Manual - Ibramed
Contents
1. Bipolar or Tetrapolar Carrying frequency 2 000 Hertz 4 000 Hertz or 8 000 Hertz where channel 1 fixed at 2 000 Hertz 4 000 Hertz or 8 000 Hertz channel 2 variable from 2 001 to 2 100 Hertz 4 001 to 4 100 Hertz or 8 001 Hertz to 8 100 Hertz Pulse shape symmetrical biphasic sinusoidal Duration length T of a unique Pulse of current at 50 of maximum amplitude for a carrying frequency of 2 000 Hertz 500useg Duration length T of a unique Pulse of current at 50 of maximum amplitude for a carrying frequency of 4 000 Hertz 250useg Duration length T of a unique Pulse of current at 50 of maximum amplitude for a carrying frequency of 8 000 Hertz 125useg Treatment Frequency Range AMF variable from 1 to 100Hz 1Hz steps Sweeping Frequency Range Sweep A AMF variable from 1 to 100Hz 1Hz steps 46 For Bipolar interferential mode Surge stimulation mode ON Time from 1 to 60 seconds OFF Time from 1 to 60 seconds RISE increase time of the Pulse Train from 1 to 9 seconds DECAY Decrease time of the Pulse Train from 1 to 9 seconds Dimensions mm 265 x 275 x 15 Wx DxH Weight approx without accessories 1 1 Kg Maximum stacking number cece sees eee ee eee eee ees 52. The Balance of the Channels is used in normal Tetrapolar Interferential mode static interferential field To achieve a maximum therapeutic effect it is necessary to ensure that the current flowing between the two channels are equal Since the body tissues are not homogenous it is necessary to adjust the current of the channels so that they are equilibrated balanced Some equipment perform this balance automatically for others it must be adjusted externally by the therapist through a control called balance or adjusting the same current in the two channels The Neurovector V 2 0 uses constant output current technology for the patient Therefore the balance is achieved by placing the same current mA in the two channels Remember that the level of current to be applied can be different for each patient Consequently the intensity should be felt however it should be pleasant to the patient Even in normal Tetrapolar mode the Neurovector V 2 0 allows the performance of manual operation MANUAL VECTOR where the therapists manually rotates the interferential field trying to localize according to what is reported by the patient the exact location of the problem 15 For this simply unbalance the channels this means leaving a channel with lower or higher current than the other For example Suppose that there is a current intensity of 30 mA in channel 1 and 30 mA in channel 2 equilibrated circuit balanced If you dec
3. RF Emissions NBR IEC CISPR 11 IEC CISPR 11 RF Emissions NBR IEC CISPR 11 IEC CISPR 11 Harmonics Emission IEC 61000 3 2 Emissions due to tension fluctuation scintillation IEC 61000 3 3 Neurodyn compact electro stimulator uses RF energy only for its internal functions However its RF emissions are very low and unlikely to cause any interference in nearby electronic equipment Neurodyn compact electro stimulator is adequate for use in all premises which are not residential and not directly connected to the public low tension electric power distribution line which supplies buildings domestic use appropriate for 48 49 Directions and Manufacturer s Statement electromagnetic immunity The Neurovector V 2 0 is destined for use in the electromagnetic environment specified below The user of the equipment must ensure that it is used in such an environment Tani E Level of Assay Level Electromagnetic Environment iita IEC 60601 of Conformity directions The flooring must be either wooden concrete or ceramic If the flooring is covered with synthetic material the humidity must be of least 30 Electrostatic Discharge ESD 6 kV per contact 6 kV per contact IEC 61000 4 2 SCENDE 8 kV by air Rapid electric transitory 2 kV in the Power 2 kV in the Power train pulse lines lines Burst The quality of the power supply should be equivalent to the one of a hospital Or a typically co
4. Controls indicators and operation VIS O SUPERIOR VIS O TRASEIRA VIS O INFERIOR 19 1 ON OFF switch 2 Luminous indicator of the connected condition 3 BACK NEXT keys 4 SET and SET control keys 5 Alphanumerical liquid crystal DISPLAY 6 STAR STOP keys 7 PROGRAM control key 8 UP and DOWN control keys channel 1 intensity 9 UP and DOWN control keys channel 2 intensity presence of an output current intensity for the patient may present a resistance to a charge of 1000 ohms a 10 luminous yellow indicators of channel 1 and 2 of the tension higher than 10 V or a current higher than 10 mA In SURGE bipolar interferential mode this indicator will flicker in accordance with the On Time OFF Time Rise and Decay times 11 Connection of output cables to the patient CHANNEL 1 and CHANNEL 2 12 Power cable port to be connected to the power supply line 13 Fuse rack 14 General characteristics board 15 Tag with the characteristics of the output current of the NEUROVECTOR V 2 0 20 How to use the Neurovector V 2 0 As described previously all the parameters are programmed by touch screen and indicated in the displayed crystal screen Thus the necessary steps to operate the equipment are listed as follows Liquid crystal screen E E A EE Do uo oW Ee Field designed for the selection of the mode MODE of interference Tetrapolar TP or Bipo
5. aspect appearance resources versatility assistance technology etc price 54 4 How old are you under 25 years old from 25 to 40 years old over 40 years old 5 Compared to your monthly wages would you say the price of the equipment is inexpensive reasonable expensive exaggerating 6 Which was the payment modality cash installment 7 Please make any comments here either positive or negative which you find relevant Name I nn nnnn anne DOB Address District City State ZIP Code Tel Equipment Serial Number
6. 0 is equipment for electrical current application through electrodes in direct contact with the patient for neuromuscular dysfunction therapy It is a transcutaneous muscular stimulator with microcomputer technology this means it is microcontrolled This equipment is intended for therapies with interferential currents and medium frequency alternate currents This technique is noninvasive without systemic effects it does not cause dependency and it does not have undesirable side effects The current intensity necessary for the treatment depends on the sensation of the patient Thus the treatment must start with minimum intensity levels very low carefully increased until obtaining the adequate effects of the procedure and according to the reaction of the patient The importance of medium frequency alternate currents is indisputable in electrotherapy In the Neurovector V 2 0 these alternate currents have an operation frequency of 2000 Hz 4000 Hz or 8000 Hz that penetrate deeply in the tissues producing a great variety of physiological effects They allow for high current densities with a slight sensorial effect on the skin becoming quite pleasant to the patient The danger of burns under the electrodes is minimal The so called interferential current is a technique in which two medium frequency alternate currents of different phases or frequencies cross The superposition of the amplitudes results in a new frequency called Bouncing Fr
7. 50 sub clauses 50 1 and 50 2 The control of the output amplitude continuously controls the intensity of the current from the minimum to the maximum and its minimum value exceeds 2 of the value at the maximum position Parameters such as output wave shapes pulse duration pulse repetition frequency output current amplitude range do not differ more than 3096 mentioned in the following technical description The values of the Duration of the pulses and pulse repetition Frequencies described here were measured at 5046 of the maximum output amplitude These parameters are valid for charge impedance in the range of 820 ohms to 1200 ohms The charge impedance effect in the described parameters is very important If the equipment is operated outside the specified charge impedance range it can produce imprecision in the values of the parameters as well as alteration of the wave shapes described below 45 THE Neurovector V 2 0 is a CLASS II monophasic equipment with BF applied part of safety and protection A Power Supply network voltage in the range of 100 240 volts 50 60 Hz Input power Consume max 85VA CLASS II EQUIPMENT with BF applied part of safety and protection Output channels 2 channels with independent amplitude control Amplitude Range mA peak to peak 120mA per channel VAMC sits EE eed ee oe variable from 1 to 60 minutes Interferential mode
