THERA vital Instruction Manual

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Table of Contents Congratulations! You have made the right choice by purchasing your THERA-vital. This therapy movement device offers supreme service. It works with the newest computer technology and is an innovative quality product, “Made in Germany”.

This table of contents will help you to get to know THERA-vital. It will be a safe guide line through the different functions and operations and will give you a few hints and some advice for the perfect use of your new therapy movement device. Before using the machine please note the safety issues on page 5.

In case you will have any further questions or remarks, the employees at medica Medizintechnik GmbH will surely be happy to assist you. Enjoy working with THERA-vital and stay active.

Operation... 9 Change of Radius, 3 Steps (Option)... 9 Change of Radius, Stepless (Option) ... 9 Level Adjustment ... 9 Set Distance at Upper Part ... 10 Upper Body Active, Break Adjustment Mecanically... 10 Foot-Rests ... 10 Calf-Rests (Option) ... 11 Foot Fixing Belts (Option) ... 11 Therapy Grips ... 11 Grip-Adaption... 12 Unlock Handle of Motorized Arm-/Upper Body Trainer... 12 Secure Handle of Motorized Arm-/Upper Body Trainer... 12 Arm-Rests (Option)... 13 Pulse Reader ... 13

Adjustments... 16 Choose Presetting ... 20 Adjust Presetting and Change it (Features) ... 20

Table of Contents Correct Use ... 3 Elements of Device and Use ... 4 Safety ... 5 General safety issues ... 5 Safety at Therapy ... 5 Therapy issues ... 6 General Information ... 6 The Position While Remaining Seated ... 6 Active and Passive Training ... 6 Training Time... 7 If Spasm Occurs ... 7 Options for Active Muscle Training ... 7 Transport and Putting into Operation ... 8

Display at Console... 14 Buttons at Console ... 15

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Features ... 21 Technical Data... 25 Cleaning and Maintenance... 25 Changing fuses... 25 Warranty ... 26 Recycling ... 26 Certificate of Free Sale... 26 Tricks and Hints for the New THERA-vital ... 27 Recommended Basic Adjustments... 28 Application Protocol... 29 Index... 30

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Correct Use Correct Use THERA-vital is a motorized therapy movement device, suited for active and passive movement training. THERA-vital is intended being used by clinics or doctor’s offices for patients still recovering, that are showing limitations in their mobility after accidents, surgeries, or after having being suffering from diseases affecting the general movement. THERA-vital is still suited for especially disabled people, people that can establish their mobility by doing regular muscle training at home.

It is not possible to make specific recommendations for the proper use of THERA-vital in regards to different diseases as well as details for a movement program, as those aspects are closely related to the patient’s individual state, his condition after surgery, age, height and the overall condition. For this reason the operation manual is mainly meant for the doctor and therapist that has to decide about the manner, intensity and duration of the use of THERA-vital. However, the patient himself can use the device independently, after he has been instructed and was told about risks that might possibly occur, whereas regular medical controls have to be done. In cases of emergency assistance by a second person is essential. The device itself is designed with an acoustic turn-off function (voice-control) for cases of emergency.

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Elements of Device and Use Elements of Device and Use

Therapy grip

Supporting arm for upper part

Console Star-shaped grip for raise adjustment

Star-shaped grip for horizontal setting

Encased sheave

Handle

Foot-rest

Floor board

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Safety Safety General safety issues

Safety at Therapy

❑ When first starting with the training do not

❑ Make sure THERA-vital is put on an even

❑ Get instructions from a dealer before using

and anti-slip ground, so that the best possible stability is guaranteed. Put the device against a wall, if possible, with the backside showing towards the wall. ❑ THERA-vital may only be used with the line voltage shown on the data plate. ❑ Only plug in THERA-vital to a regularly grounded socket. ❑ Set up the power cable in a way that nobody can stumble. ❑ Do not use THERA-vital if you notice any defects in the power cable. ❑ THERA-vital must not be used in wet or damp areas in order to prevent electric shock. ❑ Repairs are allowed to be done by a professional dealer only. ❑ Take out the power plug in any case before opening the casing. ❑ THERA-vital never can be used without the casing in order to prevent inflammability or electric shock. ❑ Do not use any solvent-based fluency when cleaning the device. ❑ Playing children have to be kept out of reach.

