Enraf-Nonius TensMed P82 & S82 DJO User manual

TENSMED P82 & S82

INSTRUCTIONS FOR USE

, 2017

March 2, 2017

Part Number-1427771_43

ENGLISH

This Instructions for Use contains

081_400_245_43_EN

The latest version of this Instructions for Use can be obtained free of charge

1. from our website www.enraf-nonius.com/downloads

or

2. by contacting distributor or by calling the telephone number: +31-(0)10-2030600, the IFU will

be delivered (free of charge) to you within 7 (seven) calendar days.

Copyright:

Enraf-Nonius B.V.

Vareseweg 127

3047 AT Rotterdam

The Netherlands

Tel: +31 (0)10-20 30 600

Fax: +31 (0)10-20 30 699

Symbols used in Instructions for Use and in device labels

Symbol Used

Description

Follow the instructions in the Instructions for Use (IFU).

It is important that you read, understand and observe the precautionary and

operating instructions

General Prohibition Sign

Prohibition is used to mean “You MUST NOT”

WARNING sign that indicates the possible side effects

Acceptable temperature range

“WARNING” indicator will explain possible safety infractions that will

potentially cause serious injury and equipment damage

“CAUTION” indicator will explain possible safety infractions that could have the

potential to cause minor to moderate injury or damage to equipment.

Council Directive 2012/19/EU concerning Waste Electrical and Electronic

Equipment (WEEE) requires not to dispose of WEEE as municipal waste. Contact

your local distributor for information regarding disposal of the unit and

accessories."

Type BF applied parts

Indicates this device generates non-ionizing radiation.

Keep the device dry

Power ON /Pause

Manufacturer name and address

Reference Number or Part Number

Indicates acceptable relative humidity

ENGLISH 
 
 
Index 
 
Introduction .......................................................................................................................................................... 2 
1 Product liability ........................................................................................................................................... 2 
Medical background ............................................................................................................................................. 3 
1 TENS .......................................................................................................................................................... 3 
2 NMES ......................................................................................................................................................... 3 
Precautionary measures ...................................................................................................................................... 4 
1 Warning! ..................................................................................................................................................... 4 
2 Cautions ..................................................................................................................................................... 6 
3 Danger ....................................................................................................................................................... 7 
4 Adverse reactions ...................................................................................................................................... 7 
Intended User ...................................................................................................................................................... 8 
Intended Use ........................................................................................................................................................ 8 
Indications and Contra-Indications ...................................................................................................................... 8 
1 Indications .................................................................................................................................................. 8 
2 Contra-indications ...................................................................................................................................... 8 
Overview .............................................................................................................................................................. 9 
1 Control buttons ........................................................................................................................................... 9 
2 Display symbols ....................................................................................................................................... 10 
Operation ........................................................................................................................................................... 11 
1 Step-by-step use ...................................................................................................................................... 11 
2 Special instructions .................................................................................................................................. 12 
Replacement of batteries ................................................................................................................................... 14 
Programs ........................................................................................................................................................... 15 
1 Preset programs – TENS..................................................................................................................... 15 
2 Preset programs – NMES .................................................................................................................... 16 
3 Custom programs ................................................................................................................................ 20 
3.1 Programming ....................................................................................................................................... 20 
3.2 Programming chart .............................................................................................................................. 21 
4 Compliance .......................................................................................................................................... 23 
Accessories ........................................................................................................................................................ 23 
Care instructions ................................................................................................................................................ 23 
1 Expected Service Life Time ................................................................................................................. 23 
2 End of Life ............................................................................................................................................ 24 
Troubleshooting ................................................................................................................................................. 24 
Frequently asked questions ............................................................................................................................... 24 
Technical data .................................................................................................................................................... 25 
1 Saftey and Performance standard ....................................................................................................... 26 
2 EMC details ......................................................................................................................................... 27 
Clinical guide ...................................................................................................................................................... 30 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

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1 Introduction

This manual has been written for the owners and operators of the TensMed P82 (1427961) and S82 (1427971). It

contains general instructions on operation, precautionary practices, maintenance and parts information. In order to

maximize the use, efficiency and lifespan of your unit, please read this manual thoroughly and become familiar with

the controls as well as the accessories before operating the unit.

