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1. constant relative the load value depends on the previous step the load is increased or decreased by the entered value Ramp absolute the load increases continuously for the duration of the training Ramp relative the load value depends on the previous step the load is continuously increased or decreased by the entered value Enter the duration speed and slope for each step A blood pressure measure ment will be performed when you select E the blood pressure option Click Insert before or Insert after to add additional steps You can change the order of the steps with Up and Down As an alternative you can select the step highlighted blue and drag it to its ap propriate position If the created steps are to be used as exercise phases without warmup and recovery highlight one step or sev eral consecutive steps Then choose Extended and Training The steps are now marked as training steps with an X in the Trng column mowo Tree gt Bood re n Par Tree Brant Rene Paon Tree gt Beod rn Ow wee Le fy de et Sope eis IN Tag HIM Teng IR IP we Cot Type 47 MANAGEMENT gt PROTOCOLS TREADMILL Protocol Type Custom Via Extended 1 and Repeat you can eas ily copy the step types With Edit you can modify the dura tion speed and slope of individual or of all steps Highlight the steps you want to modify they turn blue and enter a value for D
2. Adding Patients to a Group After you created a group you can add patients to this group To do so select a system patient highlighted blue and then click Add Add more patients as described above or by Drag amp Drop drag the patient name to a training station Click the Save button to save the group 38 NE Hr H jiii Group DATA GENERAL Deleting Patients from a Group To delete a patient click the patient name highlighted blue and then click Remove As an alternative you can dou ble click the name of a group patient to delete it To remove all patients of a group at once click the Empty button Editing a Group If you wish to edit a group highlight the group name by double clicking or by selecting the group via Management Groups and click the Edit button Change the data as appropriate and ter minate the procedure with Save 39 MANAGEMENT gt PROTOCOLS BICYCLE On the Management Protocols Bicy cle tab you define protocols for bicycle exercise tests for multiple uses The win dow shows the exercise test parameters such as Warmup Increase Training Decrease Recovery Saving the Default Protocol The system offers two methods for sav ing Protocols as Defaults on the Management Protocols tab and on the Patient Data Protocols tab see Bicycle Saving a Protocol as De fault on page 31 On the Management Protocols tab you c
3. warmup phase training duration blood pressure measurement speed and slope recovery phase Under Protocols you will find the Tread mill Default protocol This is a precon figured protocol More than one protocol can be assigned to a patient The description below explains the con figuration of custom training protocols All parameters can be defined easily and accurately Warmup Increase Training Decrease Recover Creating a Protocol With Create you configure a new pro tocol Enter a protocol name for exam ple Protocol 1 and select a protocol type Specify all required criteria Save the protocol with Apply or delete all entries with Discard By saving the protocol you add it to the drop down list of protocols 32 Preece Tree Sood rrr Series eel gt Teg He Ipad WR Crt Type PATIENT DATA gt PROTOCOLS TREADMILL Selecting the Protocol Type These are the protocol type choices Constant Workload HR controlled Speed HR controlled Slope HR controlled Custom Constant Workload permanent load without interruptions at a constant intensity HR controlled Speed the predefined training heart rate is achieved via the speed HR controlled Slope the predefined training heart rate is achieved via the slope HR controlled the predefined training heart rate is achieved both via the speed and the Slope Custom use Individual st
4. ercoline OO ELE gt _ _ ers 2 ergoline Rehabilitation System Operator s Manual 201000414000 Version 2014 04 15 Rev 00 s English This manual was written with the utmost care Should you still find details that do not correspond with the system please let us know and we will correct the issue as soon as possible We reserve the right to modify the design and technical features of the device and are not bound by the information and illustrations provided in this manual All trademarks appearing in this document are trademarks of their respective owners Their protection is acknowledged No part of this manual may be reprinted translated or reproduced without the manufacturer s written permission This manual is not subject to any change order service Please contact the manufacturer for the most recent version ergoline GmbH Lindenstrasse 5 72475 Bitz Germany Phone 49 0 7431 9894 0 Fax 49 0 7431 98 94 128 01 23 e mail info ergoline com http www ergoline com CONTENTS T Sola LT s a TTT 7 CE Marking In OrmatoN s eg sei ada N a oe oe he Sea ye ae L RKR T 7 License lM Sei senesine a doce hketae sheen beaee cee tnuateeeed sts 7 Revision T e sarias Sow ws eared area grok Rew ee See eons Co eR aes ees es 8 Mtended Audiente cc cece Z Re E R ee eee cee tS cere LE A A 4 RR 8 GST TG UCCONVENUONS be ae ors eai es ee i eh wes ek Bee eee esate ede 8 Saret Informat 2 dae ac coe
5. Petoomts A gt Viewers pei ee eet ree bees oe es Pent Pet Pa nem tome ee ee Cee Baw paate ba ASEN PAN H Poe tout of Potent 7 gt U Desi aem p KEES EN E P n n wa Sei Maw Poy Too N L Were Dese zamn Femme HETEC TE ET PER TEO P P Pp Sw Baw faii ATR eet oe en E P Per ot T REA Pee ele Pee Poe end 5 toe FSU RSS Pent vend P beet rene vee am K fr ont N B a gt o po 8 gine X B ep ra Y 57 3 2 60 65 TRAINING MONITORING Starting a Training Session The difference between HR and THR is graphically represented by three ele ments A minor deviation is indicated yellow no deviation is indicated by a green symbol a major deviation is indi cated red The colored symbols appear on the left if the value is too low and on the right if the value is too high The length of the bar represents the dura tion of the activity completed duration overall duration remaining duration A protocol can be edited at any time By double clicking the training graph you can reconfigure the protocol or via the shortcut menu Modify the protocol and confirm the procedure with Apply Ending a Training Session To terminate a training session press the right mouse button and select Stop Training from the shortcut menu Changing from the Training Phase to the Recovery Phase RP From the actual exercise phase you can choose Change trng to RP from the s
6. check that the voltage and frequency ratings of your power line match the values indicated on the device nameplate Equipment Damage Make sure that viruses malware etc do not infect your PC check USB sticks for viruses before connecting them Equipment Damage Do not set up the PC or the ergometers in the direct vicinity of a window Rain humidity and sunlight may damage the equipment Loss of Data Back up the program directory and the database directory as deter mined during installation every day to avoid loss of data Equipment Damage Set up the device in a location which affords sufficient ven tilation The ventilation openings must not be obstructed The ambient conditions stated in the user manual must be ensured at all times Equipment Configuration The PC should not be used adjacent to or stacked with other equipment If adjacent or stacked use Is necessary the equipment or system should be tested to verify normal operation in the configuration in which it is being used SYSTEM REQUIREMENTS Processor x86 or x64 processor with 2 gigahertz GHz minimum RAM 1 gigabyte GB RAM 32 bit 2 gigabyte GB RAM 64 bit Hard drive recommended minimum storage capacity of 250GB Graphics card with 1 or 2 monitor outputs depending on configuration Monitor s 1920 x 1080 pixels Input devices keyboard mouse Interfaces 1 USB interface for connection of the hardware key 1 USB interface for connection of
7. compliance with the provisions of the Council Directive 93 42 EEC about medical devices and fulfills the essential requirements of Annex of this directive The product ERS 2 system has been assigned to class Ila in accordance with Annex IX of the Directive 93 42 EEC The product fulfills the requirements of the standard EN 60601 1 Medical Electri cal Equipment Part 1 General Requirements for Safety as well as of the standard DIN EN 62304 Medical Device Software Magnetic and electrical fields are capable of interfering with the proper perfor mance of the device For this reason make sure that all external devices operated in the vicinity of the equipment comply with the relevant EMC requirements X ray equipment MRI devices radio systems cellular telephones etc are possible sources of interference as they may emit higher levels of electromagnetic radi ation Keep the equipment away from these devices and verify its performance before use By installing the software you accept the following terms Subject of this agreement is the granting of a license to use the software program and the product documentation Ergoline GmbH grants you the personal non exclusive and non transferable right to use the software and documentation The software and the accompanying documentation are protected by copyright The licensee shall comply with the provisions of copyright law Ownership and all other rights to the software are ret
8. gt GENERAL PHYSICIAN General Practitioner Medical Specialist at ers 2 0 Enter the physician s last name first ee me name title etc via the combo box into ergoline rehab system the appropriate fields By clicking the button you add a physician to the database In the new window fill out all mandatory fields identified with an asterisk ked The medical specialty can be added by clicking the button Click OK to save the medical specialty Clicking OK again will add the physician to the drop down list Click Save to finish the pro cedure 21 Patient DATA gt MEDICAL THERAPY Diagnoses Medications Remark This screen accommodates all fields for entry of the diagnosis the medications and any remarks This information is es sential for the therapist Existing medical findings and or instructions for the use of medications are adopted with Create The Create edit diagnosis or Create edit medication window opens If you select Type another window with the title Create edit diagnosis type or Create edit medication type opens Specify the type in the Name text box and click OK to close the window After you click the OK button once more the type will be added to the drop down list All entries are saved with Save With Close you exit the menu 22 Create edit diagnosis Type Value On aaa Cancel Create edit d
