Chattanooga Group
ARTROMOT ACTIVE-K CPM and CAM Operating Instructions SW 2.X REV 03/03 March 2013
Operating Instructions
75 Pages
Preview
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O p e r at i n g I n s t ruc t i o n s
ARTROMOT® ACTIVE-K CPM · CAM · Coordination US/GB · Operating Instructions SW2.X
Supplied by EME Services Ltd
1. How to use the physiotherapy unit 1.1 Fields of application 1.2 Therapy objectives 1.3 Indications 1.4 Contraindications 1.5 Secondary effects
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2. Description of the ARTROMOT® ACTIVE-K 2.1 Description of the device components 2.2 Description of the control pendant 2.3 Explanation of symbols 2.4 Explanation of symbols (connections and rating plate)
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3. Safety information
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4. Device setup 4.1 Connecting the unit, performance check, Equipment supplied 4.2 Connecting the external muscle stimulator 4.3 Adjusting the unit to the femur length 4.4 Adapting the leg support assemblies/footplate
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5. Setting the treatment values 5.1 General information on programming ARTROMOT® ACTIVE-K 5.2 Therapy parameter details 5.3 Other functions/settings
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6. Operating mode details 6.1 Passive operating mode (CPM) 6.2 Active operating mode (CAM) 6.3 Coordination mode
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7. Care, Maintenance, Transport 7.1 Care 7.2 Maintenance (fuse replacement) 7.3 Transport
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8. Environmental Protection Statement
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9. Specifications
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10. IEC 60601-1-2:2007 and IEC 60601-1-11:2010 10.1 Electromagnetic emissions 10.2 Electromagnetic immunity 10.3 Recommended separation distances
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11. Contact
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12. Technical service 12.1 Technical hotline 12.2 Shipment 12.3 Spare parts
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13. Accessories and Parts for Use with the Device
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14. Declaration of conformity
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Content
1.1 Fields of application
1.3 Indications
The ARTROMOT® ACTIVE-K is a motorized physiotherapy unit. It combines the benefits of CPM therapy (= Continuous Passive Motion), post-operative mobilization, and CAM therapy (= Controlled Active Motion), neuromuscular training to reduce functional instability. With these features, it promotes rehabilitation by allowing both, continuous passive motion and, after initial therapy, controlled active motion of the knee and hip joints. The ARTROMOT® ACTIVE-K physiotherapy unit should not be considered as an exercise machine, but as a therapy unit for early mobilization, offering active exercising to promote coordination and preservation of functional strength at an early stage.
The physiotherapy unit is indicated in the treatment of most injuries and diseases of the knee and hip joints as well as in postoperative treatment after knee and hip joint surgery. Examples:
The ARTROMOT® ACTIVE-K physiotherapy unit is an important supplement to medical and therapeutic treatment for use in hospitals, clinics, general practices and rental services.
– endoprosthetic implants
1.2 Therapy objectives
Do NOT use ARTROMOT® ACTIVE-K on patients with:
– joint distortion and contusion – arthrotomy and arthroscopy procedures in combination with synovectomy, arthrolysis, or other intra-articular interventions – mobilization of joints in anesthetized patients – operative treatment of fractures, pseudoarthrosis, and osteotomy – cruciate ligament replacement or reconstruction
1.4 Contraindications
– acute inflammatory processes in the joints, unless on the order of a physician
CPM therapy with the ARTROMOT® ACTIVE-K is mainly used to prevent the negative effects of immobilization, to allow patients to regain painless mobility of joints at an early stage, and to promote healing and achieve a positive functional result. Furthermore, the active component of the therapy unit is intended to enhance proprioception at an early stage and thus improve coordination following joint surgery.
