient s skin before pressing START Otherwise the stim current may cause the patient some discomfort upon initial contact Maintain contact of the sound head with the skin surface during the entire combination treatment this will prevent an increase in current density which may be uncomfortable to the individual e Be on the alert for signs of periosteal bone pain or any other unusual reactions to this method of treatment Preparation for Treatment Refer to section three to become familiar with the following e Indications and contraindications for interferential premodulated VMS and High Voltage Pulsed Current e Preventing adverse effects of therapeutic electrical stimulation Detailed Treatment Procedures 1 Place the power switch in the ON position The display screen will indicate the machine is going through its power up proc
72. ode The frequency automatically changes or sweeps from the HIGH to the LOW value and back in the time designated Ultrasound Intensity Ultrasound power delivered to the patient expressed in total power as watts VV or in terms of the sound head s effective radiating area watts per centimeter squared W cm VMS A symmetrical biphasic square wave that treats the tissue under each electrode equally Its single pulses have the same physiologic function as the beat frequency of the interferential current Low total current makes this Waveform good for comfortable submaximal muscle contractions 66 A CHATTANOOGA GROUP ia ISO 13485 CERTIFIED 4717 Adams Road P O Box 489 Hixson TN 37343 1 800 592 7329 1 423 870 2281 2004 Encore Medical www chattgroup com 780811
73. om of the screen to prompt you to action The Main Menu will reappear after you have initiated a treatment providing a status of the Channels in use and available waveforms selected and elapsed treatment time Main Menu Available Available Available Available Available Enter Modify Feature Start Begin Treatment 2 Active Parameter Display Screen Active Parameter Display Screen When a waveform is selected for use that waveforms preset parameters will be displayed on the LCD Basic text help is displayed at the bottom to prompt the user to action 3 Parameter Change Screen Parameter Change Screen In this example moving the highlight bar to Beat Frequency and pressing ENTER will display the available Beat Frequency parameter options Moving the highlight bar to Fixed Frequency and pressing ENTER will display the Fixed Frequency change box 9 Parameter Change Box and Display of Inactive Parameters The once Inactive Beat Fixed option is active highlighted with a change box surrounding its preset value of 100 Hz At this point the user can modify this value using the up or down arrow keys After making a modification you must press ENTER to validate the change NOTE This same sequence of active and inactive parameter options and change sequences is repeated for all waveforms Parameter Adjustment Each mode of treatment offers preset treatment parameters for quick set up Refer to individual sect
74. on of current If the patient is extremely fearful either discontinue the treatment or set the Amplitude at a level where the patient just feels the current Allow the individual to become accustomed to the current before increasing the intensity Treatment Cautions e Never turn the power on or off while the unit is connected to the individual e Stop the treatment before removing or attaching electrodes or leads e Leads and electrodes should be applied to the patient before a treatment is initiated e Never use leads or electrodes that are damaged or worn this may result in injury to the patient e Consult published sources for electrode placements settings and treatment duration e Make sure all electrodes make full contact with the patient s skin 1 Place the power switch in the On position The display screen will indicate the machine is going through its power up procedures and system checks When completed the main menu will appear on the screen 2 Connect electrodes to lead wires and plug into jacks for Channels selected Certain Channels are designated for specific modes of treatment 3 Adhere electrodes to the location to be treated Refer to guidelines under preparation for treatment earlier in this section 4 Select VMS for a symmetrical biphasic square wave current Refer to the information on indications and contraindications in section three 5 View and verify the preset parameters for VMS curr
