Enraf-Nonius Myomed 134 User manual

Brand: Enraf-Nonius

Model: Myomed 134

Type: User manual

Myomed 134

Operating Instructions

Enraf-Nonius B.V.

P.O. Box 12080

3004 GB Rotterdam

The Netherlands

Tel : +31-(0)10 - 203 06 00

Fax : +31-(0)10 - 203 06 99

[email protected]

www.enraf-nonius.com

Part number: 1437741_41

September 12, 2013

Table of Contents

1 Product description.....................................................................................................................4

2 Foreword.......................................................................................................................................4

2.1 About this manual ................................................................................................................4

2.2 Product liability.....................................................................................................................4

3 Precautionary measures.............................................................................................................5

4 Purpose.........................................................................................................................................6

4.1 EMG and pressure feedback...............................................................................................6

4.1.1 What is biofeedback?............................................................................................................6

4.2 Muscle stimulation ...............................................................................................................6

4.2.1 Indications/contra-indications and harmful effects of muscle stimulation..............................6

4.2.2 Form of current .....................................................................................................................7

5 Contents of the packaging..........................................................................................................7

5.1 Standard accessories ..........................................................................................................7

5.2 Optional accessories ...........................................................................................................7

6 Installation....................................................................................................................................8

7 Use of the electrodes...................................................................................................................8

7.1 Before the treatment ............................................................................................................8

7.2 Self-adhesive electrodes .....................................................................................................8

7.3 Current density ....................................................................................................................9

7.4 Opening and closing reactions ............................................................................................9

8 Operating instructions ................................................................................................................9

8.1 Controls ...............................................................................................................................9

8.2 Basic operation ..................................................................................................................10

8.2.1 Navigation...........................................................................................................................10

8.2.2 Main menu ..........................................................................................................................10

8.2.3 Basic screen .......................................................................................................................11

8.2.4 Parameters .........................................................................................................................11

8.3 Step-by-step operation ......................................................................................................12

8.3.1 Switching-on .......................................................................................................................12

8.3.2 Continuous EMG settings ...................................................................................................12

8.3.3 EMG work / rest..................................................................................................................13

8.3.4 EMG template curve ...........................................................................................................14

8.3.5 Alternating EMG + stimulation.............................................................................................15

8.3.6 Stimulation above threshold................................................................................................16

8.3.7 Stimulation below threshold................................................................................................17

8.3.8 Pressure settings ................................................................................................................19

8.3.9 PRESSURE work / rest.......................................................................................................20

8.3.10 PRESSURE template curve..............................................................................................21

8.3.11 EMG + Pressure ...............................................................................................................22

8.3.12 EMG + Pressure + Stimulation..........................................................................................22

8.4 Programming, retrieving and deleting protocols................................................................22

8.4.1 Programming a protocol (step-by-step)...............................................................................22

8.4.2 Retrieving protocols ............................................................................................................22

8.4.3 Deleting protocols from the memory ...................................................................................22

8.5 Preferences .......................................................................................................................22

8.5.1 Language............................................................................................................................22

8.5.2 Pressure read-out ...............................................................................................................22

8.5.3 Selecting from the main menu ............................................................................................23

8.5.4 LCD contrast.......................................................................................................................23

8.6 Switching off ......................................................................................................................23

9 Maintenance and trouble-shooting..........................................................................................23

9.1 User maintenance..............................................................................................................23

9.1.1 Cleaning the apparatus.......................................................................................................23

9.1.2 Patient cable .......................................................................................................................23

9.2 Trouble-shooting................................................................................................................23

9.2.1 Insufficient or absent output current....................................................................................23

9.3 Technical maintenance......................................................................................................23

9.4 Disposal .............................................................................................................................24

10 Parameters..................................................................................................................................24

10.1 Current parameter.......................................................................................................... 24

10.2 EMG parameters............................................................................................................ 24

10.3 Pressure parameters ..................................................................................................... 24

11 Illustrations................................................................................................................................25

11.1 Symmetric biphasic........................................................................................................ 25

11.2 Parameters for contraction program.............................................................................. 25

12 Technical specifications...........................................................................................................25

13 Pictures ......................................................................................................................................26

1 Product description

The Myomed 134 is an ‘all-in-one device’ for EMG feedback, pressure feedback and electrotherapy.

