- Frank`s Hospital Workshop
Contents
1. Penetration depth Dissipation RUPEE Rmo OA de E dn Sa Specific absorption rate SAR CHAPTER7 EFFECTS OF SHORT WAVE THERAPY 7 1 7 2 7 3 7 4 7 5 7 6 Digiti epp Reactions to hedt eser WX UST ed ux EROR EM Thermal effects c rosi mo ose Tuo Gide Pr SM Pu Greet Pp Athermal effects 75 nr val TRISTE eR gas cde Den Ta PAs Influence of electromagnetic energy on wound healing Specific effect on soft tissue lesions CHAPTER 8 INDICATIONS AND CONTRA INDICATIONS 8 1 8 2 8 3 Indications oiov Pate defen es Pave diste Absolute contra indications Relative contra indications CHAPTER9 EXAMPLES OF TREATMENT CHAPTER 10 FAULTS GUARANTEE AND MAINTENANCE 10 1 10 2 Replacing the mains fuses 10 3 Guarantee and Service ee reed 10 4 Cleaning oe etes oti 10 5 Maintenance roe e esee eet tg o Scu Qo Ve hoe os 10 6 Disinfection and sterilization 10 7 Technical maintenance2. CHAPTER 11 TECHNICAL SPECIFICATIONS 11 1 11 2 SPOCIICATIONS ie gn cea UR a Red d Ra Red IR ncaa Technical data lt eiae hue e ele weds Leu ree ueque quee quede ve met CHAPTER 12 ACCESSORIES 12 1 12 2 Standard accessories ee Optional accessories 0 000 eee ee CHAPTER 13 EXPLANATION OF THE SYMBOLS 13 1 Symbols on the front of the appliance 13 2 Symbols on the model plate BIBLIOGRAPHY Contents Instructions for use Phyaction Performa euuoneg uonoe Aug g g l RS f f j z pom Phyaction Performa Contents Instructions for use INTRODUCTION You have selected the Phyaction Performa Uniphy s short wave therapy appliance Many congratulations on your purchase We are convinced that the Performa will serve you for many years in the treatment of a great many symptoms The Phyaction Performa is an appliance used in pulsating short wave therapy whereby the various parameters can be set in a simple and orderly manner This manual should not only been seen as an instruction manual for the appliance but also as a work of reference covering various aspects of short wave therapy The first four chapters provide info
3. 3 24 Connection for potential equalizing cable 3 25 Model specification plate 3 26 Undercarriage with swivel castors 3 27 Ventilation 5 CHAPTER 4 TREATMENT ASPECTS AND SETTING SEQUENCE 4 1 Introd ction Re VORNE VANS Quae Ven gaa gah 4 2 Measures to be taken BEFORE treatment 4 3 Measures DURING treatment 4 4 Measures AFTER treatment Contents Instructions for use Phyaction Performa CHAPTER5 PARAMETERS OF SHORT WAVE THERAPY AND 5 1 5 2 5 3 5 4 5 5 5 6 TREATMENT GUIDELINES Introduction ise lexus EEG ED queri eden AREE ES Dosage few ee Ed He Pk ueque doe ee ed Gata Sates eases Treatment Number of treatments Contact control 2 a ee Re A A REE EE RE OD Treatment guidelines CHAPTER6 BASIC DATA ON SHORT WAVE THERAPY 6 1 6 2 6 3 6 4 6 5 6 6 Introduction oie Free er a ehh BRE PE dh oe LS be ist Generation of the electromagnetic field The Circuplode conductivity method
4. Switching on press the key to the right I Switching off press the key to the left 0 3 2 Selector key channel A After pressing the selector key for channel A the green lamp in the key lights up You can now set the parameters for channel A 3 3 Selector key channel B O B After pressing the selector key for channel B the green lamp in the key lights up You can now D set the parameters for channel B 3 4 Selector key for pulse length After pressing the selector key for length the green lamp in the key lights up Pressing this key links the adjustment regulator to the pulse length parameter for channel A or channel B The pulse length can now be set between 65 and 400 us and is shown on the display for A or the display for B 3 5 Channel A pulse length display This display shows the pulse length for channel A in microseconds The pulse length can be set by selecting channel A and pressing key 3 6 Channel B pulse length display This display shows the pulse length for channel B in microseconds The pulse length can be set by selecting channel B and pressing The display will light if channel is connected 3 7 Pulse repeat frequency selector key After pressing the pulse repeat frequency selector key the green lamp in the key lights up Pressing Dn this key links the adjustment regulator to the pulse repeat frequency parameter of both channel
5. 1 6 A 220 V 50 ohm 150 cm Instructions for use Phyaction Performa Page 29 CHAPTER 12 ACCESSORIES 12 1 Standard accessories quantity description Phyaction Performa User s Manual mains peer cord electrode arm grey fully adjustable Circuplode diameter 14 cm max peak output 200 W box spanners 10 mm to adjust the electrode arm crosshead screwdriver for electrode arm indicator for HF field D 12 2 Optional accessories Circuplode diameter 9 cm max peak output 100 W Potential equalizing cable 12 ACCESSORIES Instructions for use Phyaction Performa Page 30 CHAPTER 13 EXPLANATION OF THE SYMBOLS h 3 1 Symbols on the front of the appliance Circuplode Pulse width Pulse repeat frequency Peak output Average output Treatment time ae Off 3 2 Symbols on the model plate Fuse Serial number Potential equalizer Type BF Non ionizing radiation o 13 EXPLANATION OF THE SYMBOLS Instructions for use Phyaction Performa Page 31 BIBLIOGRAPHY Nederlands leerboek de fysische therapie in engere zin part 1 Wetenschappelijke uitgeverij Bunge Utrecht 1991 Fysica voor de fysiotherapeut Wetenschappelijke uitgeverij Bunge Utrecht 1984 Klein geneeskundig woordenboek Uitgeverij Bohn Scheltema amp Holkema Utrecht 1980 Therapeutic heat and cold third edition Edited by Justus F Lehmann Williams and Wilkins Balti
6. 2 5 5 Connecting the electrode cable s On one side the electrode cable is connected to the Circuplode by means of two identical bayonet connectors and on the other side connected to the connection 9 on the back of the appliance Then fix the cable in the channel of the cable guide which is fixed halfway along the electrode arm This prevents the cable touching a patient or another cable which could concentrate the electromagnetic output 2 6 Use of the high frequency induction field indicator Included as standard with the Phyaction Performa is an indicator which can make the high frequency induction field visible to both you and your patient To do this hold the indicator against the active Circuplode making sure in connection with the contact check that at least 50 of the electrode surface is covered by your hand As soon as the dosage is increased and output flows from the appliance the yellow LED on the indicator lights up The LED glows brighter as the output increases At low frequencies the LED will blink 2 INSTALLATION Instructions for use Phyaction Performa Page 6 CHAPTER 3 EXPLANATION OF THE OPERATING MECHANISMS On the last page of this instruction manual you will find a drawing showing the appliance and accessories The numbers in the text correspond with the numbers in this drawing 3 4 Mains switch The mains switch on the top of the front side of the appliance is used to switch the Phyaction Performa on and off
7. 6 BASIC DATA SHORT WAVE THERAPY Instructions for use Phyaction Performa Page 19 CHAPTER 7 EFFECTS OF SHORT WAVE THERAPY 7 1 Introduction In chapter 6 it was explained that high frequency electromagnetic energy is converted into heat in the body This process is known as dissipation Heat can be defined as an increase in the speed of particle movement This heat can lead to measurable and sometimes perceivable increase in temperature in the tissues Even temperature increases which cannot be measured can lead to a response in the cells 7 2 Reactions to heat 7 2 1 General reactions The hypothalamus regulates the body temperature and reacts to any change in this temperature The information required by this regulating mechanism is supplied by the blood temperature and thermosensors under the skin The hypothalamus tries to keep the core body temperature between 36 37 5 C This is also muscle temperature when at rest Intra articular temperature at rest is 31 32 C When the temperature increases there are three mechanisms to keep the temperature within the physiological limits namely vasodilatation sweating reduced heat production 7 2 2 Local reactions As a result of the heat local cell metabolism and transportation through the cell membranes increase The increase in local metabolism alters the oxygen tension carbon dioxide tension and the acidity These three factors determine local blood circulation owing to thei