the device for the first time. Before the very first use you must have the recommendation of a doctor or therapist. ❑ Immediately seek doctor’s advice if any symptoms occur while you train or after the training. ❑ THERA-vital can be used while remaining seated in a wheel-chair or regular chair that provides a high back. An upright position is important in this context. Make sure the chair (or wheel-chair) cannot slip backwards. ❑ The extra use of an anti-slip-device for the wheel-chair is necessary if the wheel-chair might slip backwards for very active patients or if any signs of spasm may occur. ❑ Only put the feet in the foot-rests while remaining seated and do not get into the rests by putting down the whole body weight. Never put down a weight that is higher than 25 kg per pedal! ❑ Always train in tight clothes. ❑ Never touch the pedals when the device is on or change the radius of the pedals. ❑ Patients with severe disabilities and children only can use THERA-vital if a supervising person will be around constantly. ❑ Before using the device for the first time get familiar with the voice-control-function, which stops the device by a loud yell.

exceed 15 minutes. You can slowly increase the training time to the individual capacity level of the patient. ❑ The bigger the distance between THERAvital and the seat, the more the knee-and hip-joints will be stretched. So start your training with a small distance. Avoid any overstretching of the knee-joints. ❑ Always start your training with passive exercises by using motorized power for relaxation. ❑ If any spasm tends to occur please note the following important aspects: – Choose a small length of the pedal radius. (See page 9, “Change of Radius, 3 Steps (Option)”). – Start with a small number of revolutions. (See page 17, “Number of Revolutions”). – Set program on “Anti-spasm”. (See page 21, “Spasm”). – Only use THERA-vital with foot- and calf-rests. (See page 11, “Calf-Rests (Option)”). – Hold on to the grip. – Use the tilting safety device (accessory). – Set ADL on “small” (See page 22).

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Therapy issues Therapy issues General Information

Active and Passive Training

The goal of the therapy is closely related to the specific disease of the patient and can be to obtain mobility on one hand, on the other hand the rehabilitation after surgery or injury, which means getting back mobility and capacity for work. Independent patients can be instructed how to use THERA-vital, however a training plan must be set up by a therapist and the exercises must be supervised.

With THERA-vital you can train actively as well as passively. When training actively the patient is working against the adjustable resistance of the device by using his own physical strength, he must operate with his own energy by doing so.

The Position While Remaining Seated Always make sure the patient’s position is in accordance with the goal of the therapy while working with THERA-vital. THERA-vital can be used while remaining seated in a regular chair or wheel-chair, according to the patient’s mobility. The bigger the distance between THERA-vital and the patient, the more the knee-and hip-joints or arm-and shoulderjoints will be stretched. Keep into account the physical condition of the patient, especially the mobility of the joints and the limitations that mainly occur after surgery. Start the training program by choosing small distances between the device and the patient, in order to make sure there will not be any overstretching of the joints or damage in the muscle-/tendon area.

Training passively means letting the patient work without him having to use his own physical power, only by using THERA-vital. The needed energy is being provided by THERAvital.

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Therapy issues Training Time Usually the doctor or therapist plans or recommends how often and for how long the patient should exercise on an individual basis. Regular training with THERA-vital is extremely important for any improvement in mobility and healing process. Short but regular use is better than long ones that are exhausting. So start with a maximum of 5 to 10 minutes training in a row-if your physical mobility allows you to do so. Choose a small capacity level. You can increase the training time, speed and power in small steps and day by day, whereas the patient’s capacity level never must be overcharged. The therapy will be most successful if there will be no exhausting state of any kind, the patient feels at ease during the whole time and strength and mobility slowly increase.

If Spasm Occurs Spasm can be relaxed easily with THERA-vital by doing a small and regular movement with a small pedal radius. It is important though that the distance between THERA-vital and the user of the device is being set as small as possible at first. If you make sure that your position is upright also, spasm can generally be reduced after a short period of time. According to experience and scientific researches, this reduction of spasm can last up to several hours. The training program should be developed with a doctor or therapist in a way that helps to reach the right extent regarding any reduction of spasm.