Specifications put forth in this manual were in effect at the time of publication. However, owing to Enraf-Nonius BV’s

policy of continual improvement, changes to these specifications may be made at any time without obligation on the

part of Enraf-Nonius BV.

The TensMed P82 is a dual channel nerve stimulator intended for pain relief (TENS). The stimulator features 5 preset

programs and 5 custom programs. The channels are simultaneous, which means that a selected program applies for

both channels.

The TensMed S82 is a dual channel nerve stimulator intended for both muscle rehabilitation (NMES) and pain relief

(TENS). The stimulator features 28 preset programs and 5 custom programs. The channels are simultaneous, which

means that a selected program applies for both channels.

The user of both the TensMed P82 and S82 can be a Health Care Professional or a patient. The device should be

used indoors and may be used in a healthcare facility setting or in a home environment.

1.1 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.

Enraf-Nonius cannot be held liable for any consequence resulting from incorrect information provided by its

personnel, or errors incorporated in this manual and / or other accompanying documentation (including commercial

documentation)

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.

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2 Medical background

2.1 TENS

TENS (Transcutaneous Electrical Nerve Stimulation) gives good results in acute and chronic pain conditions of many

kinds. It is clinically proven and used daily by physiotherapists, other caregivers and top athletes around the world.

High-frequency TENS activates the pain-inhibiting mechanisms of the nervous system. Electrical impulses from

electrodes, placed on the skin over or near the painful area, stimulate the nerves to block the pain signals to the

brain, and the pain is not perceived. Low-frequency TENS stimulates the release of endorphins, the body’s natural

painkillers.

TENS is a safe treatment method and has, in contrast to drugs and other pain relief methods, no side effects. It may

be sufficient as the only treatment form, but it is also a valuable complement to other pharmacological and/or physical

treatments. TENS does not always treat the cause of pain. Consult your doctor if pain persists.

2.2 NMES

NMES (NeuroMuscular Electrical Stimulation) is used successfully both in medical rehabilitation and as a

complement to athletic training on all levels.

The goal of electrical muscle stimulation is to achieve contractions or vibrations in the muscles. Normal muscular

activity is controlled by the central and peripheral nervous systems, which transmit electrical signals to the muscles.

NMES works similarly but uses an external source (the stimulator) with electrodes attached to the skin for

transmitting electrical impulses into the body. The impulses stimulate the nerves to send signals to a specifically

targeted muscle, which reacts by contracting, just as it does with normal muscular activity.

Electrical muscle stimulation is suitable for all the muscles in the body. It can be used to strengthen muscles

weakened by surgery, a fracture, etc., and improve mobility. It is also an excellent tool for stroke rehabilitation,

helping patients in handgrip and gait training.

Electrical muscle stimulation for rehabilitation purposes should be tried out individually by a physiotherapist or other

caregiver for the best results.

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3 Precautionary measures

 Inspect the equipment prior to use.

 Use the stimulator only as stated in the operating instructions.

 Only Enraf-Nonius accessories should be used with the stimulator

 Never use the Tensmed P82 or S82 on patients who have sensitivity problems or are unable to let

you know if they feel any discomfort, however slight

3.1 WARNING!

Consult with physician.

o Consult with the patient’s physician before using the device, because the device may cause lethal

rhythm disturbances to the heart in susceptible individuals.

Skin condition.

o Apply stimulation only to normal, intact, clean, healthy skin.

Long term effects.

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

Stimulation location

o Stimulation over Neck or Mouth. Do not apply stimulation over the patient’s neck (especially the

carotid sinus) or the patient’s mouth, because this could cause severe muscle spasms resulting in

closure of the airway, difficulty in breathing, or adverse effects on heart rhythm or blood pressure.