8. Buerger s disease Raynaud s disease Cardiac disorders Acute infectious diseases Acute inflammation 8 INDICATIONS AND CONTRA INDICATIONS Instructions for use Phyaction Performa Page 23 Sensation disorders Here a comparison can be made with the healthy side after which the intensity must be reduced by 30 to treat the affected side Circulation disorders Mental disorders which make it impossible to determine the dosage which is set according to the patient s subjective perception Menstruation A full stomach 8 INDICATIONS AND CONTRA INDICATIONS Instructions for use Phyaction Performa Page 24 CHAPTER9 EXAMPLES OF TREATMENT The fact that the effective area of the electrode is circular was described in paragraph 6 3 This should be taken into account when the electrodes are placed in position This chapter gives a number of examples of the position of the electrodes S Muscle rupture m rectus femoris vastus medialis Strain lig collateral lateral knee Arthritis of the wrist segmental simultaneously 9 EXAMPLES OF TREATMENT Instructions for use Phyaction Performa Page 25 Hypertonia m trapezius pars descendens Arthrosis cervical joints bilateral Inversion trauma lig talofibulare anterius Lumbago 9 EXAMPLES OF TREATMENT Instructions for use Phyaction Performa Page 26 CHAPTER 10 FAULTS GUARANTEE AND MAINTENANCE 10 1 Faults The appliance automatically tests its
9. The display shows the peak or average output depending on the choice of keys During automatic adjustment the display will flash on and off After switching on with key the display shows the actual output This can vary slightly from the values set in advance 3 12 Channel B output display This display will light up only if an electrode is connected to channel B See 3 11 for further details 3 13 Treatment time selector key O min After the treatment time selector key is pressed a green lamp in the key lights up This links the adjustment regulator to the treatment time parameter Treatment time can now be set in minutes and can be read on display Treatment can only start once the treatment time has been set 3 44 Treatment time display The treatment time display 4 shows the set treatment time or the remaining treatment time Treatment time is the same for both channels Between 0 and 10 minutes the time is displayed in half minutes between 10 and 30 minutes it is displayed in whole minutes When the timer is operational this is shown by a flashing dot on the display In the event of insufficient contact treatment is interrupted and the treatment timer stops At the end of the treatment time a buzzer will sound for 4 seconds and the output is returned to 0 Watt 3 15 Adjustment regulator All parameters are set with the adjustment regulator 5 the regulator is linked to the parameter for which the green lamp is lit
10. Therefore use only wooden glued furniture During treatment the patient must also not come into contact with any metal objects such as radiators or window frames 4 2 2 Clothing and intervening substance For all short wave treatments it is recommended that the patients remove their clothing and that a towel be placed between the skin and the electrode The towel keeps both skin and applicator dry It also prevents loss of heat promotes hygiene and ensures the patient s privacy Treating patients who are naked offers various advantages firstly it is the easiest way to ensure that no metal objects are located in the high frequency field metal in clothing such as buttons zips or hidden jewellery keys etc Secondly it also prevents undesired concentrations of energy resulting from nylon leather damp sweaty clothing ointment dressings wet dressings etc 4 2 3 Implanted electronic devices Patients with implanted electronic devices may be treated with short wave therapy as long as sufficient care is taken for example patients with an implanted pacemaker must not be treated If in doubt consult a doctor Electronic hearing aids must be removed as these may be damaged by the electromagnetic radiation or could cause a fault to occur 4 2 4 Implanted metals Metal objects in the body such as plates pins screws a coil pacemakers etc form a contra indication The electrode must be placed at a distance of at least 1 metre f
11. A and channel B The frequency can now be set between 26 and 400 Hz in ten steps and can be read on the display 3 8 Pulse repeat frequency dis splay The pulse repeat frequency display shows the pulse repeat frequency for both channels When this is set for channel A for example it is also adopted by channel B 3 9 Peak output selector key After the peak output selector key is pressed the green lamp in the key lights up Pressing this key En d causes the peak output to be shown on displays and 12 The peak output of the large Circuplode diameter 14 cm can be set between 0 and 200 Watt and of the small Circuplode diameter 9 cm between 0 and 100 Watt If the lamp flashes on and off this indicates that the peak output is being shown on the display while the key is not pressed in 3 10 Average output selector key After this key is pressed the green lamp in the key lights up Pressing this key causes the average output to be shown on display and display This also links the adjustment regulator to the output parameter The 3 EXPLANATION OF THE OPERATING MECHANISMS Instructions for use Phyaction Performa Page 7 average output for the large Circuplode can be set between 0 32 Watt and the small Circuplode HR between 0 16 Watt If the lamp flashes on and off this indicates that the peak output is being shown on the display while the key is not pressed in 3 11 Channel A output display
12. To reduce the value turn the regulator to the left To increase the value turn the regulator to the right The regulator has no start or finish settings The parameter value can be read off the appropriate display The adjustment range is determined by the parameter selected 3 16 Start stop key O When treatment is commenced the lamp in the key goes green It can only be started if a treatment time has been set Treatment can be stopped before the end of the treatment time by pressing the stop start stop key again The output is then reduced to zero The lamp in the key then lights up red 3 17 Start stop indicator lamp During the automatic test when the appliance is switched on the start stop lamp lights up yellow If treatment has stopped or has not yet started the lamp is red When treatment is started the lamp lights up green 3 18 Emitter A connection The electrode cable is connected to this connection via the bayonet connection The length and impedance of the cable are critical For this reason never use other commercially available cables Connecting any cable other than one supplied can jeopardise the patient s safety and damage the N correct operation of the appliance and is therefore prohibited 3 19 Emitter B connection For the connection of emitter see 3 18 3 20 Fixing points for electrode arms The electrode arms are fixed to the fixing points For assembly details see paragraph 2 5 3 EXPLANATIO
13. has been completed you will hear a buzzing sound and the appliance can be operated If a fault is detected during treatment this is indicated on the display by lines The appliance will no longer operate See paragraph 10 1 2 4 Placing and transportation Read chapter 1 on Safety Aspects before you use the Phyaction Performa for the first time Ensure that the appliance is horizontal and stable Do not place the appliance close to heat sources such as radiators or hot air grids and avoid leaving the appliance for long periods of time in direct sunlight Ensure that the ventilation grilles on the back of the appliance are not covered so that air can circulate freely Do not place any objects on the appliance and ensure that no liquids are spilled into the appliance If any liquids or foreign objects do enter the housing switch off the appliance immediately remove the plug from the socket and contact your supplier to have the appliance inspected before using it again We would like to emphasise the fact that the Circuplodes must be handled very carefully We also recommend that you avoid using the Phyaction Performa immediately after extreme temperature changes 2 5 Fastening electrode arms and electrodes On the last page of this instruction manual you will find a drawing showing the appliance and accessories The numbers in the text correspond to the numbers in this drawing Thanks to their special construction the Phyaction Perform