It offers you a source of biphasic pulsating current plus extensive feedback facilities. The graphical LCD

screen displays all parameter settings clearly while also providing your patient with easy-to-grasp

feedback.

A high degree of user friendliness is ensured by the menu-driven operation and the single central control

button.

WARNING (for the USA only): the Myomed 134 may only be used under the supervision of or on the

instructions of a physician or other authorized medical professional.

2 Foreword

2.1 About this manual

This manual, which is intended for the owner and user of the Myomed 134, contains general operating

instructions, precautionary measures, maintenance instructions and information about components. To

maximize the service life and efficiency of the apparatus, it is important that you read this manual through

carefully and familiarize yourself with the various controls and accessories before starting to use the

apparatus.

The specifications in this manual were effective at the time of publication. Due however to Enraf-Nonius

B.V.’s policy of continuous improvement these specifications may be changed at any time without Enraf-

Nonius B.V. being under any obligation.

2.2 Product liability

A law on Product Liability has become effective in many countries. This Product Liability law implies,

amongst other things, that once a period of 10 years has elapsed after a product has been brought into

circulation, the manufacturer can no longer be held responsible for possible shortcomings of the product.

To the maximum extent permitted by applicable law, in no event will Enraf-Nonius or its suppliers or

resellers be liable for any indirect, special, incidental or consequential damages arising from the use of or

inability to use the product, including, without limitation, damages for loss of goodwill, work and

productivity, computer failure or malfunction, or any and all other commercial damages or losses, even if

advised of the possibility thereof, and regardless of the legal or equitable theory (contract, tort or

otherwise) upon which the claim is based. In any case, Enraf-Nonius’s entire liability under any provision

of this agreement shall not exceed in the aggregate the sum of the fees paid for this product and fees for

support of the product received by Enraf-Nonius under a separate support agreement (if any), with the

exception of death or personal injury caused by the negligence of Enraf-Nonius to the extent applicable

law prohibits the limitation of damages in such cases.

The opposing party (product’s user or its representative) shall disclaim Enraf-Nonius from all claims

arising from third parties, whatever nature or whatever relationship to the opposing party.

3 Precautionary measures

This section contains general warnings and precautionary measures that are important for the safe use of

the apparatus. See also Chapter 4 for the warnings and precautionary measures that apply especially to

pain control and muscle stimulation.

WARNING:

 Under federal law (only applicable to the USA) this apparatus may only be sold by or on the

prescription of a physician or an authorized medical professional.

The apparatus may only be used under the constant supervision of or on the instructions of a

physician or other authorized medical professional.

 The apparatus should only be connected to an earthed (grounded) wall socket that satisfies the

applicable national and local electricity regulations for medical environments.

 Do not use the apparatus in the vicinity of a diathermy device, as this may cause burning under

the electrodes.

 Take care when using the apparatus in the vicinity of other equipment, due to possible

electromagnetic or other interference. Interference can be minimized by not using the apparatus

with other equipment.

 Use of electrical stimulation may affect the functioning of electronic monitoring equipment, such

as ECG monitors and ECG alarm systems.

 This apparatus is not suitable for use in an inflammable mixture of anesthetics and air, oxygen or

nitrous oxide.

 Keep the apparatus out of reach of children.

CAUTION:

 Read through the precautionary measures and operating instructions carefully and always follow

them to the letter. Always bear in mind the limitations and dangers of using an electrical

stimulator, and always observe the warning and operating labels on the equipment.

 The Myomed 134 should only be combined with other equipment by Enraf-Nonius B.V.

 Use the device at a temperature of 10 °C to 40 °C and at a relative humidity between 10% and

90%.

 Do not expose the apparatus to direct sunlight, heat from a source of thermal radiation, excessive

amounts of dust, moisture, vibrations, or mechanical shocks.

 If any liquids or moisture penetrate the apparatus, remove the plug from the wall socket and have

the apparatus checked by an approved technician (see the section on Technical Maintenance).

