Digital TENS Model TN20 Instructions for Use Rev 1 Jan 2009

1. INTRODUCTION The Target TENS is an accurate and versatile, digital TENS unit that is easy to use, with simple settings and rotating strength control knobs.

2. FEATURES •

Digital Settings Target TENS offers a wide range of settings with simple, intuitive controls. Digital settings are accurate and repeatable.

•

Large LCD display The large, clear LCD display makes its easier for visually impaired to set and operate.

•

Two Burst and two Modulation modes Offering a large choice of sensations for long term users

•

Treatment Timer Automatically switches the unit off after the set time when activated..

•

Memory Reverts to last setting used when switched on.

•

Intensity Lock Intensity controls can be locked to avoid accidental change

•

Doctor Locking Physician can lock settings to avoid accidental change

•

Power saving Unit switches off if left at zero strength for more than 5 minutes

•

Economic Uses AA batteries to give long life and low running costs

1

3. HOW “TENS” WORKS TENS stands for Transcutaneous Electrical Nerve Stimulation. TENS stimulates your body’s own natural defences against pain. TENS is totally safe, has been used successfully by thousands of pain sufferers.

THE ADVANTAGES OF TENS •

Totally Safe

….

Easy to Use

….

Drug Free

TENS sends a gentle stimulation through the skin which works in TWO ways:Pain Gate Stimulating the sensory nerves, which carry touch and temperature signals. These nerves go to the same connections in the spine as the nerves carrying pain. A strong sensory signal will block the pain signal travelling up the spine to the brain, this is known as closing the “Pain Gate” and takes effect quite quickly after the unit is switched on. You can use TENS several times a day, for as long as you like. Endorphin Release At low frequency settings, and slightly stronger output, TENS drives the motor nerves to produce a small repetitive muscle contraction. This is seen by the brain as exercise, and this promotes release of Endorphins – your body’s own natural pain killer. The relief builds up and normally takes about 40 minutes to reach a maximum level which can last for hours after the machine is switched off. By using TENS you can expect to achieve a significant reduction in pain if not complete pain relief.

4.

SIDE EFFECTS

There are no known side effects to TENS use and long-term TENS use is not harmful.

2

5.

SETTINGS

There is no one setting appropriate for a particular condition, and the most appropriate varies from one person to another, even if they have the same type of pain. Therefore, the selection of both the settings and the positioning of the pads should be performed on an individual basis. You may need to try a few positions/settings before finding the one that suits you the best. In addition to strength, the following parameters can be set: •

Pulse Frequency (measured in Hz – pulses per second)

A frequency of 80-150 Hz is good at blocking pain signals. A low frequency of less than 10 Hz allows for the release of endorphins, the body's natural morphine-like substances. • Pulse Width (measured in µS – millionths of a second) The Target TENS units offer a range of pulse widths from 50 to 250 µS. The feeling through the pads will vary depending on the pulse width. Pulses with higher pulse widths feel stronger and are more likely to stimulate muscle movement. • Constant and Burst Modes Constant mode is when the sensation is continuous as against Burst mode when the sensation, is as its name implies, is one of on and off. • Modulation Modes Modulation is when either the frequency or pulse width sweep across range of settings. This enables the body to receive many different signals and can be very beneficial and lessen any effect of accommodation. The Pain Gate is activated by signals of 80-150 Hz. If you are using TENS for the first time, it is recommended that you start with a setting of 110Hz 50 uS. The Endorphin Release mechanism is activated by signals from 1 to 10 Hz with the strength and pulse width set high enough to cause small muscle contractions. Best results are achieved at between 20 and 40 minutes, but using for longer than this may cause lead to fatigue and cause aching muscles. Burst Modes combine both Pain Gate and Endorphin release. TENS can be used for as long as is necessary. Continuous treatment is fine, but electrode pads should be repositioned regularly (at least every 12 hours) to allow the skin to be exposed to the air. 3