14. in the cell membrane reduction of the glycogen level increased numbers of leucocytes en lymphocytes These athermal effects can have a beneficial effect on wound healing 7 5 Influence of electromagnetic energy on wound healing The healing process is the same for various types of wounds For instance there is no real difference in wound healing in cases of skin injuries ruptured muscles or fractures although different cells are involved in the process In general the healing process after tissue damage can be classified according to the following phases 1 bleeding phase 20 30 minutes 2 inflammatory phase 24 36 hours increased temperature calor i swelling tumor i redness rubor functional disorder functio laesa pain dolor 3 regeneration phase proliferation phase 2 4 days production phase 4 days 3 weeks remodelling phase 3 weeks 3 months Table 3 Phases of the wound healing process after tissue damage 7 5 1 Bleeding phase Bleeding occurs briefly during the bleeding phase and ceases as a result of counter pressure from the surrounding tissues and vasoconstriction in the injured blood vessels As heat can cause unwanted vasodilation high frequency electrotherapy is contra indicated during this phase 7 5 2 Inflammatory phase This phase is marked by rubor calor dolor tumor and functio laesa The inflammation in the tissue causes the functional disorder of the affec
15. out in advance on the healthy side where the patient does have feeling When treating the affected side the determined intensity should then be decreased by 30 Schliephake has drawn up a system determining the dose according to the sensation of heat in four grades 1 submitis dose no heat is felt 2 mitis dose the patient fells a slight sensation of heat 3 normalis dose the patient feels a clear and pleasant sensation of heat 4 fortis dose the patient feels a strong but as yet not unpleasant sensation of heat If any pain or muscle hypertonia occur during treatment due to trophic disorder the maximum peak output or the average output must be reduced 5 3 Treatment frequency This depends partly on the dosage with a low dosage treatment can be given every day with a high dosage treatment frequency should be kept down to 1 3 times per week The clinical results must indicate whether treatment frequency must be changed 5 4 Number of treatments The total number of treatments is determined by the clinical results 5 5 Contact control It is very important to treatment quality that the set output is also actually transferred to the tissue The Phyaction Performa is equipped with an optical and acoustic contact control which ensures optimum energy transfer If the power emitted deviates more than 1096 from the set output the Performa is automatically switched off The contact control led on the Circuplode then flashes as doe
16. output 24 Watt 5 PARAMETERS AND TREATMENT GUIDELINES Instructions for use Phyaction Performa Page 16 CHAPTER6 BASIC DATA ON SHORT WAVE THERAPY 6 1 Introduction High frequency electrotherapy is the medical treatment which uses electromagnetic fields with a vibration frequency higher than 300 KHz Nerve tissue is no longer depolarized at such high frequencies but heat is generated by the conversion of electromagnetic output A number of specific frequencies are used in physiotherapy ie 27 12 MHz 433 92 MHz and 2450 MHz The Phyaction Performa is a device used for high frequency electromagnetic therapy in which the electromagnetic energy is generated at a frequency of 27 12 MHz The wavelength in vacuum of this frequency is 11 06 metres so that it is sometimes referred to as the 11 metre wave therapy or short wave therapy In the Phyaction Performa electromagnetic energy is emitted in pulses The therapist can regulate the pulse length and the pulse repeating frequency according to the desired therapeutic effect 6 2 Generation of the electromagnetic field Energy is transferred from the source to the surrounding area in the electromagnetic field that is generated by the Phyaction Performa Live tissues are influenced by the action of electromagnetic force on tissue molecules and ions Electric and magnetic fields can distinguished in the electric field electrical energy is exerted on charged particles and in the magnetic field this i
17. the Phyaction Performa A Circuplode with a 14 cm diameter is supplied as standard A smaller Circuplode with a 9 cm diameter is supplied as optional The smaller Circuplode can be used to treat small areas of the body The electrode should be approximately the same size as the part of the body to be treated In addition to the difference in treatment surface area between the two electrode formats there is also a difference in peak output the large Circuplode has a peak output of 200 Watt the smaller one has a peak output of 100 Watt The Phyaction Performa automatically recognises which format Circuplode is connected to which channel and adapts the maximum output immediately 5 2 2 Application with two Circuplodes simultaneously The Phyaction Performa offers the possibility of working with two Circuplodes simultaneously whether or not of the same format Simultaneous use offers the following advantages covering a large treatment area in one session complaints on two sides can be treated simultaneously one part of the body can be approached from two sides at once alocal and a segmental treatment can be given simultaneously If two Circuplodes are to be used simultaneously the pulse length and output can be set for each Circuplode individually The pulse repeat frequency and treatment time selected are equal for both Circuplodes During simultaneous use the two Circuplodes cannot weaken or strengthen the other as the pulse of on
18. 3 4 Selector key for pulse length 3 5 Channel A pulse length display 3 6 Channel B pulse length display 3 7 Pulse repeat frequency selector 3 8 Pulse repeat frequency display 3 9 Peak output selector key 3 10 Average output selector 3 11 Channel A output display 3 12 Channel B output display 3 13 Treatment time selector key 3 14 Treatment time display 3 15 Adjustment regulator 3 16 start stop key ee ae 3 17 Start stop indicator lamp 45 4 leis hole hei reu ere ie EE DER Da 3 18 Emitter A connection 3 19 Emitter B connection 3 20 Fixing points for electrode lt 3 21 Electrode atm elo e au RE RE AE RE RE ERE E Rd 3 22 Circuplode Esse ieu lv Puit e wee aei ta bie t s 3 23 Mains entry port with mains fuses
19. B The electrodes supplied with the Phyaction Performa are called Circuplodes because of their special construction which allows the circular electric field through at the front and parallel to the spool so that circular flows are generated parallel to the tissue layers In contrast to normal electrodes the radial electric field component is suppressed in the Circuplodes It has been demonstrated that an electric field penetrates tissues better with an electric field that is parallel to the tissue layers therefore the circular electric field than an electric field which is at right angles to the tissue layers the radial electric field At 27 MHz the maximum Specific Absorption Rate SAR see paragraph 6 6 of this chapter in the skin fat layer in the radial electric field is about ten times greater than in the muscle layer so that heat development is very superficial On the other hand the maximum SAR in the parallel electric field is greatest in the muscle layer even up to twenty or thirty times greater than in the skin fat layer Therefore heat development is no longer superficial Thus the effective area is ring shaped and this should be taken into account when the electrodes are put in place 6 4 Penetration depth The penetration depth is the distance across which the field is weakened by a factor of 0 37 therefore where 3796 remains Table 1 shows that both the wavelength and penetration depth decrease as the frequency increases and
20. INSTRUCTIONS FOR USE PHYACTION PERFORMA C 0344 Copyright Uniphy BV 1995 98 Phyaction is a registered trademark of Uniphy BV Art Code 93008021 5 EN Phyaction is manufactured in the Netherlands by Uniphy BV P O Box 558 NL 5600 AN Eindhoven the Netherlands Tel 31 499 491800 Fax 31 499 474734 Your supplier is Contents INTRODUCTION CHAPTER1 SAFETY ASPECTS 1 1 Electrical safety Oe et 1 2 Explosion safety Se A Xen d ee edes 1 3 Safety in use oed bei poe Leve ee Lee oo Le qoe Ci qune on quite iis 1 4 Use of the appliance 1 5 Medical device directive CHAPTER 2 INSTALLATION 2 1 Check on delivery eee eee eee Bade bade dae 2 2 Power vonage Lui aes Se ive te tae EAE Daye Ae he Baan US Saya Banya 2 3 Functional test 2 ROE Be Baa a Pe 2 4 Placing and transportation 2 5 Fastening electrode arms and electrodes 2 6 Use of the high frequency induction field indicator CHAPTER 3 EXPLANATION OF THE OPERATING MECHANISMS 3 1 Mains SWITCH oso eus ecoute a RE dbo nab A eti eri d mes 3 2 Selector key channel 3 3 Selector key