– spastic paralysis – unstable osteosynthesis
1.5 Secondary effects Currently, there is no evidence of desired or undesired secondary effects of CPM or CAM units.
Other objectives of therapy include: – improvement of joint metabolism – prevention of joint stiffness – promotion of the regeneration and healing of cartilage and damaged ligaments – faster hematoma/fluid resorption – improved lymph and blood circulation – thrombosis and embolism prophylaxis – bridging the gap between passive motion and active training with exercise machines during rehabilitation – enhancing coordination/sensory perception after surgery Supplied by EME Services Ltd
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1. How to use the physiotherapy unit (Intended Use)
The motorized physiotherapy unit permits active and passive motion of the knee joint in the form of extension / flexion in the range of –10 – 0 – 120 degrees and of the hip joint in the form of extension / flexion in the range of 0 – 10 – 115 degrees The range of motion can be set very precisely in steps of 1 degree. Additionally, in the active mode, a resistance in the direction of motion or in the opposite direction can be set individually in the range from 1 kg to 30 kg in steps of 1 kg. Furthermore, the physiotherapy unit comes with special protocols to enhance proprioception, i.e., coordination, and functional stability at an early stage. These are some of the ARTROMOT® ACTIVE-K features: – anatomically correct setup – physiological movements – control pendant for precise adjustment of patient-specific therapy values – symbols for easy operation of the control pendant – chip card for storage of the programmed therapy parameters Biocompatibility Those parts of the ARTROMOT® ACTIVE-K that come into contact with the patient when the device is used as intended, are designed to fulfil the biocompatibility requirements of the applicable standards.
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2. Description of the ARTROMOT® ACTIVE-K
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2.1 Description of the device components 9 10 11 12 13
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ACTIVE-K
special
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10 24 21 20 19 18 25
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14. Clamping lever to adjust the footplate rotation 15. Sensor for measurement of the exerted force 16. Connection for ARTROSTIM®-FOCUSplus control cable 17. Connection for control pendant 18. Connection for power cord 19. Instrument fuse 20. Power switch (ON/OFF) 21. Rating plate 22. Control pendant 23. Patient chip card 24. Grommets for attachment of fastening straps 25. Supports to secure the unit at the end of the bed/couch
1. Thigh support assembly 2. Clamping lever to adjust the height of the thigh support assembly 3. Thigh length scale (femur length scale) 4. Thigh length fixation screws (femur length) 5. Knee hinge with LED indicating the force exerted in active mode 6. Calf support assembly 7. Clamping levers to adjust the height of the calf support assembly 8. Support for storage of control pendant 9. Calf length locking catch (tibia length) 10. Calf length scale (tibia length scale) 11. Straps to secure the foot to the footplate 12. Footplate 13. Locking screw for adjustment of the footplate height
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2.2 D escription of the control pendant 2.2.1 B uttons on the control pendant
Patient chip card stores the entered therapy parameter values
MENU button displays the menu for setting the therapy parameters in each operating mode
Display Return button used to return to the previous level Arrow to the right moves the focus (blue field) for selection of a function to the right
Arrow up – moves the focus (blue field) for selection of a function up – increases values during setup
OK button
– activates functions
– confirms a selection – confirms a setting
Arrow to the left moves the focus (blue field) for selection of a function to the left
Arrow down – moves the focus (blue field) for selection of a function down – decreases values during setup
START button starts a treatment from the current setup menu or if treatment has been suspended
– deactivates functions STOP button stops a treatment and saves the values
Note During operation of the unit, ALL buttons double as EMERGENCY STOP buttons.
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Header showing: Currently highlighted function Here: passive (CPM)
Current display/function Here: symbol for Main Menu
Focus (field with blue background) highlights the currently selectable function
Scroll bar indicates whether or not additional functions are available above or below the function currently displayed
Status lines indicate the current status of each function: – green indicator, function active – value of the selected function
2.2.3 Control pendant in parameter programming mode Selected parameter here: setting for passive extension
Selected operating mode here: passive (CPM) and operating mode reference number, here: 1.1
Status of the selected function here: extension angle
Symbol for selected parameter here: setting for passive extension
Control buttons for changing the current setting here:
Additional information Appears only when needed here: current ROM limits blue = adjustable value (here: extension) grey = status of the second, corresponding value (here: flexion) and current position of the carriage (small bar) Supplied by EME Services Ltd
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– arrow up, increases the value – arrow down, decreases the value – OK, saves the setting
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2.2.2 Control pendant with main menu
Selected operating mode here: passive (CPM)
Selected parameter here: warm-up protocol
Status of the selected function here: warm-up protocol inactive When the function is activated, the square is solid green and displays a check mark.