9. recovery highlight one step or several consecutive steps Then click Training under Extended The steps are now marked as training steps identified with the X mark in the Trng column Perran Tree gt ocd rR g Peren Tree Sood rr Ow whe Le Load ais WJ PATIENT DATA gt PROTOCOLS BICYCLE Protocol Type Custom Repeat under Extended allows you to copy one step or multiple steps The cop ied steps will be appended to the existing steps With Edit you can change the duration and load of individual or of all steps Highlight the steps you would like to change and enter the value in the ap propriate field or by means of the arrow keys 11 K When you select Apply the Load abs W rel and or the Duration abs s rel will change by the entered value Close the window by selecting Apply again Editing a Protocol To edit or reconfigure an existing pro tocol select the protocol and then click Edit The parameter fields are populated with the set standard values Edit these values and exit the menu with Apply Activating a Protocol When you click Extended and then choose Activate a dialog window will be displayed If you agree and click Yes the protocol will be activated which is marked by an asterisk This protocol is now the patient s Training Protocol Deleting a Protocol Display the protocol that is not needed any more Under Extended select
10. 5 rend gt e anne e 04 shee O05 aer L Le umas sd Patient Training tey er E rs KC o ete Barge e osz m KS a a E E ar er rr Fy it a ey es ee sy st an a os ae se aani rem ores ara O et eaten Deer cme BOS aar creas ware AER EEA bare fall Be a ee st a at st a ee at oe a a ee n K BIR Eee LL Hottmana na 120 i 02 89 eee Pee Poe REST as pon Kaiser a 115 a pens Kerne na 03 er 92 LA BRT Richter ka 170 Manani Sevi annsi I eder 04 05 b Hi Sheba 1 LU 648 C ee 115 91 T NSS A ON PAS DA DAS P P Are TRAINING MONITORING Marking the ECG To highlight artifacts in the ECG right click in area 2 and select Mark ECG Turning the ECG Pump On To turn on the ECG pump from the short cut menu in area 2 select Turn on ECG Pump Turning the ECG Pump Off To turn off the ECG pump from the shortcut menu in area 2 select Turn off ECG Pump raining View This screen provides an overview of the training session the protocol the du ration and the METs value additional parameters if provided by the training device Depending on the configura tion and device type various parameter values can be selected from the short cut menu for graphic representation With a right mouse click into area 3 and choosing Training Display or with a dou ble click on the curve display you switch to the Patient Training This view presents all pa
11. BP Sp02 METs W kg Load RPM Spd Sip Energy Distance Weight From the drop down lists select the pe riod of time of the training sessions and the values you want to compare The re sults will be displayed in the form of bar charts All parameter values such as HR BP or Sp02 from the two sessions can be compared in this way Again all information about the training sessions are presented in tabular form below the bar charts With Print you obtain a printout of the overview 60 PATIENT ANALYSIS TRAINING SINGLE aa ma TTT Yee The diagram presents the parameter val ues obtained during the training OO WOO SOP SAR MOOR An A A E TESS ee Cee ee Cee eee Oe Cee eee ee oe o iy i yp yp en ey en er eer ere L H R L LJ S PAS P S S T a BP UUR EEEE 7 S p 0 2 a VAE Ces ne Cre Pr Vr Vn Pn Pre vee bs METs a e J J LL J 4 W kg aioa Load i _ RPM 1 1 111 _ Spd Sip Next to the diagram you see the full dis closure ECG As you move the mouse cursor over the diagram the correspond ing values will be displayed in a window The exercise phase is identified with a dark background color Under Training you will find all training aan sessions of this patient sorted by date a a Be T and time Analyzing the Training Sessions In the corners of the diagram select the events to be shown in the diagram HR BP SpO2 et
12. Workload Reduction Delay s Type Load rel Load abs W Mowo Tree gt ood rr Workload Control Threshold BPM Delay 19 Workload Control Ta Interval s UU ath Load rel w 4 LA Load abs Y HU opira Tate Type QL Load rel Load abs YO PATIENT DATA gt PROTOCOLS BICYCLE Protocol Type Custom Additional entries are mandatory for custom protocols With Insert before or Insert after you define the first step type Your choices are constant absolute the training workload is kept at a con stant level for the specified duration constant relative the load value depends on the previous step the load is increased or decreased by the entered value Ramp absolute the training load increases continuous ly for the duration Ramp relative the load value depends on the previous step the load is continuously increased or decreased by the entered value Enter the duration and training load for each step If you select the blood pressure option BP a blood pressure measurement will take place Additional step types can be added with Insert before and Insert after With Up and Down you change the sequence As an alternative you can se lect a row in the table highlighted blue and drag it to its appropriate position Remove allows you to delete a step If the created steps are to be used as exercise phases without warmup and
13. a printer 1 to 16 serial interfaces for connection of the ergometers Printer ink jet or laser printer with USB connector Operating system Windows XP Windows Vista Windows 7 11 12 EQUIPMENT SYMBOLS INTENDED USE Ers 2 SYSTEM The symbols that you will find on the PC and on the ergometer are explained in the corresponding user manuals Text labels explain the function of all symbols displayed on the screen Double click the icon to start the program 2 The ERS 2 system automatically controls up to 16 ergometers bicycles or tread mills and offers individual training protocols Each phase of the training protocol is documented providing the therapist physician with up to date information about the patient s status performance data and training progress at any time The ergometers used must be medical ergometers that meet IEC 60601 1 1 re quirements Both bicycle ergometers and treadmills are supported The ERS 2 system is only designed for operation in rooms used for medical purpos es It is intended for use in rehabilitation centers cardiology offices and fitness centers with medical cardiac programs The ERS 2 system is intended to be used only by trained operators under the direct supervision of a licensed health care practitioner on adult and pediatric patients Parts and accessories must comply with the applicable safety standards of the IEC 60601 series and or the system configuration must comply with the requi
14. enter the difference to the upper SpO2 value If the oxygen saturation drops below the set limit value the training workload will be adjusted accordingly Click Extended to open the Sp02 con trol window In this window you define the parameters for the SpO2 controlled exercise First of all the current SpO2 value is checked once on the basis of the values entered under Workload Reduction If the SpO2 value is below the limit for the entire duration of the delay period s the load will be reduced once Teng HIM PADDA R anna E Cot Type Teng HRPM om Cot Type bwm fmn gt Dupon fmn gt Pepe teil gt Serene Lm peas ma opira 41 MANAGEMENT gt PROTOCOLS BICYCLE Protocol Type Sp02 controlled Subsequently the SpO2 value is checked on the basis of the Workload Control pa rameters If another deviation is detect ed the training load will automatically be adjusted Entries can be made as absolute or rel ative values with respect to the training load If you do not enter any values in the Sp02 Control window the system will use the preset defaults Protocol Type Interval HR controlled In the Training pane click Extended to open the Interval HR Control window with the Workload Control parameters In this window enter the permitted de viation at Threshold 1 min and the time interval at Delay s If the heart rate deviates for the entire time interval the
15. ergometer user manuals To ensure maximum patient safety the specified measuring accuracy and inter ference free operation we recommend using only original accessories available through Ergoline GmbH The user is responsible if accessories from other manu facturers are used Ergoline GmbH is responsible for the effects on safety reliability and perfor mance of the equipment only if assembly operations extensions readjustments modifications or repairs are carried out by Ergoline GmbH or persons authorized by Ergoline GmbH the device is used in accordance with the instructions given in this manual The warranty does not cover damage resulting from the use of unsuitable acces sories and consumables from other manufacturers Always consult with Ergoline GmbH if you intend to connect equipment not men tioned in this manual Parts and accessories must comply with the applicable IEC 60601 safety stan dards and or the configured system must comply with the collateral standard IEC 60601 1 1 Safety requirements for medical electrical systems SAFETY INFORMATION General Information Operate the equipment only with power cords certified for the country of use All publications reflect the equipment specifications and standards on the safety of medical electrical equipment valid at the time of printing All rights are re served for devices circuits techniques software programs and names appearing in this manual N