75. or each Channel 9 To modify settings during treatment It is recommended that you Pause the treatment session prior to implementing a parameter change e Select the Channel to modify from the Main Menu e Press ENTER to display parameters of that Channel on both the LCD and LED displays 28 e You may want to choose PAUSE to interrupt treatment or lower the intensity prior to making changes in treatment parameters to prevent the possibility of undesirable sensation that could be perceived with a change in parameters e Use the up and down arrows located next to the ENTER button to navigate through the parameters available for Microcurrent e Once you have highlighted a desired parameter press ENTER to display a list of options available for this mode of treatment e Use the arrows once again to highlight a desired option and then press ENTER to accept e Use the Treatment Time Control to alter treatment time e Press START to resume treatment 10 Terminating Treatment When treatment ends a tone will sound and the intensity will ramp to 0 Remove electrodes from patient and inspect area of skin treated Modifying Treatment Parameters Treatment parameters can be modified prior to or during a treatment session To modify Microcurrent or any session parameters the session parameters must be displayed on the LCD and LED respectively Modify LED functions Treatment Time and Output Intensity Select the Channel you wish to modify
76. ptional 0 0 0 0 cece eee eee 30 TECHMICAlSPECITICATIONS ti eval weds eset its dete Ne lg Sal aoa hoe coed AS es 31 RUSSIAN Interrupted Sine Wave 0 0 00 eee 32 QUICK Start jo hele A eek aed tad cea A oe orl dl eaten eh chee Ae 33 Hetailed Treatment Procedures ri Be ea ek tae EN Balen Sia Nee SRA Pee aes 34 Modifying Treatment Parameters 0 eee ee eee eee 35 Russian Parameter Options 2 09 bee et de and Pek ete eet eee lee tdo 36 Technical Specifications oo hehe eink bee Beda hee nae ee h idee Bde pi 36 HIVOLT High Volt Monophasic Twin Peak Pulsed Current 00 000 0000 oo 37 STA A A tA dhs A talk ee dh Spe id oh dt O Og hel 37 Detailed Treatment Procedures x nudos o esd teed es oe a eee has Ste ek ees ee SN 38 Modifying Treatment Parameters vesie oteaan eee eee ees 40 HIVOET Parameter OptOns s cv seeks cag Bale an Cae OR OE WR Oe oe eee ete ed 40 HIVOLT Application with Hand Held Probes Optional 0 00 eee 41 Technical Specifications erws idisko enda tile ele aged bebe ba ete beled ag el ain 42 VMS Symmetrical Biphasic Square Wave 0 eee eae 42 QUICK Start at a eh acs eee hace tags ce Bool are bho tt taa baaa oN A 43 Detailed Treatment Procequres Bi VES didas a Det da e a tee Rte e nl e 44 Moditying Treatment Parameters 2 23 is torens d dete nE ee eee A BK done ES Sok bed 45 VMS Parameter Options is She cea ae A ate a an 46 Technical pe Cinca ON St A e Boe bee B
77. r very short duration pulses which are very low in charge or power output Treatment can be administered using either pads or probes and intensity displays are available in Volts or Peak Current Twin Peak High Volt current is available from Channel 1 amp 2 from Forte 200 series products and all Channels with the 400 series of products Quick Start The following is a quick step by step procedure for using HVPC stimulation Before proceeding refer to treatment cautions Procedure Comment Turn power on The unit will go through self diagnostics followed by the main menu Prepare treatment site Follow steps in preparation for treatment Position electrodes Secure electrodes around area to be treated Press HIVOLT To select High Volt stimulation Set Intensity Adjusting intensity will affect amplitude for both Channels Press Start To begin treatment End Treatment Remove electrodes and inspect treatment area 37 Setup procedure High Voltage Pulsed Current HVPC Follow this sequence of events to begin single Channel HVPC stimulation Step 1 Press HIVOLT and set intensity of displayed Channel Ch i HIVOLT Channel Method Pads Polarity Positive Cycle Time Continuous Sweep Continuous Frequency 100 pps Ramp 2 sec Display Voltage Enter Modify Feature Start Begin Treatment Step 2 Press START to begin treatment Modifying Power up Preset Parame
78. ration N A N A 20 300 microseconds Interphase Interval N A N A 100 microseconds Duty Cycle 10 50 N A N A Ramp Up Down 5 1 2 5 sec N A 5 1 2 5 sec Cycle Time 5 5 10 10 10 20 4 12 5 5 10 10 10 20 4 12 5 5 10 10 10 20 4 12 10 30 10 50 10 30 10 50 10 30 10 50 Continuous Continuous Continuous Polarity N A Pos Neg N A Intensity CC 0 100 mA Peak N A 0 200 mA Peak Intensity CV 0 100 Volts Peak 0 500 Volts Peak 0 200 Volts Peak Treatment Time 0 60 min 0 99 min 0 60 min N A Not Applicable Parameter adjustment ranges for ultrasound mode Function Ultrasound Frequency 1 MHz amp 3 3 MHz Duty Cycle 10 20 50 amp Continuous Applicator Sizes 2cm 5 cm amp 10 cm Ultrasonic Power Variable from 1 20 watts Treatment Timer 0 15 min Class BF Indications Contraindications Adverse Effects for Electrical Stimulation e Interferential Premodulated Indications Contraindications Warnings Precautions Adverse Ef e VMS Russian High Volt Indications Contraindications Warnings Precautions Adverse Ef e Microcurrent Indications Contraindications Warnings Precautions Adverse Ef e Ultrasound Indications Contraindications Warnings Precautions Adverse Ef E ects ects ects E ects Interferential Current Indications e Symptomatic relief of chronic intractable p
