NeuroTrac MultiTENS Dual Channel TENS and EMS Operators Manual Oct 2011

NeuroTrac™ Multi-TENS Operation Manual

Warnings * * * * * *

* * * * * *

* *

This unit must be used with the guidance of a Physiotherapist or Doctor. Type BF equipment, Continuous Operation. Do not insert lead wires into a mains power supply. Do not immerse unit into water or any other substance. Do not use the NeuroTrac™ Multi-TENS unit in the presence of a flammable anaesthetic gas mixture and air or with Oxygen or Nitrous Oxide. If using rechargeable 9 Volt PP3 Nickel Metal Hydride batteries, be sure to use a CE approved battery charger. Never connect the NeuroTrac™ Multi-TENS directly to a battery charger or to any other mains powered equipment. We advise not to use Ni-Cad rechargeable batteries. Patient Electrodes are for single patient use only. Keep out of reach of children. Do not use this stimulator on your facial area unless you are under strict guidance from a qualified Clinician. Application of electrodes near the thorax may increase the risk of cardiac fibrillation. Operation in close proximity (e.g. 1m) to a shortwave or microwave therapy equipment may produce instability in the stimulator output. Simultaneous connection of a patient to a high frequency surgical equipment may result in burns at the site of the stimulator electrodes and possible damage to the stimulator. This device can deliver current densities in excess of 2mA/cm2 when used at a high intensity with small electrodes. See page 19 for more detail. No modification of this equipment is allowed!

Symbols on the rear cabinet of NeuroTrac™ Multi-TENS explained: Caution (output)

Type BF Equipment

Follow instructions for use

Do not dispose in normal dustbin (see page 30 for the disposal instructions)

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NeuroTrac™ Multi-TENS Operation Manual

Contents Contents:

Page:

Warnings Introduction What is Pain? What is TENS? What is STIM? Contra Indications & Precautions Description of Unit & Functions Quick Start Instructions Setting Custom Programmes Programmes Home Compliance Using the NeuroTrac™ Multi-TENS Unit in TENS mode Treatment Modes How Long do I Use TENS For? Electrode Placement Dermatomes & Myotomes Contiguous Placement Acupuncture Points Electrode Types & Tips Suggested Electrode Placement (TENS) Care, Maintenance, Accessories and Disposal Conditions that Respond to TENS Conditions that Respond to STIM Information regarding Electromagnetic compatibility and interference (EMC) Specifications Warranty Dermatome Charts Clinical References Troubleshooting Commonly asked Questions (FAQ)

2 4 4 4 5 6 7 8 9 12 13 16 17 17 18 18 18 18 19 20 24 26 26

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27 31 32 33 35 37 38

NeuroTrac™ Multi-TENS Operation Manual

Introduction The NeuroTrac™ Multi-TENS is a dual channel device combining several treatment programmes into one unit. The NeuroTrac™ Multi-TENS features: Multi TENS mode: The front of the unit has two programme buttons allowing the unit to run a separate TENS programme on each channel. PRG 1 selects the TENS programme to run on Channel A. PRG 2 selects the TENS programme to run on Channel B. This allows the therapist to select the best combination of output to more effectively control pain. NOTE: The unit cannot run a combination of TENS, STIM or custom programmes. Backlight: A clear bright backlight and large LCD allow the display to be read more easily in low light or dark conditions. The backlight will automatically turn off after one minute to conserve battery power. Comprehensive Statistics: Comprehensive statistics backed up by a real time clock record up to 5 sessions daily for 60 days. An easy to use menu system allows the therapist to review the statistics to ensure that the patient is using the unit correctly. Multi Phase Custom Programmes: Up to 5 phases can be configured for each of the three custom programmes. The custom programmes feature a simple setup of one phase only or an advanced setup of up to 5 phases.

What is Pain? When we feel pain it is the body’s process of informing us that something is wrong. To feel pain is important, without this feeling abnormal conditions may go undetected, creating damage or injury to critical parts of the body. Although pain is essential in warning our body of trauma or malfunction, nature may have gone too far in its design. Continued long-term chronic pain has no useful value apart from its importance in diagnosis. Pain begins when a coded signal travels to the brain where it is decoded, and analysed. The pain message travels from the injured area of the body along small diameter nerves leading to the spinal cord. At this point the message is switched to a different kind of nerve that travels up the spinal cord to the brain area. The brain then analyses the pain message, refers it back and the pain is felt. 4