Symbol for selected parameter here: warm-up protocol
Control buttons for changing the current setting here: – Arrow up, activates the function – Arrow down, deactivates the function – OK, saves the setting
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2.2.4 Control pendant in programming mode for functions that can be activated
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2.3 Explanation of symbols 2.3.1 General treatment parameters Operating modes
Passive (CPM)
Active (CAM)
Coordination
Therapy protocols
Protocols available for selection under "operating mode" Coordination:
Maintain force, static
Maintain force, dynamic
Find angle, passive Find angle, active
Free training
Therapy protocols:
Cruciate ligament (ACL/PCL)
Cartilage
Total knee/hip replacement (TEP)
Level selection
Demo
Passive extension (stretching) adjustment
Passive flexion (bending) adjustment
Active adjustment (range of motion - ROM)
Timer (therapy timer)
Speed
Warm-up protocol (passive)
Extension pause
Flexion pause
Muscle stimulation
Load reversal
Extension force
Flexion force
Active zone
Extension force range
Flexion force range
Adjustable parameters
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Parameter
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2.3.2 Other symbols
Available functions/adjustments
New Patient
Documentation
Total patient therapy time
Therapy documentation
Settings
Language selection
Brightness
Volume
Transport
Total unit run time
Service menu
Lock-out function
Time/date
Lock-out function disabled
Lock-out function enabled Level 1
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Lock-out function Lock-out function enabled enabled Level 2 Level 3
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Lock-out function enabled Level 4
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2.4 Explanation of symbols (connections and rating plate)
alternating current for serial numbers < 2,000: protection class I equipment. The medical device must be connected to a system with protective earth conductor! for serial numbers > 2,000: protection class II equipment. The medical device has a double or reinforced insulation. type B applied part power switch OFF power switch ON The number next to this factory symbol is the year of manufacture
The name next to this factory symbol is the manufacturer The number next to this symbol is the article reference number Device complies with Council Directive 93/42/EEC about medical devices, tested and approved by DQS Medizinprodukte GmbH The number next to this symbol is the serial number
m
Caution! Observe warnings set forth in operation manual!
Observe Operation Manual
Do not dispose with unsorted municipal waste
Protect from moisture
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IP21
The rating IP21 means: 2 is the level of protection against contact and solid objects The digit 2 means: – Protection from contact: protected from contact with a finger – Protection against foreign object: protected against solid foreign object (diameter of 12.5 mm and greater) 1 indicates the degree of protection against water The digit 1 means: protection against vertically falling water drops 3V type CR2032 (Not user-replaceable! Contact Technical Service) Warning symbol pinch point hazard! Warning! Depending on the device settings, the moving parts of the device present pinch points! Pay particular attention to small children and babies!
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The IP rating indicates the level of protection and thus the suitability of the device for use under different ambient conditions.
Definitions
− Before therapy, a test run consisting of several exercise cycles must be completed, first without and then with the patient. Check that all setting screws are tightened.
Read the safety statements before use of the physiotherapy unit. The safety statements are classified as follows:
− Stop therapy immediately when you have doubts about the device settings and/or the therapy protocol.
m Danger! indicates an imminent hazard. If not avoided, this hazard will result in death or serious injury.
− It is important that the patient's position is anatomically correct. Therefore, carefully verify the following settings/positions:
m Warning!
1. femur length
indicates a hazard. If not avoided, the hazard can result in death or serious injury.
3. tibia length and leg rotation
2. knee joint axis 4. leg support assemblies
m Caution!
− Movements must not cause pain or irritation.
indicates a potential hazard. If not avoided, the hazard may result in minor injury and/or product/property damage.
− Patients must be fully conscious while being instructed in the use of the physiotherapy unit and during therapy. − Only the responsible physician or therapist is able and allowed to choose the therapy parameters and protocols to use. It is the physician's or therapist's decision whether or not to use the unit on a specific patient.
Safety information
m Danger! Explosion hazard - The ARTROMOT® ACTIVE‑K is not designed for use in areas of rooms used for medical purposes where an explosion hazard may occur. An explosion hazard may result from the use of flammable anesthetics, skin cleansing agents, and disinfectants.
− The patient must be familiar with the functions of the ARTROMOT® ACTIVE-K control pendant and the pendant must always be within easy reach of the patient, allowing him or her to stop treatment if needed. Patients unable to operate the control pendant, e.g. paralytic patients, must always be supervised by specially trained staff during therapy.
m Warning!
− After data storage, write the patient's name on the patient chip card. The card should only be used for this particular patient. If the patient chip card is used for another patient, be sure to delete the previous patient's data from the card first (see: "New Patient", section 5.3.2). Use original chip cards only.
Patient hazard - − Only authorized individuals are allowed to operate the ARTROMOT® ACTIVE-K. Individuals are authorized after receiving training in the operation of the unit and reading this operation manual. − Before using the device, the operator must ascertain that it is in correct working order and operating condition.