21. N OF THE OPERATING MECHANISMS Instructions for use Phyaction Performa Page 8 3 21 Electrode arm The electrode arm is connected to the fixing points Using the large bl ck knob one of the Joints of the fixing system can be locked At the end of the arm there is an opening 5 in which the Circuplode 26 can be inserted The Circuplode is locked in place by means of the small black knob The cable can be fitted into the cable guide attached to the arm 3 22 Circuplode On the back of the 6 there is Connection 29 to which the bayonet connection of the electrode cable can be connected You will also see a lamp which lights up green as soon as there is any electro magnetic output During adjustment and in the event of insufficient contact the lamp will flash on and off 3 23 Mains entry port with mains fuses The mains power cord supplied is connected to the mains entry port Here there are also two 6 3 A F mains fuses type G 250 V See paragraph 10 2 for instructions on replacing faulty fuses 3 24 Connection for potential equalizing cable A special earth cable can be supplied for use in areas for which a potential equalizing cable is required in accordance with national installation standards and connected to this connection 3 25 Model specification plate The model specification plate 6 shows appliance data such as the model and serial number for service and guarantee etc as well as connection d
22. a day Possible parameter settings for a submitis dosage Pulse length 65 us Pulse repeating frequency 26 Hz Treatment duration 10 minutes Treatment frequency daily Peak output 200 Watt Average output 0 34 Watt 5 6 2 Mild inflammatory action Mild inflammatory action can be marked by pain during or after movement particularly in an extreme position The tissues can be strained increasingly The objective to stimulate blood circulation can be achieved during the production phase by stimulating the thermal effects for which the dosage is increased from mitis to normalis A high average output with a high peak output long pulse time and high pulse repeat frequency is set Treatment lasts 20 to 30 minutes and is given 2 to 3 times a week Possible parameter settings for a mitis dosage Pulse length 150 us Pulse repeat frequency 110 Hz Treatment duration 20 minutes Treatment frequency 3 times a week Peak output 200 Watt Average output 3 30 Watt Possible parameter setting for a normalis dosage Pulse length 300 us Pulse repeat frequency 200 Hz Treatment duration 20 minutes Treatment frequency 3 times a week Peak output 200 Watt Average output 12 Watt During the remodelling phase a fortis dosage can be administered during treatment Possible parameter settings for a fortis dosage Pulse length 400 us Pulse repeat frequency 300 Hz Treatment duration 30 minutes Treatment frequency once a week Peak output 200 Watt Average
23. a s conductivity electrodes are known as Circuplodes 2 5 1 Assembly The electrode arm s must be mounted in the correct manner on the back of the cabinet See figure 1 If necessary use the crosshead screwdriver supplied to mount the arms 23 2 INSTALLATION Instructions for use Phyaction Performa Page 3 Figure 1 Fastening the electrode arm s 2 5 2 Adjusting the electrode arms Figures 2 to 6 show how the various joints of the arms can be adjusted if necessary The fixing points of the arms must be adjusted in such a way that the arms can be properly fixed in placed by hand tightening the black fixing knob For adjustment use the heaviest electrode only with the arms set at the position shown in figure 2 Use the box spanners supplied Figure 2 Figure 3 2 INSTALLATION Instructions for use Phyaction Performa Page 4 fcc HI Lj Bp 7 Figure 4 Cl H INERT A Figure 6 2 5 3 Composition of fixing system Figure 7 shows the composition of the fixing system The black fixing knob is mounted as standard on the front of the arm If required it can also be mounted on the back Figure 7 2 INSTALLATION Instructions for use Phyaction Performa Page 5 2 5 4 Electrode fastening The electrodes are inserted into the opening at the end of the electrode arms and fixed in place using the black knob2 See figure 8 Figure 8
24. are formed during the production phase are not yet able to resist functional stress Therefore a precondition for the development of optimum connective tissue structures is to submit the affected tissues to the phased exertion of tension A fortis dosage increases the elasticity of the collagen connective tissue and this eases movement In addition metabolic activity in the connective tissues increases Treatment with short wave therapy can be effective even more than three months after the lesion occurred There may still be some inflammation or in cases when the wound does not heal properly The stage of wound healing is estimated on the basis of clinical findings and the various parameters are set accordingly See paragraph 5 6 7 6 Specific effect on soft tissue lesions Soft tissue lesions the temperature of in highly vascular tissue muscle tissue joint capsule rises less quickly than in less vascular tissues ligament tissue intra articular parts of the joint so that highly vascular tissue can be treated with relatively higher electromagnetic energy When thermal treatment is administered to superficial joints such as the wrist and knee the intra articular parts may become too hot due to heat conduction 7 EFFECTS OF SHORT WAVE THERAPY Instructions for use Phyaction Performa Page 22 CHAPTER 8 INDICATIONS AND CONTRA INDICATIONS The above will have provided some insight into short wave therapy It will also be clear that thermal s
25. ata such as mains voltage and measured power 3 26 Undercarriage with swivel castors The two wheels on the front of the undercarriage are fitted with foot operated brakes to block them press down the handle 5 to release them pull the handle up 3 27 Ventilation openm S The ventilation openings in the housing allow the heat produced by the electronics to be expelled It is important that these openings are not covered 3 EXPLANATION OF THE OPERATING MECHANISMS Instructions for use Phyaction Performa Page 9 CHAPTER 4 TREATMENT ASPECTS AND SETTING SEQUENCE 4 1 Introduction This chapter deals with various measures which must be taken before during and after treatment For further information on the theory of pulsating short wave therapy and the parameters we refer you to chapters 5 through 8 Before using this appliance for the first time please read chapter 1 Safety Aspects and chapter 2 Installation 4 2 Measures to be taken BEFORE treatment Chapter 8 Indications and Contra indications contains information essential for safe and effective treatment Before commencing treatment ensure that there are no contra indications 4 2 1 Metal objects and furniture Metal articles can cause concentrations of intensity in the high frequency field This applies both to metal objects worn or carried by the patient and to objects in the close vicinity of the applicator As a rule of thumb a minimum distance of 1 metre must be observed
26. both are greater in fatty tissue than in muscle tissue The figures in the table must be treated circumspectly and are only provided to give you an impression After all they apply to separate tissues and when flat waves are used In reality we deal with successive layers of tissues and therefore these figures do not apply in practice wavelength m penetration depth m Frequency Table 1 Wavelength and penetration depth in muscle and fatty tissue using a number of frequencies 6 BASIC DATA SHORT WAVE THERAPY Instructions for use Phyaction Performa Page 18 6 5 Dissipation The energy of the electromagnetic field which penetrates the tissues is converted into heat by the flows generated by it this is known as dissipation The degree of increase in local temperature is limited and depends on the dosage the type of tissue and heat dispersal which in turn depends on the extent of the vasculated tissue The heat is dispersed to the environment by means of heat conductivity as long is this environment is cooler It is important to realize that increasing temperature in the deeper tissues cannot be sensed whereas of an increase in skin temperature can be sensed due to the presence of thermosensors Where dissipation takes place in the tissues depends on the frequency used 27 12 MHz in the case of the Phyaction Performa and type of treatment It is possible to heat structures such as muscles that are good heat conductors with the condu