6. CONTROLS Ch1 Strength

LED Ch2 Light Strength

Ch1 Light

Ch2 Light

Mode

Pulse Width Up

Pulse Rate Up

ON/OFF

Pulse Rate Down

Pulse Width Down

Timer

This key switches the unit on and off. Press once to switch the unit on. The LED light (green color)and the LCD display located at the front of the unit will light up, there will be no feeling from either lead at this point as the strength always starts at zero. Press this key again and hold for 3 seconds to switch the unit off. When the unit is turned on, it will automatically enter the mode that was used before it was turned off. During use, pressing the ON/OFF button turns the Strength Lock on or off. When activated, LOC appears on the display. 4

There are two knobs which adjust the strength : Turn clockwise to increase the strength. Turn counter-clockwise to decrease the strength. Automatic shut off: When the unit intensity levels are 0 on both channels, and it has not been in use for 5 minutes, the unit will be shut off automatically.

Stands for Pulse Rate Up, press this key to increase the frequency. Stands for Pulse Rate Down, press this key to decrease the frequency. Stands for Pulse Width Up, press this key to increase the Pulse Width. Stands for Pulse Width Down, press this key to decrease the Pulse Width. The pulse rate, pulse width and intensity adjustment has an auto-repeat function:- when the key is held down for more than 1 second, it will automatically increase/decrease 1 step per 1/4 seconds. A locking feature is available which your physician may use to prevent adjustment of settings. If this is activated, a key symbol is shown at the bottom centre of the display.

Press the both & keys simultaneously to change the waveform from bipolar to unipolar and back. Waveform symbols will be displayed for 3 seconds when you press the key. NOTE In a very small percentage of people, using T.E.N.S. in Monophasic Rectangular waveform can exacerbate the symptoms of pain. If this occurs, stop treatment in this waveform immediately.

5

Press this key to select mode. Five modes are available. Constant, Burst I, Burst II, Modul I, Modul II. When mode is changed, the intensity automatically goes to zero Press this key to set the treatment time. When the treatment timer is set, it will begin to count down in minutes. Once it counts down to Zero, the unit will automatically shut off.

7. CONTENTS • • • • • •

Target TENS Pain Relief unit 2 Lead wires Pack of 4, 50x50mm, superior self-adhesive electrode pads (item code: E-CM5050) AA 1.5v (Type LR6) batteries (2) Instruction Manual Storage Pouch

6

8. INSTALLATION OF BATTERIES When the batteries are low, the battery symbol flashes at 2Hz indicating that the batteries should be replaced. Remove Battery Cover

Insert batteries Ensure that the batteries are inserted the right way as shown in battery compartment. Note: Your unit will not function if the batteries are inserted incorrectly. To check, press the button once and the LCD display will start up. Having made this check, press the button again to switch the unit off. When the batteries are running low a low battery indicator will show on the screen (battery symbol) and it is important to change the batteries as soon as possible. Disposal of batteries Always dispose of batteries safely. Do not throw batteries onto a fire. Warning • Keep batteries out of the reach of small children • If battery leakage occurs and comes in contact with the skin or eyes, wash thoroughly with lots of water. • Do not mix alkaline and rechargeable batteries • Do not attempt to recharge alkaline batteries

7

9. CONNECTING LEAD WIRES Decide whether you wish to use the unit with one lead or two. If using two leads, insert the plugs into both sockets in the unit. If only using one lead, insert into the Ch1 socket as marked on the unit.

Attaching the electrode pads to the Lead wire At the other end of the Lead wire there are pin connections. Push the pin ends into the pigtail ends of the electrode pads.

10. POSITIONING OF ELECTRODE PADS The following body maps in this instruction booklet will show you where to place the electrode pads for a range of common complaints, dependent on your symptoms. For symptoms not illustrated, apply the pads around/near to the source of the pain or seek advice from your doctor or physiotherapist. The electrode pads must always be used in pairs, so that the signal can flow in a circuit. NOTE: Always check unit is OFF before attaching or removing pads.