79. rol button Press START to initiate the treatment LED treatment timer will begin to display elapsed time and Main Menu will reappear updated with waveform Channels in use and available as well as elapsed time To modify settings during treatment It is recommended that you Pause the treatment session prior to implementing a parameter change e Select the Channel to modify from the Main Menu e Press ENTER to display parameters of that Channel on both the LCD and LED displays e You may want to choose PAUSE to interrupt treatment or lower the intensity prior to making changes in treatment parameters to prevent the possibility of undesirable sensation that could be perceived with a change in parameters e Once you have highlighted a desired parameter press ENTER to display a list of options available for this mode of treatment e Use the arrows once again to highlight a desired option and then press ENTER to accept e Use the Treatment Time Control to alter treatment time from the arrows on the control panel e Press START to resume treatment Terminating Treatment When treatment ends a tone will sound and the intensity will ramp to 0 Remove electrodes from patient and inspect area of skin treated 39 Modifying Treatment Parameters Treatment parameters can be modified prior to or during a treatment session To modify High Voltage Pulsed Current HVPC or any session parameters the session para
80. s Power Intensity Control e Select this prompt to set or modify output intensity or amplitude Waveform Selection Buttons e IFC Interferential Stimulation This mode of therapy delivered with two Channels and four electrodes includes the Chattanooga Group unique Quad Balance Patient Control Center for easy location of the treatment area Choose the high frequency range the low frequency range or both along with Scan to deliver current to a more general area e PREMOD Premodulated Stimulation Excellent for treating small areas or where the placement of four electrodes is not practical This mode is quite versatile as it offers a premodulated interferential current using one Channel and two electrodes You may choose to set up two separate premodulated treatments at the same time using two Channels e RUSSIAN Russian Stimulation Through this mode you can deliver muscle stimulation treatments choosing from a list of options including Single Reciprocal and Co Contraction Choose from various cycle times and ramp times or customize the burst frequency e HIVOLT High Volt Stimulation The Forte Twin Peak HIVOLT is designed to deliver very short duration pulses which are very low in charge or power output Treatment can be administered using either pads or probes Intensity displayed in Volts or Peak Current to aid in documentation e MICRO Microcurrent Stimulation Deliver Microcurrent using hand held probes for manual attended
81. s Know the limitations and hazards associated with using any electrical stimulation or ultrasound device Observe the precautionary and operational decals placed on the unit DO NOT operate the Forte CPS when connected to any unit other than Chattanooga Group devices Do not operate the unit in an environment of short wave diathermy use Federal law restricts this device to sale by or on the order of a physician or licensed practitioner This device should be used only under the continued supervision of a physician or licensed practitioner Keep electrodes separated during treatment Electrodes in contact with each other could result in improper stimulation or skin burns This unit is not designed to prevent the ingress of water or liquids Ingress of water or liquids could cause malfunction of internal components of the system and therefore create a risk of injury to the patient The Ultrasound generator should be routinely checked before each use to determine that all controls function normally especially that the intensity control does properly adjust the intensity of the ultrasonic power output in a stable manner Also determine that the treatment time control does actually terminate ultrasonic power output when the timer reaches zero 2 AX CAUTION AN CAUTION AX CAUTION WARNING Ay WARNING Ay WARNING AX WARNING Ay WARNING A DANGER Use of controls or adjustments or performance of procedures other than