27. ctivity method using the specially constructed Circuplode without the skin and fatty tissue increasing significantly in temperature or any sensation of heat The amplitude of the electric field strength decreases owing to dissipation 6 6 Specific absorption rate SAR High frequency electromagnetic energy is converted into heat in the body The amount of energy that can be dissipated by tissue per time unit the energy is indicated by the SAR Specific Absorption Rate The energy Joules leads to an increase in temperature The SAR can be calculated using the following formula SAR 0 50 E p Watt kg o the specific electrical conductivity of the tissue E the local electric field strength amplitude p the specific mass density For muscle tissue p 1070 kg m For fatty tissue p 940 kg m SAR varies from one place to the next in the body because E depends on the site For this reason indicating the maximum SAR which occurs somewhere in the tissues in any given situation will suffice in practice Table 2 shows that conductivity o of tissues becomes greater when the frequency increases It also shows that the conductivity of muscle tissues is ten times greater than that of fatty tissue The local strength of the electric field E depends on the type and position of the source Frequency Specific conductivity S m MHz fat muscle Table 2 Specific conductivity of fatty and muscle tissue with a number of frequencies
28. e Circuplode is transmitted in the pulse pause of the other 5 PARAMETERS AND TREATMENT GUIDELINES Instructions for use Phyaction Performa Page 13 5 2 3 Electrode placement The Circuplode must be placed with the permeable screen aimed at the area of the body to be treated In order to ensure an optimum alignment it is important that the electrode is not placed further than 1 cm away from the part of the body to be treated Direct contact with the area of the body with a towel as an intervening substance is to be preferred Above all the part of the body to be treated must be large enough in relation to the Circuplode to ensure a sufficient transfer of power As explained in paragraph 6 3 the effects of the Circuplode only take place around the edges in other words where the coils of the spool are located Theoretically there is no electromagnetic field in the middle of the Circuplode and virtually no heat will be generated there The middle of the coil is therefore the least effective The Circuplodes must therefore be placed in such a way that the outside part of the coil affects that part of the body where power dissipation is desired and can be expected 5 2 4 Pulse length The average output is the product of the peak output pulse length and pulse repeat frequency The pulse length on the Phyaction Performa is adjustable in 7 steps from 65 400 usec 5 2 5 Pulse repeat frequency The pulse repeat frequency on the Phyaction Performa
29. e currents generated In practice it is impossible to measure these heat increases especially when they are only very small The patient can sense temperature changes in the skin Deeper tissues do not contain thermosensors This means that we always have to rely on the patients subjective perceptions This is determinative for the dosage of the therapy along with the nature and condition of the complaint of course Athermal effects also cannot be measured in practice The therapist must rely on clinical effects in the course of time such as changes in mobility pain swelling and temperature which can be measured before during and after treatment For more extensive information on the theory of short wave therapy please turn to chapters 6 7 and 8 5 2 Dosage A number of factors play a significant role in determining the dosage in short wave therapy and the therapist has to make a choice for a specific setting The following must be considered Circuplode format Application with one or two Circuplodes simultaneously Electrode placement Pulse length Pulse repeat frequency Peak output or average output Treatment time Dose These parameters are covered in sequence the following paragraphs 5 2 1 Circuplode format The conductivity electrodes of the Phyaction Performa are known as Circuplodes thanks to their special construction see paragraph 6 3 Two sizes of Circuplode can be used on
30. elf once it is switched on ie a number of the appliance s vital functions are checked If the microcomputer detects a fault during the test or during treatment this will be indicated on the display by means of two lines The appliance will cease to function Such a fault could be caused by a breakdown of mains power In that case the appliance only needs to be switched on again The automatic test will be repeated and if everything is ion order the appliance is ready for use If the Phyaction Performa does not operate properly or does not operate at all check the following points to trace the fault THE LIGHTS IN DISPLAY AND THE INDICATOR LIGHTS REMAIN OFF Check whether the plug is inserted correctly in the wall socket the wall socket is connected to the mains current the fuses in the mains entry port are functioning These can be replaced if necessary See paragraph 10 2 below THE DISPLAY AND LIGHTS FOR ONE OF THE CHANNELS REMAIN OFF Check whether an electrode is connected to the channel in question use another cable or electrode to check whether it is functioning If it does the fault lies with the cable or electrode TREATMENT CANNOT BE STARTED Check whether the treatment time has been set electrode has been connected use another cable or electrode to check whether it is functioning If it does the fault lies with the cable or electrode Please contact your supplier if you are unable t
31. f improved localized metabolic activity heat increases the elasticity of collagen tissues in the capsule This makes it easier move the wrists as nerve tissue also consists of collagen connective tissue the elasticity of the connective tissue increases here as well In addition heat in the nerve cells causes depolarization which is insufficient to generate an activity potential This will increase the irritability of the nerve tissue At a temperature increase of 10 C the conductive speed of a nerve increases by a factor of 1 7 2 secondary effects include pain reduction and that chronic inflammatory reactions can be influenced 74 Athermal effects Athermal effects can contribute to tissue recovery by vasodilation through increased metabolic activity and axon reflexes The hypothalamus is not involved in this process 7 EFFECTS OF SHORT WAVE THERAPY Instructions for use Phyaction Performa Page 20 The temperature in muscle tissue and probably also in the joints is regulated almost exclusively by local chemical changes and axon reflexes As the Circuplodes are able to achieve good heat development in muscle tissue it appears possible to activate only localized processes and to exclude a reaction from the central nervous system thereby generating athermal effects Also see paragraph 5 2 5 Athermal effects described in the literature are increased extracellular Ca level stabilized Ph increased excitation by changes
32. hort wave therapy is contra indicated in all cases of disrupted blood circulation where there is a chance of increasing the infl ammation as a result of heat After all it is not possible for this heat to be dispersed Moreover the treatment must never be painful or too hot 8 1 Sp Indications ecific indications for pulsing short wave therapy are Post traumatic lesions such as distortion contusion rupture fracture haematoma Post operative lesions Infl De ammation such as arthritis in a non active stage bursitis possibly with calcification sinusitis tendinitis wound healing generative lesions such as arthrosis rheumatoid arthritis Lesions of the peripheral nerves such as pareses neuritoids neuralgias herpes zoster neuropathy 8 2 Absolute contra indications Short wave therapy must not be administered in the following cases Pacemakers Malignant tumours Pregnancy Fever Bacterial infections 8 3 Relative contra indications If the choking field electrode is placed more than 1 metre away from the situations given below short wave therapy may be administered if necessary with an adapted dosage Always consult a physician when in doubt Any metal present in the body Nylon and other materials which do not absorb moisture Bleeding phase as described in chapter 7 EFFECTS OF SHORT WAVE THERAPY paragraph 7 5 1 Circulation disorders such as thrombosis gangrene increased tendency to bleed
