Chattanooga Group
Electrotherapy Devices
Cefar Basic TENS Electrotherapy Unit User Manual and Electrode Placement Guide Rev C May 2020
User Manual and Electrode Placement Guide
256 Pages
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Page 1
ELEKTRODENPOSITIONERUNGSANLEITUNG
ELECTRODE PLACEMENT GUIDE
GUÍA PARA LA COLOCACIÓN DE ELECTRODOS
OPERATING INSTRUCTIONS... 31
GUIDE DE POSITIONNEMENT DES ÉLECTRODES
MODE D’EMPLOI... 87
GEBRAUCHSANWEISUNG... 3
MANUAL DE INSTRUCCIONES... 59
ISTRUZIONI PER L’USO... 115
GUIDA AL POSIZIONAMENTO DEGLI ELETTRODI
GEBRUIKERSHANDLEIDING... 143 BRUKSANVISNING... 171
OVERZICHT PLAATSING VAN DE ELEKTRODEN
ELEKTRODEPLASSERINGSGUIDE
ELEKTRODPLACERINGSGUIDE
GUIA DE COLOCAÇÃO DE ELETRODO
BRUKSANVISNING... 199 INSTRUÇÕES DE FUNCIONAMENTO... 227
2797
© 05/2020 DJO - 1567 - Rev C
GEBRAUCHSANWEISUNG – DEUTSCH VOR DER VERWENDUNG DES STIMULATORS 1.
EINFÜHRUNG...4
2. MEDIZINISCHER HINTERGRUND...5 3. VORSICHTSMASSNAHMEN...6
PATIENTENINFORMATIONEN 4. ÜBERBLICK...10 STEUERTASTEN...10 DISPLAYSYMBOLE... 11
5. BETRIEB... 12 SCHRITTWEISE ANLEITUNG...12 AUTO-STIMULATIONSMODUS...13 TIMER...14 PROGRAMM UNTERBRECHEN...14
6. AKKUS BZW. BATTERIEN WECHSELN... 15
INFORMATIONEN FÜR DEN PROFESSIONELLEN EINSATZ 7. PROGRAMMÜBERSICHT...16 PROGRAMMSPERRE...18 ÜBERWACHUNGSFUNKTION...18
ZUSÄTZLICHE INFORMATIONEN 8. ZUBEHÖR...19 9. PFLEGEANLEITUNG...20 10. FEHLERSUCHE... 21 11. HÄUFIG GESTELLTE FRAGEN (FAQ)...22 12. TECHNISCHE DATEN...23 ZEICHENERKLÄRUNG... 24
13. ELEKTRODENPOSITIONIERUNGSANLEITUNG.SIEHE UMSCHLAG 14. ELEKTROMAGNETISCHE VERTRÄGLICHKEIT (EMV)-TABELLEN...25
3
OPERATING INSTRUCTIONS – ENGLISH BEFORE USING THE STIMULATOR 1.
INTRODUCTION...32
2. MEDICAL BACKGROUND...33 3. PRECAUTIONARY MEASURES...34
PATIENT INFORMATION 4. OVERVIEW...38 CONTROL BUTTONS... 38 DISPLAY SYMBOLS... 39
5. OPERATION...40 STEP-BY-STEP USE...40 AUTO STIMULATION MODE...41 TIMER... 42 PROGRAM PAUSE... 42
6. REPLACEMENT OF BATTERIES...43
PROFESSIONAL INFORMATION 7. PROGRAM GUIDE...44 PROGRAM LOCK... 46 COMPLIANCE... 46
ADDITIONAL INFORMATION 8. ACCESSORIES...47 9. CARE INSTRUCTIONS...48 10. TROUBLESHOOTING...49 11. FREQUENTLY ASKED QUESTIONS...50 12. TECHNICAL DATA... 51
KEY TO THE SYMBOLS...52
13. ELECTRODE PLACEMENT GUIDE...SEE COVER 14. ELECTROMAGNETIC COMPATIBILITY (EMC) TABLES...53
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1. INTRODUCTION 32
CEFAR Medical AB has been a medical supplier of professional TENS Pain Relief products for more than 30 years. The company was established in Sweden in 1975 and is currently represented in large parts of the world. The Cefar stimulators are widely used and endorsed by medical professionals and top athletes around the world. TENS is effective, has no side effects and it’s economical. Through clinical research, areas of application for TENS and EMS are rapidly expanding. Cefar is working actively to further develop the method towards a natural treatment alternative for the consumer. More information about TENS (Transcutaneous Electrical Nerve Stimulation), EMS (Electrical Muscle Stimulation) and our products can be found on our web site: www.cefar.se INTENDED USE: CEFAR BASIC (1529) is a dual channel (four electrodes) nerve stimulator (TENS) with non-independent channels. CEFAR BASIC is designed for use by both professionals and home users. Its three preset pain programs provides relief of a wide range of pains, like back pain and neck pain. The stimulator has buttons for setting of program, amplitude and timer. An automatic key lock is activated 10 seconds after the amplitude has been set. INTENDED USER: The user of CEFAR BASIC 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.