8

ELECTRODE PAD POSITIONS Low Back Pain

Neck and Shoulder Tension

Sciatica

Shoulder Pain

Knee Pain

Elbow Pain

Ankle Pain

Wrist Pain

Leg Pain

Where only two pads are shown on the arm, shoulder, and leg, use the other two pads either on the opposite limb or place all four pads on the same limb in a square pattern with each pad being about 4 inches apart. 9

11. GENERAL PAD ADVICE • • • • • •

•

The electrode pads supplied are reusable but are for single patient use. In order to obtain the best conductivity through the pads always ensure that they are in good condition and tacky. Before use make sure your skin is clean and dry. Peel the electrode pads from their protective plastic shield by holding and lifting one corner of the pad and pulling. Do not pull on the pigtail wire of the pad. After use always replace the pads on the plastic liner and replace in the re-sealable plastic bag. If the pads dry out then it is best to buy a replacement pack of electrodes. In an emergency it may be possible to restore some of the tackiness of the pad by adding a tiny drop of water on each pad and spreading around. If too much water is added the pads will become too soft then it is suggested in order to try re-establish some adhesiveness to place them sticky side up in a refrigerator for a few hours. In very hot weather the gel on the pads may become soft. In such cases place the pads, still on their plastic liners and in their bag into a fridge until they return to their normal condition.

12. CLEANING The case and lead wires can be cleaned by wiping with a damp cloth and a solution of mild soap and water. Wipe dry. Do not immerse your TENS machine in water. Do not use any other cleaning solution than soap and water.

13. TROUBLESHOOTING If your TENS machine is not working properly please check the following: BATTERIES: i) Have they been fitted correctly? ii) Do they need replacing? LEADS These may develop intermittent faults if roughly treated. Try changing the leads over. If this cures the problem in one channel, purchase a replacement lead. If the above review has failed to resolve your problem, call TensCare or your local dealer (address on back cover) for advice. 10

14. CAUTIONS & WARNINGS Do not use TENS : • if you have a heart pacemaker or have a heart rhythm problem • if you have epilepsy • during the first three months of pregnancy • when driving or operating machinery • if you are suffering from acute, feverish or infectious diseases • to mask or relieve undiagnosed pain. Do not place electrode pads : • on broken skin • to skin which does not have normal sensation. If the skin is numb, too great a strength may be used, which could result in skin inflammation. • on the carotid arteries • over the eyes • across the front of the head • on the abdomen at anytime when pregnant • near malignant tumours Do not: • ignore any allergic reaction to the electrode pads: If a skin irritation develops. • start your TENS treatment until the cause of pain has been diagnosed. If you are in any doubt about any of these warnings please consult your medical adviser. Also do not : • immerse your TENS unit in water or place it close to excessive heat. • attempt to open up the TENS unit. Such actions will void the guarantee. • mix old, new or different types of batteries. Be sure to dispose of old batteries safely. Caution: • observe caution when using electrotherapy at the same time as being connected to electro-monitoring equipment with body worn electrode pads as interference may occur with the signals to the electromonitoring equipment. Do:

Remove batteries from your TENS machine if the unit is unlikely to be used for a long period.

11

15. GUARANTEE Your TensCare device is guaranteed for two years from the date of purchase. If a fault develops return the unit to TensCare at the address below, together with a copy of your invoice and details of the problem. The guarantee does not cover the batteries, electrode pads or mono lead wire. Please note that the Guarantee is invalidated if i) incorrect batteries have been fitted ii) the unit has been immersed in water, maltreated or tampered with.

16. CONSUMABLES AND SERVICING Replacement electrode pads, new batteries and lead wires are available from your supplier or distributor (see back cover for contact details), by mail order from TensCare, by telephone using a credit or debit card, or through our website. Accessories/Spares The following replacement parts may be ordered from Tenscare E-CM5050 Pack of 4 50x 50 Electrode pads: L-TN20 Lead wire B-AA Batteries 1.5V AA batteries

12

17. DISPOSAL OF WASTE ELECTRICAL AND ELECTRONIC PRODUCTS (WEEE) One of the provisions of the European Directive 2002/96/CE is that anything electrical or electronic should not be treated as domestic waste and simply thrown away. To remind you of this Directive all affected products are now being marked with a crossed-out wheelie bin symbol, as depicted below. To comply with the Directive you can return your old electro-therapy unit to us for disposal. Simply print a postage-paid PACKETPOST RETURNS label from our website www.tenscare.co.uk, attach this to an envelope or padded bag with the unit enclosed, and post it back to us. Upon receipt we will send your old device for components recovery and recycling to help to conserve the world's resources and minimise any adverse effects on the environment.