82. s during treatment It is recommended that you Pause the treatment session prior to implementing a parameter change e Select the Channel to modify from the Main Menu e Press ENTER to display parameters of that Channel on both the LCD and LED displays e You may want to choose Pause to interrupt treatment or lower the intensity prior to making changes in treatment parameters to prevent the possibility of undesirable sensation that could be perceived with a change in parameters e Once you have highlighted a desired parameter press ENTER to display a list of options available for this mode of treatment e Use the arrows once again to highlight a desired option and then press ENTER to accept e Use the Treatment Time Control to alter treatment time from the arrows on the control panel e Press START to resume treatment 10 Terminating Treatment When treatment ends a tone will sound and the intensity will ramp to 0 Remove electrodes from patient and inspect area of skin treated 19 Modifying Treatment Parameters Treatment parameters can be modified prior to or during a treatment session To modify interferential or any session parameters the session parameters must be displayed on the LCD and LED respectively Modify LED functions Treatment Time and Output Intensity Select the Channel you wish to modify Treatment Time and Output will be displayed 2 15 00 00 Channel Min Sec Output POWER bm
83. se measurements are with load impedance of 1 000 ohms Pulse duration varies according to body impedance load resistance Channel 1 amp 2 Forte 200 Stim and Combo and 1 2 3 amp 4 Forte 400 Stim and Combo Voltage Current 0 500 Volts CV Frequency 1 120 pulses per second Maximum Average Current Density at Electrodes 23 microamps mm 3 electrode Maximum Power Density at Electrode 69 microwatts mm 3 electrode High Voltage Pused Waveform High Volt Peak Current 500 V l 100 ps 9900 ps Pulse Duration Interpulse Interval VMS Symmetrical Biphasic Square Wave e Introduction e Quick Start e Setup Procedure Modifying Power up Presets Parameters e Preparation for Treatment e Detailed Treatment Procedures Treatment Cautions e Modifying Treatment Parameters e Technical Specifications 42 Introduction to VMS A symmetrical biphasic square wave that treats the tissue under each electrode equally Its single pulses have the same physiologic function as the beat frequency of the interferential current Low total current makes this waveform good for comfortable submaximal muscle contractions Quick Start The following is a quick step by step procedure for using VMS stimulation Before proceeding refer to treatment cautions Procedure Comments Turn power on The unit will go through self diagnostics followed by the main menu Prepare treatment s
84. sion prior to implementing a parameter change e Press the channel to modify from the Main Menu e Press ENTER to display parameters of that channel on both the LCD and LED displays e You may want to choose PAUSE to interrupt treatment or lower the intensity prior to making changes in treatment parameters to prevent the possibility of undesirable sensation that could be perceived with a change in parameters e Once you have highlighted a desired parameter press ENTER to display a list of options available for this mode of treatment e Use the arrows once again to highlight a desired option and then press ENTER to accept e Use the Treatment Time Control to alter treatment time e Press START to resume treatment 10 When treatment time has expired a tone will sound The amplitude will ramp to zero remove electrodes from patient and wipe excess coupling agent from skin and sound head 56 Modifying Treatment Parameters Please refer to Ultrasound Modify Treatment Parameters section and Premod Modify Treatment Parameters section for modification parameters Setting Up a Second Treatment After setting up the first treatment you may wish to set up a second or third treatment Select the waveform you wish to use by pressing the appropriate button on the control panel You may choose the same waveform s selected for the first treatment for example PREMOD and PREMOD or a different waveform When you s