THERA-vital is being designed with “intelligent” electronics that recognize spasm whenever it occurs and stops the engine. However, the Anti-spasm-function must be turned on for this (operation see page 21). Most patients are showing the symptom of “stretching spasm”. Whenever stretching spasm occurs, THERA-vital stops and keeps on operating forward after a short break. By keeping to operate forwardly the muscle length is reduced and the spasm can relax (Operation see page 21). Whenever “bending spasm” occurs, which is a rather unusual form of spasm, THERA-vital keeps on operating backwards after spasm has set i (Operation see page 21). If the spasm function sets in four times within a short time as a result of spasm that occured, it may be that a wrong training position or setting of the device is the reason for that. THERA-vital stops the engine. In that case please check the number of revolutions, pedal radius and seat distance before starting THERA-vital anew.

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Options for Active Muscle Training 1. The device is turned off and the patient is working against the low resistance of the engine. 2. The number of revolutions is set on “0”, the resisting power (torque) however has been preset on a certain level (see page 17). The patient is working against the resisting power, without any motor support by using his own muscle strength. 3. The number of revolutions is set on a low level, the resisting power (torque) however has been preset on a certain level (see page 17). The patient is working with motor support, he is treading the pedals faster than the preset number of revolutions though. 4. The number of revolutions and the resisting power (torque) are preset (see page 17). The patient is doing cyclic burden-and re-burdening exercises. The function “spasm” must be deactivated here (see page 21).

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Transport and Putting into Operation Transport and Putting into Operation Before First Use Take THERA-vital out and check it to see if there are any possible damages as a result of transport. Also check and see if the line voltage shown on the data plate has the same voltage shown on your power cable. In the case of any damage or wrong line voltage please immediately contact your deliverer. Transport of the Device

Power Connection Plug THERA-vital into the socket with the power cable. Turn the line switch located in the back behind the bush on “I”. THERA-vital is now ready for use. How to Switch the Device On and Off Simply press the ON/OFF button located at the console, to switch THERA-vital on or off. PC-Port You can work on, safe, invoke and direct cyclic training processes for patients to any extent desired, which is made possible by a “medica-soft” (accessories) for THERA-vital. The connection to the PC is directed to an RS 232 interface. You can save up to 3 individual programs in the console.

Line switch PC-Port

THERA-vital is being designed with feed rolls, fitted as standard. In the case of transport simply incline THERA-vital backwards as shown in the picture and pull it right behind you. You have to carry the device if you are crossing any steps or stairways. Two people are needed for that.

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Bush Power cable

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Operation Operation Change of Radius, 3 Steps (Option)

Change of Radius, Stepless (Option)

Level Adjustment

By using the change of radius the mobility capacity of the feet (Hub) can be set according to the individual patient.

After the assembling of the most suitable guide bars the handle length of the feet pedals can be set steplessly. This way an individual mobility level of the feet (Hub) can be reached for each patient individually.

The upper part of THERA-vital can be set keeping into account the seat height and the physical height of the patient.

1

1

1

❑ Switch THERA-vital off by pressing the ON/ OFF button. ❑ Untie the locking screw (1) with the wrench provided. ❑ Bring the foot-rest in the desired position and tie the locking screw. ❑ Set the pedal on the other side in the same way. Pay attention to get equal lever lengths. Once in a while unequal lever lengths may be intended for therapy reasons.

❑ Switch THERA-vital off by pressing the ON/ OFF button. ❑ Untie the locking screw (1) with the wrench provided. ❑ Bring the foot-rest in the desired position and tie the locking screw. ❑ Set the pedal on the other side in the same way. Pay attention to get equal lever lengths. Once in a while unequal lever lengths may be intended for therapy reasons.

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❑ Untie the star-shaped grip (1) located on the lower side of the supporting arm for half a reverse. ❑ Take out the star-shaped grip to untie the arresting device and place the upper part simultaneously as you wish. ❑ Let go the star-shaped grip and push the supporting arm slightly till the star-shaped grip locks in. ❑ Tighten the star-shaped grip. Do not adjust the upper part down if the feet are in the foot-rests, as the knees may collide.

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Operation Set Distance at Upper Part The upper part of THERA-vital can be removed according to the patient’s physical height.

Upper Body Active, Break Adjustment Mecanically When using a mechanical arm-/upper body trainer the brake power has to be adjusted by using an adjusting screw.