Stimulation across Chest.

o Do not apply stimulation across the patient’s chest, because the introduction of electrical current into

the chest may cause rhythm disturbances to the patient’s heart, which could be lethal.

Across the head.

o Since the effects of stimulation of the brain are unknown, stimulation should not be applied across

the head, and electrodes should not be placed on opposite sides of the head.

Stimulation over compromised skin.

o Do not apply stimulation over open wounds or rashes, or over swollen, red, infected, or inflamed

areas or skin eruptions (e.g., phlebitis, thrombophlebitis, varicose veins).

Stimulation near cancerous lesions.

o Do not apply stimulation over, or in proximity to, cancerous lesions.

Stimulation over metallic implants.

o Do not apply stimulation directly over implanted metallic devices, because this may cause shock or

burns.

Stimulation over eyes.

o Do not apply stimulation directly on the eyes.

Environment

o Electronic monitoring equipment. Do not apply stimulation in the presence of electronic monitoring

equipment (e.g., cardiac monitors, ECG alarms), which may not operate properly when the electrical

stimulation device is in use.

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Bath or Shower.

o Do not apply stimulation when the patient is in the bath or shower. Do not apply stimulation in humid

atmosphere exceeding 75% of relative humidity.

Sleeping.

o Do not apply stimulation while the patient is sleeping.

Driving or operating machinery.

o Do not apply stimulation while the patient is driving, operating machinery, or during any activity in

which electrical stimulation or involuntary muscle contraction can put the patient at risk of injury.

Electrodes for Single Patient.

o Do not share electrodes with other persons. All users should have individual set of electrodes to

prevent undesirable skin reactions or disease transmission.

Accessories.

o Use this device only with the leads, electrodes, and accessories recommended by the manufacturer.

Use of other accessories may adversely affect the performance of the device or may result in

stronger electromagnetic emissions or reduce the electromagnetic immunity of the device.

No Modification.

o No modification of the equipment is allowed.

Pregnancy.

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

Skin irritation.

o Some patients may experience skin irritation or hypersensitivity due to the electrical stimulation or

electrical conductive medium (gel). The irritation may be reduced by using an alternate conductive

medium or alternate electrode placement. Some patients may experience redness under the

electrodes after a session. This redness usually disappears within a few hours. Advise the patient to

consult the clinician if the skin redness does not disappear after a few hours. Do not start another

stimulation session in the same area if the redness is still visible. Don’t scratch the redness area.

Heart Disease.

o Patients with suspected or diagnosed heart disease should follow precautions recommended by their

physicians.

Epilepsy.

o Patients with suspected or diagnosed epilepsy should follow precautions recommended by their

physicians.

Internal Bleeding.

o Use caution when the patient has a tendency to bleed internally, such as following an injury or

fracture.

After Surgery.

o Use caution following recent surgical procedures when stimulation may disrupt the patient’s healing

process.

Over uterus.

o Do not place electrodes directly over the uterus or connect pairs of electrodes across the abdomen if

you are pregnant. The reason is that, theoretically, the current could affect the foetus’s heart

(although there are no reports of it being harmful).

Lack of sensation.

o Use caution if stimulation is applied over areas of skin that lack normal sensation. Don’t apply

stimulation on patient unable to express themselves.

Stimulation.

o The stimulator should only be used with skin electrodes intended for nerve and muscle stimulation.

Muscle soreness may occur after stimulation but usually disappears within a week.

Hot casing or batteries.

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o Under extreme use conditions, some parts of the casing might reach up to 109 °F (43 °C). Use

caution when manipulating the batteries right after device use or when holding the device. There is

no particular health risk associated with this temperature besides your comfort.

Children.

o Keep this device out of the reach of children.

Electrode Size.

o Do not use electrodes with an active area less than 16 cm2, as there will be a risk of suffering a burn

injury. Caution should always be exercised with current densities more than 2mA/cm2.

Strangulation.

o Do not wrap leadwires around your neck, and keep them out of the reach of children. Strangulation

may result from entanglement in the leadwires.