 Do not use sharp objects such as pencil-points or pen-tips to manipulate the buttons on the

control panel, as this can cause damage.

Before you start treating a patient you must be familiar with the operating procedures for each treatment

mode and with the indications, contra-indications, warnings and precautionary measures. For additional

information about the use of electrotherapy, consult other sources.

4 Purpose

4.1 EMG and pressure feedback

4.1.1 What is biofeedback?

Feedback is a way of managing a system by communicating back to it the results of its (previous)

performance. Biofeedback is a way of managing certain physical functions by means of a feedback

mechanism. A feedback training enables patients to adjust their actions to suit their physical capabilities

and to bring these under control through continuous feedback.

Indications:

Biofeedback is being used successfully in many areas. It offers a wide range of treatment options for

many applications, including incontinence, muscle training, post-surgical rehabilitation, RSI and lower

back complaints.

4.2 Muscle stimulation

4.2.1 Indications/contra-indications and harmful effects of muscle stimulation

Indications:

 Relaxation of muscular spasms.

 Prevention or treatment of degenerated muscles.

 Stimulation of local circulation.

 Rehabilitation.

 Stimulation of the calf muscle immediately after an operation, to prevent thrombosis.

 Strengthening or enlargement of the movement range.

Contra-indications:

 The apparatus should not be used on patients with a pacemaker.

 The apparatus should not be used on carcinomas.

 Do not attach electrodes at places where current is released in the area of the carotid sinus

(ventral side of the neck).

 Do not attach electrodes at places where current is released transcerebrally (i.e. through the

head).

 Do not attach electrodes at places where current is released transthoracically (releasing current

to the heart can lead to cardiac arrhythmia).

Warnings:

 The long-term effects of chronic electrical stimulation are unknown.

 The safety of therapeutic electrical stimulation during pregnancy has not been established.

 Electrical stimulation should not be applied to swollen, infected or inflamed areas of skin

(phlebitis, thrombophlebitis, caput medusae, etc.).

 See also Chapter 3, Precautionary measures, for general warnings and precautionary measures.

Precautionary measures:

 Suitable precautionary measures must be observed when treating patients in whom heart

problems are suspected or have been diagnosed, or who suffer from epilepsy.

 Caution must be exercised if bleeding occurs rapidly after acute injury or a fracture.

 Caution must be exercised after a recent operation, as the healing process can be disrupted by

muscle contraction.

 Caution must be exercised in the menstruating uterus.

 Caution must be exercised with sensitive areas of skin.

 In some patients, skin irritation or hypersensitivity can arise due to electrical stimulation or an

electrically conductive medium. The irritation can usually be reduced by using a different

conductive medium or by attaching the electrodes elsewhere.

 See also Chapter 3, Precautionary measures, for general warnings and precautionary measures.

Harmful effects:

 Cases of skin irritation and burns under the electrodes have been reported as a result of

therapeutic electrical stimulation.

4.2.2 Form of current

Muscle stimulation (to improve the muscle function):

 Neuromuscular Electrical Stimulation (NMES) is the use of electrical stimulation to activate

muscle tissue by stimulating the intact peripheral nerve.

 Functional Electrical Stimulation (FES) is the use of NMES to replace orthoses.

 Electrical Muscle Stimulation (EMS) is the use of electrical stimulation to directly activate

denervated muscle tissue.

Muscle stimulation is often used with the symmetrical biphasic pulsed form of current. This form of current

is also fully compensated (i.e. it has no residual DC components). See Fig. 11.1 for an illustration. The

specified phase length applies to both pulse phases, as a result of which the quantity of energy available

is twice that of the asymmetric pulsed form of current. See section 10 for the available parameters.

Muscle stimulation is often used in combination with an expansion/contraction program, in which periods

of effort and rest are alternated. See Fig. 11.2 and section 10 for the available parameters.