33. in a high concentration of electromagnetic output causing a great deal of heat If a certain arrangement does cause the cables to touch the patient or each other a layer of felt at least 4 cm thick must be placed on the point of contact as an intervening substance Movement of the electrodes can be prevented by fixing them in place with Velcro 4 3 Measures DURING treatment An automatic test is always carried out every time the Phyaction Performa is switched on See paragraph 2 3 4 3 1 Setting sequence For an explanation of the operating mechanisms we refer you to chapter 3 EXPLANATION OF THE OPERATING MECHANISMS The following parameters are set in sequence a 1 It is possible to set the pulse length separately for channel and channel B Therefore it is necessary to indicate which channel is to be set Select Circuplode A or B with the appropriate OL selector key A green lamp lights up on the selector key pressed If no electrode is connected to channel or B the parameters in question cannot be set Before mmm you can set the parameters the Circuplode must be connected to the appliance On the back of the Phyaction Performa near the connections for the electrode cables there is a sticker showing which connection is for channel A and which for channel B If you are facing the operating pad of the Phyaction Performa the left connection is for channel A and the right for channel B s 2 Press the pu
34. is adjustable in 10 steps ranging from 26 400 Hz For a given intensity and a variable pulse length the pulse repeat frequency determines whether a cumulative thermal effect can take place causing the tissue temperature actually to increase This process is dependent partly on local blood circulation and the extent to which it cools down the area Figure 10 shows that if the thermal effect can be equalized in the pulse pause the temperature will not increase and no heat will be felt If a new impulse is given after the thermal effect has disappeared a new thermal effect will occur just as large as the previous one while the athermal effect is added to the athermal effects already present Therefore we can see that summation is taking place Figure 9 Heat development during pulsing short wave therapy A no measurable temperature increase B measurable temperature increase 5 2 6 Peak output or average output The Phyaction Performa offers the therapist the choice of displaying the peak output or the average output Peak output Watt refers to the size of the pulse in figure 10 in other words the intensity The maximum peak output of the large Circuplode diameter 14 cm is 200 Watt and of the smaller Circuplode diameter 9 cm is 100 Watt The average output P Watt is the product of the set peak output the pulse length and the pulse frequency If you are interested in viewing the average output resulting from the set
35. lse length selector key to adjust the pulse length for the Circuplode selected Set the se pulse length by turning the knob 3 Press the pulse frequency selector key to adjust the pulse frequency then turn the knob to set the required frequency o w 4 Pressing the peak output or average output key allows you to set the peak output or average t output for the selected Circuplode The output can be then set by turning the knob Ow anis 4 TREATMENT ASPECTS AND SETTING SEQUENCE Instructions for use Phyaction Performa Page 11 start stop If you wish to execute an application using only one Circuplode move straight on to point 6 When applying two Circuplodes simultaneously select the second electrode by pressing the appropriate selector key after having carried out steps 1 to 4 Then set the pulse length and output for the second Circuplode in the manner described above Once all the parameters for one or both Circuplodes have been set treatment time can be set by pressing the treatment time selector key and setting the desired treatment time in minutes by turning the knob Treatment can only commence once the treatment time has been set Treatment can now be started by pressing the start stop key which causes the green lamp on the key to light up During the automatic tuning the value on the output display flashes on and off In order to ensure treatment
36. more 1982 Trofiek behandelen theorie amp Fysiotechnische behandelvormen author Gerard Koel Hogeschool Enschede 1995 Pulsating Short wave Diathermy Value in Treatment of Recent Ankle and Foot Sprains from Arch Phys Med Rehabil Vol 59 August 1978 Effects of high peak pulsed electromagnetic field on the degeneration and regeneration of the common peroneal nerve in rats from The journal of bone and joint surgery vol 65 B No 4 August 1983 Treatment of Various Hand Injuries by Pulsed Electromagnetic Energy Diapulse Physiotherapy June 1983 vol 69 no 6 Comparison of Short wave Diathermy and Pulsed Electromagnetic Energy in Treatment of Soft Tissue Injuries from Physiotherapy October 1974 vol 60 no 10 Short wave and microwave diathermy by Luther Kloth F A Davis Company Philadelphia 1986 Pulserende hoogfrequenttherapie by Coen van Stralen and Henk van Zutphen February 1973 Elektro Therapie Gillert Rulffs Boegelein Pflaum Verlag GmbH amp Co KG M nchen 1995 BIBLIOGRAPHY Instructions for use Phyaction Performa Page 32
37. o trace the fault 10 2 Replacing the mains fuses The user can replace a broken fuse in the following way Set the mains switch to O remove the mains power cord first remove the plug from the wall socket Unscrew the fuse holder for instance by using a coin Replace the faulty fuse with one of the same type 6 3 A F type G 250V Replace the fuse holder and tighten it reconnect the mains cable 10 3 Guarantee and service Your supplier is only responsible for effective operation of the appliance when allrepairs modifications extensions or settings are carried out by authorized persons the appliance is opened only by authorized bodies electrical installations in the areas involved comply with the applicable legal guidelines the appliance is used by authorized persons in accordance with the instructions in this manual the appliance is used for the purpose for which it was designed maintenance has been carried out regularly and in the prescribed manner and the legal guidelines pertaining to the use of the appliance have been adhered to Apart from the fuses no components in the appliance can be replaced by the user In the event of improper use or lack of maintenance according to the guidelines Uniphy and its representative are released of all liability of any ensuing damage injury breakdowns and malfunctions Your supplier is responsible for service and guarantee Your supplier s terms and conditions of deliver
38. quality the contact control is switched on automatically if there is insufficient contact As soon as contact is restored treatment is resumed During treatment the settings can be adjusted by the same method We recommend that you do not increase the intensity during treatment After treatment is finished you will hear a short bleeping sound and the output is reduced to zero The red light on the start stop key lights up The pulse length and frequency remain in view on the displays Treatment can also be terminated at any time by pressing the start stop key 4 3 2 Regarding the patient During treatment the therapist must regularly check the patient s subjective heat sensation Increased blood flow can cause tissue temperature to increase If there is insufficient blood circulation this heat cannot be adequately dispersed which can result in thermal lesions If pain or muscle tension increase during treatment the dosage should be reduced for example by reducing the pulse frequency 4 4 Measures AFTER treatment After treatment has finished the electrode s should be removed and if appropriate the appliance switched off 4 TREATMENT ASPECTS AND SETTING SEQUENCE Instructions for use Phyaction Performa Page 12 CHAPTER5 PARAMETERS OF SHORT WAVE THERAPY AND TREATMENT GUIDELINES 5 1 Introduction In chapter 6 we discuss how the output of the electromagnetic field which penetrates the tissue is transformed into heat by th