Tripping.

o Care should be used to avoid tripping on lead wires

 .

Damaged Device or Accessories.

o Never use the device or any of its accessories if it is damaged (case, cables, etc.) or if the battery

compartment is open as there is a risk of electric shock. Carefully inspect the lead wires and

connectors prior to each use.

Inspect Electrodes.

o Inspect electrodes before each use. Replace electrodes when they begin to deteriorate or lose

adhesion. Poor contact between the electrodes and the patient’s skin increases the risk of skin

irritation or burns. Electrodes will last longer if used and stored according to instructions on electrode

packaging. Attach the electrodes in such a way that their entire surface is in contact with the skin.

Heat and Cold products.

o The use of heat or cold producing devices (e.g. electric heating blankets, heating pads or ice packs)

may impair performance of the electrode or alter the patient’s circulation/sensitivity and increase the

risk of injury to the patient.

Pulled muscles.

o Do not apply electrodes over pulled muscles. Using the stimulator on a previously extended muscle

might further pull such muscle. The higher the stimulation intensity, the higher the risk to further

overextends such muscle.

3.2 CAUTIONS

Electrosurgical equipment or defibrillators.

o Disconnect the stimulation electrodes before using electrosurgical equipment or defibrillators.

Otherwise skin burns may be caused below the electrodes and the device might be destroyed.

Magnetic Resonance Imaging.

o Do not wear electrode or the device during Magnetic Resonance Imaging (MRI) scans as this may

result in metal overheating and causing skin burns in the area of the electrode.

Flammable or explosive environment.

o Do not use the device in areas where there is a risk of fire or explosion, such as oxygen-rich

environments, in the vicinity of flammable anaesthetics, etc.

Power supply.

o Never connect stimulation cables to an external power supply as there is a risk of electric shock.

Near other equipment.

o Do not use the device beside or stacked on top of any other equipment. If you must use it side by

side or on top of another system, you should check that the device works properly in the chosen

configuration.

Supervision.

o Use this device only under the continued supervision of a licensed practitioner. Electrode placement

and stimulation settings should be based on the guidance of the prescribing practitioner.

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Manufacturer.

o The manufacturer does not take any responsibility for any electrode placements other than

recommended.

Foreign bodies.

o Do not allow any foreign bodies (soil, water, metal, etc.) to penetrate the device and the battery

compartment.

Batteries.

o Do not carry batteries in a pocket, purse, or any other place where the terminals could become short-

circuited (e.g. by way of paper clip). Intense heat could be generated and injury may result. Never

open the battery cover during stimulation in order to avoid electrical shock. Remove the batteries

from the device if you do not intend to use it for a prolonged period of time (more than 3 months).

Extended storage of the batteries in the device might lead to batteries and device damage.

Cable.

o The cable is best preserved if left attached to the stimulator between sessions. Do not jerk the cable

or connection.

Additional Precautions for TENS

TENS is not effective for pain of central origin, including headache.

TENS is not a substitute for pain medications and other pain management therapies.

TENS devices have no curative value.

TENS is a symptomatic treatment and, as such, suppresses the sensation of pain that would otherwise serve

as a protective mechanism.

Effectiveness of TENS is highly dependent upon patient selection by a practitioner qualified in the

management of pain patients

3.3 DANGER

Electrodes.

Any Electrode with a minimum active area of 16 cm² may be used with this device. Use of an electrode with an

area less than 16 cm² can cause burns when the unit is used at higher intensities. Consult your clinician prior

to using any electrode less than 16 cm².

•

Dangerous voltage.

Stimulus delivered by the waveforms of the device, in certain configurations, will deliver a charge of up to 20

microcoulombs (µC) or greater per pulse and may be sufficient to cause electrocution. Electrical current of this

magnitude must not flow through the thorax because it may cause a cardiac arrhythmia

3.4 ADVERSE REACTIONS

Patients may experience skin irritation and burns beneath the stimulation electrodes applied to the skin.