5 Contents of the packaging

1437910 MYOMED 134

5.1 Standard accessories

The following accessories are included with the Myomed 134:

User guide

3444222 Pre-gelled disposable electrodes 20 mm, for EMG and stimulation, set of 8

3444102 Electrode cable 2 mm black

3444119 Electrode cable 2 mm purple

3444131 Mains adapter ENA-1524

3444172 Battery pack

3444290 Mains lead

3444647 Reference cable

3444667 Snap connector 2 mm, quantity: 5

5.2 Optional accessories

3444117 Anal sensor

3444118 Vaginal sensor

3444222 Pre-gelled disposable electrodes 20 mm, for EMG and stimulation, set of 80

3444056 EN-Trode, self-adhesive electrodes, dimensions 32 mm Ø, 1 pack = 10 sheets of 4

3444135 EN-Trode, self-adhesive electrodes, dimensions 50 mm Ø, 1 pack = 10 sheets of 4

3444057 EN-Trode, self-adhesive electrodes, dimensions 50x50 mm, 1 pack = 10 sheets of 4

3444058 EN-Trode, self-adhesive electrodes, dimensions 50x90 mm, 1 pack = 10 sheets of 4

6 Installation

Initial procedures

 Take the Myomed 134 and any extra parts out of the cardboard packaging and check everything

for possible transport damage

 Check that the voltage on the serial plate of the ENA-1524 mains voltage adapter (100 V – 240

V) corresponds to the available mains supply

 Connect the ENA-1524 mains voltage adapter to the connector [10]

 Insert the mains voltage adapter into a wall socket

 CAUTION:

 Only connect the Myomed 134 to an adapter of type ENA-1524, as this adapter forms an integral

part of the power supply circuit that guarantees safe operation

 Do not use direct current (DC)

 Place the apparatus so that no one can trip over the power cable and so that the power cable

cannot be accidentally pulled out during treatment

 Make sure that the adapter is well earthed

The adapter should only be connected to an earthed wall socket that satisfies the applicable national and

local electricity regulations for medical environments.

7 Use of the electrodes

CAUTION:

 The connection of accessories that are not specified by the manufacturer can adversely affect the

safety of the patient and the proper working of the apparatus and is therefore not permitted

NB:

 The following description is applicable to electrotherapy in general. The electrolytic side-effects

mentioned below do not apply to the Myomed 134, because this apparatus only generates fully

compensated TENS currents that do not contain any DC component

7.1 Before the treatment

 Check whether the contra-indications and warnings described in sections 4.1 and 4.2 apply to the

patient

 Test the heat sensitivity of the area to be treated

 Rinse clean the area to be treated. Hairy skin surfaces should be shaved

7.2 Self-adhesive electrodes

Self-adhesive electrodes have a higher serial impedance than rubber carbon electrodes. As a result the

stimulator can terminate the treatment at higher current amplitudes. If this happens, it is advisable to

continue the treatment with rubber carbon electrodes and well-moistened sponges.

7.3 Current density

In conformity with IEC 60601-2-10, the maximum permissible ‘current density’ is 2 mA RMS per cm². With

smaller electrodes, such as the 3.2 mm self-adhesive electrodes, this is not the case. To check whether

the maximum permissible current density of 2 mA RMS per cm² is being exceeded, divide the RMS

output current in mA by the effective electrode surface in cm². The result should be less than 2. With

asymmetric TENS currents the RMS value of the output current can be calculated as follows:

IRMS = Ipeak √ ( Phase length [µs] * pulse frequency [Hz] * 10-6 )

With symmetric TENS currents the phase length must be multiplied by 2. The value of the peak

current Ipeak can be read off on the current display.

The electrodes must be attached carefully but firmly. The use of small electrodes can cause skin irritation

and burns at high current amplitudes.

7.4 Opening and closing reactions

This apparatus releases constant current (CC), which can cause unpleasant opening and closing

reactions if the electrodes are not properly attached or come loose from the skin. When attaching and

removing electrodes, make sure that the output current has been set to 0 mA.

8 Operating instructions

8.1 Controls

See page 2 for more information.

[1] Connector for patient cable for channel 1

Connection for the patient cable for channel 1

[2] Connector for reference electrode

Connection for the reference electrodes

[3] Storing settings 

With this button you can store manual control settings and program your own treatment protocols.