2. MEDICAL BACKGROUND WHAT IS TENS? TENS = Transcutaneous Electrical Nerve Stimulation. TENS is an effective method offering Pain Relief. TENS utilises the nervous system’s own pain relief mechanisms to ease both acute and chronic pain.
WHEN IS TENS USED? Good results are observed in acute and long-term pain conditions of many kinds, but above all when the pain originates in joints, the skeleton, muscles, skin, viscera, or nervous system. In some cases, TENS on its own may be sufficient, and in other cases it may provide a valuable complement to other forms of treatment.
HOW DOES IT WORK? With the Pain Relief programs, impulses are sent through the nerves to block the pain impulses. Pain Relief is usually most efficient during stimulation, but the effect can also last after the program has finished. It also increases the circulation. The Pain Relief programs do not always treat the cause of pain. If the pain persists, seek medical advice.
WHEN AND HOW SHOULD I USE TENS? The programs in the CEFAR BASIC can be used on any occasion when Pain Relief or Muscle Relaxation is needed. All the programs can be used as often as required. Guidelines for using the treatment programs with indication examples, suggested electrode placements and recommended treatment time are included in this manual.
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3. PRECAUTIONARY MEASURES 34
3.1. CONTRAINDICATIONS •
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.
3.2. WARNINGS •
Consult with physician. 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. Apply stimulation only to normal, intact, clean, healthy skin.
•
Long term effects. The long-term effects of chronic electrical stimulation are unknown.
•
Stimulation location. 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. 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. 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. 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. Do not apply stimulation over, or in proximity to, cancerous lesions.
•
Stimulation over eyes. Do not apply stimulation directly on the eyes.
•
Environment. 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.
•
Bath or Shower. 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. Do not apply stimulation while the patient is sleeping.
•
Driving or operating machinery. 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.
•
Electrosurgical equipment or defibrillators. 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. 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. 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. Never connect stimulation cables to an external power supply as there is a risk of electric shock.
•
Near other equipment. 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.
•
Miscellaneous. Electrodes for Single Patient. Do not share electrodes with other persons. All users
•
should have individual set of electrodes to prevent undesirable skin reactions or disease transmission.
•
Accessories. 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. No modification of the equipment is allowed.
3.3. PRECAUTIONS •
Supervision. 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.
•
Manufacturer. The manufacturer does not take any responsibility for any electrode placements other than recommended.
•
Pregnancy. The safety of electrical stimulation during pregnancy has not been established.
•
Skin irritation. 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. Patients with suspected or diagnosed heart disease should follow precautions recommended by their physicians.
•
Epilepsy. Patients with suspected or diagnosed epilepsy should follow precautions recommended by their physicians.
•
Internal Bleeding. Use caution when the patient has a tendency to bleed internally, such as following an injury or fracture.
•
After Surgery. Use caution following recent surgical procedures when stimulation may disrupt the patient’s healing process.
•
Over uterus. 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. 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. 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. 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. Keep this device out of the reach of children.
•
Electrode Size. 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. 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. Care should be used to avoid tripping on lead wires.
•
Damaged Device or Accessories. 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.
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36
•
Inspect Electrodes. 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.
•
Foreign bodies. Do not allow any foreign bodies (soil, water, metal, etc.) to penetrate the device andthe battery compartment.
•
Batteries. Do not carry batteries in a pocket, purse, or any other place where the terminals could become shortcircuited (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. The cable is best preserved if left attached to the stimulator between sessions. Do not jerk the cable or connection.