• Patients may experience headache and other painful sensations during or following the application of

electrical stimulation near the eyes and to the head and face.

Patients should stop using the device and should consult with their physicians if they experience adverse

reactions from the device.

•Do not disconnect any stimulation cables during a session while the stimulator is switched on. Switch the

stimulator off first. Always turn off the stimulator before moving or removing any electrodes during a session.

• •Do not use electrodes with an active area less than 16 cm2, as there will be a risk of suffering a burn injury.

Caution should always be exercised with current densities more than 2mA/cm2.

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•Do not apply stimulation in the vicinity of metal. Remove jewelry, body piercings, buckles or any other

removable metallic product or device in the area of stimulation. Never use the electrodes contra-laterally, i.e.

do not use two pins connected to the same channel on opposite segments of the body.

Never carry out an initial stimulation session on a person who is standing. The first five minutes of stimulation

must always be performed on a person who is sitting or lying down. In rare instances, people of a nervous

disposition may experience a vasovagal reaction. This reaction is connected with fear of the muscle

stimulation as well as surprise at seeing one of their muscles contract without having intentionally contracted

it themselves. A vasovagal reaction causes heart to slow down and blood pressure to drop, which can make

you feel weak and faint. If this does occur, stop the stimulation and lie down with the legs raised until the

feeling of weakness disappears (5 to 10 minutes).

Sudden temperature changes can cause condensation to build up inside the stimulator. To prevent this,

allow it to reach room temperature before use

4 Intended User

The Tensmed P82 and Tensmed S82 are intended to be used, and shall only be used, by or under the supervision of

professional users in the field of physical medicine and rehabilitation.

5 Intended Use

The Enraf Tensmed P82/S82 are multifunctional electrotherapy devices with various treatment modes that allow for

neuromuscular electrical stimulation (NMES). The Enraf Tensemed S82 offer also transcutaneous electrical nerve

stimulation (TENS).

6 Indications and Contra-Indications

6.1 INDICATIONS

As an NMES device, indications are for the following conditions:

 Retarding or preventing disuse atrophy

 Maintaining or increasing range of motion

 Re-educating muscles

 Relaxation of muscle spasms

 Increasing local blood circulation

As a TENS device, indications are for the following conditions:

 Symptomatic relief and management of chronic, intractable pain

 Adjunctive treatment for post-surgical and post-trauma acute pain

 Relief of pain associated with arthritis”

6.2 CONTRA-INDICATIONS

Implanted electronic devices.

Do not use the device on patients who have a cardiac pacemaker, implanted defibrillator, or other implanted

electronic device, because this may cause electric shock, burns, electrical interference, or death.

•

TENS for Undiagnosed Pain.

Do not use the device as a TENS device on patients whose pain syndromes are undiagnosed.

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7 Overview

7.1 CONTROL BUTTONS

1. ON/OFF

Turns the stimulator on and off.

Turns the stimulator off even when the key lock

is activated.

Can be used for terminating the stimulation at all

times.

2. INCREASE (left and right channel)

Increases the amplitude (intensity of stimulation).

Press and hold the button to increase the

amplitude continuously.

Note! Always increase the amplitude cautiously.

Scrolls through choices in programming mode.

3. DECREASE (left and right channel)

Decreases the amplitude (intensity of

stimulation).

Press and hold the button to decrease the

amplitude continuously.

Deactivates the key lock.

Scrolls through choices in programming mode.

4. PROGRAM

Selects a program (P1–P28).

Use P+ to step forward through the programs

and P– to step backward.

5. HAND SWITCH CONNECTION

By using the hand switch, the contractions in

programs with intermittent stimulation can be

manually controlled.

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7.2 DISPLAY SYMBOLS

1. BROKEN CIRCUIT (left and right

channel)

Broken circuit. The reason for a broken

circuit may be too high resistance or

cable breakage. See chapter

2. KEY LOCK

Activated key lock. The key lock is

automatically activated if no key is

pressed for 20 seconds.