NeuroTrac™ Multi-TENS Operation Manual

What is TENS? Transcutaneous Electrical Nerve Stimulation (TENS) uses a small battery operated unit to provide a non-invasive, drug free method of controlling acute and principally long term intractable pain. It can also be used as an adjunctive treatment in the management of post surgical traumatic pain problems. In TENS mild electrical impulses are transmitted through the skin via surface electrodes to modify the body’s pain perception. TENS does not cure problematic physiological conditions; it only helps to control the pain perception. TENS will not work for every user. Please seek advice from your Doctor. There are millions of small nerve fibres throughout the body and it only requires a few impulses to produce chronic pain. In addition to small fibres, which allow the sensation of pain to be felt, the body is also made up of larger diameter nerve fibres. These larger nerve fibres transmit less unpleasant sensations such as touch or warmth, assisting us to form an impression of our environment. Stimulating the larger nerve fibres using TENS may have the effect of inhibiting the transmission of pain along the smaller nerve fibres to the spinal cord [known as the ‘Pain Gate Theory’].

What is STIM? Neuromuscular Stimulation has been used for many years to stimulate muscle and nerve fibres to treat a number of muscle and nerve related conditions. Over the last 30 years numerous clinical trials and papers have been written. Neuromuscular Stimulation is increasingly understood by Therapists and Doctors. There is a better understanding of the mechanisms which exist between nerves and muscles that makes it possible to stimulate the neuromuscular system with precise electrical signals. The NeuroTrac™ Multi-TENS offers precision giving full control of Pulse Widths, Rates, Ramp up times, Work / Rest cycles as well as alternating or synchronous application if two channels are being applied. Customer Care We welcome constructive comments regarding our equipment particularly those that might help us to improve existing features, add new ones or develop new products for the future.

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NeuroTrac™ Multi-TENS Operation Manual

Contra Indications & Precautions Before using this equipment you must first seek the advice of your Physiotherapist or Doctor. Read this operating manual before using the unit TENS and STIM should not be used: * * * * * * * *

* * *

* * *

By patients fitted with a demand style cardiac pacemakers unless so advised by their Doctor During pregnancy [unless medically advised] By patients with undiagnosed pain conditions By patients with undiagnosed skin conditions With patients who have diminished mental capacity or physical competence who cannot handle the device properly On anaesthetised or desensitised skin When driving a vehicle or operating potentially dangerous equipment Do not place electrodes: > Over carotid sinus nerves > Over larynx or trachea > Inside mouth > Over the area of the heart unless so advised by your Doctor > On your facial area unless under strict guidance from a qualified Clinician The patient should use the unit only as prescribed Do not immerse the unit in water or any other liquid If you experience skin irritation this may be due to over-stimulation. In this case leave the skin to heal and use TENS only for the periods prescribed. Turning the current up too high can cause skin irritation. In this case allow the skin to heal and use TENS at a lower intensity. Some people experience an allergic reaction to the adhesive coating on the surface of the electrode. If this happens use a different make of electrode or change the electrode. If it continues try reducing the pulse width. If the problem still persists try moving the electrode position each day by just the width of the electrode, making sure the electrode positioning is still over the dermatome Keep unit out of reach of children Only use CE approved skin electrodes If in doubt about the use of the NeuroTrac™ Multi-TENS unit, call your Doctor, Therapist, Clinician or your distributor for advice

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NeuroTrac™ Multi-TENS Operation Manual

Description of Unit & Functions

Channel A

Lead Wire and Pin

Channel B

Power

Select CH A Programme Select CH B Programme SET ESC Lock Button

* PRG 1 button

Selects the desired programme: P01 ~ P13 - TENS programmes (Channel A). P14 ~ P17 - STIM programmes (Channel A & B). PC1 ~ PC3 - Custom programmes (Channel A & B).

* PRG 2 button

Selects the desired programme: P01 ~ P13 - TENS programmes (Channel B). PRG 2 is disabled for P14 ~ P17 and PC1 ~ PC3.

NOTE: * SET button

Configures custom programmes. Sets time for TENS programmes (P01 ~ P13).

* ESC button

Stores customised programme / time and returns to the home screen.

* Power button

Turns unit on / off and ends the current programme. 7

NeuroTrac™ Multi-TENS Operation Manual

Quick Start Instructions 1. 2. 3. 4.

5. 6.