8. 80 MHz and 800 MHz highest frequency band is applied NOTE 2 These directions may not be applicable in all situations The electromagnetic propagation is affected by the absorption and reflection of structures objects and people The Field intensities established by the fixed transmitters such as base radio stations telephone cellular wireless and mobile terrestrial radios radio amateur transmission radio AM and FM and TV transmission cannot be theoretically predicted with accuracy To evaluate the electromagnetic environment due to fixed RF an electromagnetic it is recommended to check the local If the field intensity measurement at the local where Neurovector V 2 0 is used exceeds the level of conformity used above the equipment must be observed in order to verify whether the operation is normal IF an abnormal performance is observed additional procedures may be necessary such as reorientation or the reinstalling of the equipment Above 150 KHz to 80 MHz frequenc band the field intensity should be lower than 10 V m 52 Recommended Separation Distances between portable and mobile RF and Neurovector V2 0 The Neurovector V 2 0 electro stimulator is conceived to be used in electromagnetic environments in which RF disturbances are controlled The user may help to prevent electromagnetic interferences by keeping a minimum distance between the portable and mobile RF communication equipment transmitters and the Neurovector V 2 0 as re
9. end of the stimulation and remains active for a period of 2 to 3 hours 30 8 Modulation of pain and control of edema in immediate post operation of LCA ligamentoplasty menistectomy and condroplasty Carrier 4000Hz AMF 5Hz and AAMF 15Hz following an AMF of 70 Hz and AAMF 80Hz Sweep Au 6 6 Tetrapolar technique Stimulation Intensity sensorial intensity Time 30 minutes Mechanism activated for pain modulation pain tolerance and release of endogenous opioids Analgesia started after 10 to 20 minutes after the end of the stimulation and remains active for a period of 2 to 3 hours 9 Functional recovery for muscles with predominance of type I fibers RF pred Type I muscles carrier 2000 Hz AMF 5Hz and AAMF 7Hz Sweep J 1 1 Bipolar pre modulated technique intensity above the motor threshold time equal to 20 minutes or the number of desired contractions 10 Functional recovery for mixed lia and lib muscles RF mixed IIa and IIb muscles carrier 2000 Hz AMF 35Hz and AAMF 15Hz Sweep JL 1 1 Bipolar pre modulated technique intensity above the motor threshold time equal to 20 minutes or the number of desired contractions 11 Functional recovery for muscles with predominance of type IIb fibers RF pred Type IIb muscles carrier 2000 Hz AMF 50Hz and AAMF 20Hz Sweep ML 1 1 Bipolar pre modulated technique intensity above the motor threshold time equal to 20 minutes or the number of desired contractions The dev
10. in interferential therapy alternate currents are used without a fixed polarity the term pre modulated or pre combined more clearly describes the application technique AMF CONTROL Treatment frequency bouncing frequency AMF also known as bouncing frequency or treatment frequency can be controlled by two basic methods known as Continuous constant and Sweep A AMF mode In Continuous constant mode the equipment generates a unique bouncing frequency that can be selected by the 16 operator In this method the equipment generates a constant difference in the frequency between the two channels For example as already mentioned the frequency in one channel is always 4 000 Hz and the frequency in the other channel varies from 4 001 Hz to 4 100 Hz In Continuous constant mode the operator selects a frequency of 4 050 Hz the equipment generates a different between the two channels 4 050 4 000 this means a fixed treatment frequency AMF bouncing frequency of 50 Hz A more useful method for controlling the bouncing frequency is Sweep A AMF mode In this case the equipment automatically generates the bouncing frequency inside a pre selected range This pre selected range is known as frequency extension The word extension can be interpreted as range of treatment frequency This frequency range is automatically and rhythmically increased and decreased inside a pre established AMF range For exa
11. installations grounding system as well as its adaptations The warranty does not cover either parts subjected to wear and tear such as command switches control keys handles and mobile parts sucker applicators application pens for microderm abrasion power cable connection cables to the patient transducer cables conductive silicon rubber applicators diathermy applicators batteries ultra sonic transducer when improper use or its fall is proved equipment cabinet 6 No sales point of IBRAMED has authorization to alter the conditions here mentioned or to take any commitment in the name of IBRAMED Equipment Serial Number Anvisa M S Registered Date of Manufacture Validity Period 5 anos Responsible Engineer Maicon Stringhetta CREA 5062850975 43 TROUBLESHOTTING What might seem to be a problem at first sight may not always be a malfunctioning Therefore before contacting the technical assistance check the items described on the table bellow Problems Solution The equipment does not tum on 1 Is the power cable properly connected If it is not connect it Also check the power outlet on the wall The equipment does not turn on 2 Have you checked the protection fuse Some IBRAMED equipment models use external fuses Check if they are properly connected Check also if the value is in accordance with the indicated in the operation s manual The equipment is connected
12. linear resistance and also as a condenser The resistance offered by a condenser to the passage of alternate current is called capacitive reactance It acts in combination with the linear resistance of the skin The capacitive reactance has a useful feature this means it decreases as the frequency of the applied current increases Consequently if we had a current of higher frequency the resistance of the skin will decrease providing a more efficient stimulation Additionally higher frequencies have a shorter pulse duration leading to a more pleasant stimulus In electrotherapy the spectrum of the frequency can be divided thus High Frequency gt 100 000 Hz 100KHz Medium Frequency 1 000 to 100 000 Hz 1KHz to 100K Hz Low Frequency gt 1 000 Hz 1KHz 9 If we increase this frequency this resistance of the skin will dramatically drop Research shows that the resistance of the skin is very low when the applied alternate current is in the range of 2 000 Hz to 10 000 Hz These alternate currents of Medium Frequency of operation of 2 000 Hz to 10 000 Hz penetrate deeply into the tissues producing a great variety of physiological effects Since in this case the resistance of the skin is low high current densities with low sensorial effect on the skin are possible becoming quite pleasant for the patient The danger of burns under the electrodes is minimal However we have a problem As it has been seen in order to lower t
13. of an application time of 1 to 60 minutes 1 Step Turn on turn off key 1 When turning on the equipment the liquid crystal display 5 will show for a few seconds the following presentation message gt NEUROVECTOR v 2 0 Com moo ooo We After this presentation a sound signal beep will be heard and the screen 5 will start operating now indicating SEGUE Elsa mm TP 4 Off Normal 22 Note that the MODE TP TETRAPOLAR field is flickering 2 Step BACK and NEXT 3 control keys These keys are used to select the necessary treatment parameters As you press the NEXT key you will be advancing to another parameter As you press the BACK key you will be returning to the previous parameter Note that at each selection you choose through the BACK and NEXT keys the chosen parameter will be in flashing mode 3 Step SET and SET 4 control keys These keys are used to choose the marks of each necessary parameter to the therapy SET Increasing values SET Decreasing values 4 Step START STOP 6 control keys Once the parameters and their values are respectively selected as described in the previous paragraphs press the START key Observe that the parameters stop to flicker At this moment the program will start Now choose the current intensity necessary for the treatment If you wish to interrupt the application just press