Foot-Rests The foot-rests are applicable for both the training with or without shoes. You can easily fix your feet in the ergonomically convenient 7 degrees-position, as the front part of the rests are designed widely enough. The fixing of the feet with the belts is extremely important when training passively or if showing one-sided motoric disorders. By fixing the muscles you can also burden to “Zug” (=Pull) when training actively.

1 1 ❑ Untie the star-shaped grip (1) located above at the supporting arm for half a turn.

❑ Adjust the application of load needed at the

❑ Take out the star-shaped grip to untie the

adjusting screw (1). If you do not use the arm-/upper body trainer, the handles must be adjusted horizontally and must be secured by tightening the adjusting screw.

arresting device and place the upper part as you wish at the same time. ❑ Let go the star-shaped grip and push the supporting arm slightly forward or backwards till the star-shaped grip locks in. ❑ Tighten the star-shaped grip. While training the upper body the adjustment is the best possible if the arms at distant pedal position do not get stretched completely.

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❑ Make use of the button

(= get in support) to bring the pedals in a convenient position one after the other. ❑ Put in one foot after the other and fix them with the belts.

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Operation Calf-Rests (Option)

Foot Fixing Belts (Option)

Therapy Grips

The calf-rests help to support the shanks. They are connected with the foot-rests in order to not hinder the movement of the crack joints.

If the patient suffers from any disorders in the foot section like e.g. unequal posture or disorders in foot motoric, it is often recommended to fix the feet tightly in the foot-rests. With this option, the feet can be fastly and by your own fixened in the foot-rests.

The therapy grips make a variable holding of the grip possible at the upper body training. You simply put them on top of the pedals of the upper body trainer.

1 1

❑ Construct/Deconstruct the therapy grips by putting pressure on the lock pin (1).

❑ Adjust the calf-rests regarding the length if needed by untying the two screws (the screws are hidden in this picture). ❑ Fix the shanks with the belts. Patients that have been fixed with the belts in THERA-vital must be supervised!

Here is what to do, take one step after the other: ❑ Open the foot fixing belt (1) in a forward direction. ❑ Put the foot in the foot-rest. ❑ Close the foot fixing belt once again.

The therapy grips are not designed to get support for your body weight or to carry the device.

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Operation Grip-Adaption The grip-adaption refunctions the pedal of the upper-body-trainer into the simple handle.

Unlock Handle of Motorized Arm-/ Upper Body Trainer

Secure Handle of Motorized Arm-/ Upper Body Trainer

In order to use the arm-/upper body trainer the handle must get unlocked first.

If you do not use the arm-/upper body trainer, you must secure the handle.

2 1

1

1

❑ Draw down the arresting button (1) , turn it

❑ Pull down the arresting button (1), turn it

round (quarterly turn-round) and let go. Do not activate the motorized arm-/upper body trainer together with the arresting handle.

❑ Turn the handle (2) to a horizontal position

☞

❑ Block the pedals as described below, if you have a motorized upper limb device.

❑ Construct/Deconstruct the grip-adaption with pressure onto the lock pin (1). The therapy grips are not designed to get support for your body weight or to carry the device.

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round (quarterly turn) and release it. till the arresting button locks in.

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Operation Arm-Rests (Option)

Pulse Reader

A simple application of the arm-rest is a convenient supplement to offer patients suffering from paralysis, spasm, or stiff hand-/or armsections a safe hold.

The value given by the pulse reader is being compared with the programmed pulse upper limit. If the value is being crossed, THERA-vital reduces the treading resistance.

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You can fix the underarms in the rests with belts. You can either... ❑ put the arms into the attached arm-rests and fix it afterwards, or: ❑ mount the arm-rests onto the arms first in order to clip them to the therapy grips then. Patients that have been fixed with the belts in THERA-vital must be supervised!

❑ Plug in the plug at the bottom side of the device (1).

❑ Preheat the ear and mount the pulse reader at the ear lobe with the clip.

❑ Fix the cable of the pulse reader at your clothes. The pulse reader is not designed for making any diagnosis. If the pulse reader strongly vibrates at the ear lobe or just moves, incorrect values may occur.

