Winner - Rich-Mar Corporation
Contents
1. 24 25 Winner Specifications amp Accessories 1 25 Ultrasound Technical Information ee 26 Appendix A Ultrasound Technical Information Service M anual available on our w ebsite W richmarw eb com LIMITED WARRANTY This equipment is sold under an exclusive one year warranty from date of sale which warrants it to be free from defects in material and workmanship We agree to repair or replace at the point of manufacture without charge all parts showing such defects provided the unit is delivered to us prepaid to our factory intact for our examination within one year from date of sale and provided such examination discloses in our final judgement that it is defective This warranty does not apply if the equipment has been subject to misuse neglect accidents incorrect wiring not our own improper installation or put to use in violation of instructions furnished by us has been damaged by excess voltage or has been repaired or altered outside our factory or if the equipment has had its serial number altered or removed Changes Rich M ar reserves the right to modify or change the equipment in whole or in part at any time prior to delivery in order to include refinements deemed appropriate by the Company but without incurring any liability to modify or change equipment previously delivered or to supply new equi2. 2AD Pure OLD e oe Ao dGZIND GAND HVI HOIH 03 19 oc 02 01 m 17 oam mmm coo m m 01201 08 01 NE 39uns Ee jns Wey puisse A Si 44d OL ZIND 3 OT ZIND SPPQU PUMA 02701 m m 0105 06701 m 1 05 0 m YVA HOId earn ALISMALNI MN ued dvis YLS AUM 1902 09 a3ouna TWHHON 3914044 Ade i SLI si UVW HOld 03 13 tcm 0201 179 am OLCLEN 05 0 mw 514049 jde 2v uas EN M cis SM is a built in ramp up time of three seconds in the on time and ramp down of one second in the off time Co Contraction M odeis the same as the Surge mode except that it will concurrently run tw o channels either 1 and 2 or 3 and 4 to the same on and off time Independent intensity levels can be set Alternating Channel M ode will alternately turn one channel on and then a second channel on as soon as the first channel goes into the off time For example in an Alt mode both Ch 1 and Ch 2 will be used If the 10 10 option is selected in the Time On Off then after intensity levels have bee
3. 5 Electrical stimulation should not be used in electrically Sensitive areas 6 Electrical muscle stimulation EMS should not be used over Swollen infected or inflamed areas of skin eruptions e g phlebitis thrombo phlebitis varicose veins 7 Caution should be used in the transthoracic application of electrical muscle stimulation EM S in that the introduction of electrical current into the heart may cause arrythmias 8 Electrical muscle stimulation EMS devices should be kept out of the reach of children 9 Safety has not been established for use of electrical stimula tion during pregnancy 10 This device should be used only under the continued Supervision of a physician 11 Transcutaneous Electrical Nerve Stimulation TENS is a symptomatic treatment and as such suppresses the sensation of pain which would otherwise serve as a protective mechanism Precautions Precautions should be taken when using a Rich M ar muscle stimulator the presence of one or more of the follow ing conditions 1 When there is a tendency to hemorrhage follow ing acute trauma or fracture 2 Follow ing recent surgical procedures w hen muscle contrac tions may disrupt the healing process 3 Over the menstruating uterus 4 When sensory damage is present by a loss of normal skin sensation 5 When using this device at current outputs above 40mA extra caution should be observed to avoid burns by using an adequate conductive medium a
4. Checking lead cords on a routine basis and replacing them annually will ensure your patient s comfort safety and the effectiveness of the treatment Patient Electrode Connection Plug shielded ends of lead cord into the output jacks on the device red end into red jack and white end into white jack for each channel Rich Mar Muscle Stimulator Indications for Treatment All Winner Models For Hi Volt onophasic and Russian Waveforms Rich M stimulation devices are indicated for the following conditions 1 Relaxation of muscle spasms 2 Prevention or retardation of disuse atrophy 3 Increasing local blood circulation 4 Muscle re education 5 Maintaining or increasing range of motion 6 Immediate post surgical stimulation of calf muscles to prevent venous thrombosis If the device has Quadpolar Interferential or Bipolar Interferential output capabilities they are also indicated for the following conditions 7 Symptomatic relief of chronic intractable pain 8 Management of pain associated with post traumatic or post operative conditions Rich Mar Microamperage Pulsed Current Indications for Treatment All Winner Models For Quadpolar IFC Pre Mod IFC and Microcurrent Rich M stimulators that have microcurrent output are indicated for the follow ing conditions 1 Symptomatic relief of chronic intractable pain 2 Management of pain associated with post traumatic or post operative conditions Ult