Insert a 9 volt PP3 Alkaline battery. Alternatively insert a rechargeable Nickel Hydride battery [Which is safer and has a much longer life than the Ni-Cad rechargeable batteries] into the battery compartment. Insert lead wire/s to channel A and B if both channels are to be used. Switch on the unit by pressing the Power button. Press the PRG 1 [Programme] button to select: P01 ~ P13 for preset TENS programmes. (Channel A only). P14 ~ P17 for preset STIM programmes. (Channel A and B) PC1 ~ PC3 for custom programmes. (Channel A and B). To start press channel A+ and B+ button if you are using both channels, increase the stimulation to the desired level. To stop the programme, press the ON/OFF button which will turn the unit off.

LCD Display Channel A Frequency / Pulse Width

Programme Time

Channel B Frequency / Pulse Width Lock / Statistics Symbol

Channel A Programme Mode / Number

Home Screen

Channel B Programme Mode / Number

Running Programme Channel A Channel B programme programme

Channel A milliamps

Channel B milliamps

Channel A & B paused

Channel B Channel A disconnected disconnected electrode electrode STIM only programme (both channels fixed to one programme) 8

Low battery indicator

NeuroTrac™ Multi-TENS Operation Manual

Setting Time in Pre-set Programmes: . 2.

3.

Select P01 ~ P17 using the PRG 1 button. Press the SET button and the Clock symbol will flash ON/OFF, then press the either + or – button to adjust the time between: TENS: 30 minutes, 1,4,9 hours, CON - no time limit. NMS: 30 minutes, 1 or 2 hours. Press ESC to save the time for the selected programme.

Setting Custom Programmes 1.

Select PC1, 2 or 3 by pressing the PRG 1 button on the front panel. Remove the battery lid where you will see two buttons SET and ESC.

2.

Press the SET button once to customise a single phase. Hold the SET button for three seconds to enter advance mode and customise up to 5 phases. Press the SET button once to select the next phase.

3.

Press B + / - to set the phase time. Press A + to select the phase mode.

4.

Press B + / - to select the phase mode: continuous (CON), modulated (MOD), burst (BST), Neuromuscular stimulation (NMS). Press A+ to configure the phases parameters.

CON (continuous TENS mode) 1. Press B + / - to set the frequency (Hz) between 2Hz and 200Hz Press A + to set the Pulse Width. 2.

μS) between 50μS and 450μS. Press B + / - to set the pulse width (μ NOTE: If frequency 105 Hz or higher is set, the pulse width will be restricted to 300μS maximum for safety.

3.

Press the SET button to configure the next phase or press the ESC button to save the parameters.

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NeuroTrac™ Multi-TENS Operation Manual

MOD (modulated TENS mode) 1. Press B + / - to set the low frequency (Hz, LO) between 2Hz and 200Hz. Press A + to set the high frequency. 2.

Press B + / - to set the high frequency (Hz, HI) between 2Hz and 200Hz. Press A + to set the low pulse width.

3.

μS, LO) between 50μS and Press B + / - to set the low pulse width (μ 450μS. NOTE: If a frequency of 105 Hz or higher is set, the pulse width will be restricted to 300μS maximum for safety. Press A + to set the high pulse width.

4.

μS, HI) between 50μS and Press B + / - to set the high pulse width (μ 450μS. NOTE: If a frequency of 105 Hz or higher is set, the pulse width will be restricted to 300μS maximum for safety. Press A + to set the milliamp modulation adjustment.

5.

Press B + / - to set a milliamp modulation (ADJ) between 50% and 100% (100% is no milliamp modulation). Press A + to set the modulation time.

6.

Press B + / - to set the modulation (TME) time between 3 and 60 seconds.

7.

Press the SET button to configure the next phase or press the ESC button to save the parameters.

BST (BURST TENS mode) 1. Press B + / - to set the frequency (Hz) between 35Hz and 200Hz Press A + to set the Pulse Width. 2.

μS) between 50μS and 200μS. Press B + / - to set the pulse width (μ Press A+ to set the number of bursts per second.

3.

Press B + / - to set the frequency (FRQ) of bursts per second between 2 and 9.

4.

Press the SET button to configure the next phase or press the ESC button to save the parameters. 10

NeuroTrac™ Multi-TENS Operation Manual

NMS (Neuromuscular (STIM) mode) 1. Press B + / - to set the frequency (Hz) between 2Hz and 200Hz Press A + to set the Pulse Width. 2.

μS) between 50μS and 450μS. Press B + / - to set the pulse width (μ NOTE: If frequency 105 Hz or higher is set, the pulse width will be restricted to 300μS maximum for safety.

3.

Press B + / - to set the work seconds (WRK) between 2 and 99 seconds. Press A + to set the rest seconds.