16. o1 P Load 34 va v St es C bem De Yaa We Wee ee T sa creme A ae Hoffmann L sensen apts wa gt e vP on it s N 23 02 sa 0 81 Sa gt IR 0 Kaiser ma 115 L 903 99 on an Marenne Desi bow were LC 03 a 05 Sa TRAINING MONITORING Removing a Patient To remove a patient right click the com mand Remove Patient the patient will immediately be deleted Please note that it is not possible to remove a patient while a training is in progress Assigning a Device To assign a monitoring training device to a training station right click and select the Assign Mon Device Assign Trng Device Then select the appropri ate device in the window that opens and confirm your selection with OK Removing a Device Select Remove Mon Device Remove Trng Device from the shortcut menu to disconnect the device Switching Devices With Switch Mon Device Switch Tra Device you can exchange monitoring and training devices Select another de vice and close the window with OK Starting a Training Session To start an individual training session choose the Start Training command from the shortcut menu The screen displays all relevant training data The values for HR THR in area 2 and the duration of a training session in area 3 are shown 50 oi me wher Beem 93 85 70 113 sL ne 120 a 70 285 LL 9058 na 110 71 115 SL 95 s Toot H lt
17. workload will be adjusted accordingly At Type you determine the nature of the workload change absolute or relative 42 Workload Reduction Workload Control Delay 9 T lt Interval 19 Type L lt Type Load rel 4 TE Load rel Load abs W Load abs W Twi Management L om hansa TORR kene reen Tree Pearl T contented lt Treg IR I gt ood rr Q Oi Type l Workload Control Threshold BPM TO Type Delay 9 lr Load rel MANAGEMENT gt PROTOCOLS BICYCLE Protocol Type Custom Various training steps can be configured for this protocol type With Insert before or Insert after you define the first step and choose a step type constant absolute the training workload is kept at a con stant level for the specified duration constant relative the load value depends on the previous step the load is increased or decreased by the entered value Ramp absolute the load increases continuously for the duration of the training Ramp relative the load value depends on the previous step the load is continuously increased or decreased by the entered value Enter the duration and load for each step If a blood pressure measurement is to be performed select the blood pressure option Additional steps can be added with Insert before and Insert after You can change the order of the steps with Up and Down As an alternative you can se
18. you display the predicted value of the HR for example An overview of all data is shown below the diagrams By clicking a point on the diagram you update the ECG display which changes to display the corresponding segment You can drag the scroll boxes over the entire length of the scroll bars to get an overview of the ECG A printout is initiated with the Print button Patient Analysis Lae ol eha v Prete cere T ert TOURS O20 aN soa TEI STE EEE r Benn Tas Leos week paras Jarm kwon torn RORY bea B nanna I a s 2 aaa br Ae pord SUB Ennu praal EVAS pat pees peas pard pant p f N wa 1 KUEN FERA PEZA PEPI PIER ITEY PEPI PERI T LST PU ITEY EPI SREDI ER TITS AnA a EEEN ADE PAN ENT S Lys els peas S P S S S T H E A VRAE RS GE L L L LR ee E on bes nt 4 VA VA VUSS VUNE VUEN PANNY PAN PUEN PAS PA Saan Choe r pamm v vand on vemp oe sne pred tg pet H SUMI AR 5 am tom 1 65 an gt orn 1 645 ae M YVR 11 ae aw oe 5 w fr mr G on 3 4 TooLs Karvonen Formula The Tools menu is available on all tabs of the ers 2 software Via Tools you can configure the Karvonen formula The Karvonen formula is used to de termine the optimal heart rate HR for different forms of exercise This value is different for each patient The formula takes the patient s resting heart rate HR at Rest and maximum heart rate HR max into account The factor for the training intensity is indi cat
19. 2 tamed 04 3 05 S 06 07 08 gt 01 K dara Hoffmann 120 L 708 Kaiser ban 15 03 94 lt 05 06 3 07 08 LI i se R 2 d TFSSRESESESS TTT FT V 422 E w 77 13 06 07 08 gt Area 1 Area 2 Area 3 bk Ta ide e Pankete C ews sern R reh trees Fees pose 1 SET Pe mema 1 ren 122 80 gt fr coe T a ee 98 7 131 0 item e v 138 89 gt Tate mra ee Do AES Gar an war 98 oo R Me Dwe Aae ioe Took E lt baient U iay c te ear D eS SS ee Se vreg Tee oy bop eres or pneey pemer weeer prea ps PEA Pe AN SA A PSAs iia spor ene t Tere P 132 83 po 98 L Show Ting opr op PCC hpa tec ine d ofe as Yan 2 128 83 rierpg werzhe oe 97 E me mu aa t parr ka 69 ka 62 a 37 it 60 63 rs 41 la 60 Loa 64 ome 70 t gt ka 67 w 37 ese 0 e 0 w 60 ve 67 eh ANALYSIS PATIENTS The Analysis Patients view provides an organized overview of all patients in the system The Group list comprises all groups that were created If you select a group the patients of that group will be displayed With Find you can quickly access the pa tient data After typing the first letters or a part of the patient s name or the ID the patient will be displayed With Select or by double clicking the patient highlighted blue you open the Patient Analysis PATIENT ANALY
20. De lete and then confirm the question asked in the dialog window with Yes to delete the protocol Please note that it is not possible to de lete an active protocol 30 Ow ote LH e 40 oes Ove ret TN we djo c Lead KRA fev v PPN aed re 1 x s 7 6 ergoline rehab system 2 Do you really want to activate the selected protocol ergoline rehab system 2 demo Do you really want to delete the selected protocol PATIENT DATA gt PROTOCOLS BICYCLE Saving a Protocol as Default At this point you can define one of the protocols as the Default Having entered the protocol name protocol type etc you click Extended and choose Save def The default protocols can be viewed and edited on the Management Protocols tab see Bicycle Saving the Default Proto col on page 40 The protocols are very flexible and can be applied to other patients as templates Loading a Default Protocol Created default protocols can be loaded via Create Extended Load def Choose your default protocol in the next window Double click or click OK and Apply to add the default protocol to the patient s protocol list All parameters of this protocol can now be adapted to the patient s needs and then you can Ac tivate the protocol Gerdes lt Leed Sef Patient DATA gt PROTOCOLS TREADMILL The illustration shows relevant informa tion such as training heart rate
21. SIS These are the tabs of the Patient Analy sis windows GENERAL MEDICAL PROTOCOLS OVERVIEW TRAINING Some of the tabs offer further options The following paragraphs discuss the Overview and Training tabs The tabs General Medical and Protocols are discussed in Patient Data gt General on page 19 Patient Data gt Medical on page 22 and Patient Data gt Pro tocols Bicycle on page 26 57 PATIENT ANALYSIS OVERVIEW TREND This screen provides an overview of all analyzed parameters such as HR BP Sp02 METs W kg Load RPM Spd Slp Energy Distance Weight When you move the mouse cursor over the curves the values will be updated and displayed At Period you can choose from various options You can change the displayed time window easily be selecting the high lighted option blue and scrolling or you can use the arrow keys on the keyboard t L All training sessions are listed in the area below the curves Analyzing the Training Sessions In the corners of the diagram choose the values to be displayed e g the minimum maximum first last average value When you click Show the correspond ing values and training sessions data points will be alternately shown and hidden The different colors make the differentiation easier The selected train ing session Is highlighted with a dark bar cursor Additional details of all tra
22. Z A R TR ewes RE ER E RR E 8 General informatio lt beta a cue nieret coated eran RR nE RA AR RRR R 8 bayanet Sacco wae na Sueur eee Ene ee see ORERE ues poheeee sees se E 9 Sare OU eae S N Se were ees ee eee se ee ee ee ee See ee eee 9 SM REQUIN 1 ns agunteduan inanes EErEE ERRARE REESEN EREA nes 11 SUIT oe S EE E E EE 12 ICM ed USE s isersersiisrisnyr ees ns eee cee tS aeeeaeenedsetas ss eeueuse 12 ES 2 CIs eet See x wares seas ee so ee ee eee ae ee H E EEA 12 Tones an le 2 2 eee dese pe oe dae bean oe ew ose geese eee tae ae hee ean 12 An overview of the key performance features of the software 13 System Relie se ic ean reed do weeks odees oe dd ned Suda eee Renee ae 14 Starting the xo sa sussie pews yet eaved eevee ewe eee eee ae 17 Patient Data Gera as aire wicker a ete es bate ah RE a 19 PERSO A A Me ya eat Sears wb ow oe ee wes hae oh ew oe se ee ee ee ee eee ees 19 Cona T 21 PAYS eea E E E R ee te E R E 21 Patient Data gt Medical sees es 22 EADY E E E EEEE E E E T ET E EEE TETEN 22 EX OMUNG ONS eR Z oo SX wo RR R R A EERE E ees 23 A cass TEE cesce Suess eps eteuee eee eee see eens seer ee nesses 24 Sis e nt owe cbencmne meee donee ieee tea ees E e 25 Patient Data gt Protocols BIYE E ee eine ee ee cee sieercgr eee ane else es See a es ace 26 LCD a FKOUOCO ee carrse er eis pee ew ee eS ee ae ee S 26 selecting the Protocol YPE s cece ca renni irer s amet see ne AERAR 27 Protocol Type Sp02 controled s sR
23. ained by Ergoline GmbH You are not entitled to transfer the software to another computer via network or data channel The program and the accompanying product documentation shall not be modified copied or in an altered version merged with other software and made accessible to third parties The licensee is liable to the licenser for any damage arising from the breach of the copyright or infringement of the conditions of this agreement 7 8 Revision HISTORY Revision 1 0 Date 2014 04 15 Comments Applies to software version 1 0 and later INTENDED AUDIENCE This manual is geared for clinical professionals Clinical professionals are expected to have working knowledge of medical procedures practices and terminology as required for completing these examinations STYLISTIC CONVENTIONS Control keys soft keys and hard keys are emphasized by different styles e g Start training or Create SAFETY INFORMATION General Information This manual is an integral part of the device It should be available to the equip ment operator at all times Close observance of the information given in the man ual is a prerequisite for proper equipment performance and correct operation and ensures patient and operator safety Please note that information pertinent to several chapters is given only once Therefore read the manual once in its entire ty Also observe the information given in the enclosed separate user manuals e g the PC and