85. t Microcurrent 0 0 0 0 cc eee eens 15 Mieroctirrent Probesiais 2 3 5 0 gobi a O Pan eae RAD Bundy hae a aad eed ad 16 PINOT RODS orcas rascar i oth eas fhe teh aa e AE at tt Det dl Oe tard dl hoe Ate As A LA LS an 16 IEG Interterential Curent Sine Wave sit eal hed ea od ee ea tod ate i E ed 17 QUICK Start yee dt Sieh ae eect dete O E A iA 17 Detailed Treatment Procedures ose Sova Sk ee SCR el Sad ee Beaten Sen RS Sean Le OA aces 18 Modifying Treatment Parameters 2 0 0 0 eee ee eens 20 Interferential Parameter Options ooo 20 Technical SpeciticatiOAS 4 4 ete d ll Reade Gt ng sate ante ie id a 21 PREMOD Premodulated Sine Wave eresi erea eean eee nae 22 QUICK Start ie eet Bie AI hate a an ee tase AON ah apenas AS 22 Detailed Treatment Procedures sa Lion win And eed etd ee Ad Gee a Se wes aw ee Sd 23 Modifying Treatment Parameters e ssaa iee tradera eee eee a a ees 24 Premod Parameter Optlons x osoa Gre 88 wah oe oe PRAT ea Oe Sha ak oda RE Gee aes 25 Technical Sp cifications gt 2 chez miie a o tia addy aoe Gh acne tant a son RE A Seems 26 MICRO Microcurrent Microamperage Pulsed Current 0 0 0 0 aaan aana a 26 QUICK Stan a We eA a A A ar Oikos pira a 27 Detailed Ir atment Proceduress lt 2 dla endo o tee dl en o dd o e dt ss dd toe OE 28 Modifying Treatment Parameters Cog Loan a eee nee eee 29 Microcurrent Parameter Options encia new odes Oo ee es en Dele 29 Microcurrent Application with Hand Held Probe O
86. tached to an electrode and placed neat the treatment site e Select the parameters you wish to change then press the start button to begin treatment NOTE Place the reference electrode as close to the treatment site as possible where it will not interfere with placement of the active electrode for example do not place the reference electrode on the leg if you are treating the arm 16 Treatment Timer Once you press the start button the timer will count from the preset time parameter to zero When the current is stopped the timer will reset to the previous time setting Press the start button again to begin a new treatment continue in this way until the session is completed IFC Interferential Current Sine Wave e Introduction e Quick Start e Setup Procedure Modifying Power up Presets Parameters e Preparation for Treatment e Detailed Treatment Procedures Treatment Cautions e Modifying Treatment Parameters e Technical Specifications Introduction to Interferential Interferential current consists of two Channels with two sinusoidal waveforms one of fixed frequency and one of variable frequency When the four electrodes are positioned so the two Channels cross each other the waveforms mix within the tissues to produce a train of pulses whose frequency and amplitude are dependent on the sweep mode beat frequency and amplitude settings respectively This mode of therapy also includes Chattanooga Group s unique Patient Co
87. tarting treatment e Use the up and down arrows located next to the ENTER button to navigate through the parameters available for Russian current e Once you have highlighted a desired parameter press ENTER to display a list of options available for this mode of treatment e Use the arrows once again to highlight a desired option and then press ENTER 7 Set Power Intensity using the controls located on the control panel The amplitude is displayed digitally on the LED adjacent the intensity control button Set the output intensity for the displayed Channel using the arrow keys located next to the Power Intensity button 8 Press Start to initiate the treatment The stimulation will ramp up to the set values and the Main Menu will reappear displaying the Channels and waveforms in use as well as the treatment remaining for each Channel 34 9 To modify settings during treatment It is recommended that you Pause the treatment session prior to implementing a parameter change e Select the Channel to modify from the Main Menu e Press ENTER to display parameters of that Channel on both the LCD and LED displays e You may want to choose PAUSE to interrupt treatment or lower the intensity prior to making changes in treatment parameters to prevent the possibility of undesirable sensation that could be perceived with a change in parameters e Once you have highlighted a desired parameter press ENTER to display a list of options
88. ted w Adhere electrodes to the location to be treated Secure electrodes in the area to be treated Refer to guidelines under preparation for treatment earlier in this section gt Select IFC for interferential current 5 View and verify the preset parameters for interferential current Preset parameters for interferential current Beat Frequency 80 150 Hz Amplitude Modulation 40 Scan Treatment Time 15 minutes D To modify treatment parameters prior to starting treatment e Use the up and down arrows located next to ENTER button to navigate through the parameters available for interferential current Time and output intensity is modified with the keys below their LED display e Once you have highlighted a desired parameter press ENTER to display a pop up menu of options available for this mode of treatment e Use the up and down arrows to highlight the desired option then press ENTER 7 Set Power Intensity using the controls located on the control panel Set the output intensity for both Channels in use using the arrow keys located next to the POWER INTENSITY button The amplitude is displayed digitally on the LED adjacent the intensity control button 8 Press Start to initiate the treatment The stimulation will ramp up to the set values and the Main Menu will reappear displaying the Channels and waveforms in use as well as the treatment time remaining for each Channel 9 To modify setting