4.

Press B + / - to set the rest seconds (RST) between 2 and 99 seconds. Press A + to set the ramp up time.

6.

Press B + / - to set the ramp up time (R:UP) between 0.0 and 9.9 seconds. Press A + to set the ramp down time.

7.

Press B + / - to set the ramp down time (R:DN) between 0.0 and 9.9 seconds. Press A + to set the current type.

8.

Press B + / - to set the current type to either synchronous or alternating (SYN or ALT). NOTE: The SYN current stimulate both channels at the same time. The ALT current stimulates channel A and then channel B. If SYN is selected, press A + to set the delay between channel A & B.

9.

Press B + / - to set the delay (DLY) between channel A & B from 0.0 to 4.0 seconds.

10.

Press the SET button to configure the next phase or press the ESC button to save the parameters.

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NeuroTrac™ Multi-TENS Operation Manual

Programmes Mode

Fre que ncy

Pulse W idth

TENS P01 CON P02 CON P03 CON P04 CON P05 CON P06 CON P07 CON P08 CON P09 CON P10 BST P11 MOD P12 MOD P13 HAN STIM P14 WR P15 WR P16 WR P17 WR CUST PC1 CON, BST, MOD,W R PC2 CON, BST, MOD,W R PC3 CON, BST, MOD,W R

W ork

Re st

Ra mp Up

Ra mp Dow n

De fault Time 4 Hrs 4 Hrs 4 Hrs 4 Hrs 4 Hrs 4 Hrs 4 Hrs 4 Hrs 4 Hrs 4 Hrs 4 Hrs 4 Hrs 4 Hrs

6 6 6 10

8 6 8 10

2 1 1 1

2 1 1 1

2 Hrs 2 Hrs 2 Hrs 2 Hrs

MODALITIES CON - Constant TENS Stimulates constant frequency and pulse width on both channels. BST - Burst TENS Stimulates nine pulses of 200μS at 150Hz repeated two times per second. MOD - Modulated TENS Stimulates over a six second cycle modulating frequency and / or pulse width. P11: Frequency starts at 100Hz decreasing exponentially to 65Hz. Pulse width starts at 200μS decreasing exponentially to 100μS. P12: Frequency starts at 10Hz increasing exponentially to 90Hz. Pulse width fixed at 200μS. HAN 3 second of 100Hz, followed by 3 seconds of 2 Hz. W/R - Work / Rest Stimulation Stimulates constant frequency and pulse width on both channels with work / rest intervals. 12

NeuroTrac™ Multi-TENS Operation Manual

Home Compliance Lock Mode Function A "concealed" Lock button is included in the NeuroTrac™ Multi-TENS unit, which allows the clinician to accurately monitor the "Home Compliance" of the patient between appointments. Whenever you lock the device, it resumes or starts to record the statistics of use. If the unit is not locked, the statistics are not stored in the memory. You can lock the unit in two ways: Press the concealed button and {L:T} or {L:P} will be flashing on the LCD, press B+ to select one of the options: L:P - This will lock the selected programme and will not allow user to alter any parameter, such as the programme number and time, programme type (Constant, Burst, etc). Use this option if you want to keep the same settings through out a course. L:T - This option will allow you to alter all the parameters during the course: programme, time, etc. Use this option if you are an advanced user and you are allowed to alter the parameters during the treatment. The recorded statistics are the same for both {L:P} and {L:T} options. Locking the Unit and recording statistics Remove the battery cover and using the end of the lead wire, gently press on the concealed lock button as shown in the diagram on page 7 until you hear a double bleep. The lock symbol will appear on the LCD screen and {L:T} or {L:P} will be flashing. Your unit will start recording the daily statistics. It is very important to set up the timer and calendar correctly - see page 15. Displaying Global Statistics To display the global statistics, remove the battery cover and using the end of the 2mm dia pin press the concealed switch once and you will hear a single beep. On the diagram below, the basic global statistics are displayed on the LCD: how many days the unit was used, number of hours in total the unit was used and the average intensity [m A] used. When you have noted the information press the OFF/ON button to bring the unit back to the Home position. Total Number of Days in Use

Total Number of Hours in use.