[4] Selection button for treatment channel 1

This button is used to select channel 1. This gives you direct access to the stimulation current parameters

of channel 1

[5] Central control button

This button has various functions.

Switching on: switch on the Myomed 134 by pressing the central control button 3 times.

Settings: turn the button to scroll through the menu. Confirm a selection by pressing the central part of the

button. You will then be taken to the following menu or will be able to set the relevant parameter. Confirm

the setting of the parameter on each occasion in order to continue scrolling through the settings.

[6] Display with backlighting

Displays signals, operating modes and parameter settings.

[7] Selection button for treatment channel 2

This button is used to select channel 2. This gives you direct access to the stimulation current parameters

for channel 2

[8] Connector for the pressure sensor

For the connection of pressure accessories

[9] Connector for patient cable for channel 2

Connection for the patient cable for channel 2

[10] Power supply connector

Connection for the external mains voltage adapter.

CAUTION:

Only connect the Myomed 134 to an adapter of type ENA-1524, as this adapter forms an integral part of

the power supply circuit that guarantees safe operation

[11] Battery flap

For storing the battery pack

The battery contains material that is harmful to the environment. When removing the battery you must

follow the local regulations

[12] Battery Pack

For operation without an external adapter. The battery pack is installed by default and should be charged

before use with the AC adapter type ENA 1524.

The battery contains harmful materials to the environment. When removing the battery, please do in

accordance with your local regulations.

8.2 Basic operation

8.2.1 Navigation

The Myomed 134 is equipped with a simple and logical operating interface that enables you to navigate

through all the operating modes and parameter settings using just one central button. You select a

function with the central control button [5]. The selected item will be indicated by a cursor in the form of a

horizontal bar. You then confirm the selection by pressing the central control button again [5].

 If the selected item is an operating mode, then pressing the central control button will take you to

the next screen. If you move the cursor to < at the top of the screen and press the central control

button you will be returned to the previous screen.

 If the selected item is a parameter then pressing the central control button will open the

parameter, after which the value can be changed using the central control button. If you press the

central control button again the parameter will be closed and the changes made will be saved.

8.2.2 Main menu

When the apparatus is switched on it first performs a self-test, after which the main menu will appear. The

main menu offers access to all the principal functions.

8.2.3 Basic screen

EMG

EMG + Stimulation

Pressure

EMG + Pressure

EMG + Pressure + Stimulation

Protocols

System settings

Shut down

With the central control button you select a function and then confirm it by pressing the central control

button again. This takes you to the next screen. There, make a selection by turning the central control

button and then confirm the choice by pressing the central control button again. All selections can be

made and parameters set in this way.

8.2.4 Parameters

Depending on the menu, various parameters can be chosen and set.

 Treatment time: with this option the total treatment time per minute can be set

 Threshold: with this option a threshold value can be set on the graph or bar. The threshold value

is shown by a line. This level can also be the signal for starting the stimulation current and

animation.

 Graph: with this option you can change the display on the LCD screen. There are 2 options:

Curve or Bar.

 Sound: with this option an acoustic signal can be set: proportional, below the threshold or above

the threshold. When making the transition from work phase to rest phase a sound will always be

made. To switch this sound off the volume should be set to 0.

 Volume: with this option the sound intensity is set in steps of 25% of the maximum volume.

 Start: the Start option must be used to commence the therapy.

 Rest time: with this option the rest time before an active phase can be set.

 Working time: with this option the length of the active signal can be set. This is shown on the

screen by a weightlifter

 Stimulation rest time: with this option a rest time can be set after an active phase

 Stimulation time: with this option the length of the stimulation can be set

 Cycles: with this option the number of repetitions between working time and rest time can be set

 Type template curve: with this option 1 of the 7 template curves can be selected

 Pause template curve: here the rest time between two successive template curves is set

 Height template curve: with this option the height of the curve can be set

 Phase length, expressed in µs: this is the time from the beginning of a pulse phase to the end of

it. In the symmetrical biphasic pulse the phase length applies to both pulse phases. See Figs.

11.1 and 11.3.