•
Heat and Cold products. 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. 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. • 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.
3.4. DANGERS •
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.
3.5. 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.
•
Precaution: 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.
•
Precaution: 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.
•
Precaution: 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.
•
•
Precaution: 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). Precaution: Sudden temperature changes can cause condensation to build up inside the stimulator. To prevent this, allow it to reach room temperature before use.
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4. OVERVIEW/CONTROL BUTTONS 38
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)
1 2
2
3
3
4
4
5
6
· Increases the amplitude (intensity of stimulation). Press and hold the button to increase the amplitude continuously. Note! Always increase the amplitude cautiously. · Terminates AUTO stimulation mode. · Increases the number of minutes when setting the timer (right button). · Used when turning the program lock on and off (left button). (PROFESSIONAL USE)
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. · Terminates AUTO stimulation mode. · Decreases the number of minutes when setting the timer (right button). · Used when turning the program lock on and off (left button). (PROFESSIONAL USE)
4. AUTO (left and right channel) · Starts the AUTO test mode. · Confirms the selected amplitude level in AUTO test mode.
5. PROGRAM · Selects programs 1-3. · Pauses an ongoing program. · Used when activating/deactivating the program lock.
6. TIMER · Initiates the timer setting.
4. OVERVIEW/DISPLAY SYMBOLS 1
2
3
4
5
39
1
6
7 8
8
9
10
10
9
1. BROKEN CIRCUIT Broken circuit. The reason for a broken circuit may be too high resistance or cable breakage. See chapter TROUBLESHOOTING.
2. PAUSE Paused program.
3. KEY LOCK Activated key lock. The key lock is automatically activated if no key is pressed for 10 seconds. Deactivate the key lock by pressing the left or right DECREASE button.
4. PROGRAM LOCK Activated program lock.
5. BATTERY STATUS Empty batteries. This symbol is shown when the batteries are almost empty.
6. PROGRAM NUMBER Selected program number.
7. REMAINING TIME Remaining program time in minutes and seconds. Time is flashing during timer setting.
8. AUTO STIMULATION MODE (left and right channel) Activated automatic amplitude setting. “AUTO” is flashing during test mode and steady during stimulation.
9. AMPLITUDE BARGRAPH (left and right channel) Selected amplitude as a bargraph.
10. AMPLITUDE LEVEL (left and right channel) Selected amplitude in mA (not shown in Auto stimulation mode).
5. OPERATION 40
STEP-BY-STEP USE 1. INSERT THE BATTERIES
Insert the batteries (see chapter REPLACEMENT OF BATTERIES).
2. ATTACH THE ELECTRODES
A. Connect the electrodes to the cable.
B. Attach the electrodes to your body.
3. SWITCH THE STIMULATOR ON
Press the ON/OFF button . This button can be used for terminating the stimulation at all times, even when the key lock is activated. AUTO
AUTO
S before removing electrodes from Always switch the stimulation off P the skin.
4. SELECT A PROGRAM (1-3)
AUTO
AUTO
S Press the PROGRAM button P repeatedly until the program of your choice is shown on the display.
Note! When selecting programs the amplitude must be set to 00.0 mA for both channels. For further information on the programs, see section PROGRAM GUIDE.
C. Connect the cable to the CEFAR BASIC.
5. START THE STIMULATION
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. AUTO
41
AUTO
Note! Always increase the amplitude cautiously! S
P
The treatment time is preset, but can be changed by using the timer function, see section TIMER. An automatically activated key lock prevents unintentional changes during treatment. The key lock is activated if no button is pressed for 10 seconds. Press any of the DECREASE buttons to deactivate the key lock. When the program is finished, Remaining time “00:00” is flashing on the display.
AUTO
P
AUTO
S
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.
AUTO STIMULATION MODE To provide a pain relieving effect, the level of stimulation should be perceived as a little bit stronger than the pain intensity. Since the body initially adapts to the set level of stimulation, it is often required to adjust the amplitude a couple of times to reach the optimal level of stimulation. By using the Auto stimulation mode the amplitude is automatically adjusted, and the optimal level is reached after a few minutes of stimulation. To use the Auto stimulation mode: Follow steps 1-4 in the section STEP-BY-STEP USE.