Channel A Average Milliamps

Channel B Average Milliamps 13

NeuroTrac™ Multi-TENS Operation Manual

The NeuroTrac™ Multi-TENS records up to five sessions per day for a period of 60 days. This feature allows the therapist to check each individual session to ensure that the patient is using the device properly at the prescribed times. Viewing Detailed Statistics When your device is locked, and you press the concealed button, it displays the global statistics, as described in previous chapter. You can see more of your recorded home compliance by pressing the following buttons: A+ to scroll the Days. Press A+ to view the total time and average intensity [mA] for each day. The day number is displayed on the top left corner of the LCD. Press A+ and scroll through the days, after the last day, the Global statistics will be displayed. B+ to scroll Sessions of the selected day Press B+ to see the session time and sesson average mA for each channel. The number of sessions recorded for the selected day is displayed on top middle of the LCD, as “SESSIONS: X/Y” where “X” is the selected session and “Y” is the total number of sessions recorded this day. SET - which programme was used Select the session and see which programme was used on each channel by pressing the SET button. Selected day (1~60)

Selected session (1~5)

Total session time

Channel A Average Milliamps

Channel B Average Milliamps

Channel A program

Channel B program (if different from A)

A+, then SET, then A+ to see the calendar day Press A+ to select the Day, press SET then A+ to see the calendar date of the selected Day (the date and time should be set correctly when you lock the unit). NOTE: Additional sessions are added to the fifth session if a patient uses the device more than 5 times a day. Sessions less than two minutes are not recorded. 14

NeuroTrac™ Multi-TENS Operation Manual

Unlocking the unit. If you see the LOCK symbol on the LCD, your unit is locked. To unlock the unit, press the concealed button, then PRG.1 for 10 seconds. The LOCK symbol will disappear. You need to unlock the unit to: - change the treatment parameters if it was locked as L:P; - stop the statistics recording, the statistics will still be there in the memory. - be able to delete the statistics (see next chapter for how to delete the statistics). Deleting the statistics The statistics are not automatically deleted when the unit is unlocked. To delete the statistics completely, make sure the unit is unlocked, then press the concealed button. The {L:P} or {L:T} is flashing, now press the following buttons, one after another: SET then A+, then A-, then B+, then B5 beeps will sound and all the records will be deleted. Now your unit can be used again for the next patient or treatment. After you deleted the statistics, the timer and calendar is displayed and can be adjusted, please make sure it is up to date, see the next chapter of how to set it. Timer / calendar reviewing and setting The NeuroTrac™ Multi-TENS has a built-in real time clock to track unit usage and statistics. The time and date settings will be lost if the unit has the battery removed for more than ten minutes, so it is important to check the timer and calendar whenever you insert the new battery or lock the unit. To review or set the real time clock, hold the PRG 1 button for ten seconds, until the LCD will start flashing the first parameter (hour). Press A+ to select the next parameter: Hour, Minutes, Day, Month, Year Press B+ and B- to adjust the parameter. Year Time Day

Month 15

NeuroTrac™ Multi-TENS Operation Manual

Using the NeuroTrac™ Multi-TENS Unit in TENS mode RATE [Hz or pulses per second] The RATE to be selected depends primarily on the electrode placement on the patient’s body. If one uses contiguous and dermatome (the electrodes alongside or over the area of pain) electrode placement, a higher rate of 80 Hz - 100 Hz is desirable. The patient should experience steady continuous stimulation. It has been found that an optimal setting of 80 or 90 Hz with a pulse width of 200 μS has good effect for most patients and is a good first choice for pain-gating. Patients using Trigger, motor or acupuncture points tend to respond to low rate stimulation 2 Hz - 10 Hz and pulse width of 200 μS. The desired effect is for the patient to feel individual pulses. PULSE WIDTH [Duration] The wider pulse widths will deliver stronger stimulation for any given intensity [mA] setting. By using a combination of intensity and pulse duration, it is felt that various pulse widths are capable of stimulating different groups of nerve fibres. The wider pulse duration is needed to recruit motor fibres, where as the narrow pulse duration is used more on the sensory fibres. The selection of which pulse duration to use is dependent upon the intended treatment protocol. Stimulating the larger nerve fibres is thought to reduce the speed and the amount at which information is transmitted along the smaller nerve fibres. Also under certain circumstances the brain is thought to produce its own analgesic pain-killing substances, known as endorphins or endogenous opiods. Intensity [mA] Patients respond differently to the level of intensity, this is due to differences in individual patient’s skin resistance, enervation and the type and condition of electrode being used. A good formula for setting the intensity is to increase the current so that the patient feels slight muscle contraction, but not strong enough to move a joint, and then slightly reduce the intensity so that it feels comfortable. When using low rate TENS settings, individual twitches will occur. The higher rate TENS settings will increase muscle tension. It is not advised to increase the intensity to experience strong muscle contraction.