24. aining and then click Insert When you finally confirm your input with OK you return to the Findings window The text sample you created appears as a button The text samples corresponding to the buttons can be modified and supple mented Click Edit and select the but ton you want to edit highlighted blue Modify the text and click OK to close the window To emphasize text blocks or paragraphs highlight them with the cursor or by dou ble clicking Select the font character size and style bold italic underlined Editorial changes in the findings text can be entered directly in the text box Then click Save to save the entry Pac prede pe 25 Patient DATA gt PROTOCOLS BICYCLE The graphic shows relevant information such as training heart rate warmup phase training duration blood pressure measurement load control recovery phase The Protocol drop down list that you open with the arrow button shows all protocols that you configured You can configure a number of protocols for a patient and save them The text below explains how to config ure patient specific training protocols It is very easy to define the exact training parameters Warmup Increase Training Decrease Recover Creating a Protocol A new protocol is set up with Create Assign a name for example Protocol 1 and insert a protocol type Depending on the type additional parameters have
25. ating the Default Protocol ns cadet teaser edoehia ew ib dneeendoedes 48 Deleting Me Default Protocol 22 6 9 6 6 2 T 5 ces adhoc R A LR RA ER E A ii 48 WANING TTT 49 IEEE yin ose seen onan w dew oct re ee a bw ww Baan mam oO eer mw oe eee se F 49 Assigning a Patient oh ce S ne eine hae Ae tae ot ERNE EREEREER EELEE paii 49 Pre VO VAN ET NAG ssir oa wee eave ora wok haw oe eee eee eR me 50 Assigning a DEVICE esise asrine hone eee dbase oon tonne edn So oer eat 50 Fe PIU A DEVICE ets Sicha we dew moet Geet mad id ane E aw Berke Gs eee aT ws are Be E 50 SWICKI DEVES an cen newt Rew be gd Hw ae Os ha Oe sare a anes Ba 50 Staring a lraining SESSION ix want dea ak Z 6 Kem oe ee eet RS oe ek ees 50 Ending a raining SESSION 224 o cue tS aareeaed cand e baw eae eres aadaesa RERE 51 Changing from the Training Phase to the Recovery Phase RP 51 Suspending Heart Rate Control during a Training eee ee eee 51 Pa Tene D E EEE E A 52 Patent ANAYSSI s creses Z TEE Z Te R re ERER R RE ERE ER RE es 52 Editing the Borg Valls soes cute ee dG aoe ace ww ae EEE EEEE we ee 52 S ad ROR AE TEETER EN E E asda ea os hie nee Rae ae eee ea 52 PEO oee eE EEEE EEE EA 53 Measuring Blood Pressure sosise 2542256555004 ninpi Ek iE AIEE RRs Kt 53 Adding Blood Pressure Readings nnana es woe dee wee oad 53 Marking the ECGs meresi irre Seances dice Arann heap ET PERT am AS EEEF 54 urnim the EEG Ti 7 TTT 54 turning the ECO PUMPUN co cewces coe sk
26. c Click Show to alternately show and hide the line Click the Predicted button to show the predicted value If you click any point on the diagram the ECG display will be updated to show the corresponding segment You can drag the scroll box over the entire length of the scroll bar to get an overview of the ECG If you detect signs of a dysrhythmia for example highlight the corresponding segment by clicking the mouse button and dragging the mouse TESS ee ee ee ee ee ee ee ee oe oe ee s ae A 1 4 1 1 1 1 p F P d P P P w LA ANT A Pa E P P P 11 hhh P B pun ey pe T S H T w ONES PAS AES AS VAES P AS ONS OES VAS PS 1 TLS kra PATIENT ANALYSIS TRAINING SINGLE Analyzing the Training Sessions In the new window you can enter a writ ten comment With OK you exit the window with Cancel no marker will be set All markers are listed in the Marker drop down list annotated with the time of their occurrence With the I lt and gt I buttons you change between the first and last marker with lt and gt you navigate between the segments All segments for which a marker exists are identified with a dark background To change a remark click the Edit button and close the dialog window with OK To remove a remark select Delete and answer the next question with Yes Via the shortcut menu you can change the displayed channels the sweep speed and the ampli
27. cae xan pare R REER KR R RR oot 27 Protocol Type Interval HR controlled saw enseeiaen td oeews ne 28 EGG ype CUSION E cami wwe E enue eats ee be eee eae 29 Editing a Protocol keener omnes dest wae Soaps oor oa ee es a a Sh wk ee 30 Activatng A I NiO BO ce Seca ate be pt we ear e B ee 3 ec Se ws ow a OE Re A Ma oe 30 LIT 2 Nea a lt 5650s cca shee a RESO RENAE ESETE Eee Raa eae 30 Saving a Protocolas Default a caw rai ea wd hae eS eee dew wee oe 31 Loading a Default PIOWOCOL ican ess cand ds eews anaran 31 4 Patient Data gt Protocols reaa a ser e aee amen eee ee eek ewe oo ens eee ee eee 32 CHEATING TOE gear E caw E scant heiaw deans EIER ERRER REEE s 32 SCIC CHING the Protocol Type ace ae aw ob otk a ha Go dn we ew he Mk Sa nem ae S 33 Protocol Type HR controled oe 2122060460054 canner tandsa bes si RR RE 33 Protocol ype CUSTOM wenn eax ot o Meh wae ew degkw atone wan eta L d an ae 34 EOI x ae 666 onwkeae sd sede sn beneed eons Lene ae eawes maa heake 35 Activating d S n e oxeateceae hea ets Aasea tone a boo eae baw swn st 35 Deleting a TIOtOCO 2c55554 nae ea pena ceaees manos EERTE bead naene neeed 35 Saving a Protocol as Default xy once hoax eo ad ae eran dewentSeeudae hess 36 Loading a Default Protocdgl st edee dca dnstewstadusdceaes 36 Management Grou e tren a oder ae E See eo A ti a ne es ee 37 GENE Mian a ssa ae dee iaw Chena 6 E he eae ena hea w ene wa ween cee s 37 EEIT OlOUDsenen ute E REEE 38 Selec
28. d data once more With Format you prepare data for their first use or delete the data on the chip card Remark Remarks concerning the patient or par ticular conditions can be entered in this text box After you click the Save button the entries will be saved to the database With Close your entries will be discarded A warning will be displayed Click Yes to save the entries or click No to exit the menu without saving New entries are always adopted via the button If the entry already exists in the list a warning will be displayed The input is not unique This prevents double entries in the database With the Close button you always exit the current level and return to the parent menu Click the Exit button to return to the initial screen 20 Chip Card ergoline rehab system 2 Do you want to save the changes The input ts not unique Please check and try again PATIENT DATA gt GENERAL Contact DATA Patient Contact Data Emergency Contact Data Enter address names etc on this screen a ers 2 These inputs are optional waa pag ad ree pr me HE HE E m m T Ld ms emen HE HE E e n mat State Country or Relation are added via the button Type a name and save it with OK The new entries will be added to the drop down list Click the Save button to save your entries or click Close to exit the contact data PATIENT DATA
29. ded and select Delete If you confirm the command with Yes the protocol will be deleted It is no lon ger available for selection Please note that it is not possible to de lete an active protocol 44 Ow oe Lal Ow rt N w ej ago iii Wood aoe fev ood rat al R tje som cree ptss lt RS Sewie ergoline rehab system 2 Do you really want to activate the selected protocol ergoline rehab system 2 demo Do you really want to delete the selected protocol MANAGEMENT gt PROTOCOLS TREADMILL On the Management Protocols Treadmill tab you define general Default Protocols The following parameters are presented for configuration Warmup Increase Training Decrease Recovery Saving the Default Protocol The program allows you to create and save Default Protocols as templates on the Management Protocols tab and on the Patient Data Protocols tab see Treadmill Loading a Default Proto col on page 36 The Default Protocols can be swiftly transferred to other patients in the sys tem various settings need to be entered only once On the Management Protocols tab you create Default Protocols with Create In the new window enter all necessary data such as the name Protocol 1 for example the type etc Save the entries with Apply Selecting the Protocol Type At Type you can choose from various options Constan
30. ed as a percentage EXPLANATIONS Borg Rating The Borg rating is an evaluation of the patient s perceived exertion during the physical exercise phase the patient s own impression of how hard and stren uous the required exercise level is The scale ranges from 0 to 20 no exertion at all to maximum exertion The patient is asked to describe the degree of perceived exertion and rate it using the Borg scale 64 Calculate Karvonen Formula HR max BPM HR at Rest BPM Factor Trng HR BPM Trng HR ABBREVIATIONS Bc const BP BPM Ctrl ctrid HR ID Load abs Load rel Mon Device Pat Cnt Pat Lim Rev RP Slope abs Slope rel Slope Speed abs Speed rel Speed Sp02 SSN THR Trng HR Trng Device Trng bicycle constant blood pressure in beats per minute control controlled heart rate identification number absolute load relative load monitoring device patient count patient limit RPM recovery phase absolute slope relative slope Slope absolute speed relative speed Speed oxygen saturation social security number training heart rate training heart rate training device training 65 er oline ergoline GmbH Lindenstrasse 5 72475 Bitz Germany Phone 49 0 7431 98 94 0 Fax 49 0 7431 98 94 128 e mail info ergoline com http www ergoline com