14. the STOP key The current will be interrupted and the parameters will flicker again in order to perform a new programming At the end of the programmed time you will hear a sound signal several beeps and the current will stop Press the STOP key so that the sound signal is disconnected and for the equipment to go back to the programming condition As you can see there are two functions in the same keyboard START beginning the treatment STOP stop the treatment 23 NOTE 1 If during the programming you forget to enter the application time a sound signal beeps will also be emitted indicating an operation error At this moment the screen 5 will display a mio oo He Press the STOP 6 key and note that the error message has disappeared Then select the necessary time and continue your work 2 Once the Start is pressed for the treatment the BACK and NEXT 3 SET and SET 4 keys do not operate any more new values for the parameters during the application cannot be selected and chosen In this case the Stop key must be pressed in the treatment and then modify the parameter 3 If the operator wants to interrupt the treatment or choose a new time after the end of application alarm sounds they will need to press the STOP 6 key again for the equipment to go back to the condition of programming new parameters Thus the equipment is ready to receive a new programming 4 When the type o
15. the equipment The size area in cm E of the electrodes used in electrostimulation is very important We recommend to use only electrodes that are provided as accessories of NEUROVECTOR V 2 0 in the 30 x 50 or 50 x 50 mm The application method of these electrodes is very simple Generally the used 50 X 50 mm is perfectly accommodated on several parts of the body causing a deep effect on tissues and a comfortable treatment for the patient If a more localized effect is required the 30 X 50 mm electrodes can be used however the effect is more superficial If the user wishes to use a different type of electrode we always recommend electrodes of larger size than those provided as accessory Electrodes of lower size than those provided as accessory may cause irritation and skin burns If the use of these smaller electrodes is necessary we recommend the current density does not exceed 2 mA effective cm If it necessary to surpass these values the user must be attentive of the possible harmful effects NBR IEC 60601 2 10 The maximum values of the output current for the patient provided by this equipment do not exceed the current density limit specified by the standard NBR IEC 60601 2 10 Thus if it is necessary the equipment can be operated in the maximum output mode with the recommended electrodes Some chemical products gel creams etc can damage the electrodes decreasing their useful life Always use the gel provi
16. therapy AMF treatment frequency corresponds to the frequencies normally used in electrotherapy with low frequency Consequently we have the advantages of medium frequencies 4 000 Hz resistance of the lower skin and are well within the biological range 0 1 to 200 Hz AMF AMF f2 f1 f2 4 050 Hz and f1 4 000 Hz AMF 4 050 4 000 50 Hz treatment frequency 1 ciclo da frequ ncia de Figure 1 In the above diagram 1 is the channel fixed at 4 000 Hz and 2 is the channel where the frequency was selected at 4 050 Hz At certain points the two phases will be identical A and B and in such situations the resulting sum will produce an increase in the total amplitude In point C the two currents are equal and opposite canceling each other The envelope dotted line shows the shape of the bouncing frequency cycle The number of envelopes per second represents the AMF this means 4 050 Hz 4 000 Hz 50 Hz treatment frequency 11 STATIC INTERFERENTIAL FIELD normal or standard tetrapolar In interferential treatment known as normal or standard tetrapolar four electrode are necessary two per channel These four electrodes are usually applied on the patient as shown in figure 2 Circuit 2 Circuit 1 Circuit 1 Direction Of the interferenti Circuit 2 Figure 2 The two circuits are placed in the best possible diagonal manner The interferential effect occurs only in the shaded a
17. units is not intended for rooms with risk of explosion such as anesthesia departments or the presence of an anesthetic flammable mixture with air oxygen or nitric oxide POTENTIAL ELETROMAGNETIC INTERFERENCE As for the limits regarding electromagnetic disturbance Neurovector V 2 0 ist electro medical equipment that belongs to Group 1 Class A The simultaneous connection of the patient to the NEUROVECTOR V 2 0 stimulator and to surgical equipment of high frequency can cause burns in the application area of the electrodes and it may damage the stimulator The operation at a short distance 1 meter for example from shortwave or microwave therapy equipment can produce instability in the output of the equipment In order to prevent electromagnetic interference we suggest you to use an electric network line for NEUROVECTOR V 2 0 and a separate group for short wave or microwave equipment We also suggest that the patient o NEUROVECTOR V 2 0 and the connection cables are placed at least at a distance of 3 meters away from the shortwave or microwave therapy equipment Mobile or portable radio frequency communication equipment may produce interference and affect the performance of Neurovector V IBRAMED 6 Description of the NEUROVECTOR The NEUROVECTOR V2 0 was designed following the existing technical manufacturing standards for medical equipment NBR IEC 60601 1 NBR IEC 60601 1 2 and NBR IEC 60601 2 10 Basic Performance The Neurovector V2
18. ATTENTION THIS MANUAL OF INSTRUCTIONS REFERS TO NEUROVECTOR WV 2 EQUIPMENT MANUFACTURED BY IBRAMED PLEASE READ THIS MANUAL CAREFULLY BEFORE USING THE EQUIPMENT AND ALWAYS REFER TO IT WHENEVER DIFFICULTIES APPEAR KEEP THIS MANUAL ALWAYS AT HAND NEUROVECTOR V 2 0 Operation Manual 2 edition 09 2009 TABLE OF CONTENTS General care of the equipment 2 Explanation of the utilized symbols 3 Preliminary Observations 5 NEUROVECTOR V 2 0 Description 6 NEUROVECTOR V 2 0 Essential Performance 6 NEUROVECTOR V 2 0 Electrical AC Input 7 Interferential Currents Introduction 8 Static Interferential Field 11 Dynamic Interferential Field 13 Pre modulated Interferential Currents 15 AMF Selection treatment frequency 16 NEUROVECTOR V 2 0 Controls indicators and usage instructions 17 NEUROVECTOR V 2 0 BIPOLAR Mode 31 NEUROVECTOR V 2 0 TETRAPOLAR Mode 33 Cautions Indications and Counter indications 35 E
19. am described on page 21 will be executed Note the cursor flickering on the MODE field E m ums PIER j Select the BP Bipolar interferential mode Press the SET key until the MODE field displays BP At this time the liquid crystal screen will indicate Bed ESSE BP 4 Off Normal sas a 25 2 Select the Surge stimulation mode Press the BACK key until the curser is positioned flickering on the STIM MODE field Now press the SET key until the word Srg Is displayed At this time the liquid crystal screen will indicate som os ee gm ur 3 Now select the other parameters Carrying frequency Carrier 2 KHz modulation frequency AMF 50 Hz sweeping mode sweep mode off rise 2 seconds on 5 seconds decay 2 seconds off 10 seconds treatment time 20 minutes Press the NEXT key until the cursor is positioned flickering on the RISE s field Now press the SET key until 2 seconds is displayed in this field Proceed in the same manner for the other fields and always use the NEXT and SET keys to select the other parameters Note In case the value is accidentally exceeded use the SET key to decrease the value Very well the programming of all the necessary parameters was selected The information displayed in the liquid crystal screen will oiee eso Lau Wu m 26 Now press the START key for the start and execution of the selected programming Note that the flickering cursor di
20. ant of all The mode is widely used for avoiding accommodation Example If a basic AMF of 20 Hz and an extension of 50 Hz is selected then using this program a frequency sweeping starts at 20 Hz increasing and passing through all the frequencies inside the extension in seconds until the highest frequency of 70Hz and immediately decreases in the following six seconds again passing through all the frequencies until 20 Hz and starts a new cycle 3 STIM MODE Stimulation Mode Continuous constant AMF the equipment generates a unique bouncing frequency that can be selected by the operator In this method the equipment generates a constant difference in the frequency between the two channels In this stimulation continuous mode the Sweep program can still be used Srg Once the AMF and or SWEEP is selected when in SURGE stimulation mode the equipment introduces the known gradients rise on decay e off Note It is worth remembering that Continuous or Srg modes operate only in the technique with two electrodes Bipolar and is generally used for strengthening muscle 33 4 Carrier Carrying frequency The frequencies of 2KHz 4KHz and 8KHz can be selected Clinical use has demonstrated that frequencies approximated at 2 000 Hz produce greater motor activity The current is less soft and produces more stimulation at a muscular level A frequency of 2KHz should be used only in painful conditions As a general rule a