− Any accessories used with the ARTROMOT® ACTIVE-K must first be approved by DJO Global.
The cables and connectors, in particular, must be checked for signs of damage. Damaged parts must be replaced immediately, before use. Supplied by EME Services Ltd
− Modifications to the medical device described in this document without the manufacturer's written consent is prohibited. 13
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3. Safety information
− After use, store the device in a safe place! Ensure device stability also during storage! − This device is not a toy!
– The simultaneous treatment of both legs by simultaneous use of two CPM devices is not permitted because the motion elements might interfere with each other.
m Warning! Shock hazard - Strictly observe the following warnings. Failure to do so endangers the lives of the patient, the user, and other persons involved.
− If the physiotherapy unit is used in the active mode or in the coordination mode, the side supports (25) must be folded down to stabilize the unit and protect it against moving at the end of the mattress.
− Allow the ARTROMOT® ACTIVE-K to reach room temperature before use. If the device has been transported at temperatures below 0°C (32°F), leave it to dry at room temperature for about 2 hours, until any condensation has disappeared.
− The sole purpose of the side supports is to prevent that the unit moves while in use. Do not use them to adjust the angle setting of the unit. The supports are not designed for this purpose.
− The ARTROMOT® ACTIVE-K must only be operated in dry rooms.
− For transporting the ARTROMOT® ACTIVE-K, the side supports must be folded in to prevent pinching fingers.
− When disconnecting the unit from the power line, remove the plug from the wall outlet first, before disconnecting the cable from the device.
− Stability of the physiotherapy unit must always be ensured while it is in use. The ARTROMOT® ACTIVE-K must only be setup of surfaces that guarantee its stability. Very soft or instable surfaces (such as waterbeds) are NOT suitable.
− When connecting the unit to other equipment or when creating a medical system, check that the sum of leakage currents will not cause any hazard. Please contact DJO Global if you have questions in this matter. − Do not use multiple portable socket outlets (MPSO) to connect the unit to the power line. The ARTROMOT® ACTIVE-K must be connected to a properly installed wall outlet with a non-fused earthed wire. Before connecting the power cord, it must be completely unrolled and placed such that it will not get caught in the moving parts of the unit.
− The utmost caution is advised under the following conditions. Depending on the judgement of the responsible physician, the unit may only be applied under supervision and with the parameters defined by the responsible physician. Otherwise the exercise may be too strenuous for the patient: 1. hypertension (> stage 2), ischemic heart disease and cerebrovascular diseases
− Before cleaning and service interventions, disconnect the unit from the power line by removing the power cord from the wall outlet.
2. cardiovascular diseases 3. pregnancy
− Liquids must not be allowed to enter the physiotherapy unit or the control pendant. If liquids have entered into the units, ARTROMOT® ACTIVE-K must be immediately checked by a service technician, before it can be reused.
4. age: under 16 years
m Warning! − Extreme caution should be taken when in use around small children and babies! Sufficient distance to the device is mandatory for their safety! − Never leave the device unattended when it is switched on! Switch the device off and disconnect the power line from the wall outlet!
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− Do not allow parts of the body or objects (such as blankets, cushions, or cables) to get caught in the moving parts of the physiotherapy unit.
m Caution! Equipment damage -
− Magnetic and electrical fields are capable of interfering with the proper performance of the unit. For this reason make sure that all external devices operated in the vicinity of the unit comply with the relevant EMC requirements. X-ray equipment, MRI devices, radio systems, cell phones, etc. are possible sources of interference as they may emit higher levels of electromagnetic radiation. Keep the unit away from such equipment and verify its performance before use.
− Check that the voltage and frequency ratings of your local power line are those indicated on the rating plate. − The leg support element withstands a maximum continuous load of 30 kg on both axes (horizontal and vertical). − Do not allow any objects (such as blankets, cushions, or cables) to get caught in the moving parts of the unit. − Do not expose the ARTROMOT® ACTIVE-K to direct sunlight, because some of the components may reach inadmissibly high temperatures. Furthermore, the device must be set up at a safe distance from radiators to prevent excessive temperature rises.
− Refer repair and maintenance to authorized persons. Persons are authorized after training by a specialist trained and commissioned by the manufacturer.