31. ents Liquids must not be allowed to enter the devices If liquids have entered the devices the ERS 2 system must be checked by a service technician before being used again Do not open any of the devices There are no user replaceable components inside the devices Do not insert objects of any kind into the device They may touch live components and you might suffer an electric shock cause fire or damage the device Warning Patient Hazard For stress test examinations a defibrillator and a pacemaker regularly checked for proper functioning must be readily accessible at all times Patient Hazard Interpretation Hazard A qualified physician must overread all computer generated records Patient Hazard The operator must be trained in the use of the device Patient Hazard Equipment Damage Do not modify the ERS 2 system in any way SAFETY INFORMATION Safety Information Warning Risk of Poisoning Observe all information provided by the manufacturers of chemical products required for the use and care of the devices Always keep these chemical products in their original containers to avoid any confusion which may have severe consequences RF Interference Known FF sources such as cell phones radio or TV stations and two way radios may cause unexpected or adverse operation of the ERS 2 system Check the performance before each use Caution Equipment Damage Before connecting the device to the power line
32. ep types to configure personalized training sessions Protocol Type HR controlled With this protocol the speed regulation for the training phase always starts with a Slope setting of 0 The slope will be in creased only if the heart rate cannot be achieved via the speed during the train ing phase mawor Tree gt Sood rn Paeon Tyee gt Sood rn Teng IP we Cot Type Teng HRPM Patient DATA gt PROTOCOLS TREADMILL Protocol Type Custom Additional entries are mandatory for custom protocols Define the first step with Insert before or Insert after and choose the step type constant absolute the training workload is kept at a con stant level for the specified duration constant relative the load value depends on the previous step the load is continuously increased or decreased by the entered value Ramp absolute the training load increases continuous ly for the duration Ramp relative the load value depends on the previous step the load is continuously increased or decreased by the entered value Enter the duration speed and slope for each step If you select the blood pres sure option BP I a blood pressure measurement will take place Additionally you can use Insert before or Insert after to add further step types You change the order of steps with Up and Down or by drag amp drop If one step or more are to be used as exercise phases without
33. from routine tasks allowing them to focus on patient care But even with the training device itself the ergoselect Reha ergometer the focus is on the patient Op tions for modular expansion and upgrades allow the equipment to be adapted to increasing demands e g automatic blood pressure measurement options for adjusting the saddle etc An overview of the key performance features of the software Control of up to 16 ergometers or treadmills Clear display and intuitive operation Integrated patient and analysis database Admission of new patients possible even while a training session is in progress The most important data of all patients are always visible Access at any time to all relevant additional information even while a training session is in progress Patient data diagnosis previous examinations ECG trends Training sessions stored earlier Comparison with other training sessions of the same patient Acquisition of the patient s complete diagnosis allows optimal creation monitor ing and adaptation of individual training protocols 13 14 Ers 2 SYSTEM An overview of the key performance features of the software Comprehensive individual training protocols for each patient Constant load Constant pulse the software controls the ergometer load such that the patient s heart rate is constantly kept at a defined level Interval training Universal warmup and recovery phase definit
34. hortcut menu to initiate the recovery phase for the patient The workload is reduced and the recovery phase starts as configured in the settings in Patient Data Protocols Suspending Heart Rate Control during a Training When working with a HR controlled protocol you can suspend the heart rate control with the command Suspend HR ctrld trng from the shortcut menu during the training which is defined in the protocol The training continues with the current workload ma teres S a hey 110 i 71 115 i 95 s 120 97 120 i 82 415 i 92 s 120 hd Toot AEN Pet ere ESS Pane ee Poe van dae Sent Desai ee 5 es PN PAN AS ee es ae ae em Dees Toot SEN P A P P T T P P ae om Desa i EPEN VES AST PESARE PEN PEN VET P Se L 7 R kad La ka 5 era N nam t weber Baw I sedet U lt Kaala alanda poet noes eee am Cen Bowe 1 sehet 126 89 K ree rrn 99 KE M f 8 5 derel L C ww oe pa 134 85 K Fend mra Y sa 97 mee pa 139 82 99 97 oe pa 139 88 gt Feoi terete 9 57 32 60 65 70 x7 60 62 51 TRAINING MONITORING Patient Data Via the shortcut menu in area 1 you go to the Patient Data while all training Stations and ECGs remain displayed on the right side With Patients Patient Data and se lection of a patient you also reach the Patient Data window The shortcut menu
35. i we EE ETIE E E ERAR ERSA 54 H ON a teat ck w a R T ye eek HT 54 selecting the Training Protool wd dene S aca hae Race ee She Gla wh Ne Swe Bi 55 Manae ME aeee Gow 6 oo ew we ee ae ee Bek Se ee we we eee 56 PAC Sen ca nace sew eed Mae Ae ERTELE ETT EEEE EET 56 WIG cicero ew ne ee eee ee kw eee ey 56 Analysis 260 oe aces on ee bares new eee week Gaede eee eens See oo 57 Patent AMI SIS lt 6 4 hacengnehone se REER ences aneseaceeetiaseee chased 57 Oa ITEC E EE 58 Analy ing the Training Sessions lt 0 9 9 a oa KR R R K enian RA karin rimir 58 Editing Deleting a Training Session 0 cc cece eee eee eens 59 kaining Detall Sies ices payee ie een ee ones EREEREER EEEREN EERENS 59 Overview e cie sss een cone oe ou whee none ee ees AE eE E E E X 60 Taning SN E sarea E E EE E ER EREE oe 61 Analyzing the Training Sessions 1 i ek sed oe eee ne ee Kae ee ae hoe 61 Training Compare 22546 nace cdaneteeteettorsaesunenestensseneenseness 63 Analyzing the Training Sessions s is iseis cect e R e e etek wen eda RR RRR 63 TODI ca cates 4 Gare E aed Bae eee wee ae EN AR 64 Karvonen ION UA lt 506 waa oo hae oe wees ao nee oe Roe be ede dame one nee 64 PROOF OVIGUIONS e siene eed se ee nee rk weer weer ee ee 65 5 6 INTRODUCTION CE MARKING INFORMATION LICENSE TERMS The product ERS 2system bears the CE marking CE 0123 notified body TUV SUD Produkt Service GmbH Ridlerstrasse 65 80339 M nchen Germany indicating its
36. iagnosis type Name Cancel Patient DATA gt MEDICAL EXAMINATIONS Exercise ECG a S T Echocardiogram panes SEI Ergospirometry emis A soon Remark man reee RE ETES a You will find a number of different en i try fields Enter values for HR at rest ss BP at rest etc Use the arrow buttons 4 K or t J on the keyboard to change values With the drop down arrow you can sos z choose the training device When the Medication a Treadmill text box is active blue you can select the device by typing the first letter b for the bicycle and t for the treadmill Edit echocardiogram If you click the Edit button in the Echocardigram or Ergospirometry pane one another window opens Enter all relevant Eject Fract es CS data and click OK and Save to close Poraa Eit pos 83 the window daa S EBB3 l Cancel Edit ergospirometry Date WoO O O Vol 02 eee Bale Vol CO2 eee a gt Resp Quotient Ball Resp Rate Hee ES 93 Resp Minute Vol O 4 gt Tidal Volume 0 Gea Resp Equiv 02 es Resp Equiv CO2 Rie LE Cancel If data were entered for these items a Ca date in a gray text box will be displayed ieee 1 bot l Additional information can be entered in the Remarks text box Patient DATA gt MEDICAL ALARMS Heart Rate Blood Pressure p02 Bicycle Treadmill It is recommended to enter all values concerning the patient s co
37. inings are pro vided in text form below the curves 58 PATIENT ANALYSIS OVERVIEW TREND Analyzing the Training Sessions With the Export command you create a CSV file comma separated values default storage path C ers2 ers2ex change of the training session By double clicking a training session data point you change to the Training Single tab Editing Deleting a Training Session With a right mouse click you can edit the weight the Borg value and the effort or you can delete a training session Edit the values as needed and confirm the modification with OK If you wish to delete a training session answer the question in the window that pops up by selecting Yes Training Details In addition to the diagram there is am ple space for commenting on the training sessions The buttons on the right con tain sample phrases With Edit you can save new frequently used sample phras es and easily add them to your comment with a mouse click The default phrases assigned to the buttons can be modified if needed see Patient Data gt Medical Findings on page 25 Click Save to save all entries To create a printout click Print wa enag ergoline rehab system 2 Do you really want to delete the selected training PATIENT ANALYSIS OveRVIEW COMPARE In this overview two training sessions are compared The illustration shows measured values for HR
38. ion The therapist can change the training parameters directly at any time Group training all patients start at the same time Individual training patients come when desired and train as long as desired Immediate printout of a patient s current ECG is possible at any time Quality assurance Full documentation of the complete training session Storage of all data recorded during the training session Full disclosure ECG the ECGs of all patients and all training sessions are stored System Configuration The central component of the ERS 2 system is a PC with an MS Windows operat ing system and special software which runs the training programs The training ergometers are connected to the PC system via control lines All data are shown on 1 or 2 large TFT monitors up to eight patients can be displayed and monitored on each monitor For ECG monitoring the ergometers are equipped with sin gle channel ECG amplifiers whose signals are transmitted to the PC via the serial interfaces In addition automatic blood pressure measurement can be integrated in the training protocols if the ergometers are equipped accordingly 17 TFT monitor Printer PC system CD burner archive 16 STARTING THE PROGRAM Start the program by double clicking the icon a The initial screen is displayed MANAGEMENT TRAINING ANALYSIS CONFIGURATION EXIT MANAGEMENT In the Management window you will find the pa