Deactivate the key lock by pressing the

left or right DECREASE button

3. BATTERY STATUS

Empty batteries. This symbol is only

shown when the batteries are almost

empty.

4. PROGRAM NUMBER

Selected program number.

5. REMAINING TIME

Remaining program time in minutes and

seconds

6. AMPLITUDE BARGRAPH (left and

right channel)

Selected amplitude as a bargraph.

7. AMPLITUDE LEVEL (left and right

channel)

Current of selected amplitude in mA

8. WORK/REST (intermittent

stimulation)

Work/rest indication for programs with

intermittent stimulation. The upper part

of the symbol is flashing during work

time and the bottom part during rest

time

9. HIGH/LOW FREQUENCY (mixed

frequency stimulation)

High/low frequency indication for mixed

frequency programs. The upper part of

the symbol is flashing during high

frequency and the bottom part during

low frequency.

10. PROGRAM STEPS

This marker informs you about the

active sequence during a program and

during programming.

There are 3 sequences available.

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8 Operation

8.1 STEP-BY-STEP USE

The TensMed P82 can be used TENS treatments and the TensMed S82 for TENS and NMES treatment. Use only

those treatment programs that your health care provider has determined are the most effective for your needs. The

stimulator has two simultaneous channels, which means that both channels stimulate with the same program. A hand

switch is provided to make it easy to manually control muscle contractions in NMES programs.

1. INSERT THE BATTERIES

Insert the batteries (see chapter Replacement of Batteries).

2. ATTACH THE ELECTRODES

See instruction of the self-adhesive electrodes

Connect the electrodes to the cables

Attach the electrodes to the

body

Connect the cable to the unit

3. CONNECT THE HAND SWITCH (optional accessories)

Note! This is only applicable for programs P6–P19 and P26–P28.

4. SWITCH THE STIMULATOR ON

Press the ON/OFF. This button can be used for terminating the stimulation

at all times, even when the key lock is activated.

Always switch the stimulation off before removing electrodes from the skin.

5. SELECT A PROGRAM (P1–P28)

Press the PROGRAM P+ or P- to step forward until the program of your

choice is shown on the display.

Note! When selecting a program the amplitude must be set to 00.0 mA for

both channels.

For further information on the programs, see chapter PROGRAMS.

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6. START THE STIMULATION

TENS

Press the INCREASE button ▲ for each channel until you reach a

comfortable level of stimulation. Press and hold the button to increase the

amplitude continuously.

NMES

Press the INCREASE button ▲ for each channel until you get visible

muscle contractions. Press and hold the button to increase the amplitude

continuously

Note! Both channels must be used for programs P20 and P21.

Note! Always increase the amplitude cautiously!

See section SPECIAL INSTRUCTIONS for the following cases:

 Mixed frequency stimulation

 Intermittent stimulation + hand switch

 Intermittent stimulation with Active Rest

An automatically activated key lock prevents unintentional changes during treatment. The key lock is activated if no

button is pressed for 20 seconds.

Press any of the DECREASE button ▼to deactivate the key lock.

7. STOP THE STIMULATION

You can stop the stimulation before the program time has elapsed by pressing the DECREASE button ▼until the

amplitudes are 00.0 mA or by pressing the ON/OFF .

When the program is finished, remaining time “00:00” is flashing on the display.

The last used program is saved when the stimulator is turned off and then pre-selected the next time the stimulator is

turned on.

The stimulator turns off after 5 minutes of inactivity to spare batteries.

8.2 SPECIAL INSTRUCTIONS

Mixed frequency stimulation (P4)

Mixed frequency stimulation is a combination of high (80 Hz) and low (2 Hz) frequency stimulation with separate

amplitude settings.

1. First set the amplitude for 80 Hz stimulation when the upper part of the high/low frequency

symbol is flashing

2. When the bottom part of the symbol flashes for the first time, the amplitude for 2 Hz stimulation

will start at the same level as is set for 80 Hz. Adjust the amplitude until you get visible muscle

contractions.