21. boxes Temperature p transport and storage 5 to 50 C Room Temperature for work eese 5 to 45 C Note The equipment and its characteristics are subject to change without previous notice mA milliamperes Hz Hertz useg uS microseconds min minute s seconds VA volt amperes Bibliography Savage Brenda Interferential Therapy De Domenico Giovanni Interferential Stimulation Enraf Nonius Interferential Therapy 47 Electromagnetic Compatibility Neurovector V 2 0 was designed to comply with the requirements determined by norm IEC 60601 1 2 of electromagnetic compatibility The objective of this norm is to guarantee that the level of the spurious signals generated by the equipment and irradiated to the environment are below the limits specified in the norm TEC CISPR 11 group 1 class A radiated emission to guarantee the immunity of the equipment to electrostatic discharges by either contact or air stemming from the accumulation of electrical static discharges acquired by the body Electrostatic Discharge IEC 61000 4 2 to guarantee the immunity of the equipment when submitted to an electromagnetic field inciding from external Immunity to Irradiated RF IEC 61000 4 3 Precautions The operation at a short distance 1 meter for example of a short wave or microwave equipment can produce instability in the output of the equipment In order to prevent e
22. but does not emit current to the patient 1 Have you followed the recommendations and instructions in the operation manual correctly Check and go through the steps described in the chapter about controls indicators e operation The equipment is connected but does not emit current to the patient 2 Have you verified the electrodes and connection cables on the patient Check if the cable plug is properly connected to the equipment Verify if the electrodes are correctly located on the body of the patient 44 NEUROVECTOR V 2 0 Accessories accompanying the equipment 2 pairs of 50 x 50 mm silicone rubber electrodes 2 pairs of 30 x 50 mm silicone rubber electrodes 2 connection cables to the patient blue channel 1 green channel 2 detachable power cable 1 tube of gel 1 spare protection fuse 1 manual of instructions The use of cables electrodes and other accessories different from those specified above may result in the increase of emissions and in the decrease of the equipment immunity NEUROVECTOR V 2 0 Technical Characteristics The NEUROVECTOR V 2 0 is equipment designed for continuous operation mode It uses microcontrollers which guarantees the precision of the values displayed This exactitude of the operation data is in accordance with what is prescribed by the particular standard for the safety of neuromuscular stimulation equipment NBR IEC 60601 2 10 clause
23. commended below according to the maximum potency of the communication equipment Distance of Separation in accordance with the frequency of the transmitter m Maximum Nominal Output potency of the transmitter 150 kHz to 80 MHz 80 MHz to 800 MHz 800 MHz to 2 5 GHz d 124P d 0 35VP d 0 7VP For transmitters with a maximum nominal output potency not listed above the separation distance recommended in meters m may be determined by an equation applicable to the frequency of the transmitter where P is the maximum nominal output potency in watts W according to the manufacturer of the transmitter NOTE 1 From 80 MHz to 800 MHz the distance of separation relative to the highest frequency band is applied NOTE 2 These directions may not be applicable in all situations The electromagnetic propagation is affected by the absorption and reflection of structures objects and 53 WARRANTY AND TECHNICAL ASSISTANCE DETACH AND SEND THIS PAGE TO IBRAMED In order to better serve you in future please answer the following questions 1 Your choice of this IBRAMED product was based on newspaper or specialized magazines sales representative advice friend s advice exhibitor or showroom manufacturer s image technical assistance 2 Have you already owned similar equipment before yes IBRAMED yes other brands no 3 In your opinion what is considered as being more important in an equipment
24. cular endothelium with subsequent vascodilation This protocol can be used in situations of peripheral vascular illnesses or previous therapeutic techniques such as massotherapy or lymphatic drainage Bibliography reference J Gareth Noble Gail Helderson A Fiona L Cramp Deirdre M Walsh Andrea S Lowe The effect of interferential therapy upon cutaneous blood Flow in Humans Clinical Physiology 20 1 2 7 2000 5 Modulation of acute pain Carrier 4000Hz AMF 60Hz and AAMF 100Hz Sweep LA 6 6 Tetrapolar technique Stimulation Intensity sensorial intensity Time 20 minutes Mechanism activated for pain modulation pain tolerance Modulation of pain in these situations is due to the time of use of the therapeutic electrical current 6 Modulation of chronic pain Carrier 4000Hz AMF 5Hz and AAMF 20Hz Sweep JA 5 1 5 Tetrapolar technique Stimulation Intensity sensorial intensity Time 30 minutes Mechanism activated for pain modulation release of endogenous opiodes Analgesia started after 10 to 20 minutes after the end of the stimulation and remains active for a period of 2 to 3 hours 7 Modulation of pain in patients with osteoarthritis of the knee Carrier 4000Hz AMF 3Hz and AAMF 7Hz Sweep Au 6 6 Tetrapolar tehcnique Stimulation intensity sensorial intensity Time 40 minutes Mechanism activated for pain modulation release of endogenous opiodes Analgesia started after 10 to 20 minutes after the
25. ded as an accessory After using the electrodes clean them with tap water Always clean the electrodes before storage Attention The application of the silicone electrodes close to the thorax may increase the risk of cardiac fibrillation 37 ELECTRODES BIOCOMPATIBILITY ISO 10993 1 Ibramed declares that the silicone rubber electrodes provided with the equipment do not cause allergic reactions These electrodes must only be placed in contact with the intact surface of the skin respecting time limit duration of 24 hours of contact There is no risk of harmful effects to the cells nor is there any allergic reaction or of sensitivity The electrodes do not provoke a potential irritation of the skin Self adhesive Electrodes disposable The material used in the manufacture of these electrodes eliminates risks and special techniques for their elimination We suggest to follow the instructions of the manufacturer selected by the user Durability of the silicone rubber electrodes Wear of the silicone rubber electrodes is normal with time and use A worn electrode will lose uniformity in the conduction of electrical current giving a sensation that the equipment is weak Electrical conduction points may also appear where the current density will be very high which may cause an uncomfortable sensation to the patient Change the silicone electrodes at least every six months even if they have not been used or even monthly in case of in
26. electrode cables fixation connector has screws which must be fixed to the output connector 11 located on the equipment panel For a perfect electrostimulation always tighten the screws of the fixation of this connector 2 To remove the banana clips of the electrodes just pull them from their protective covering Never pull the cable Conector de fixa o do cabo dos eletrodos a E pisostenens J Jf umn de Tra o dest conector 3 We suggest that the preparation procedures for the patient and the placing of the electrodes are performed before connecting and programming the instrument 4 The technique used in the treatment for interferential currents is noninvasive without systemic effects it does not cause dependency and it does not have undesirable side effects The current intensity necessary for the treatment depends on the sensation of the patient Thus the treatment must start with minimum intensity levels very low carefully increased until obtaining the adequate effects of the procedure and according to the reaction of the patient Precautions Interferential therapy is not a dangerous treatment method However we would like to stress the following cautions Diathermy equipment interference it is extremely important that the professional knows the danger in the use of the equipment with current such as interferential close to shortwave diathermy units The radio frequency emitted by t