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Display at Console Display at Console The display shows the actual operating state and the settings for the number of revolutions, treading resistance, direction of rotation, armor feet-trainer, as well as the duration of the training. After the device has been turned on the following presettings are activated: Number of revolutions: 0 Treading resistance: 0 Direction of rotation: forward Arm-/foot-trainer: Foot Time: 15 minutes State bar: as safed Number of revolutions, treading resistance and time are shown digitally as well as analogue (graphically). The “Information panel” provides information regarding the momentary active functions in the display. The “Function line” of the display shows the program-functions activated in the presettings. ADA = function for “automatic torqueand number of revolutions-adjustment” (page 22). AMU = function for “Active muscle support” (page 22). SPASTIK = function for automatic reaction to spasm (page 21).

Number of revolutions, slow

Number of revolutions, fast

Treading resistance, small

0 0

Direction of rotation

Pulse frequency

Treading resistance, wide

Arm-/or feet-trainer

0 0

0 0.0

Revolutions: -Reduce +Incr.

Patient´s achievement

ADA AMU

Actual speed

Covered distance

Information panel

Function line

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Buttons at Console Buttons at Console Make the first adjustments as follows:

❑ Choose the desired function by MODE ❑ Change the value or the adjustment by pressing + or 5 Get-in-button This function automatically brings the pedals in a convenient position to get in the foot. By operating it once more the pedals will keep going for 180 degrees. Then you can slowly put in the second foot.

ON/OFF button 1 Activate THERA-vital with the ON/OFF button. If no button is pushed for 30 seconds, the function „Einstieg“ (get in) will automatically be activated. Deactivate THERA-vital by pressing the ON/OFF button.

Minus-button 2 Press the minus-button to decrease the value marked in the display: Pressing each time separately slowly changes the value, if you hold it down for some time the value will decrease faster.

4 PLUS-button Press the PLUS-button to increase the value shown in the display (or to choose parameter of a function). Pressing once will increase the specific value for one degree, holding down will increase the value faster. 3 Mode-button Each time you press the MODE-button the next function will be activated. Only each active function can be adjusted with the PLUS and MINUS buttons. The display automatically changes back to the function “number of revolutions” whenever you do not press PLUS or MINUS for 10 seconds after you have chosen from a function.

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Adjustments Adjustments Simple display

Professional display

Program selection simultaneously

simultaneously

Program Selection

45 7

0 0 0 13

medica for a life in motion

Presetting 1 Presetting 2 Presetting 3

0 1.0

Revolutions -Reduce +Incr.

foot-trainer +/-arm-trainer

ADA AMU

ADA AMU

no button is pressed for 60 ☞ Ifseconds, the display changes or

or Number of revolut.

slower/faster

Treading resistance smaller/higher

Number of revolut.

back to “number of revolutions”

slower/faster

Treading Tretwiderstand resistance smaller/higher

Presetting 1

Direction of rotation

forward/backward

Direction of rotation

forward/backward

Presetting 2

Arm-/foot-trainer

selection

Arm-/foot-trainer

selection

Presetting 3

Time

shorter/longer

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Programming see page 20 ff

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Adjustments Number of Revolutions

45 7 0 13

45 7

0 1.0

0 13

0 1.0

45 7 0 13

Revolutions: -Reduce +Incr.

Torque: -Reduce +Incr.

Direction +/- Change

ADA AMU SPASTIK

ADA AMU SPASTIK

ADA AMU

You can regulate the number of revolutions for passive training between 0 and 60 rev./min. ❑ By pressing the PLUS-button twice after the device was switched on the device starts with the number of revolutions-level 10 rev./min. ❑ Increase the number of revolutions by pressing the PLUS- or MINUS-button to the value needed. ❑ Do not set any or only a small number of revolutions if the patient should train actively. If you set the ADA-feature additionally THERA-vital automatically adjusts the number of revolutions to the momentary capability of the patient (see page 22).

☞

Direction of Rotation

Treading Resistance

You can adjust the treading resistance for active training from 0 to 15, it approximately shows the power in Nm. The bar display for the treading resistance is separated in two: • The upper line shows the treading resistance chosen by you. • The lower line shows the engine power needed to move the patient in a passive way with the preset number of revolutions, if the patient’s capability starts to weaken or misses completely.

❑ Mark the function with MODE ❑ Set the treading resistance by pressing the PLUS- or MINUS-button to the value needed. If you choose the ADA-feature additionally, THERA-vital automatically adjusts the engine power to the momentary capacity level of the patient (see page 22).