39. is available here too Patient Analysis By selecting Patient Analysis from the shortcut menu in area 1 you display the overview of all analyses With Print you can print an overview diagram activities and report with Export you create a CSV file comma separated values default storage path C ers2 ers2exchange Editing the Borg Value Right click in area 1 to edit the Borg value either by typing it into the text box or by using the arrow buttons 4 K de pending on your configuration the value may not be displayed Editing Effort From the shortcut menu in area 1 se lect Edit Effort You can enter the pa tient s perceived exertion level in the window that opens Choose an option and confirm with OK depending on your configuration the value may not be displayed 52 Edit Borg v e 4 E oS E K K Borg Hal Cancel Edit Effort Effort vv Very very light Very light Light Medium Hard Very hard E L 008 LLL Hoffmann Th KK 1 oes Bren teers 02 Prees poses EENET 72 pii Kaiser ag 15 _ B v mez oras storteane ain Keg Te Dawe een 03 lt l 62 pt Richter 120 n 1 tG Ry nan tommy 04 05 E 06 07 08 Aad ea lue be KE ow l TRAINING MONITORING ECG Display The parameters currently displayed are the ECG the HR and the THR If your training device supports the required functi
40. ise load will be adjusted accordingly Preece Tree gt Boos reams egas 044 Teng HRPM 27 PATIENT DATA gt PROTOCOLS BICYCLE Protocol Type Sp02 controlled Click Extended to open the Sp02 con trol window In this window you define the parameters for the SpO2 controlled exercise The settings under Workload Reduction define how the current SpO2 value will be controlled If the SpO2 value is below the limit value for the entire duration of the Delay s the load will be reduced once Then the Workload Control will take over These settings determine the intervals for subsequent checks of the oxygen saturation The load will be increased or decreased depending on how much the measured oxygen saturation deviates from the limits Entries can be made as absolute or rel ative values with respect to the training load If you do not specify any values the sys tem will use the preset defaults Protocol Type Interval HR controlled In the Training pane of this protocol you will find the Extended button which leads you to the interval HR control with the Workload Control Under Workload Control you define the permitted deviation of the heart rate at Threshold 1 min and the time interval at Delay s If the measured heart rate differs for the entire duration the load will be corrected At Type you define the parameters for modification of the workload Absolute or Relative 28
41. lect the step highlighted blue and drag it to its appropriate position If the created steps are to be used as training phases without warmup and recovery highlight one step or sev eral consecutive steps Then choose Extended and Training The steps are now marked as training steps with an X in the Trng column With Repeat in the Extended menu you can copy step types Protece Tree gt ood rn Pee Tren Brant Rens mowo Tree gt ood rrn Ow whe Le Lend da IW Teng RPO we Cot Type Teng iR IP Oi Type opira opira MANAGEMENT gt PROTOCOLS BICYCLE Protocol Type Custom With Edit you can change the duration and load of the steps Mark individual or consecutive steps highlighted blue and enter the values for Duration abs s rel or Load abs W rel us ing the keyboard or the arrow buttons a Select Apply to adopt the new values To close the window click Apply once more Editing the Default Protocol To edit a Default Protocol click Edit Edit the settings and close the window with Apply The changes will be effec tive from now on Activating the Default Protocol You activate a Default Protocol by click ing Extended and Activate Answer the question in the next window with Yes The Default Protocol is now active which can be recognized by the asterisk Deleting the Default Protocol To delete a Default Protocol click Exten
42. n laws of biology and includes in particular pedagogical psychological and sociotherapeutic methods and aims to achieve lasting health literacy Ergometer training is used in this case particularly in the areas of early mobili zation and exercise therapy within the scope of inpatient and increasingly also in outpatient rehabilitation in order to increase the performance capacity of cardio vascular patients As studies have been able to show the performance capacity and thus also the quality of life can be significantly improved even in patients with heart failure by selecting an appropriate form of training interval training The increased requirements with regard to efficient work but also quality as surance and complete documentation efficiency monitoring of the training performed with all acquired data can however only be met by an appropriately designed ergometer training system The development of the new ergoline ERS 2 rehabilitation system was able to draw on the experience of more than 250 installed ergoline rehabilitation sys tems Through intensive collaboration with many users therapists sports scien tists and physicians a new modular system for controlled ergometer training was developed which meets all of the requirements listed The PC software controls the patients entire predefined training protocols simultaneously documents all relevant data e g ECG heart rate training data and thus frees therapists
43. ndition at the beginning of the physical therapy The settings for bicycle and treadmill entered here override the settings in the different protocols The action selected in the Heart Rate Blood Pressure and SpO2 panes will be performed The action determines how the training session continues if a patient s parame ter values exceed or fall below the indi vidual alarm limits ranges None the training continues alarm is ignored Alarm initiates visual and audible signals re fer to Training Monitoring on page 49 Recover the patient enters the recovery phase Terminate the training session will immediately be terminated Click the drop down arrow and select an option from the list box As an alter native you can click in the text box and type the first letter from the keyboard or choose an option with the f 1 keys Save the selection with Save 24 Alarm None Recover Terminate Patient DATA gt MEDICAL FINDINGS Use this space to document findings or results concerning the patients Frequently used phrases can be assigned to the buttons on the right with Edit The Findings text samples dialog opens Use the buttons Insert before or Insert after to define the position of the button in the list for example after Signature Assign a unique name and create your text sample by manual inputs or by us ing the placeholders System Patient Tr
44. o part of this manual may be reprinted without written permission from Ergoline GmbH 2013 Ergoline GmbH Lindenstrasse 5 72475 Bitz Germany Definitions The safety information in this manual is classified as follows Danger indicates an imminent hazard If not avoided the hazard will result in death or se rious Injury Warning indicates a hazard If not avoided the hazard can result in death or serious injury Caution indicates a potential hazard If not avoided the hazard may result in minor injury and or product property damage Safety Notices Explosion Hazard The ERS 2 system is not designed for use in areas of rooms used for medical purpos es where an explosion hazard may occur Potentially explosive atmospheres may result from the use of flammable anesthetics skin cleansing agents or disinfec tants Furthermore great care must be exercised when the system is used in an oxygen enriched atmosphere he atmosphere is considered to be oxygen enriched when the room air contains more than 25 of oxygen or nitrous oxide Shock Hazard Before use verify that the equipment is in correct working order and operating condition Check the cables and connectors in particular for signs of damage Re place damaged cables and connectors immediately before use Do not expose the equipment to direct sunlight to prevent system components from reaching inadmissible high temperatures The equipment has no additional pro
45. ok reor ire pa E A S S aE man pa TRAINING MONITORING Selecting the Training Protocol With a right click in area 3 and by choos ing Select Training Protocol you access the protocols this is not possible while a training is in progress The new window shows all Protocols created in Patient Data or Management Define a protocol for the patient either with a double click or by selecting the protocol and clicking OK 3 x T ma s 55 TRAINING MANAGEMENT Via Management you display the tabs PATIENTS Groups PROTOCOLS The pane on the right shows all training stations with the most important data Frequently used commands are easily ac cessible via shortcut menus PATIENTS With the Patients button you access the options Create Patient Patient Data Patient Analysis Create Group and Group Data These functions allow you to create view and modify numerous data TRAINING This Training menu refers to all associ ated training stations You can assign an entire group with Assign Group remove all patients with Remove Patients start all training sessions with Start Train ings stop all training sessions with Stop Trainings switch from the training phase to the recovery phase with to RP view the training overview with Show Irng Overview switch on all ECG pumps with Turn on ECG Pumps or switch them off with Turn off ECG Pumps 56 mtn Rar 01 os 02 a eis Kaiser ba 115 03 v
46. ons you will also see the most recent BP value and the SpQ2 value From the ECG Display shortcut menu in area 2 you go to the Patient Training ECG A faster way to display the Patient Training ECG is to double click the ECG segment This window allows you to view moni tor analyze and print real time ECGs Additional markers can be created di rectly in the ECG by clicking the mouse button and dragging the mouse cursor With the keys I lt and gt I you navi gate from the first to the last marker and with lt and gt you navigate be tween the individual segments refer to Patient Analysis Training Single on page 61 When you select the Scroll Position Automatic check box default setting the ECG will be continuously displayed All training stations can be seen on the right side and in these areas too the shortcut menus can be selected Optional settings for the channels sweep Speed and amplitude can be determined after a right mouse click in the Patient Training ECG or in Training Monitoring in area 2 Measuring Blood Pressure A blood pressure measurement can be initiated from the Measure BP shortcut menu in area 2 Adding Blood Pressure Readings The results of a manual blood pressure measurement can be added with the In sert BP function 01 m 87 bee KL ahaa a 120 s 02 ho 895 aada seer ve Lop Kaisar ae us pR De ii rpe H 03 Freep 92 DE a as Paes 10