39. r effect on the pre capillary sphincters and or the meta arterioles which in turn regulate local homeostasis by alternating contraction and relaxation and by increasing the interchange of substances though diffusion and filtration These actions regulate circulation in the capillaries and therefore in the tissues 7 2 3 Tissue damage Tissue damage occurs when the temperature rises above 42 C The tissues react to this in the form of inflammation initially only locally but more extensively after some time Short pulses with high peak output induce brief strong stimuli at cellular level This could damage the cells 7 3 Thermal effects The thermal effects play the most important role in high frequency electrotherapy These effects are caused by a rise in blood temperature by stimulation of the thermosensors in the skin and an increase in local temperature Localized tissue damage can result from an increase in local temperature As soon as the temperature in the skin rises the hypothalamus will regulate vasodilation reflexively The following thermal effects are worth mentioning increased elasticity in connective tissue particularly of the skin muscles ligaments or joint capsules For instance ligament tissues can stretch more easily when tissue temperature increases the above also applies to the connective tissue of the muscles In addition the hypertonus caused by increased activity of nocisensors can return to normal as a result o
40. r supplier in question We recommend that you pay attention to the following points in order to reduce the chance high frequency interference to a minimum Avoid simultaneous use of other electro medical equipment in the direct vicinity of the appliance Under the influence of electromagnetic output electronic equipment can become damaged or break down This not only applies to electro medical equipment but also to audio video appliances watches diskettes and cashpoint cards etc This can only be completely prevented by installing a Faraday cage The greater the distance between the short wave appliance and other equipment the lesser the chance of high frequency interference Place the short wave appliance and the patient at a distance of at least 1 metre from surrounding equipment and or long metal objects 15 advisable that the short wave appliance be connected to a separate power group Ensure that the power cord of the short wave appliance is kept out of the way of the patient and or other electrode cables or mains leads of other electro medical equipment Use a treatment chair or couch that is completely metal free 4 2 7 Measures regarding the appliance Ensure that all operating switches are set to zero Electrode cables also emit an electromagnetic field Ensure that the electrode cables do not come in contact with the ground with the patient or with each other If contact is made or nearly made this results
41. rmation on the various safety aspects installation operating mechanisms and methods for adjustment Chapters 5 to 9 will be of interest to those interested in the theory of short wave therapy basic data effects explanation of the various parameters indications and contra indications In chapter 10 practical applications for short wave therapy are shown for a number of indications If you have any questions or comments we would be glad to hear from you Our physiotherapists are always ready to help you We wish you every success with the therapy Uniphy BV February 2004 INTRODUCTION Instructions for use Phyaction Performa Page 1 CHAPTER1 SAFETY ASPECTS 1 1 Electrical safety The appliance may only be used in areas containing facilities which comply with current legal requirements Pay particular attention to the use of the earth connection as otherwise the patient s leakage current will exceed the permitted limit for BF type appliance 1 2 Explosion safety The appliance is not suitable for use in areas where inflammable gases or fumes are present Therefore remove the plug from the socket before disinfecting the area in which the appliance is located as some disinfectants evaporate to form an explosive mixture 1 3 Safety in use Metal parts can cause concentrations of intensity in the high frequency field This applies both to implanted metal objects and objects which the patient is carrying and which are located close to
42. rom the implanted metal In order to prevent undesired concentrations around the metal and the dangers related to this internal burns short wave therapy resulting in a perceivable thermal effect should not be given 4 2 5 Other points of attention The patients must receive clear instructions on what he or she may and or must feel Any unpleasant sensations must be avoided From the point of view of safety use only the original undamaged electrode cables and electrodes Patients who have a reduced thermal sensitivity in the area to be treated must be treated with care In these cases use only a low dosage and short treatment times It may be necessary to carry out a check on the patient s subjective experiences and for a doctor to carry out an objective skin reaction check Application on a treatment area which has been locally anaesthetized is strongly advised against 4 2 6 Simultaneous use of other electronic equipment The Phyaction Performa generates a high frequency field at the legally permitted frequency of 27 12 MHz This field can affect the electronic circuits of equipment in the vicinity 4 TREATMENT ASPECTS AND SETTING SEQUENCE Instructions for use Phyaction Performa Page 10 The sensitivity of equipment to high frequency fields can vary greatly This is because some manufacturers do not adequately shield their equipment against high frequency fields If this occurs we recommend that you contact the manufacturer o
43. s magnetic energy As the electrical force is much stronger than the magnetic force only the electric component affects live tissue There are two ways of generating the electric field in short wave therapy by means of condensor field electrodes condensor method or by means of choking field electrodes conductivity method The electrodes are insulated in both methods which makes conductive contact with skin impossible As the conductivity method is used in most cases this is the only application available on the Phyaction Performa The method will be discussed in greater detail below 6 3 The Circuplode conductivity method The choking field electrode is flat spiral spool inside a metal casing The electromagnetic force does not have any effect on the electrode s insulation material The patient s body can never make contact with the conductor metal so that there is no risk of burning Figure 11 An example of a Circuplode Figure 12 shows that in the conductivity method the electric field close to the spool is relatively strong and is aligned according to the spool s loops The strength of the electric field on the spool s axis also known as the radial electric field is minimal 6 BASIC DATA SHORT WAVE THERAPY Instructions for use Phyaction Performa Page 17 strong Figure 12 Alignment pattern and relative strength distribution of the magnetic field component in circular spool winding A and of the electrical field component
44. s the power indicator on the appliance Above all a pulsing acoustic signal sounds to indicate that contact should be restored It is important for good contact that the Circuplode is placed at not more than 1 cm from the part of the body to be treated and that the part of the body to be treated is large enough in relation to the Circuplode Direct contact with the part of the body to be treated is to be preferred with a towel as intervening substance 5 6 Treatment guidelines A general distinction can be made between treatment guidelines which apply in the case of severe inflammatory action and those which apply in the case of mild inflammatory action The parameter settings indicated must only be used as a guideline as the dosage is often dependent on the subjective heat sensations of the patient 5 PARAMETERS AND TREATMENT GUIDELINES Instructions for use Phyaction Performa Page 15 For further information on the various phases of the inflammation process please see paragraph 7 5 5 6 1 Severe inflammatory action Severe inflammatory action is marked by pain during rest and or movement during clinical examination Movement is restricted and strain capacity is reduced The immune systems can be stimulated by stimulating the athermal effects This is achieved by setting a low average output with a high peak output short pulse lengths and a low pulse repeat frequency Treatment lasts 10 to 20 minutes and is given daily or even several times