 Frequency, expressed in Hz or pps (pulses per second): with this option you define the repetition

rate of the TENS pulses

 Surge pattern: with this option you can program a sequential increase or decrease in the current

amplitude

 Ramp up, expressed in s: with this option you can define, in an expansion/contraction program,

the time that the current takes to be increased from 0 to the pre-set level. See Fig. 11.7. The

contraction time can be adjusted in increments of 0.1 s

 Hold time, expressed in s: with this option you can define, in a expansion/contraction program,

the length of time for which the current is held at the pre-set level. See Fig. 11.7. The hold time

can be adjusted in increments of 1 s

 Ramp down time, expressed in s: with this option you can define, in a expansion/contraction

program, the time that the current takes to be reduced from the pre-set level to 0. See Fig. 11.7.

The expansion time can be adjusted in increments of 0.1 s

 Current: here the intensity of current of the stimulator is set, in increments of 0.1 mA. During the

setting the stimulator becomes active.

8.3 Step-by-step operation

8.3.1 Switching-on

 Connect the supplied ENA-1524 mains voltage

adapter to the connector [11]

 Insert the plug of the mains voltage adapter into the

wall socket

 Switch on the apparatus by pressing 3 times on

the central button [1]

 During the start-up a self-test will be performed

 The main menu will be displayed

 Connect the reference cable to the plug [2]

 Connect the patient cables to the connector [1] +

[9]

 Attach the electrodes to the patient

EMG

EMG + Stimulation

Pressure

EMG + Pressure

EMG + Pressure + Stimulation

Protocols

System settings

Shut down

8.3.2 Continuous EMG settings

 Select the desired function by turning the central

control button, then confirm the choice by pressing

the central control button again

 You will automatically be taken to the next menu:

EMG

EMG + Stimulation

Pressure

EMG + Pressure

EMG + Pressure + Stimulation

Protocols

System settings

Shut down

 Select the desired function by turning the central

control button, then confirm the choice by pressing

the central control button again

 You will automatically be taken to the next menu:

< Main menu

Continuous

Work / Rest

Template curve

Continuous 1+2

Work / Rest 1+2

Template curve 1+2

 Select the desired parameter by turning the central

control button, then confirm the choice by pressing

the central control button again

 Change the parameter by setting the value with the

central control button. Confirm the parameter by

pressing the central control button again

 Use the central control button to select the next

parameter

< EMG menu

Treatment time 00:00 min

Threshold for EMG 1 0 µV

Graph Curve

Sound off

Volume 25

> Start

To start the therapy:

 With the central control button select Start

 Start the program by pressing the central control

button

 The treatment time will start automatically and the

measurements will be displayed on the curve or

bar.

< EMG menu

Treatment time 00:00 min

Threshold for EMG 1 0 µV

Graph Curve

Sound off

Volume 25

> Start

8.3.3 EMG work / rest

 Select the desired function by turning the central

control button, then confirm the choice by pressing

the central control button again

 You will automatically be taken to the next menu:

EMG

EMG + Stimulation

Pressure

EMG + Pressure

EMG + Pressure + Stimulation

Protocols

System settings

Shut down

 Select the desired function by turning the central

control button, then confirm the choice by pressing

the central control button again

 You will automatically be taken to the next menu:

< Main menu

Continuous

Work / Rest

Template curve

Continuous 1+2

Work – Rest 1+2

Template curve 1+2

 Select the desired parameter by turning the central

control button, then confirm the choice by pressing

the central control button again

 Change the parameter by setting the value with the

central control button. Confirm the parameter by

pressing the central control button again

 Use the central control button to select the next

parameter

< EMG menu

Rest time 5 s

Working time 5 s

Cycles 10

Threshold for EMG 1 0 µV

Graph Curve

Sound off

Volume 25

> Start

To start the therapy:

 With the central control button select >Start

 Start the program by pressing the central control

button

 The treatment time will start automatically and the

measurements will be displayed on the curve or

bar.