47. rameters se lected via Patient Data Protocols or in Management Protocols The training stations are displayed on the right side 54 6 L Toot LA 01 BZ R D Ser oer Per ma 120 47 02 ete D 895 A err E vem Kaiser me 115 ALU SE Marenne Dew come f 505 sea 03 pire PEBR 1 on p Bok Richter kad 120 Tone a manani kaad ecn med 1 vedet Dd S ape os Mont r enai ra Toot Faris 7 gt Vere 01 E tases OR ADES PEN Van ner Boa PEATAS EN Wi Hoffmann na 120 i su 02 73 LLL gt Kaiser ne CRIED G Martone Owe nae t rebe 03 sia l BEH PER VESTRE PER TEPS Richter 199 ALU v e Rand Bep N h Ie 04 05 bet Ory Mn spome Tek LA EO Patient Training L lees rete ere a eee oy a pot Kac Type n Tong oen jma wa r w ke rre E Ins ger Lr U r Rae ma gt Deresse irman ma Recovery Pres Ted WA O Thee 128 84 rian A _ 99 we pe na cool cos UF gett X meere 97 m oe rra 137 84 K Febond tate 97 oe eee ia 121 85 K pr eg N A 98 a IN oval wee K UF drel L m 97 s zag ps 137 80 gt fep terete 97 w p KLN 01 Ka Kd 02 03 Richter Ae 1 04 06 07 08 gt 70 61 m 48 4l L 60 35 60 68 w 58 61 E ar 3 2 _ S an Tes S w 13 L A new 58 mh were 17 S a l wm 42 w 62 i be s Daan pee Soar Pres pees pean wees ere 1 ren 91 LLL 115 lt i gt R r
48. re can be added with the Camera web cam or with the File button as a BMP PNG JPG or GIF file With the Delete button you can remove the picture The date of birth is entered in the form of digits separated by blanks or periods DD space bar MM space bar YYYY With the drop down arrow you open the menu for selection of the gender male or female As an alternative you can place the cursor in the text box and type the initial letter s of the word for example m for male Weight and height can be entered di rectly into the appropriate boxes You can use the arrow buttons 4 K or the keys f 4 on the keyboard to increase or decrease the value Add options to ethnicity and language via the button Enter a designation name and click OK When you click the arrow button you can insert an option from the drop down list Each new entry will be appended to the list Last Name First Name res a meea om L roa e ka ergoline rehab system 2 Invalid input Please check and try again Photo OK Camera File Delete Date of Birth Gender Weight kg L k Height cm 41 K Ethnicity 10 Language a E Create edit ethnicity Name i Cancel LU p T U ZF PATIENT DATA gt GENERAL PERSONAL DATA Chip Card Via Standard Write you save the data to the chip card Via Extended View you can review the entere
49. reate a Default Protocol with Create In the new window enter all necessary data such as the name Protocol 1 for example the type etc Save the entries with Apply Selecting the Protocol Type These are the protocol types that you can choose Constant Workload HR controlled p02 controlled Interval Interval HR controlled Custom 40 Fy it Peper Tree gt Sood rer hit Protece Tree gt Sood r Tag ie e RO Tie bamen Le toad fun lt Pres fend gt Pres emd gt wem Be gae mn a e urease ma f sat w Peng RIM om Cot Type opira MANAGEMENT gt PROTOCOLS BICYCLE Selecting the Protocol Type Constant Workload permanent load at a constant intensity without interruptions HR controlled the load controls the predefined train ing heart rate p02 controlled the training workload is controlled to ensure that the 5002 value will not permanently drop below the lower limit Interval Short strenuous exercise intervals al ternating with short recovery phases Interval HR controlled the training workload is adjusted on the basis of the measured heart rate Custom use this option to define your own training session by means of different step types Protocol Type Sp02 controlled In the Training pane you have the pa rameters Limit and Threshold At Limit enter the lower Sp02 value at Threshold
50. rements of the standard IEC 60601 1 1 for medical electrical equipment Introduction The role of exercise therapy as part of the rehabilitation of cardiac patients in the follow up treatment phase Il is viewed positively by most experts based on decades of favorable experience In recent years various studies have been able to show the positive impact of exercise therapy on coronary patients KELLERMANN et al 1967 HELLERSTEIN 1973 KONIG et al 1977 HOLLMANN et al 1983 ROST et al 1991 among others Through constant advancement of new diagnostic and therapeutic methods there has additionally been a fundamental transformation of the rehabilitation process of cardiology patients in the past few years Along with the phases of early mobi lization and exercise therapy sports therapy has also taken on greater importance today Early mobilization refers to passive and active mobilization as soon as permitted by the patient s clinical condition Exercise therapy is medically indicated and prescribed movement which is planned and regulated by the specialist therapist monitored together with the physician and performed with the patient alone or in a group Ers 2 SYSTEM Introduction Sports therapy is an exercise therapy measure which uses appropriate sports means to compensate for and regenerate disrupted physical mental and social functions prevent secondary injuries and promote health oriented behavior It is based o
51. stration shows an overview of existing groups with these group details Name Type Number of patients Pat Cnt Maximum number of patients Pat Lim The Find text box allows you to search _ for existing groups After you type the e oom initial letters of the group name high EE lighted yellow into the text box the es S group matching the criteria will be dis played With Create you create a new group By selecting a group highlighted blue and clicking the Edit button or with a double click you open the tab Group Data General Group DATA GENERAL Group Patients a System Patients e Under Group Data General you first find all patients belonging to a group followed by the system patients ssa Via the Find text box you can search for a specific patient From the Group drop down list you aa can select a group to view only the pa tients of that group LU Group DATA GENERAL Creating Groups To configure a new group go to Man agement Groups and click the Create button First enter the name e g Group 1 the type and if needed the patient limit Selecting the Group Type You can choose between Assignment and Arrangement Assignment means that you assign a Specific training device to a particular patient You can change the order with the Up and Down buttons The option Arrangement allows you to assign the patients consecutively to free training stations
52. t Workload HR controlled Speed HR controlled Slope HR controlled Custom Preece Type eed frome Peper Tree gt ood rn Tag ie e RO Tipe Pong IR PM om Cot Type 45 MANAGEMENT gt PROTOCOLS TREADMILL Selecting the Protocol Type Constant Workload permanent load without interruptions at a constant intensity HR controlled Speed the predefined training heart rate is achieved via the speed HR controlled Slope the predefined training heart rate is achieved via the slope HR controlled the predefined training heart rate is achieved both via the speed and the Slope Custom use Individual step types to configure personalized training sessions Protocol Type HR controlled With this protocol the speed regulation for the training phase always starts with a Slope setting of 0 The slope will be in creased only if the heart rate cannot be achieved via the speed during the training phase 46 Peper Tree gt Sood TK Peper Tree ood re Tong IR pr Oi Tp Mes fered usA Mex Beer 41 Speed umna gt epe n MANAGEMENT gt PROTOCOLS TREADMILL Protocol Type Custom This protocol type allows you to con figure your own training steps With Insert before or Insert after you define the first step and choose a step type constant absolute the training workload is kept at a con stant level for the specified duration
53. t remains available for future use Please note that it is not possible to de lete an active protocol ergoline rehab system 2 Do you really want to activate the selected protocol Patient Data ergoline rehab system 2 demo Do you really want to delete the selected protocol PATIENT DATA gt PROTOCOLS TREADMILL Saving a Protocol as Default Frequently used protocols can be saved as the Default protocol Select Extended Save Def The default protocols can be edited on the Management Protocols tab see Treadmill Saving the Default Pro tocol on page 45 The protocols are very flexible and can be applied to other patients as templates Loading a Default Protocol Existing Default Protocols can be opened via Create Extended Load Def The existing default protocols are shown in the next window Select the proto col then click OK and Apply or dou ble click to transfer the Default Protocol e g Protocol 1 to the patient s list of protocols Then you can adapt the proto col parameters to this patient and acti vate it with the Activate button 36 Patient Data foe Medal Prevecots Preece Heme gt tarzad 2 Laed Sef Save Get Patient Data foe Meta ol Prececots lalai fodd 2 RTS Seve Det lein Pretest renra name 1 edhe Mre gt MANAGEMENT GROUPS e On this tab you configure different train ing groups for your patients The illu