89. tensity of displayed Channel Ch Tz Premod Channel 1 Cycle Time Continuous Beat ipp eq 80 150 Hz CC Cv CV Enter Modify Feature Start Begin Treatment Step 2 Press Start to begin treatment Modifying Power up Preset Parameters With the exception of output intensity all power up preset parameters can be modified using the following sequence of steps 1 Select and change the desired parameter setting then press ENTER 2 Next press and hold the PAUSE button then press the ENTER button Preparation for Treatment Refer to section three to become familiar with the following Indications Contraindications Warnings Precautions and Adverse Effects for Premodulated current Detailed Treatment Procedures Remember that most patients are unfamiliar with electrical stimulation and may be anxious or apprehensive during the initial sensation of current If the patient is extremely apprehensive either discontinue the treatment or set the Output Intensity at a level where the patient just feels the current Allow the individual to become accustomed to the current before increasing the intensity Treatment Cautions e Never turn the power on or off while the unit is connected to the individual e Stop the treatment before removing or attaching electrodes or leads Leads and electrodes should be applied to the patient before a treatment is initiated e Never use leads or electrodes that are damaged or worn
90. ters With the exception of output intensity all power up preset parameters can be modified using the following sequence of steps 1 Select and change desired parameter setting next press ENTER 2 Next press and hold the PAUSE button then press the ENTER button Preparation for Treatment Refer to section three to become familiar with the following Indications Contraindications Warnings Precautions and Adverse Effects for HVPC current Detailed Treatment Procedures Remember that most patients are unfamiliar with electrical stimulation and may be anxious or apprehensive during the initial sensation of current If the patient is extremely fearful either discontinue the treatment or set the Amplitude at a level where the patient just feels the current Allow the individual to become accustomed to the current before increasing the intensity Treatment Cautions e Never turn the power on or off while the unit is connected to the individual e Stop the treatment before removing or attaching electrodes or leads e Leads and electrodes should be applied to the patient before a treatment is initiated e Never use leads or electrodes that are damaged or worn this may result in injury to the patient e Consult published sources for electrode placements settings and treatment duration e Make sure all electrodes make full contact with the patient s skin 38 Application of High Voltage Pulsed Current HVPC Us
91. the On position The display screen will indicate the machine is going through its power up procedures and system checks When completed the main menu will appear on the screen 2 Connect electrodes to lead wires and plug into jacks for Channels selected All Channels are available for Microcurrent treatment 3 Adhere electrodes to the location to be treated Refer to guidelines under preparation for treatment earlier in this section 4 Press MICRO for Microcurrent current Refer to the information on indications and contraindications in section three 5 View and verify the preset parameters for Microcurrent electrode therapy Preset parameters for Microcurrent Therapy Method Pads Waveform Bipolar Frequency Steps Fine Frequency 0 1 Hz 6 To modify treatment parameters prior to starting treatment e Use the up and down arrows located next to the ENTER button to navigate through the parameters available for Microcurrent e Once you have highlighted a desired parameter press ENTER to display a list of options available for this mode of treatment e Use the arrows once again to highlight a desired option and then press ENTER 7 Set Power Intensity using the controls located on the control panel 8 Press Start to initiate the treatment The stimulation will ramp up to the set values and the Main Menu will reappear displaying the Channels and waveforms in use as well as the treatment time remaining f