45. se of the Phyaction Performa ranges from 10 C to 40 C The temperature range for storage and transport of the device ranges from 20 C to 70 C 1 5 Medical device directive This device complies with the essential requirements of the Medical Device Directive of the European Committee 93 42 EEC For information on manufacturer s liability see chapter 10 FAULTS GUARANTEE MAINTENANCE 1 SAFETY ASPECTS Instructions for use Phyaction Performa Page 2 CHAPTER2 INSTALLATION 2 1 Check on delivery Check that the appliance the electrode arm s and the conductivity electrode s were not damaged during transport and that the accessories are intact and complete see chapter 12 ACCESSORIES In the event of damage and or missing parts contact your supplier 2 2 Power voltage Your appliance is suitable for a nominal power voltage of 110 120 or 220 240 Volt AC 50 60 Hz The model plate on the reverse of the appliance indicates the power voltage for which your appliance is wired You cannot change this yourself Check this data carefully before putting the plug in the socket The mains entry port is located on the back of the appliance 2 3 Functional test The appliance is tested during production for electrical safety Each time the appliance is switched on the processor carries out a two second safety test to assess whether the appliance is functioning correctly You must check whether all the displays and lamps light up After the test
46. t is essential that Phyaction Performa is checked and subjected to a safety test every year in order to fulfil the legal guidelines that apply in countries where the IEC601 1 standard is applied We recommend that the appliance is checked by your supplier or some other body authorized by the manufacturer It is also advisable to keep a record of maintenance work In some countries this is obligatory 10 FAULTS GUARANTEE AND MAINTENANCE Instructions for use Phyaction Performa Page 28 CHAPTER 11 TECHNICAL SPECIFICATIONS 11 1 Specifications Frequency Channels Pulse length Pulse frequency Peak output Average output Treatment length 11 2 Technical data Dimensions Appliance weight Electrode arm Safety class Earth Earth leakage voltage 27 12 MHz 0 6 95 2 65 82 110 150 200 300 400 us 5 96 26 35 46 62 82 110 150 200 300 400 Hz 5 96 0 200 Watt 20 96 in 50 ohm 0 32 Watt 20 96 in 50 ohm 0 30 minutes 5 96 45 x 52 5 x 86 cm wxdxh excluding undercarriage approx 22 kg excluding arm approx 4 5 kg type BF Typical of 0 12 Ohm LEC requirement lt 0 2 Ohm Typical of 200 uA IEC requirement lt 500 uA Earth leakage voltage in the event of a single fault Mains voltage Mains frequency Energy consumption Electrode cable 11 TECHNICAL SPECIFICATIONS Typical of 400 uA IEC requirement lt 1000 uA 110 120 V 220 240 V 15 50 60 Hz max
47. ted organs eg a muscle This could can cause a functional disorder Pulsing short wave therapy intended to achieve athermal effects can have a beneficial effect on localized metabolism There is no perception of heat during this treatment We do not recommend short wave therapy in cases of severe inflammatory reactions as it could induce auto immune inflammatory processes 7 5 3 Regeneration phase This phase can be subdivided into the proliferation production and remodelling phases Proliferation means an increase in the number of cells Division takes place in the monocytes and lymphocytes that clean the wound Granulation tissue with large number of fibroblasts and a high blood vessel density develops This tissue forms the infrastructure for the production phase in which the still weak collagen develops Athermal application of high frequency electrotherapy in which the amount of electromagnetic energy can be increased somewhat is indicated during the proliferation phase Electromagnetic energy in a submitis dosage just unable to be felt is indicated During the production phase the thermal load can be increased gradually 7 EFFECTS OF SHORT WAVE THERAPY Instructions for use Phyaction Performa Page 21 to a mitis or normalis dosage so that the patient feels a slight or specific heat sensation This also activates blood circulation During the remodelling phase the tissues develop into a tension resistant structure The tissues that
48. the applicator The standard minimum distance is 1 metre from the applicator See paragraph 4 2 Patients with a pacemaker may not be treated Patients implanted with other electronic equipment may receive short wave therapy as long as sufficient care is taken If there is any doubt consult a doctor See paragraph 4 2 3 The appliance is not suitable for use in wet areas The appliance must not be disinfected or sterilised Each time the appliance is switched on with the main switch an automatic test is carried out The Circuplode s including the cable and plug must be checked regularly for damage Using this appliance in the proximity of another high frequency electrotherapy appliance can affect the correct operation of the appliance The proper and safe operation of the device can only be guaranteed if it is used with the standard and or optional accessories as mentioned in these operating instructions see chapter 12 ACCESSORIES n order to safeguard the long term safety of the device we advise you to have a technical safety check of the device and the accessories performed at least once every year 1 4 Use of the appliance The appliance and accessories must be used solely by qualified persons trained in the application of short wave therapy in accordance with all the requirements included in this manual The Phyaction Performa must be used solely for providing short wave therapy The temperature range for the u
49. tings the output display can be set to show the average output instead of the peak output The maximum average output of the large Circuplode is 32 Watt and the small Circuplode 16 Watt 5 PARAMETERS AND TREATMENT GUIDELINES Instructions for use Phyaction Performa Page 14 Figure 10 Pulse output P and average output P 5 2 7 Treatment times In general treatment times between 10 and 30 minutes are recommended With normal blood circulation maximum vasodilation will have been achieved within this period of time 5 2 8 Dose For the application of pulsed electromagnetism the dose of treatment is determined by the product of the peak output pulse length pulse repeat frequency and treatment length The setting is implemented according to subjective criteria If the patient can and may feel heat for a certain indication a subjective heat sensation by the patient is assumed when determining the dosage When using the Circuplode most heat is generated in places where there are no thermosensors in the muscles and heat sensation in the skin is relatively low Therefore the patient should certainly not feel any heat at the start of treatment Later on in the course of treatment this is permissible as the skin has been heated by the muscles by means of conduction The set dose must not be increased during treatment If the patient has no feeling in certain areas the dose should be set and a test carried
50. y are applicable The guarantee lapses if the appliance is not used in accordance with the instructions above The expected lifetime of the appliance is 10 years 10 FAULTS GUARANTEE AND MAINTENANCE Instructions for use Phyaction Performa Page 27 10 4 Cleaning First switch off the appliance and remove the plug from the wall socket The appliance and accessories must be cleaned regularly Remove grease marks with a cloth and some turpentine Other stains can be removed with a damp cloth Prevent any liquid from entering the appliance The electrodes can be disinfected with a cloth moistened with 7096 alcohol The electrodes and electric cables may not be cleaned with steam or gas 10 5 Maintenance First switch off the appliance and remove the plug from the wall socket Regularly check that the electrodes and cables for poor contact and that they have not been damaged Do not use damaged electrodes or electric cables The cable length is critical therefore only use cables supplied by Uniphy 10 6 Disinfection and sterilization The appliance may only be disinfected or sterilized with a damp cloth Prevent any liquid from entering the appliance The accessories can be disinfected with a cloth moistened by 70 alcohol Those parts that come into contact with the patient s body must be rinsed with water after disinfection to prevent allergies The electrodes and cables may not be sterilized with gas or steam 10 7 Technical maintenance I
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