− The presence of children, pets and rodents does not normally impair the functioning of the device. However, avoid contamination of the device by children or animals, from dust and lint, and keep them at a safe distance from the device. The safety statements set forth apply.
− Route all cables below the device frame to either side, ensuring that they cannot get caught by the moving parts during operation. − Inspect the ARTROMOT® ACTIVE-K for damage and loose connections at least once a year. Damaged and worn parts must immediately be replaced with original spare parts by authorized staff.
m Caution! Preventing chafing and pressure sores - When your patient is adipose, very tall or very short, be sure to prevent chafing and pressure sores Place the leg concerned in a moderate abductive position if deemed appropriate.
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m Warning! Equipment malfunction -
Note: For an illustration of the individual device components, see page 5.
, then actiSelect the function with vate the function by pressing the arrow up button .
4.1 C onnecting the unit, performance check, Equipment supplied
. The iniConfirm the selection with tial screen for setting the unit to the home position will be displayed. Press
The equipment supplied includes these items: base unit, programming unit (control pendant, 22), patient chip card (23), power cord (not shown), footplate (12), clamping lever to adjust the footplate rotation and to fasten the footplate (14), operating instructions
.
The unit automatically enters the home position allowing you to perform the mechanical adjustment (40° flexion). On the display, you will see the main menu. – Adjustment with programmed chip card
1. Mount the footplate (12) by slipping the pin through the sensor housing (15) at the foot bracket, screwing the clamping lever (14) onto the end of the pin and locking the clamping lever.
Insert the original patient chip card (23) into the control pendant (22).
2. Connect the programming unit (22) to the provided socket (17) by plugging it in and screwing it tight. 3. Connect the power cord to socket (18) of the unit and connect the mains plug to a wall outlet with a non-fused earthed wire (100 to 240 Volt, 50/60 Hz). 4. Turn the power switch (20) on.
Press
5. Follow these steps to set the carriage to the home position.
The unit automatically enters the mounting position (set extension + 10°).
– Initial setup for new patients Insert the original patient chip card (23) into the control pendant (22).
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Performance check If the control pendant can be operated as described above and the ARTROMOT® ACTIVE-K enters the home position, the therapy unit has passed the performance check. The home position is: − if a programmed chip card is used: set extension angle + 10° − after programming for New Patient: stop position = 40 °
Press the MENU button on the control pendant until you see the main menu (for selection of the operating mode).
The device also runs performance checks regularly during operation. This is what happens, if a problem is identified:
Using the arrow buttons, move the focus (blue field) for selection of a function (field displayed with a blue frame) to highlight . the New Patient function
− the unit switches off immediately
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− an audio signal sounds − the message ERROR and an error code (e.g. ERROR 5) appear on the display. 16
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4. Device setup
4.3 A djusting the unit to the femur length 1. Measure the length of the patient's thigh (femur) from the greater trochanter to the outer knee joint gap (Fig. A).
4.2 Connecting the external muscle stimulator
m Caution! Patient hazard, equipment malfunction - Only the ARTROSTIM® FOCUS®plus muscle stimulator with EN 60601-1 approval, from ORMED GmbH (manufacturer: Empi, Inc., USA) may be connected to the ARTROMOT® ACTIVE-K physiotherapy unit.
Fig. A 2. Set the carriage to the home position (see 4.1). 3. Adjust the measured value at the femur scale (3) of the carriage (Fig. B):
Use the "muscle stimulation" cable (part no. 2.0037.024) to connect the muscle stimulator. Other cables are not approved. The cable can be ordered separately from DJO Global. 1. Plug the jack into the ARTROSTIM® FOCUS® plus muscle stimulator.
Fig. B • Loosen the two fixation screws (4). (Open the screws as far as necessary to enable adjusting the slide without any resistance.) • Extend the scale (3) to the required length.
2. Connect the round plug to connector (16) of the ARTROMOT® ACTIVE-K and turn it a little clockwise to lock. 3. Turn on the ARTROMOT® ACTIVE-K first, then turn on the muscle stimulator.
m Caution!
Note
Equipment damage - Do not attempt to extend the femur scale beyond the stop.
• Tighten the fixation screws (4) to set the scale to the new length.
– For information on connecting and programming the muscle stimulator, refer to the operation manual that comes with the ARTROSTIM® FOCUS®plus. – The EMS control function is only available in the "passive" operating mode. – The ARTROMOT® ACTIVE-K only synchronizes motion therapy and electrotherapy; the therapy parameters must be programmed at each device.