92. the exception of output intensity all power up preset parameters can be modified using the following sequence of steps 1 Select and change the desired parameter setting then press ENTER 2 Next press and hold the PAUSE button then press the ENTER button Preparation for Treatment Refer to section three to become familiar with the following Indications Contraindications Warnings Precautions and Adverse Effects for Microcurrent current 27 Detailed Treatment Procedures Remember that most patients are unfamiliar with electrical stimulation and may be anxious or apprehensive during the initial sensation of current If the patient is extremely fearful either discontinue the treatment or set the Amplitude at a level where the patient just feels the current Allow the individual to become accustomed to the current before increasing the intensity Treatment Cautions e Never turn the power on or off while the unit is connected to the individual e Stop the treatment before removing or attaching electrodes or leads Leads and electrodes should be applied to the patient before a treatment is initiated e Never use leads or electrodes that are damaged or worn this may result in injury to the patient e Consult published sources for electrode placements settings and treatment duration e Make sure all electrodes make full contact with the patient s skin Pads Electrode Application of Microcurrent 1 Place the power switch in
93. this may result in injury to the patient e Consult published sources for electrode placements settings and treatment duration e Make sure all electrodes make full contact with the patient s skin 1 Place the power switch in the On position The display screen will indicate the machine is going through its power up procedures and system checks When completed the main menu will appear on the screen 23 2 Connect electrodes to lead wires and plug into jacks for Channels selected 3 Adhere electrodes to the location to be treated Refer to guidelines under preparation for treatment earlier in this section 4 Press PREMOD for premodulated current Refer to the information on indications and contraindications in section three 5 View and verify the preset parameters for Premodulated current Preset Parameters for Premod Beat Frequency 80 150 Hz Treatment Time 15 minutes 6 To modify treatment parameters prior to starting treatment e Use the up and down arrows located next to the ENTER button to navigate through the parameters available for Premodulated current e Once you have highlighted a desired parameter press ENTER to display a list of options available for this mode of treatment e Use the arrows once again to highlight a desired option and then press ENTER 7 Set Power Intensity using the controls located on the control panel The amplitude is displayed digitally on the LED adjacent the intensity co
94. tion of muscle spasms Technical Specifications for VMS Symmetrical Biphasic Description Symmetrical biphasic rectangular pulse with interphase interval between the positive and negative phases Channels 0 200mA Peak Intensity CC 0 200 mA Peak Intensity CV 0 200 Volts Peak Pulse Frequency 5 200 Biphasic Pairs Second Phase Duration 20 300 microseconds Interphase Interval 100 microseconds VMS Wave Forms Symmetrical Biphasic Rectangular Waveform 46 VMS Wave Forms Symmetrical Biphasic Rectangular Waveform lt Phase Duration lt Interphase Interval Pulse Rate Pulse Train US Ultrasound e Introduction e Quick Start e Setup Procedure Modifying Power up Preset Parameters e Indication e Contraindications e Precautions Ultrasound Applicators Electronic Signature Head Warming e Detailed Treatment Procedures e Modifying Treatment Parameters e Technical Specifications Introduction to Ultrasound Therapy Utilizing ultrasound waves through muscle nerve and connective tissue has been well documented as effective in reducing pain muscle spasms and joint contractures There are 3 ultrasound applicators available with the Forte CPS Combo 2 cm 5 cm and 10 cm Frequency of 1 MHz or 3 3 MHz may be selected both before and during treatment 47 Quick Start The following is a quick step by step procedure for using ultrasound US Befor
95. trasound frequency is measured in cycles per second and is determined by the size and shape of the crystal All the available Forte CPS sound heads 2 cm 5 cm and 10 cm are capable of providing 1 or 3 3 MHz frequencies Duty Cycle Continuous or pulsed settings are available 51 Technical Tip Display Ultrasound output can be displayed in Watts or Watts cm W cm You will see a value change in the Output LED read out when you toggle the display from the preset watts cm to Watts For example when using a 5 cm head an output value of 1 5 W cm will be displayed as 6 0 Watts if display is changed Technical Note Head Warm From the parameter screen head warm is turned on and off Head warm is activated when you return to the main menu where the display will say WARM You will notice the LED output displaying 2 watts of output to rapidly warm the applicator to slightly above skin temp Output will drop to a 2 watt maintenance level to keep applicator head warm Technical Specifications for Ultrasound Channel U Ultrasouna Ultrasound Frequency 1 0 MHz 5 3 3 MHz 5 Duty Cycle 100 Continuous Mode 50 Pulsed Mode 20 Pulsed Mode 10 Pulsed Mode Pulse Duration 5 msec 20 50 duty cycle pulsed mode 2 msec 20 20 duty cycle pulsed mode Ultrasonic Power Variable from 1 watt to 20 watts 10 cm crystal Variable from 0 4 watt to 10 watts 5 cm crystal Variable from