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NeuroTrac™ Multi-TENS Operation Manual

Treatment Modes (TENS) There are three treatment modes available on the NeuroTrac™ Multi-TENS unit: 1. Conventional TENS or normal. This mode enables the user to select any rate between 2 Hz - 200 Hz, and a pulse width between 50 μS - 300 μS. This is the most frequently used of the three modes. The most common selection is 80 - 90 Hz with a 200 μS pulse width. 2. Burst Mode. This mode is comparable to the low rate TENS technique except that each low rate pulse is substituted for by a short BURST of 9 pulses [200 μS] at 150 Hz or 185 Hz. It is a combination of conventional and low rate TENS. The burst mode is often referred to as acupuncture - like TENS. 3. Modulation TENS this mode was designed to help prevent nerve accommodation that some patient’s experience. It is achieved by continuously cycling the pulse width and rate. How Long Do I Use TENS For? This depends on the individual patient’s condition, accuracy of electrode placement, stimulation and the characteristics selected, but typically the onset of pain relief starts after 20 - 30 minutes. Generally TENS is used for longer periods of normally 1 hour 30 minutes per session. With some patients it can be much longer.

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NeuroTrac™ Multi-TENS Operation Manual

Electrode Placement (TENS) The placement of electrodes is one of the most important parameters in achieving effective pain relief using TENS. This is best left to your Physiotherapist or Doctor to advise as to which location is most appropriate. It may transpire that various positions need to be experimented with before the user finds the most effective positioning. The positioning may be via the contiguous, dermatome, myotome, motor, trigger or acupuncture points. Dermatomes & Myotomes These are areas of the body enervated by a single nerve root via the spinal cord. Each nerve root serves a known area of the skin. The dermatomes are named after the nerve root which serves it. For details of dermatome sites refer to diagrams on pages 33 & 34. Contiguous Placement This form of electrode placement is the most common method used. It involves placing the red lead [proximal] alongside the spine where the dermatome [on which your pain lies] enters and exists. The black lead [distal] is normally placed over or near to the pain site. Your Physiotherapist or Doctor may direct the current to cross through the pain area or using the ‘bracket’ system allow the current to flow on either side of the pain site through the nerve branches that supply the pain location. Acupuncture Points The placement of the red and black electrodes on the skin forms the electrical circuit for TENS. It is the skin itself that creates the highest electrical resistance to stimulation. The Physiotherapist or Doctor may consider using acupuncture loci (acupoints), which offer much lower resistance properties, as a more effective site for placing the electrodes. Accurately locating an acupuncture point can be difficult, please seek advice from you doctor or physiotherapist.

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NeuroTrac™ Multi-TENS Operation Manual

Electrodes Types and Tips *

Self-Adhesive Hypoallergenic electrodes have a typical life span (if looked after) of 4/6 weeks. We recommend cleaning the skin before placing the electrodes. After use place the electrodes back onto the plastic film and in the zip-tag plastic pouch. Store in a cool environment. Skin Electrode Types Available: SHAPE

CODE

DESCRIPTION

VS.4040

40 x 40 mm, square [** max 53mA]

VS.5050

50 x 50 mm, square (recommended for general use)

VS.9040

90 x 40 mm, rectangular

VS.9050

90 x 50 mm, rectangular

VS.10050 100 x 50 mm, rectangular VS.30

30 mm diameter, round [** max 46mA]

VS.50

50 mm diameter, round

** IMPORTANT : Don’t use VS 4040 at more than 53mA and VS3030 at more than 46 mA.

A Few Good Tips [Self- Adhesive Electrodes] *

* *

If you find the electrodes will not stick due to oily skin, cleanse the skin with soap and water, then rinse and dry the area around the electrode site. If this does not work, try cleansing the skin with a swab impregnated with alcohol. Clip away hairy skin using scissors; don’t use a razor to remove the hairs! The electrodes conductive material is water- based. If it becomes saturated (e.g. from perspiration), it will lose its adhesive qualities. After use leave the electrodes face up overnight to dry out (replace on plastic film in the morning). At some point the electrodes will become dry. Moisten the adhesive surface with a few drops of water, and apply onto the plastic film overnight. This procedure will increase the electrode life by few more days. 19

NeuroTrac™ Multi-TENS Operation Manual

Suggested Electrode Placement (TENS)

+ = Red - = Black

Knee Arthritis

Finger Arthritis

Neuralgia of Trigeninus

Cervical (2 Positions) 20