54. tec tion against the ingress of humidity 10 SAFETY INFORMATION Safety Information Shock Hazard When disconnecting the device from the power line remove the plug from the wall outlet first before disconnecting the cable from the device Do not use multiple portable socket outlets MPSO to connect devices to the power line If a printer is operated in the patient environment the printer must comply with IEC 60601 requirements or it must be a modified printer with additional protective earth conductor potential equalization All devices of a system must be connected to the same electric circuit Devices that are not connected to the same circuit must be electrically isolated when operated e g by means of an isolated RS232 interface not required in the USA Devices may be connected to other devices or to parts of systems only when it has been made certain that there is no danger to the patient the operators or the en vironment as a result In those instances where there is any element of doubt concerning the safety of connected equipment the user must contact the manufacturers concerned or oth er informed experts as to whether there is any possible danger to the patient the operator or the environment as a result of the proposed combination of equipment Standard IEC 60601 1 1 EN60601 1 1 must be complied with in all cases All bicycle ergometers and treadmills connected to the system must meet IEC 60601 1 requirem
55. tient database with these tabs PATIENTS GROUPS PROTOCOLS From some of the tabs you can access further sub categories which will be ex plained in detail on the following pages 17 MANAGEMENT PATIENTS This is a list of all patients stored in the database with their name ID and SSN social security number The Find function allows you to conve niently access any patient in the data base Entering the first characters of a patient name or of the ID highlighted yellow is sufficient The search function returns all patients matching the search criteria With Create you can add a patient to the database If you double click an existing entry in the list or click the entry highlighted blue and then the Edit button the window Patient Data General Perso nal Data opens 18 PATIENT DATA gt GENERAL PERSONAL DATA Patient Data At this point in the program patients are added to the database Type the patient s personal data such as last name and first name in the appropriate text boxes Mandatory fields are identified with an asterisk You can activate the text box es by clicking them or you can press the TAB key 4 to navigate between the fields If boxes are left blank or are only partial ly filled they turn red when you click the Save button A warning will be displayed Check all entries and make changes where appro priate Confirm by clicking Save The patient s pictu
56. ting the Group Type lt x e Z HL NTE 6 teens anne stones de deasa san RE ho mor 38 Adang Panents 0 2 TOR a ox Back oe nb un Beene Bebo ENE bw eee ee Me ws 38 Deleting Fatients from a GlOUD scan hau RKR os Reco 60 KK ones ee RL T ad eens 39 EERE T o evan ka cus eee aw kas heme aut aes oy ee oe ene ox soe eee 39 Management gt Protocols CVC arte E eo en een ee es ws i wre we ne ee E ee ee 40 Saving the Default Protocol si 4ec 54enicadveetncneeticeews ex RR RR RR 40 Selecting the Protocol Type fan ccaunenadnens cours Sonat ae o4eeo Ree EREET 40 Protocol Type S5p02 controlled cx wasn soi wd wo wie eae ee OR dw eee ex ew we 41 Protocol Type Interval HR controlled 0 0 0c cece eee ees 42 Protocol SIS CUSI OM ae sc oe wm peace dem eh ms a ane a ee aoe ow ee a ew ara 43 Editing the Default Protocol sess cp eee R X RL R Seed sane suse tens RAT R 44 Activating the Default Protocol dena scan tsce noe sevassceed os 44 Deleting the Default Protocol s asc R T c8dws joked nspa EIE oa RRR R ns 44 Management gt Protocols MESONI oak ho tN ee es ee le A eS E 45 Saving the Default Protocol a 60 ooo cede scan gadendaeene heeeee scenes 45 selecting the Protocol Type nan R R ad eye ee ose uae aw ee nsw ee R se 45 Protocol lype HR controlled ess cit odds 64s Ode owe nia aoe ee dae nei 46 Protocol pe CUS COM lt 47 or K e T ey oe ause ives seen RKR 47 Editing the Default Protocol 4c nen 9 X w es aeae teeny R R RRR dete delete 48 Activ
57. to be specified The protocol just created is saved with Apply With Discard all entries will be lost The new protocol will be included in the list 26 Monee Tree Sood rrn peas mun Dursan ren Dorper m gt Pur gia Lel gt f 7 mmes ma Tag ie e R Cet Tipe Teng w fpe E O Type opdra PATIENT DATA gt PROTOCOLS BICYCLE Selecting the Protocol Type You can choose from various protocol types Constant Workload HR controlled p02 controlled Interval Interval HR controlled Custom Constant Workload permanent load without interruptions at a constant intensity HR controlled the load controls the predefined train ing heart rate p02 controlled the 5002 value is the basis for optimally correcting the load to the defined value Interval short strenuous exercise intervals al ternating with short recovery phases Interval HR controlled the training workload is adjusted on the basis of the measured heart rate Custom describe custom configured training sessions by specifying step types Protocol Type Sp02 controlled In the Training pane of this protocol you will find the Duration min and the Load W as well as the Limit and the Threshold At Limit enter the lower Sp02 value at Threshold l enter the difference to the upper SpO2 value If the oxygen saturation drops below the set limit value the exerc
58. tude By clicking the Print button you obtain a printout of the training session or of the page of ECG data 62 Create edit marker Remark OK Cancel E Mere bees teem es T T See treet Cee mn L Cn Oe Oe Oe Oe Oe Une Dee Pe Ce en EUL bout i Im i IAEA a a a a a a a at s IIT TLS ee ONES Cee eee ee ee OAS S DAS V 1 4 ht p Chew s Tree eere B PS AS PAS PNS PS OS PS PNS PS S p s ee gg TTT a zi pin pasi pam pei fopin EEH pens pear pas yy T E pat part past PENI band Pass rast pas bast Part Past PI aeaea aaea Seid Bonat eana 1 S one 1 1 P PANSES P 1 1 1 P a D PATIENT ANALYSIS TRAINING COMPARE This view allows two training sessions to be compared The following parameter values are shown HR BP Sp02 METs W kg Load RPM Spd Slp As you move the mouse cursor over a diagram the corresponding measured values will be displayed The actual exer cise phase Is identified with a dark back ground The ECGs are shown next to the diagrams Under First and Second you will find the completed training sessions Choose the periods of time from the drop down lists Analyzing the Training Sessions In the area between the diagrams you can choose the parameter values to be displayed in the diagrams HR BP Sp02 etc When you click Show the correspond ing values will be alternately shown and hidden With Predicted
59. uration abs s rel dwl Speed abs km h rel Yo and or Slope abs l rel When you click Apply the modifications will be adopt ed To close the window click Apply Editing the Default Protocol To edit a Default Protocol click Edit Edit the settings and close the window with Apply The changes will be effec tive from now on Activating the Default Protocol You activate a Default Protocol by click ing Extended and Activate Answer the question in the next window with Yes The Default Protocol is now active which can be recognized by the asterisk Deleting the Default Protocol To delete a Default Protocol click Extended and select Delete When you click Yes the protocol will be removed and is no longer available Please note that it is not possible to de lete an active protocol 48 Dor abs LG QU L Dw ret fad Speed abe Der T KIL See Speed d a T KIC Aawi Supe ame 5 ej S Sope re S MR eje sour ergoline rehab system 2 Do you really want to activate the selected protocol ergoline rehab system 2 demo Do you really want to delete the selected protocol TRAINING MONITORING The overview presents the different areas in the form of tabs MONITORING MANAGEMENT PATIENTS RAINING From this screen you start training ses sions assign patients and review train ing data If the measured values exceed or drop belo
60. w the preset limits the system emits an audible and visual alarm in the illustration training station 01 to allow the user physician therapist to respond promptly to the problem You silence the signal by clicking the red button All settings can be modified even while the training is in progress These changes affect the individual patient or this par ticular training station On this screen you can access three areas With a right mouse click in one of these areas you open the shortcut menu Assigning a Patient Right click a training station and select Assign Patient In the following window highlight a pa tient and click OK As an alternative you can double click the patient name The correspondence between patients and training devices can be swiftly changed by dragging the patient name to another training station not during a training session g oeg Ne spomen tom B D L B gt U oe 01 ve pat las 15 aie e E eee OE been A 66 na 108 gt tpo 98 gt e pu mrasa owes es llc are 14 r TTT TTT LOT ke isat 10 02 68 re L TE PERN Ress Saas e 137 82 gt ina iy 62 Kaiser m uS si 902 99 me o ma Ne ower Ae dtro ir a e Se were 15 03 E a ias 60 3 tee ae S D yee 7 m 63 Richter a 120 gt tp 99 n gt ae on d Naren gt e av peer eee m m 5 m ets s 04 Training station 0S Z 06 gt 07 os Area 1 Area 2 Area 3 a rr L N L ka N L N U ti
61. warmup and recovery highlight these steps Then select Training under Extended The steps are now marked with an X in the Trng column Steps can easily be copied with Repeat under Extended Save the custom protocol with Apply 34 Preece Tree gt ood rRe n ar Tree LL Pawon Tree ocd reams Ow be Le fyerd wn Dee Bee es N we Cot Type PATIENT DATA gt PROTOCOLS TREADMILL Protocol Type Custom With Edit you can modify the duration abs s rel o the speed abs km h rel Yo as well as the slope abs rel Yo of the steps Highlight the steps you want to modify and enter a value in the appropriate field using the keyboard or the arrow keys 4 K When you click Apply the modifications will be adopt ed Clicking Apply again will save the modifications Editing a Protocol If you wish to modify a protocol you can do so at any time with Edit Select a protocol perform the changes and con clude your inputs with Apply Activating a Protocol To Activate a protocol click Extended If you click Yes in the new window the protocol becomes active which is marked by an asterisk This protocol is now the patient s Training Protocol Deleting a Protocol To delete protocol you must first call it up Then select Delete via Extended gt If you exit the dialog with Yes the pro tocol will be deleted if you choose No i

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