☞

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0 1.0

The direction of rotation can be preset: forward = arrow up backwards = arrow down ❑ Mark the function with MODE. ❑ Change the direction of rotation with the PLUS- or MINUS-button. THERA-vital slows down, changes the direction of rotation and smoothly increases speed till the former number of revolution is reached again.

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Adjustments Time

Arm-/Foot-Training

45 7

58 15 25

0 13

0 13

0 1.0

0 1.0

Feet Trainer +/- Change

Training Time -Reduce +Incr.

ADA AMU

ADA AMU

This feature enables you to choose between foot- and arm-training. ❑ Mark the function with MODE ❑ Change the adjustment by pressing the PLUS- or MINUS-button. THERA-vital stops and sets the number of revolutions to zero. ❑ Bar the handle of the arm-trainer if you want to change from arm-training to foottraining (see page 12). ❑ Unlock the handle of the arm-trainer if you change from foot-training to arm-training (see page 12). ❑ Adjust the number of revolutions that you wish.

The training time can be preset from 0 to 60 minutes. The training time is set in minutes and is being counted backwards to zero. Graphically it is shown in 5-minute-steps. ❑ Mark the function with MODE. ❑ Set the training time by pressing the PLUSor MINUS-button. ❑ THERA-vital automatically stops as soon as the training time is finished. Your very first training should not exceed 15 minutes.

☞

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Adjustments Pulse Display (♥) The pulse display only works if the pulse reader is plugged in and the ear clip sticks to the patient. In some unfortunate cases the test value can be influenced through vibration. The display indicates beats per minute. Speed Display (KM/H) The speed is displayed in km/h and approximately equals the value that is being reached riding the bicycle, reaching the same capacity level.

80 13

45 7

Capacity Display (WATT) Here the patient’s momentary capacity level is shown. THERA-vital gets the value shown by taking into account the number of revolutions and brake power.

0 1.0

Distance (KM) The distance covered is displayed in km and approximately equals the value that is being reached riding the bicycle, covering that distance.

Revolutions: -Reduce +Incr. ADA AMU

Information Display The information display shows features just chosen by you. Moreover, it tells what to do if you made any mistake in your programming. Function Line (Lowest Line) The function line displays the momentary active features (ADA, AMU, SPASTIC, see page 21 and following).

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Adjustments Choose Presetting THERA-vital posesses three memory locations to safe number of revolutions, torque and features for the supervision of the patients. There can be saved 3 additional programs with “medica-soft” (option). Information once safed will not get lost if the power cable is not plugged in. Program Selection

Presetting 1 Presetting 2 Presetting 3

❑ Turn on THERA-vital. ❑ Operate the MODE-button. ❑ Press the PLUS-and MINUS-button twice simultaneously to get the display shown in the picture above. ❑ Choose the presetting that you wish by operating the PLUS-button. ❑ Save this option with MODE. ❑ Simultaneously operate the PLUS-and MINUS-button to get back to the standard display. The values safed before in the chosen presettings are activated now. For security reasons the number of revolutions always goes back to zero if you change the presetting.

☞

Adjust Presetting and Change it (Features) Change and safe up to three features needed often as shown below: ❑ Turn THERA-vital on ❑ Set the features that you wish to have regarding the number of revolutions, treading resistance, direction of rotation, arm-/foot-training and time. ❑ Simultaneously operate the PLUS- and MINUS-button twice, till the left display appears. ❑ By pressing the PLUS-button e. g. choose “presetting 1” ❑ Confirm the selection with MODE. ❑ You can invoke the right menu selection one by one, those functions are being adjusted and safed. Leaf through by pressing the MODE-button, starting above and heading down. (After the very last menu aspect you will get back to the regular display). ❑ Change the adjustment with every menu feature with the PLUS-button and confirm the adjustment with the MODE-button. ❑ Safe your adjustments with the next-to-last command. If you do not safe the adjustments, they will still be activated till you turn the device off, or till you make any new adjustments. ❑ When giving the last command, choose the presettings THERA-vital should start with after it has been switched on.

Spastic

forward backward off

Spastic sensitivity

high medium low

Automatic torque limitation

high medium low

Automatic torque adjustment

off on

Active muscle training support

off on

Upper limit pulse

0 - 160

Sensitivity microphone

high medium low

Representation display

simple professional

Safe as presetting

do not safe safe

Start program

1 2 3

Back to the simple/professional display

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