27. elopment of the treatment must be performed by modifying the modulations times in gradient rise decay on and off You should always try to increase the contraction time by maintaining or increasing the rest time The rise and decay are based on the discretion of the therapist Once a protocol is selected press the PROG key again Now press the START key Select the intensity necessary for the treatment 31 NEUROVECTOR V 2 0 Bipolar Interferential mode 1 Possibility of selecting AMF treatment frequency from 1 Hz to 200 Hz 1 Hz steps 2 Sweep or A AMF AMF sweeping range With the passing of time a patient subjected to electrical stimulation will soon feel it with less intensity and can even stop feeling the sensation caused by the current This process is called accommodation and occur due to the sensors being stimulated passing information regarding the external changes in decreasing degree The accommodation can be avoided by varying the AMF treatment frequency SWEEP A AMF sweeping mode JL The AMF remains in the basic frequency for one second and then switches abruptly to a higher frequency in which it also remains for one second This is repeated automatically This method of treatment has an aggressive effect and becomes more aggressive if a large extension of AMF sweeping is selected An effect can be observed immediately after the treatment with this type of program it is superficial hyperemia Thi
28. ement is rhythmically produced by the design of the currents altering the position of the maximum stimulation area Figure 3 illustrates this principle Circuit 2 10076 Of Interferential effect Circuit 1 These arrows l Indicate D placement of the Helad Figure 3 14 In the case where the patient presents not well localized symptoms the dynamic vector system automatic vector can be a useful method for this problem However it should be understood that since the field of influence is sweeping the tissues a part pf the treatment time can not be spent on the injury The automatic vector dynamic vector system should not be seen as a shortcut to allow for the therapeutic treatment of the problem without locating it correctly With the electrodes well placed before the start of the treatment the dynamic vector systems may increase the efficiency of the treatment However this treatment efficiency depends largely on the correct placement of the electrodes It is worth emphasizing here that the effects seen in figure 3 occur in homogenous medium It is difficult and almost impossible to accurately predict the pattern of the interferential effect on the patient subject to the static or dynamic interferential fields There is no evidence to suggest that the manual or automatic vector mode is significantly better than the normal or standard mode EQUILIBRIUM OF THE CIRCUITS BALANCE OF THE CHANNELS
29. equency or Modulated Amplitude Frequency AMF We highlight the following characteristics of the NEUROVECTOR V 2 0 e Operation via touch keyboard with the information demonstrated on an alphanumerical liquid crystal display Interferential stimulation mode Bipolar pre modulated continuous or surge mode Tetrapolar normal or with manual or automatic vector exploration 7 e Possibility of selecting the automatic sweeping range of the Modulated Amplitude Frequency SWEEP also known as A AMF Possibility of selecting the carrying frequency at 2000 Hz 4000 Hz or 8000 Hz e On Off Rise and Decay for muscle exercise surge mode e Possibility of selecting the application time automatically disconnecting the emission current at the end of the program NEUROVECTOR V 2 0 ELECTRICAL INPUT equipment with BF applied part of safety and protection Functioning in network voltages in the range of 100 240 volts 50 60 Hz consequently it is not necessary to be concerned regarding the voltage of the local power supply line Just plug in the equipment to the power outlet and the equipment will perform automatically the selection to 110 220 volts The connection cable to the electric line is detachable The equipment uses the line plug as a resource to separate electrically the circuits of the power line in all the poles NEUROVECTOR V 2 0 is a CLASS II monophasic ATTENTION On the rear part of the Neur
30. f stimulation selected STIM MODE is SURGE the luminous indicators of channels 1 and 2 flicker according to the Rise On Decay and Off times selected on indicators turned on off indicators completely turned off We suggest increasing the intensity of the channels only when the LEDs are turned on maximum contraction The SURGE mode operates only when the interferential mode of Bipolar BP is selected 5 In case the electrical network stops lack of electricity the equipment will be disconnected automatically Thus when the network energy comes back you must execute again the programming necessary for the treatment 24 As it has been seen up to this point the Neurovector V 2 0 panel is self explanatory only a few minutes of use is enough to become familiarized with its programming NOTE We suggest that the preparation procedures for the patient and the placing of the electrodes are performed before connecting and programming the instrument Example 1 Let us suppose that the clinical practice or existing literature suggests the BP Bipolar interferential mode with Surge stimulation mode with the following parameters for a certain pathology Carrying frequency Carrier 2 KHz Modulation frequency AMF 50 Hz Sweeping mode sweep mode off rise 2 seconds on 5 seconds decay 2 seconds off 10 seconds treatment time 20 minutes Turn on the equipment The default progr
31. he resistance of the skin we use Medium Frequency current in the range of 2 000Hz to 10 000 Hz However it is not known that the biological range presented by the tissues is from 0 1 Hz to 200 Hz Low Frequency The Medium Frequency currents are very far from the biological range of the tissues And now Stimulation by INTERFERENTIAL CURRENTS Interferential Current is the phenomenon that occurs when two or more oscillations are applied simultaneously at the same point In interferential therapy two medium frequency alternate current stimuli 4 000 Hz to 4 100 Hz for example are applied at the same time on the same point One of these alternate current stimuli is fixed at 4 000 Hz while the other stimulus can be selected from 4 001 Hz to 4 100 Hz A third frequency called Bouncing Frequency or Modulated Amplitude Frequency AMF is created where these two medium frequency stimuli cross For example The interferential current equipment has two output channels Channel 1 is fixed at 4 000 Hz and channel 2 is variable from 4 001 Hz to 4 100 Hz this means this channel 2 frequency is selected by the operator within this range from 4 001 Hz to 4 100 Hz Then supposing that the frequency selected on channel 2 is 4 050 Hz and the frequency on channel 1 is fixed at 4 000 Hz a third frequency AMF of 50 Hz will be generated on the intersection points 10 of the two currents generated in each channel In interferential
32. he short waves can 35 change the characteristics of the interferential current causing risk to the patient We suggest a distance of at least 2 to 3 meters between the two equipment When using high densities of current always verify there are no reactions with the skin of the patient These reactions can occur if the size of the electrode is inappropriate small Indications Painrelief acute and chronic Reduction of acute and chronic edema Muscle re education and strengthening Reduction of muscle spasms Improvement in the operation of abdominal organs particularly in the treatment of incontinence Stimulation and improvement of superficial and deep circulation General curative effect Counter indications Fever conditions Tumor areas cancer Purulent infection areas Implanted Electronic Device it is recommended that patients with an implanted electronic device for example a cardiac pace maker not to be subject to stimulation unless a specialized medical opinion has been previously obtained Menstruation Areas with large open wounds Hyper sensitivity to electrical stimulation Children under 10 year old Elderly senile patients 36 ELECTRODES RECOMMENDATIONS As already seen the NEUROVECTOR V 2 0 enables transcutaneous neuromuscular stimulation with Interferencial currents For this we use special rubber silicone electrodes that are provided with
33. ing of all the necessary parameters was selected Now press the START key for the start and execution of the selected programming Note that the flickering cursor disappears and the liquid crystal screen will indicate the information regarding the intensity of the m on current CARRIER aaa A iiid EE Ch1 Ch2 OmA OmA o 5x m HL Now press the UP or DOWN keys of the channel that is being used to select the current intensity necessary for the treatment At the end of the programmed time the emission of current will be interrupted and a sound alarm will indicate the end of the treatment Press the STOP key to stop the alarm Now the equipment can be disconnected or will be ready to repeat the programming or perform a new programming Observe that the procedure to program the equipment in example 1 is almost identical to example 2 Consequently the procedure to program the parameters of Neurovector V 2 0 is always the same it is only necessary to practice a little and acquire a habit to use it 28 Control key PROGRAM 7 Program is the key which allows the operator to select treatment protocols Are quick treatment programs that are stored in the equipment memory We are going to provide a small example Turn on the equipment as described on page 21 Press the PROG key The liquid crystal screen will display SWEEP MODE SWEEP TREO ss Up Using the SET SET key you will be able to select 8 set treatment programs p