5. START THE AUTO TEST
Press the AUTO button for the left or right channel. “AUTO” starts flashing on the display, S and the amplitude increases gradually. P AUTO
AUTO
6. FINISH THE AUTO TEST Press the AUTO button
AUTO
P
S
AUTO
again when you feel the stimulation at a comfortable level.
If you press AUTO too late, or want to start again for any reason, press the AUTO button again to start over.
7. REPEAT THE AUTO TEST FOR THE OTHER CHANNEL WITHIN 3 SECONDS If you want to use the Auto stimulation mode for both channels, repeat steps 5-6 for the other channel.
8. THE STIMULATION STARTS 42
The program starts after a few seconds, and the amplitude is automatically adjusted to an optimal level of stimulation. Even if you use Auto stimulation mode, you can increase or decrease the amplitude at any time by pressing the INCREASE or DECREASE buttons until the stimulation feels pleasant. If doing so, the automatic amplitude setting is lost. AUTO
P
TIMER
AUTO
S
The preset treatment time is set to 30 minutes, but the timer function allows you to set the treatment time yourself. You have the option to change the timing from “- -“ to 60 minutes. If you choose to stay on “- -“, the stimulation will go on until you stop the stimulation manually. To set the timer: 1. Select a program and start the stimulation, see section STEP-BY-STEP USE. 2. Press the TIMER button
to initiate the timer function.
3. Increase the time by pressing the right INCREASE button . The time is increased by 1 minute each time you press the button. Decrease the time by pressing the right DECREASE button . The time is decreased by 1 minute each time you press the button. The time is flashing on the display, S P while setting the timer. S P
AUTO
P
S
AUTO
AUTO
AUTO
4. Press the TIMER button AUTO
PROGRAM PAUSE S P
AUTO
to confirm the timer setting.
AUTO
You can pause the programs up to 5 minutes. To pause a program: 1. If key lock is on, press any of the DECREASE buttons AUTO
2. Press the PROGRAM button
P
AUTO
to deactivate it.
to Spause the program.
Start stimulation again by pressing the PROGRAM button
AUTO
.
P P
AUTO
S AUTO S
AUTO
If stimulation is paused for more than five minutes, the stimulator turns off automatically to spare batteries.
AUTO
6. 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. The endurance of the batteries depends on the amplitude and number of channels activated during a program being used. For example, if you use one channel at P1 with an amplitude of 30 mA the nonrechargeable batteries last approximately 11 hours and rechargeable 7 hours.
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 sliding it downwards about 1 cm and then lifting it upwards. 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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7. PROGRAM GUIDE 44
Each program is described with the indications it is best suited to treat, how the electrodes should be placed, and how long the treatment should last. To each example of indication is at least one Electrode Placement number, which refers to the suggested electrode placements shown in the cover of the manual. No.
Program name
Frequency
Pulse duration
Treatment time
Preset time
1
Conventional TENS
80 Hz
180 µs
No limit (minimum 30 minutes).
30 minutes
2
Burst TENS
2 Hz
180 µs
20–45 minutes, 3 times a day. Remember that Burst TENS can cause muscle soreness.
30 minutes
3
Modulated pulse duration stimulation
80 Hz
70–180 µs
No limit (minimum 30 minutes).
30 minutes
45 Program description
Examples of indications/ Electrodeplacement no.
Conventional TENS (high-frequency stimulation) is the first choice for both acute and long-term pain, both neurogenic and nociceptive. Conventional TENS is based on the Gate Control theory, which states that electric stimulation of A-beta fibers inhibits impulse transfer in the pain pathways. As a rule, the electrodes should be placed on or near the painful area, or over an area segmentally related to the painful area. Adjust the amplitude so that the stimulation gives strong, but pleasant paraesthesia – tingling. When using high-frequency stimulation, it’s important to ensure that the patient has normal sensory of touch in the area where the electrodes are placed.
Neck pain...1 Shoulder pain...2 Elbow pain...6 Rheumatic pain...7 Fractured rib...12 Lumbago...10,11 Menstrual pain... 13 Phantom limb pain...14 Hip pain...16 Osteoarthritic pain in the knee...17,18 Wound healing...19
Burst TENS (low-frequency stimulation) is usually most effective for radiating (projected) pain in the arms and legs (rhizopathy), for conditions with reduced or changed sensory of touch, for deep muscular pain, or when the posttreatment effect of Conventional TENS is too short. Burst TENS treatment alleviates pain by stimulating muscles to release the body’s own morphine-like substances, endorphins. Place the electrodes on a muscle in the painful area so that a visible contraction occurs, or on acupuncture points in the painful area. The stimulation should feel pleasant and give visible muscle contractions. Remember that the patient often feels the stimulation clearly before contractions become visible.