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In this situation, you may attempt to restart the unit by turning it briefly off and on again with the power switch. With the unit switched off, check that all plugs are correctly connected. If the error message persists when the unit is switched on again.
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4.4 Adapting the leg support assemblies/footplate 1. Set the leg support assemblies and the footplate (1, 6, 12) to the expected positions before accommodating the patient. • Loosen locking catch (9) to adjust the footplate (12) to the length of the patient's lower leg (Fig. C). The locking catches can be secured in the open position for this purpose.
Fig. F
Fig. C Loosen clamping lever (14) to adapt the footplate's rotation and loosen locking screw (13) to adjust the height to the patient (Figs. D and E).
Fig. G 2. Place the patient's leg on the carriage and repeat the steps outlined under 1 above to adjust the unit to the patient.
m Caution! Equipment damage-Cover the leg support assemblies with disposable tissues when using ARTROMOT® ACTIVE-K immediately after surgery. This helps prevent discoloration.
m Caution!
Fig. D
Patient hazard-Ensure that the rotational axes of the physiotherapy unit and of the knee joint coincide both in the vertical and in the horizontal plane (Fig. H).
Fig. E • To adjust the height of the support assemblies for calf (6) and thigh (1), loosen clamping levers (2 and 7) (Figs. F and G).
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Fig. H
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Symbol 1: Measure the length of the patient's thigh (femur) from the greater trochanter to the outer knee joint gap
Symbol 2: Set the carriage to the home position (see 4.1) and adjust it to the measured femur length. Symbol 3: Adjust the height of calf and thigh support assemblies; adjust the footplate to the height and length of the lower leg.
Note To optimize the stability of the ARTROMOT® ACTIVE-K while it is in use, it can be secured to the therapy couch by means of straps. The straps can be fastened at the four grommets (24) on the unit. Furthermore, two adjustable side supports (25) are fitted at the end of the carriage. The supports can be folded out to secure the carriage at the end of a therapy couch or bed. For this purpose, fold the supports down. If used in a bed, the supports are best placed between the mattress and the bed frame so as to optimally absorb movements of pulling and pushing.
m Caution! Patient hazard-The sole purpose of the supports is to secure the unit in the patient's bed. Do not use them to adjust the angle setting. The supports are not designed for this purpose. When transferring the unit with the supports folded out, be careful not to pinch your fingers. Ensure the stability of the physiotherapy unit. This is only guaranteed on solid surfaces. Do not use the unit in waterbeds, for example, or on other unstable surfaces. Supplied by EME Services Ltd
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m Warning!
This is what happens when you press the OK button to select a parameter:
Patient hazard - Before therapy, a test run consisting of several exercise cycles must be completed without the patient. Then repeat the test run with the patient and check that the movements do not cause any pain.
− The corresponding symbol appears enlarged on the display. − The set value is displayed. With the arrow up/arrow down buttons you change the displayed value. When you press and hold the button, the value will change at a faster rate.
Note: See also 2.2 and 2.3!
5.1 G eneral information on programming ARTROMOT® ACTIVE-K
Some of the (special) functions can only be enabled and disabled. This is done with the arrow up/arrow down buttons. Active parameters are identified with a green square next to the symbol and a check mark.
Initial adjustment with chip card "Special" (red)
To confirm a selection, press the OK button.
Turn on the unit's power switch (20).
Then the display returns to the higher-level menu and you can continue making selections.
The display will show the main menu for selection of an operating mode (passive, active, coordination), the therapy protocols, the documentation function, the New Patient function, or the Settings function. The active setting is indicated with a green dot in the box below the symbol.
Next, press the START button: ARTROMOT® ACTIVE-K automatically verifies the set values and the sessions starts.
The header displays the symbol, which represents the main menu. Next to it, you see the current selection (here: passive (CPM)). The scroll bar in the margin on the right shows whether or not additional functions can be selected. You select the options that are currently out of sight by moving the focus (blue field) past the top or bottom line of symbols. The focus highlights the "passive" operating mode. You shift the focus by pressing the appropriate arrow button. Select one of the fields and activate the corresponding setup menu with the MENU button. The display will show the available therapy parameters or sub-functions and the current selections below the corresponding symbol. You select a treatment parameter or function by pressing the OK button while the focus is on that particular field. Supplied by EME Services Ltd
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5. Setting the treatment values