34. lar BP CARRIER Field intended for the selection of the carrying frequency at 2000 Hz 4000 Hz or 8000 Hz SWEEP MODE Field intended for the selected of the vacuum JIL SL A operation mode Field intended for the selection of the SWEEP soi E gens A AMBP frequency range from 1 to 100Hz 1 Field intended for the selection of the modulation frequency bouncing frequency 1 to 100Hz Field designed for the selection of the mode ETSI 3E of stimulation normal Tetrapolar Tetrapolar with automatic vector continuous Bipolar and surge Bipolar 21 When in Surge Bipolar mode field designed for the RISE selection of the parameter PULSE RISE TIME time SE s ou j j go from rest to maximum contraction pulse increase gradient variable from 1 to 9 seconds When in Surge Bipolar mode Field designed for the CIT selection of the parameter CONNECTION TIME time of sustentation of the maximum muscle contraction variable from 1 to 60 seconds When in Surge Bipolar mode field designed for the DECAY s selection of the parameter PULSE DESCENT TIME time to go from maximum contraction to rest pulse decrease gradient variable from 1 to 9 seconds When in Surge Bipolar mode field designed for the OFF 5 selection of the parameter REST TIME time of the muscle contraction variable from 1 to 60 seconds Field designed for the selection of the parameter 9 APPLICATION TIME TIMER Allows for the selection
35. lectrodes Recommendations 36 Environmental Protection 37 Cleaning of the Electrodes Maintenance 38 Warranty and Technical Assistance 21 Sales Points 40 Warranty Term 41 Trouble spotting 43 Accessories and Technical Characteristics 44 Electromagnetic Compatibility 47 Free Technical Assistance Contract 53 ATTENTION RISK OF ELECTRIC SHOCK DO NOT OPEN The lightning bolt symbol inside a triangle is a warning about the presence of dangerous voltage without insulation in the internal part of the equipment which may be strong enough to cause risk of electrical shock An exclamation mark inside a triangle alerts the user about the existence of important operation and maintenance instructions technical service for this equipment ATTENTION To prevent electrical shock do not use the equipment plug attached to an extension cable or to any other type of plug except that the terminals fit perfectly in the receptacle Disconnect the input plug from socket when not using the equip
36. lectromagnetic interference we suggest you to use an electric network line for NEUROVECTOR V 2 0 and a separate group for short wave or microwave equipment We also suggest that the patient o NEUROVECTOR V 2 0 and the connection cables are placed at least at a distance of 3 meters away from the shortwave or microwave therapy equipment Mobile or portable radio frequency communication equipment may produce interference and affect the performance of Neurovector V 2 0 Always install this equipment according to the guidelines described in this manual of instructions Attention The Neurovector V 2 0 complies with all the technical norms of electromagnetic compatibility if the cables electrodes and other accessories supplied by IBRAMED and described in this manual are used chapter Accessories and technical characteristics The use of cables electrodes and other accessories from other manufacturers and or different from those specified in this manual are used as well as the substitution of internal components of Neurovector V 2 0 this can result in increase of emissions or decrease in the equipment immunity The Neurovector V 2 0 must not be used adjacently or stacked on top of other pieces of equipment Directions and Manufacturer s Statement electromagnetic emissions The Neurovector V 2 0 is destined for use in the electromagnetic environment specified below The user of the equipment must ensure that it is used in such an environment
37. ll count from the first purchase date by the consumer even when the product is transferred to a third party The replacement of parts and the cost in repairs of malfunctions originated from manufacturing will be comprehended in the warranty 3 The warranty procedures will be exclusively made by IBRAMED sales points by IBRAMED itself or by other parties specifically designated by IBRAMED 4 WARRANTY DOES NOT COMPREHEND DAMAGES WHICH COULD OCCUR TO THE EQUIPMENT IN CASE The equipment is not used exclusively for medical purposes The specifications and recommendations in the user s manual are not observed in the installation and use of the equipment Accidents or natural hazards connection to electrical system with inappropriate voltage and or excessive fluctuation or overcharge overvoltage occur The equipment is not handled properly is not taken proper care of or suffers alterations or repairs made by not certified people or companies There is removal or adulteration of serial number of the equipment Any accident in transportation occurs 42 5 Legal warranty does not cover expenses with installation of product installation of software installation of microcomputer transport of product to the factory or sales point labor cost materials parts and adaptations necessary to the preparation of the premises where the equipment will be used such as electric wiring computer technician expertise masonry hydraulic
38. ll other applications use a frequency of 4KHz 4 000Hz or 8KHz 8 000Hz NEUROVECTOR V 2 0 Tetrapolar Interferential Mode AMF and Sweep A AMF equal to bipolar mode Possibility of selecting Tetrapolar interferential modes Normal Standard Manual Vector disbalance channel or Automatic Vector automatic vector See page 14 15 of this manual Notes Remember that to execute Tetrapolar mode with Manual Vector the channels must be unbalanced different current intensities It is the different current intensity that rotates the vector In interferential current therapy the bipolar mode is preferred because in this case the modulation depth is always 100 In tetrapolar mode the modulation depth can vary between 10046 to 45 In interferential therapy modulation depth of 100 is very important because it guarantees an optimum stimulation effect In practice it is easier and faster to place two electrodes than four For these reasons the bipolar method is preferred The tetrapolar method is used for large areas The vector technique produces a stimulation effect inside a large area If the location of the problem is clear the manual vector method is preferred Thus the unbalance of channels is used to achieve a modulation depth of 10096 in the area in question Not having a specific location the method used should be automatic vector which will pass through the area in question 34 Reminders 1 The
39. ment for a long period of time General Care of the Equipment The NEUROVECTOR V 2 0 does not need special installation measures or care We suggest that you Avoid places subject to vibrations Install the equipment on a firm and horizontal surface in a site with perfect ventilation In case of a built in cabinet verify that there is no block for free circulation of air in the rear part of the instrument Do not lay it on carpets rugs cushions or other soft surfaces that can obstruct the ventilation Avoid humid hot and dusty places Place the cable in order to leave it free out of places where it can be trodden on and do not place any furniture over it Do not insert objects into equipment orifices and do not place recipients with liquid on it 4 Do not use volatile substances benzene alcohol thinner and solvents in general to wipe the equipment cabinet because they can damage the finishing Use only a soft dry and clean piece of cloth Explanation of the Symbols Used ATTENTION Check and follow the instructions in this manual Equipment CLASS IL The protection against electric shock is not based only in the basic insulation but also incorporates additional safety precautions such as double or reinforced insulation not holding grounding resources protection or depending on installation conditions Equipment with BF type applied part AN Risk of electrical shock IPX0 Equip