13

18. TECHNICAL SPECIFICATION Channel:

Dual

Output:

Maximum 150mA(peak value) across 500Ω load 20 steps of approx 7mA

Pulse Width:

From 50µS to 250µS adjustable in steps of 10 µS

Pulse Rate:

From 1Hz to 150 Hz adjustable. 1,2,3,4,5,10,12,14,16,18,20,25, 30, 35, 40, 50, 60, 70, 80, 90, 100,110,120,130,140,150,

Waveform:

Symmetrical Bi-phasic rectangular or Monophasic rectangular

Modes:

5 Modes are available Mode A Constant Mode B Burst I. Two trains per second, 250ms on, 250ms off; 25 pulses within one train, pulse width=200µS Mode C Burst II . Two trains per second, 250ms on, 250ms off; Pulse width and Pulse rate are selectable. Mode D

Modul I , Pulse width modulation. Pulse width modulates from 100µS to 250µS within 6 seconds and then back to 100µS in the next 6 seconds. Pulse rate is selectable.

Mode E Modul II, Pulse rate and Pulse width Modulation. Frequency increases from 50Hz to 100Hz while pulse width decreases from 200µS to 60µS within 5 seconds. Treatment timer: Safety Classification Environmental Specifications: Operating: Storage: TYPE BF

Continuous,15min,30min,45min,60min, 90min selectable. Internal power source. Type BF. Designed for continuous use. No special moisture protection.

Humidity: 20 to 65% RH, Temperature range: 0 to 35C Humidity:10 to 90% RH, Temperature range: 0 to 55C Equipment providing a degree of protection against electric shock, with isolated applied part.

EQUIPMENT This symbol on the unit means “Refer to instructions for use” Statement:

This T.E.N.S. Unit has been tested for EMC requirement according to EN60601-1-2

NB:

The electrical specifications are nominal and subject to variation from the listed values due to normal production tolerances

14

Detailed information regarding the Waveform, Pulse duration, Pulse frequency, Output voltage range, and Peak pulse output current: A. Waveform There are 2 types of waveform: (1). Symmetrical Bi-Phasic rectangular waveform Amplitude...

(2).Mono-Phasic waveform Amplitude

Time

Time

B. Pulse duration By pressing PW+ or PW- key, the pulse width can be adjusted from 50µS to 250µS in steps of 10µS . except in Modes B, D, and E, for which pulse duration is fixed C. Pulse frequency By pressing PR+ or PR- key, the pulse width can be adjusted to one of the following values (Hz): 1,2,3,4,5,10,12,14,16,18,20,25, 30, 35, 40, 50, 60, 70, 80, 90, 100,110,120,130,140,150, except in Modes B and E, for which pulse rate is fixed. D. Output voltage range The output voltage of two channels can be adjusted individually in 20 steps. The peak pulse output current of two channels can be adjusted individually in 20 steps. For 500Ω load, the output voltage can be change from 12mA to 150 mA in steps of about 7 mA .

Doctor Locking Press “timer key”for 2 seconds to lock the unit. A key symbol appears on the display While the unit is locked, only timer and intensity parameters can be adjusted. Pressing ON/OFF key does not release the lock.

15

Distributed by:

TENSCARE LTD 9, Blenheim Road, Epsom, Surrey KT19 9BE, United Kingdom

TEL: +44(0) 13 72 72 34 34 FAX: +44(0) 13 72 74 54 34 e-mail: [email protected] www.tenscare.co.uk

Pub Ref : I-TN20-UK Rev 1.0 01/09