< EMG menu

Rest time 5 s

Working time 5 s

Cycles 10

Threshold for EMG 1 0 µV

Graph Curve

Sound off

Volume 25

> Start

8.3.4 EMG template curve

 Select the desired function by turning the central

control button, then confirm the choice by pressing

the central control button again

 You will automatically be taken to the next menu:

EMG

EMG + Stimulation

Pressure

EMG + Pressure

EMG + Pressure + Stimulation

Protocols

System settings

Shut down

 Select the desired function by turning the central

control button, then confirm the choice by pressing

the central control button again

 You will automatically be taken to the next menu:

< Main menu

Continuous

Work / Rest

Template curve

Continuous 1+2

Work / Rest 1+2

Template curve 1+2

 Select the desired parameter by turning the central

control button, then confirm the choice by pressing

the central control button again

 Change the parameter by setting the value with the

central control button. Confirm the parameter by

pressing the central control button

 Use the central control button to select the next

parameter

< EMG menu

Type of template curve rectangular

Total time of template curve 5 s

Pause of template curve 5 s

Height of template curve 60 µV

Cycles 10

Sound off

Volume 25

> Start

To start the therapy:

 With the central control button select Start

 Start the program by pressing the central control

button

 The treatment time will start automatically and the

measurements will be displayed on the curve or

bar.

< EMG menu

Type of template curve rectangular

Total time of template curve 5 s

Pause of template curve 5 s

Curve height 60 µV

Cycles 10

Sound off

Volume 25

> Start

8.3.5 Alternating EMG + stimulation

 Select the desired function by turning the central

control button, then confirm the choice by pressing

the central control button again

 You will automatically be taken to the next menu:

EMG

EMG + Stimulation

Pressure

EMG + Pressure

EMG + Pressure + Stimulation

Protocols

System settings

Shut down

 Select the desired function by turning the central

control button, then confirm the choice by pressing

the central control button again

 You will automatically be taken to the next menu:

< Main menu

Alternating EMG - Stimulation

Stimulation above threshold

Stimulation below threshold

Alternating EMG – Stimulation 1+2

Stimulation above threshold 1+2

Stimulation below threshold 1 +2

 Select the desired parameter by turning the central

control button, then confirm the choice by pressing

the central control button again

 Change the parameter by setting the value with the

central control button [5]. Confirm the parameter by

pressing the central control button

 Use the central control button to select the next

parameter [5]

< EMG – Stimulation menu

EMG rest time 5 s

EMG work time 5 s

Stimulation rest time 5 s

Stimulation time 5 s

Cycles 10

Threshold for EMG 1 0 µV

Graph Curve

Sound off

Volume 25

> Stimulation parameters

 Select stimulation parameters to set the current

parameters

 Change the parameter by setting the value with the

central control button [5]. Confirm the parameter by

pressing the central control button again [5]

 Use the central control button to select the next

parameter [5]

< EMG settings

Phase duration 100 µs

Frequency 80 Hz

Surge pattern yes

Ramp-up time 0.2 s

Hold time 4 s

Ramp down time 2.0 s

Interval time 8 s

Intensity 0 mA

> Start

 Select Intensity and set the desired intensity with

the central control button

 With the central control button select Start

 Start the program by pressing the central control

button

 The treatment time will start automatically and the

measurements will be displayed on the curve or

bar.

< EMG settings

Phase duration 100 µs

Frequency 80 Hz

Surge pattern yes

Ramp-up time 0.2 s

Hold time 4 s

Ramp down time 2.0 s

Interval time 8 s

Intensity 0.0 mA

> Start



8.3.6 Stimulation above threshold

 Select the desired function by turning the central

control button, then confirm the choice by pressing

the central control button again

 You will automatically be taken to the next menu:

EMG

EMG + Stimulation

Pressure

EMG + Pressure

EMG + Pressure + Stimulation

Protocols

System settings

Shut down

 Select the desired function by turning the central

control button, then confirm the choice by pressing

the central control button again

 You will automatically be taken to the next menu:

< Main menu

Alternating EMG - Stimulation

Stimulation above threshold

Stimulation below threshold

Alternating EMG - Stimulation 1+2

Stimulation above threshold 1 + 2

Stimulation below threshold 1+2

 Select the desired parameter by turning the central

control button, then confirm the choice by pressing

the central control button again

 Change the parameter by setting the value with the

central control button [5]. Confirm the parameter

by pressing the central control button again [5]