40. ment not protected against harmful water dripping Ate Indicates electrostatic discharge sensibility lt P Indicates the start of the action START Q Indicates the end of the action STOP Q Indicates Off without electrical power supply Indicates On with electrical power supply V Volts in Alternate Current line Alternate current power line In the Transportation Box FRAGILE The content in this package is fragile and should be handled with care THIS SIDE UP Indicates the correct position to ship the package KEEP IT AWAY FROM THE RAIN This package should not be shipped under rain E 0 C TEMPERATURE LIMITS Indicates the limit 5 C temperatures for transportation and storage the package 3 MAXIMUM STACKING NUMBER The maximum number of identical packages which can be stacked For El this equipment the limit stacking number is 5 units Preliminary Observations The NEUROVECTOR V 2 0 is an electrical stimulator use in therapies for interferential medium frequency currents This technique is noninvasive without systemic effects it does not cause dependency and it does not have undesirable side effects As for the type and degree of protection against electrical shock the NEUROVECTOR V 2 0 corresponds to a BF applied part CLASS II of safety and protection It must only be operated by qualified professionals and in duly accredited medical departments The use of these
41. mmercial t kV in the input t kV in the input establishment IEC 61000 4 4 output lines output lines 1 kV differential 1 kV differential The quality of the power supply should mode mode be equivalent to the one of a hospital or a typically commercial 2 kV regular mode 2 kV regular mode establishment Surges TEC 61000 4 5 aT eae ee Level of Assay Level Electromagnetic Environment dne IEC 60601 of Conformity directions 590 U gt 95 of tension fall in U per 0 5 cycle 596 U gt 95 of tension fall in U per 0 5 cycle 40 U 60 of tension fall in U per 5 cycles 40 U Tension falls short 60 of tension fall in U interruptions and tension variations in the input power lines 10 U 70 U IEC 61000 4 11 30 of tension fall in U per 5 cycles 30 of tension fall in U per 25 cycles per 25 cycles lt 5 U gt 95 of tension fall in U per 5 seconds lt 5p U gt 95 of tension fall in U per 5 seconds Magnetic Field in the frequency of Power feed 50 60 Hz TEC 61000 4 8 NOTE U is the c a power feed tension before the application of the assay level The quality of the power supply should be equivalent to the one of a hospital or a typically commercial establishment If the user of the equipment requires continuous operation during energy interruption it is recommended that the equipment should be fed by a source of uninterrupted power sup
42. mple An AMF basic treatment frequency of 20 Hz is selected and an extension this means Sweep A AMF of 50 Hz is required The current released to the patient starts with an AMF treatment frequency of 20 Hz and with an extension of 50 Hz passing successively through the other frequencies until a frequency of 70 Hz is reached then gradually decreasing until 20 Hz This process is repeated automatically The SWEEP mode is widely used for avoiding adaptation A large extension will prevent adaptation more efficiently than a close extension Using a large extension of frequency notable sensations and or contractions occur Selection of AMF or Treatment Frequency The selection of AMF depends on the nature stage severity and location of the problem The sensations experienced by patients in different AMF should be considered Higher frequencies are perceived as pleasant and lighter Higher AMF 75 Hz to 200 Hz are recommended for acute high pain or hypersensitivity problems When the patient demonstrates a certain fear to electrostimulation a high AMF should be used at the start of the treatment In low frequencies the sensation is more rough and heavy Frequencies between 25 Hz to 50 Hz tend to produce contractions tetanic In muscle contractions chronic or sub acute problems a low AMF is more appropriate Low frequencies of 50 Hz produce pulsed and fibrillated contractions 17 18 NEUROVECTOR V 2 0 VIS O FRONTAL
43. nce there is no practical way to measure the interferential effect area the professional must rely on the report of the patient regarding the area and stimulation extent It is relatively easy to find the effect when the four electrodes are close to each other but this serves as a superficial comparison of the treatment There are mathematical methods to describe the effect of interference and its distribution but their use is clinically limited because of certain situations encountered by the patient 13 DYNAMIC INTERFERENTIAL FIELD tetrapolar with manual or automatic vector The described Static Interferential Field represents the tetrapolar normal or standard mode or application standards of interferential currents Over the years this basic process underwent interesting developments The most significant was the so called Manual Vector and Automatic Vector This Manual or Automatic Vector mode is nothing more than the flow of current produced increases the two circuits channels together in a vectorial manner A better technical description would be the concept of de rotational or dynamic vector system The concept of dynamic vector system is basically simple this means it involves the rotation of the Static Interferential Field of zero to approximately 45 degrees and back to zero again The field influence area in the tissue becomes more extensive than in the Static Interferential Field This mov
44. ovector V 2 0 is located the protection fuses To replace them turn the equipment off unplug it from the power outlet and with a small screwdriver take the protective lid off disconnect the fuse perform the replacement and put the lid back to its original place Install the correct fuses Use a fuse for 5 0A nominal current 250V operation voltage and fap action 20AG model 50A rupture current SECURITY RISKS MIGHT OCCUR IF THE EQUIPMENT IS NOT PROPERLY INSTALLED NOTE There are dangerous voltages inside them Never open the equipment Resistance of the Skin As itis already known our biological systems respond to low frequencies this means within an approximate range of 0 1Hz to 200Hz This is called the biological reach range Therefore the current stimulators work within this range However the human skin offers high resistance to the passage of these low frequency currents and with a relatively long duration of the pulse Since the resistance of the skin is high a higher voltage shall be applied to the skin to get the correct and necessary current into the tissues The higher the applied voltage the higher will be the current intensity and the stimulus may become unpleasant to the patient If the resistance of the skin is lowered a lower voltage will be necessary However the skin is a complex biological resistance it is hard to predict the exact value of the resistance in any part of the body The skin acts as a
45. ply or a battery Magnetic fields in the frequency of power supply must be on the same levels characteristic of a hospital environment or a typically commercial establishment 50 51 Directions and Manufacturer s Statement electromagnetic immunity The Neurovector V 2 0 is destined for use in the electromagnetic environment specified below The user of the equipment must ensure that it is used in such an environment 2 Level of Assay Level UT Immunity Assay IEC 60601 of Conformity Electromagnetic Environment directions RF Communication equipment portable or mobile must not be used next to any part of NEUROVECTOR 2 0 including cables with a separation distance of less than the recommended calculated from the equation applicable to the frequency of the transmitter Separation distance recommended d2124 P RF Conducted 3 Vrms IEC 61000 4 6 150 kHz to 80 MHz d 0 35 VP 80 MHz up to 800 MHz d 0 7 4 P 800 MHz up to 2 5 GHz RF Radiated 10 V m A P ii the ee ue spear potency of ee in watts according to the manufacturer of the equipment an is the separation IEC 61000 4 3 80 MHz to 2 5 GHz distance nme in meters m d i It is also recommended that the Field intensity established by the RF transmitter as determined by an electromagnetic inspection at the site should be lower than the conformity in each frequency band Interference around the equipment marked with the following symbol might occur 2 NOTE 1 In
46. reas Meanwhile the shaded areas in the figure are applied only for homogenous tissue 12 In the majority of clinical situations the tissues of the patient are not homogenous and the area represented in the figure will probably be modified The field seen in figure 2 is known as the Static Interferential Field At this point it is important to make some considerations regarding the application of the electrodes in interferential therapy An effective treatment only occurs when the patient perceives a dominant sensation concentrated in the area where the problem is found In other words the patient will feel a significant pricking sensation around and in the area where the problem is found An adjustment in the position of the electrodes on the skin is important to achieve the best results One of the reasons found for the results not to be satisfactory in interferential therapy is the inadequate position of the electrodes The patient should experience a pleasant prickling sensation as soft as a needle prick It is possible for the patient to experience a sensation under the electrode but must also always feel the possible prickling sensation in the are where the problem is located The leaf shaped model shown in figure 2 represented the so called Static Interferential Field and is commonly used to describe the area of interferential effect However there are other aspects in the shape and distribution of this field Si