96. treated Set Intensity Set ultrasound output intensity followed by premod intensity Press Start To begin treatment End Treatment Remove electrodes clean and inspect treatment area Combination Therapy Parameter Options The following sequence of events are followed to begin Combination treatment with PREMOD Step 1 Press COMBO set Ultrasound Output intensity on Ch U and press ENTER Ch 2 U Combo 5cm Ch Select Ultrasound US Freq 1 MHz Duty Cycle Continuous Display W cm2 Head Warm OFF Mode Premod Enter Modify Feature Start Begin Treatment Step 2 Set Premod output intensity displayed on Channel 2 and press START Ch 2 U Premod Combo Ch Select Channel 2 Cycle Time Continuous Beat Freq 80 150 Hz CC CV CV Enter Modify Feature Start Begin Treatment Step 3 Press START to begin treatment 54 Modifying Power up Preset Parameters With the exception of output intensity all power up preset parameters can be modified using the following sequence of steps 1 Select and change the desired parameter setting then press ENTER 2 Next press and hold the PAUSE button then press the ENTER button Indications Contraindications The operator should be familiar with the operating procedures for ultrasound and therapeutic electrical stimulation as well as indications contraindications precautions and warnings prior t
97. upling agent to the patient s skin Place the sound head in contact with the patient s body with a firm uniform pressure You must keep the sound head moving during the treatment Failure to keep the sound head moving may result in hazardous exposure to the ultrasound energy Set POWER INTENCITY using the controls located on the control panel Use the intensity control buttons located on the control panel to increase the ultrasound intensity to the desired level Press START to initiate the treatment If desired changes may be made to treatment parameters by moving the highlight to the Channel marked U The operator then can proceed with changes as desired To modify settings during treatment e Select the channel to modify from the Main Menu e Press ENTER to display parameters of that channel on both the LCD and LED displays e Choose PAUSE to interrupt treatment or lower intensity prior to making changes in the treatment parameters to prevent an undesirable sensation by your patient e Once you have highlighted a desired parameter press ENTER to display a list of options available for this mode of treatment When the highlight is placed around Frequency or Display pressing ENTER will toggle to the next selection e Use the arrows once again to highlight a desired option and then press ENTER to accept e Use the Treatment Time Control to alter treatment time e Press START to resume tr
98. utic deep heating between 40 C and 45 C in all of its operating modes while using any of the applicators available for this device 48 Contraindications e This device should not be used for symptomatic local pain relief unless etiology is established or unless a pain syndrome has been diagnosed This device should not be used when cancerous lesions are present in the treatment area This device should not be used when open wounds are present in the treatment area e Other contraindications are patients suspected of carrying serious infectious disease and or disease where it is advisable for general medical purposes to suppress heat or fevers e This device should not be used over or near bone growth centers until bone growth is complete e This device should not be used over the thoracic area if the patient is using a cardiac pacemaker eThis device should not be used over a healing fracture e This device should not be used over or applied to the eye e This device should not be used over a pregnant uterus e This device should not be used on ischemic tissues in individuals with vascular disease where the blood supply would be unable to follow the increase in metabolic demand and tissue necrosis might result e Patients with an implanted neurostimulation device must not be treated with or be in close proximity to any shortwave diathermy microwave diathermy therapeutic ultrasound diathermy or laser diathermy anywhere on their body

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