 Use the central control button to select the next

parameter [5]

< EMG + Stimulation menu

Rest time 5 s

Stimulation time 5 s

Cycles 10

Threshold for EMG 1 0 µV

Graph Curve

Sound off

Volume 25

> Stimulation parameters

 Select stimulation parameters to set the current

parameters

 Change the parameter by setting the value with the

central control button [5]. Confirm the parameter by

pressing the central control button again [5]

 Use the central control button to select the next

parameter [5]

< EMG settings menu

Phase duration 100 µs

Frequency 80 Hz

Surge pattern yes

Ramp-up time 0.2 s

Hold time 4 s

Ramp down time 2.0 s

Interval time 8 s

Intensity 0.0 mA

> Start

 Select Intensity and then set the desired intensity

with the central control button

To start the therapy:

 With the central control button select Start

 Start the program by pressing the central control

button

 The treatment time will start automatically and the

measurements will be displayed on the curve or

bar.

< EMG settings menu

Phase duration 100 µs

Frequency 80 Hz

Surge pattern yes

Ramp-up time 0.2 s

Hold time 4 s

Ramp down time 2.0 s

Interval time 8 s

Intensity 0 mA

> Start

Procedure:

The patient must try to exceed the threshold. When the threshold is exceeded the apparatus will switch

over to muscle stimulation. After the stimulation the apparatus automatically reverts to EMG mode.

8.3.7 Stimulation below threshold

 Select the desired function by turning the central

control button, then confirm the choice by pressing

the central control button again

 You will automatically be taken to the next menu:

EMG

EMG + Stimulation

Pressure

EMG + Pressure

EMG + Pressure + Stimulation

Protocols

System settings

Shut down

 Select the desired function by turning the central

control button, then confirm the choice by pressing

the central control button again

 You will automatically be taken to the next menu:

< Main menu

Alternating EMG - Stimulation

Stimulation above threshold

Stimulation below threshold

Alternating EMG – Stimulation 1+2

Stimulation above threshold 1 + 2

Stimulation below threshold 1+2

 ·Select the desired parameter by turning the central

control button, then confirm the choice by pressing

the central control button again

 Change the parameter by setting the value with the

central control button [5]. Confirm the parameter by

pressing the central control button again [5]

 Use the central control button to select the next

parameter [5]

< EMG + Stimulation menu

EMG rest time 5 s

EMG working time 5 s

Stimulation time 5 s

Cycles 10

Threshold for EMG 0 µV

Graph Curve

Sound off

Volume 25

> Stimulation parameters

 Select stimulation parameters to set the current

parameters

 Change the parameter by setting the value with the

central control button [5]. Confirm the parameter by

pressing the central control button again [5]

 Use the central control button to select the next

parameter. [5]

< EMG settings menu

Phase duration 100 µs

Frequency 80 Hz

Surge pattern yes

Ramp-up time 0.2 s

Hold time 4 s

Ramp down time 2.0 s

Interval time 8 s

Intensity 0 mA

> Start

 Select Intensity and then set the desired intensity

with the central control button

To start the therapy:

 With the central control button select Start

 Start the program by pressing the central control

button

 The treatment time will start automatically and the

measurements will be displayed on the curve or

bar.

< EMG settings menu

Phase duration 100 µs

Frequency 80 Hz

Surge pattern yes

Ramp-up time 0.2 s

Hold time 4 s

Ramp down time 2.0 s

Interval time 8 s

Intensity 0 mA

> Start

Procedure:

If the patient does not remain above the pre-set threshold during the EMG working time then the

apparatus will automatically be switched to Stimulation and the current will drop to the pre-set intensity

of current. When the whole of the stimulation program has been completed the apparatus will

automatically switch to the EMG program. The number of repetitions is set under the ‘cycle settings’

parameter

The current can be adjusted during the contraction. Select current channel (button 4 for channel 1) and

adjust the intensity with the central control button [6]

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Enraf-Nonius Myomed 134 User manual

Enraf-Nonius Myomed 134 User manual

Enraf-Nonius Myomed 134 User manual

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