47. rease and increase only channel 2 you will be rotating the vector In the Neurovector V 2 0 you can also select the automatic vector stimulation mode where the equipment will complete the rotation of the vector automatically Remember that the manual vector or automatic vector techniques are valid only in normal Tetrapolar Interferential mode PRE MODULATION INTERFERENTIAL CURRENTS bipolar It is possible to emit interferential currents to the patient using two electrodes instead of the conventional four In this system the two currents are combined inside the equipment and transmitted to the patient through two electrodes There is a significant different between this technique and tetrapolar normal mode which uses four electrodes In conventional mode tetrapolar normal the interferential current is produced endogenously inside deeply in the patient In bipolar mode pre modulated the interferential current is applied through two electrodes to the skin of the patient It is unlikely that there is a clinical difference between the two methods other than the obvious ease of application in pre modulation mode For many situations the pre modulated mode is mostly selected for example in muscle stimulation The equipment that have the Bipolar mode pre modulated normally require the use of only two channels The terms two poles or bipolar can be misleading because this can imply two different poles As
48. rotocols These are 1 Muscular lesion acute phase Carrier 4000Hz AMF 5Hz and AAMF 20Hz Sweep A 6 6 Tetrapolar technique Stimulation Intensity Sensorial intensity Time 20 minutes Mechanism activated for pain modulation release of endogenous opioids 2 Muscular lesion sub acute and regenorative phase Carrier 4000Hz AMF 50Hz and AAMF 100Hz Sweep J 5 1 Tetrapolar technique Stimulation Intensity Sensorial intensity Time duration of associated technique This therapeutic protocol involving interferential therapy should be used together with cinesiotherapeutic techniques such as extending transversal massage stretching or manual therapeutic techniques Mechanism activated for pain modulation pain tolerance 3 Delayed muscle pain post physical activity Carrier 4000Hz AMF 10Hz and AAMF 20Hz Sweep s 1 1 Tetrapolar technique Stimulation Intensity Sensorial intensity Time 20 minutes Mechanism activated for pain modulation release of endogenous opioids 29 4 Increase of cutaneous blood flow Carrier 4000Hz AMF 10Hz and AAMF 10Hz Sweep A 6 6 Tetrapolar technique the electrodes must be fixed on the skin near to the ganglia nervous of the sympathetic nervous system preferably parallel to the vertebral column Stimulation Intensity Sensorial intensity Time 12 minutes Mechanism activated for the increase of blood flow reduction of sympathetic tone on the wall of the peripheral vas
49. s program is recommended for chronic and sub acute problems Example If a basic AMF of 20 Hz and an extension sweep of 50 Hz is selected using this program the AMF remains for one second at 20 Hz switches abruptly to 70 Hz remains for one second at 70 Hz switches abruptly at 20 Hz and starts a new cycle The AMF remains at a basic frequency for five f seconds passing through all the other frequencies inside the selected extension in one second until reaching a higher frequency in which it remains for 5 seconds This is repeated automatically This method of treatment has softer characteristics and more tolerated by patients with acute disorders 32 Example If a basic AMF of 20 Hz and an extension of 50 Hz is selected then using this program the AMF remains for five seconds at 20 Hz passes through all the frequencies within the selected extension 21 to 69 Hz in one second until reaching the frequency of 70 Hz remains for five seconds at 70 Hz goes back through all the frequencies again 21 to 69 Hz in one second until reaching 20 Hz again and starts a new cycle The AMF is never stationary as in other programs It is continually varied this means in the first six seconds it increases through all the frequencies inside the selected extension until reaching the highest frequency and decreases immediately in the next six seconds This is repeated automatically Of the three types of programs this is the most pleas
50. sappears and the liquid crystal screen will indicate the information regarding the intensity of the current SWEEP MODE SWEEP FREQ mobo oo WR Now press the UP or DOWN keys of the channel that is being used to select the current intensity necessary for the treatment At the end of the programmed time the emission of current will be interrupted and a sound alarm will indicate the end of the treatment Press the STOP key to stop the alarm Now the equipment can be disconnected or will be ready to repeat the programming or perform a new programming Example 2 Let us now suppose that clinical practice or existing literature suggests certain pathology for TP Tetrapolar interferential mode with Sweep sweeping mode with frequency Sb range of Sweep A AMF 30 Hz and AMF 40Hz We use a carrying Carrier frequency 8 KHz modulation frequency 40 Hz normal stimulation mode and treatment time 10 minutes Connect the equipment and the default programming described on page 21 will be executed Note the cursor flickering on the MODE field TP 4 Off Normal STIM MODE OY min 27 1 Always using the BACK NEXT and SET SET keys select the parameters necessary for the treatment Thus the liquid crystal screen will indicate SWEEP Md SWEEP Ee Es em TP 8 Normal miss o a Note In the SWEEP MODE field note the small arrow that indicates which program is selected FLAA Very well the programm
51. tense use When cracks appear the electrode must be changed immediately Environmental Protection IBRAMED declares that there are no risks or special techniques associated with the elimination of this equipment and accessories at the end of their useful lives 38 CLEANING OF THE ELECTRODES After using the electrodes clean them with tap water Always clean the electrodes before storage MAINTENANCE We suggest that the user inspects the e JA equipment and performs preventive maintenance at IBRAMED or at the authorized technical locations each 12 S months the equipment is used As E P e manufacturers IBRAMED is deemed Y responsible for technical or safety characteristics of the product only in cases when the unit has been used in accordance with the instructions contained in the user s manual and where maintenance repairs or modifications have been made by the manufacturer or by expressly authorized agents and where the components which can cause safety risks and also where components for the proper functioning of the equipment have been substituted in case of repairs with original substitution parts If requested IBRAMED will be able to provide technical documentation circuit layout list of parts and components etc necessary for eventual equipment repairs However this does not imply a repair authorization We do not assume any responsibility for repairing performed without our express written authoriza
52. tion 39 WARRANTY IBRAMED Ind stria Brasileira de Equipamentos M dicos LTDA herein identified to the consumer at the address and telephone number Rua Mil o 50 Amparo SP telephone number 55 19 38179633 guarantees this product for the period of eighteen 18 months observed the conditions of the warranty terms attached to the documentation of this equipment What stupid equipment TECHNICAL ASSISTANCE c c Do not wait until you get to this point Call 19 3817 9633 Please contact our technical department 40 SALE POINTS STATE CITY COMPANY PHONE Cear Fortaleza Escossia e Pita 85 265 1331 Mato Grosso C Grande S Fisio 67 383 0013 Minas Gerais BH FisioTecnica 31 3241 2978 Paran Cascav l ISP 0800 455639 Paran Curitiba ISP 0800 6433808 Rio de Janeiro R Janeiro HB Fisioterapia Ltda 21 2295 6811 Rio Grande Sul Port Alegre ProFisiomed Ltda 51 3217 4439 S o Paulo Piracicaba Beatriz B M Ltda 19 3422 1066 S o Paulo Santos Presmam Ltda 13 3234 7666 S o Paulo S o Paulo Carci Ind Com Ltda 11 33462100 S o Paulo Ara atuba Med Ata 18 624 1954 S o Paulo Amparo IBRAMED 19 3807 9633 41 Warranty Term 1 Your IBRAMED product is certified against manufacture defects 1f considered the established conditions in this manual for 18 following months 2 The period of warranty wi
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