The period between the frequency changes is preset to 3 seconds.

See chapter FREQUENTLY ASKED QUESTIONS for further information on mixed frequency

stimulation

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Intermittent stimulation + hand switch (P6–P19 and P26-P28)

Programs P6–P19 and P26-P28 are intermittent stimulation programs with rest time between the muscle contractions

(work time), see figure.

The contraction gradually increases during ramp-up time and reaches maximum contraction during work time. During

ramp-down time, the stimulation gradually decreases until the rest time starts. The rest time can be without or with

stimulation (Active Rest).

In intermittent stimulation programs the work/rest symbol is shown on the display. The upper part of the symbol is

flashing during work time and the bottom part during rest time.

Programs P6–P19 and P26-P28 can be used together with the hand switch to manually control the duration of the

work time and rest time. Press the hand switch button during rest time for ramp-up time and contraction. The duration

of the work time is preset but can be shortened by pressing the hand switch button. The rest time lasts until the hand

switch button is pressed again.

See chapter FREQUENTLY ASKED QUESTIONS for further information on using the hand switch.

Intermittent stimulation with Active Rest (P16- P17)

In programs with Active Rest, the stimulation is active also during the rest time, which means that you have to

perform two amplitude settings for each channel.

Amplitude setting for contractions (work time):

When the upper part of the work/rest symbol is flashing, increase the amplitude gradually until you get muscle

contractions without pain.

Amplitude setting for Active Rest: When the bottom part of the work/rest symbol is flashing, increase the

amplitude gradually until you get muscle vibrations.

See chapter FREQUENTLY ASKED QUESTIONS for further information on Active Rest.

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9 Replacement of batteries

A battery symbol is shown on the display when the batteries are almost empty.

As long as the stimulator is working normally you can continue the treatment. When stimulation feels weaker than

usual or the stimulator turns off, it is time to replace the batteries.

If the stimulator is not used for some time (approximately 3 months), the batteries should be removed from the

stimulator.

The stimulator operates on either two non-rechargeable 1.5 V AA batteries or two rechargeable 1.2 V AA batteries,

recharged in a separate charger.

REPLACING THE BATTERIES

1. Turn off the stimulator.

2. Locate the battery compartment on the back of the stimulator.

3. Remove the battery cover by pressing the mark at the top firmly and sliding the cover downwards.

4. Remove the batteries.

5. Insert the new batteries correctly according to the polarity markings (+ and –) inside the battery compartment,

see picture.

6. Replace the battery cover.

7. Dispose of the exhausted batteries in accordance with local and national regulations.

NOTE! Non-rechargeable batteries may not be charged due to the risk of explosion.

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10 Programs

10.1 PRESET PROGRAMS – TENS

The TensMed P82 has 5 preset TENS programs for pain relief. (P1 – P5)

The program overview below shows the stimulation mode and parameter settings for each program.

For information on treating various pain conditions with TENS, see the clinical guide last in this manual. For further

information on programs P4, see chapter FREQUENTLY ASKED QUESTIONS.

Program 1

Conventional TENS

Frequency

80 Hz

Pulse duration

180 µs

Treatment Time

30 minutes

Program 2

Burst TENS

Frequency

2 Hz

Pulse duration

180 µs

Treatment Time

30 minutes

Program 3

Modulated Pulse

Duration

Frequency

80 Hz

Pulse duration

70 < > 180 µs

Treatment Time

30 minutes

Program 4

Mixed frequency TENS

Frequency 1 (low)

2 Hz

Frequency 2 (high)

80 Hz

Modulation time

3 seconds

Pulse duration

180 µs

Treatment Time

30 minutes

Program 5

Nausea treatment

Frequency

10 Hz

Pulse duration

180 µs

Treatment Time

10 minutes

ENGLISH

081-400-245-43_EN Page 16 of 39

10.2 PRESET PROGRAMS – NMES

The TensMed S82 offers additional to the 5 TENS programs 23 NMES programs, adjusted to either smaller or larger

muscle groups. The pulse duration is 200 µs when stimulating smaller muscle groups and 300–400 µs when

stimulating larger muscle groups.