Mononeuropathy...8 Central pain...4, 5 Cervical rhizopathy...3 Sciatica...15 Knee pain...18
Modulated pulse duration stimulation is a type of high-frequency stimulation where the pulse duration varies continuously. This can cause an undulating sensation, which may be more pleasant than a constant pulse duration. Use program 3 for pain alleviation and a massage effect on muscles like the trapezius.
Trapezius pain...9 Lumbago...10, 11 For more examples, see Program 1.
PROGRAM LOCK 46
The stimulator can be locked to prevent changing of programs. To activate/deactivate the program lock: 1. Select the program you want to lock/unlock, see section STEP-BY-STEP USE. AUTO
2. Press the PROGRAM button onds.
P
AUTO
andS the left DECREASE button
simultaneously for 2 sec-
3. Press the left INCREASE or DECREASE button . “ON” is shown on the left side of the display when activating the program lock and “OFF” when deactivating it. (TheP button toggles between S ON and OFF). AUTO
AUTO
4. Press PROGRAM button
AUTO
AUTO
P
AUTO
AUTO
toSfinish the program lock setting. S P
COMPLIANCE Compliance gives you the possibility to monitor the use of the stimulator: 1. Turn the stimulator ON. 2. Press the TIMER button
and the right DECREASE button
simultaneously for 2 seconds.
3. The left side of the display shows the usage time in hours and the right side in minutes. To reset the usage time, press the right DECREASE button for 2 seconds. AUTO
AUTO
AUTO
P 4. Wait for 5 seconds or Spress TIMER button
.
P
AUTO
S
5. The left side of the display shows the total usage time in hours and the right side in weeks. The total usage time cannot be reset. S P AUTO
AUTO
S P 6. Wait for 5 seconds or press the TIMER button
AUTO
P
AUTO
AUTO
S
AUTO
to exit compliance mode.
8. ACCESSORIES The electrodes will eventually wear out and need to be replaced. It is recommended to replace the electrodes after approximately 20-40 times of usage. For purchase information, contact your Cefar dealer or visit www.cefar.se CEFAR BASIC comes with a neck strap and a belt clip, allowing you to wear the stimulator around your neck or on your belt and have your hands free during treatment. The cables are best preserved if left attached to the stimulator between sessions.
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9. CARE INSTRUCTIONS 48
Taking care of and cleaning the Cefar equipment is simple with the following instructions: • Keep stimulator and accessories in the original case when they are not in use. It may, however, be practical to allow the electrodes to remain on the body between treatments. Carbon rubber electrodes can generally remain for 2–3 hours without the electrode gel drying out (does not apply to adhesive gel). They must then be taken off, washed, and dried before being applied again. This is especially important for persons with sensitive skin. In connection with stimulation, make sure that the electrodes are firmly in place. • W . hen using carbon rubber electrodes, use plenty of electrode gel and avoid drying out by applying tape around all the edges of the electrodes. Rinse the carbon rubber electrodes and the skin with water after use. Do not use detergent for the electrodes. • Self-adhesive multi-use electrodes are re-moistened if necessary with a few drops of water and kept air-tight (in a plastic bag) on protective paper when they are not in use. • Never expose the stimulator to water. Wipe it off with a damp cloth if necessary. • Do not jerk cables or connections. • The cables are best preserved if left attached to the stimulator between sessions. • No other maintenance of the device is required. Service life of the device can vary depending on usage conditions. Typical service life ifs 7 years. • Never service the device while in use. • The device should be operated in temperatures between 10°C and 40°C, atmospheric pressures between 50 and 106 kPa, and relative humidity between 30% and 75%. • The device should be transported and stored in temperatures between -40 °C and 70 °C, atmospheric pressures between 50 and 106 kPa and relative humidity between 10% and 90%. • Contact manufacturer for assistance in setting up, using or maintaining the equipment orreport events.