Two programs can have the same headline. The difference between them is for instance the length of the work time

and the rest time and/or the frequency. Have your patient’s status in mind when choosing programs. If the patient’s

muscular capability is assessed the correct program is easier to find. A longer rest time is recommended when

stimulating a weaker muscle since the muscle is then given a longer preparation time before the next contraction.

The use of a hand switch will individualize the treatment even more.

Program 6

Intermittent stimulation for smaller

muscle groups

Frequency

50 Hz

Pulse duration

200 µs

Ramp up time

1 sec.

Work time

2 sec.

Rest time

2 sec.

Ramp down time

1 sec.

Treatment Time

20 minutes

Program 7

Intermittent stimulation for smaller

muscle groups

Frequency

65 Hz

Pulse duration

200 µs

Ramp up time

2 sec.

Work time

4 sec.

Rest time

4 sec.

Ramp down time

2 sec.

Treatment Time

20 minutes

Program 8

Intermittent stimulation for smaller

muscle groups

Frequency

50 Hz

Pulse duration

200 µs

Ramp up time

2 sec.

Work time

5 sec.

Rest time

15 sec.

Ramp down time

2 sec.

Treatment Time

20 minutes

Program 9

Intermittent stimulation for smaller

muscle groups

Frequency

50 Hz

Pulse duration

200 µs

Ramp up time

2 sec.

Work time

10 sec.

Rest time

10 sec.

Ramp down time

2 sec.

Treatment Time

20 minutes

Program 10

Intermittent stimulation for smaller

muscle groups

Frequency

50 Hz

Pulse duration

200 µs

Ramp up time

2 sec.

Work time

15 sec.

Rest time

30 sec.

Ramp down time

2 sec.

Treatment Time

20 minutes

Program 11

Intermittent stimulation for large

muscle groups

ENGLISH

081-400-245-43_EN Page 17 of 39

Frequency

50 Hz

Pulse duration

400 µs

Ramp up time

1 sec.

Work time

2 sec.

Rest time

2 sec.

Ramp down time

1 sec.

Treatment Time

20 minutes

Program 12

Intermittent stimulation for lager

muscle groups

Frequency

65 Hz

Pulse duration

400 µs

Ramp up time

2 sec.

Work time

4 sec.

Rest time

8 sec.

Ramp down time

2 sec.

Treatment Time

20 minutes

Program 13

Intermittent stimulation for lager

muscle groups

Frequency

65 Hz

Pulse duration

400 µs

Ramp up time

2 sec.

Work time

5 sec.

Rest time

15 sec.

Ramp down time

2 sec.

Treatment Time

20 minutes

Program 14

Intermittent stimulation for lager

muscle groups

Frequency

50 Hz

Pulse duration

350 µs

Ramp up time

4 sec.

Work time

8 sec.

Rest time

24 sec.

Ramp down time

2 sec.

Treatment Time

20 minutes

Program 15

Intermittent stimulation for Lager

muscle groups

Frequency

50 Hz

Pulse duration

350 µs

Ramp up time

2 sec.

Work time

10 sec.

Rest time

10 sec.

Ramp down time

2 sec.

Treatment Time

20 minutes

Program 16

Stimulation with active rest Smaller

muscle groups

Frequency

35 Hz

Rest frequency

8 Hz

Pulse duration

200 µs

Ramp up time

2 sec.

Work time

10 sec.

Rest time

10 sec.

Ramp down time

2 sec.

Treatment Time

20 minutes

Program 17

Stimulation with active rest Larger

muscle groups

Frequency

50 Hz

Rest frequency

8 Hz

Pulse duration

350 µs

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Enraf-Nonius TensMed P82 & S82 DJO User manual

Enraf-Nonius TensMed P82 & S82 DJO User manual

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