5. Duty Cycle Pulsed outputs can be selected from 1096 2096 or 5096 or 10076 Treatment Time Select the desired treatment time betw een 1 and 99 minutes To Adjust Ultrasound Parameters During Treatment You can adjust Treatment Time Intensity Transducer Duty Cycle and Frequency at any time during the treatment by using the appropriate control To Pause An Ultrasound Treatment Once an ultrasound treatment is running pause it by pressing the Pause Resume button The time will stop flashing the Ultrasound Active light will go out and the Intensity will start flashing indicating a paused treatment To resume treatment press the Pause Resume button 13 CAUTION Do not operate the soundhead in an unloaded condition without Aloe Sound coupling Lotion Gel and patient contact This can cause the transducer to get very hot and may cause unrepairable damage NOTE When administering an ultrasound treatment be sure that the treatment area of the patient has an ample quantity of Rich M ar Aloe S ound Lotion or Gel Plus as a coupling medium The quantity and quality of the coupling medium used has a direct bearing on the amount of ultrasonic energy transmitted to the treatment area Combo Models Only The Winner CM4 and CM2 units allows the user to combine a stim treatment with an ultrasound treatment by emitting Stimulation and ultrasound through the soundhead at the same time Quick and easy self jacking can be accom
6. Intensities for each of these setting will be divided by the transducer s Effective Radiating Area ERA Spatial Average Temporal Average ERA Example 5 Watts 35 Duty 5cm Transducer Spatial Average 1 75 Watts bcm 0 35 Watts cm The pulse width On time of all Rich Mar therapeutic ultrasound devices is 2 5 milliseconds mS The time between pulses Off time in milliseconds is calculated as follows Pulse width On time 2 5mS Off time 2 5 2 5 Duty cycle 06Duty cycle Where Duty cycle is represented as a decimal Please see the following example for computing the Off time for a 10 Duty cycle timez 2 5 2 5 0 10 0 10 2 22 5 milliseconds Additional Technical Notes The peak power is the same in the pulsed modes as in the 100 modulated mode Unless otherwise stated all technical parameters are accurate within 20 When in the pulse modes the unit is still generating therapeu tic heat although it is an amount reduced by a factor directly related to the duty cycle The pulse rates are used to allow the practitioner to treat areas of bony prominences without creating periosteal pain The line leakage 15 tested in both the forward and reverse polarities to be less than 50 microamperes exceeding all standards for medical devices in this class The device is designed to meet or exceed UL Standards 544 for medical devices and the Canadian Standards Association CSA No 125 28
7. View Adjust button Stimulation Treatment Time Treatment time for the Winner stimulation is adjustable from 1 99 minutes You can adjust treatment time in one minute increments at any time by pressing the increase or decrease buttons below the treatment time during the displayed treatment Setting Waveform Defaults and Therapy Profiles Waveform Defaults To set particular parameters so that they are defaults for a Waveform button select the Waveform and set all the parameters as desired Treatment time Mode Time On Off if applicable and Pulse Rate Once all parameters are selected set the Intensity and PRESS AND HOLD THE START ACCEPT BUTTON UNTIL YOU HEAR TWO CLICKS AND A LONG TRILL When this occurs it has stored those displayed param eters as the default for that waveform Repeat this process for each waveform For example if you wanted to change the Pre M od defaults to a Surge treatment Press the PreM od IFC button Select the Surge M ode Select the 10 10 Timing Cycle Press the Pulse Rate View Adjust and set a 65 Hz pulse rate and press the Pulse Rate View Adjust again Set the Treatment Time for 8 minutes Turn the dial to set the intensity and PRESS AND HOLD THE START BUTTON UNTIL YOU HEAR TWO CLICKS ANDA LONG TRILL Now whenever you press the PreM od IFC button it will come up with the above treatment Therapy Profiles The Winner devices will allow you to use either the Easy Therapy P
8. dam age to the unit Winner CM Specifications Dimensions Clinical devices 19 W x 10 D x 4 H Portable devices 17 W x 10 D x 8 H Weight CM4 models 13 105 CM2 models12 Ibs models 20105 CM2P models 18 Ibs Power Input 115 VAC 60 Hz or 230 VAC 50 Hz Power Consumption 110 Watts Fuse 1 Amp Line Leakage Less than 50 mA Winner ST Specifications Dimensions Clinical devices 19 W x 10 D x 4 H Portable devices 17 W x 10 D x 8 H Weight ST4 10 105 ST2 10lbs ST4P 17 Ibs ST2P 16 Ibs Power Input 115 VAC 60Hz or 230 VAC 50 Hz Pow er Consumption 110 Watts Fuse 1 Amp Line Leakage Less than 50 mA Winner Accessories The accessories that come standard with the Winner units as Well as the optional accessories available for the unit are listed below Their part numbers are included for easy reordering Standard Accessory Package for all Winner units White pin lead cord LC1718A Red pin lead cord LC1719A 1 package of one of the follow ing MultiStim self adhesive electrodes 1 75 x 1 75 PD1081 1 75 x 3 75 PD1083 CM models only 1 Aloe Sound Lotion bottle 160z L01903 or 1 Aloe Sound Gel bottle 807 Optional Accessory Package 4 4 round carbon electrodes PD1042 4 4 round sponges for PD1042 PD1054 4 2 x 30 Velcro straps 52105 Other Accessories BlueStim self adhesive electrodes 1 75 x 1 75 PD1031 1 75 x 3 75 PD1033 SuperStim self adhesive elect
9. een 5000 and 5200Hz sine waves and channel two Channels one and two operate in concert to treat one site The user may select a fixed beat or pulse rate betw een zero and 200 The user may also select a scan setting which scans between a low beat and a high beat setting Quadpolar Interferential Parameters Carrier Frequency 5000Hz Beat Frequency Fixed 0 200Hz Beat Frequency Scan Low 2 to 200Hz Beat Frequency Scan High 0Hz to 200Hz Vector Options On or Off Alternating Rate Not Available Surge Rates On Not Available Off Not Available Ramp On Fixed 3 Seconds Ramp Off Fixed 1 Second Quadpolar Interferential The Total Output Current 50mA rms The meter shown on the display of the Winner units is listed as rms current To convert rms to peak current multiply rms by 1 414 Examples are given below 20 Meter Reading ms Peak Current Meter Reading ms Peak Current Milliamps mA Conversion mA Milliamps mA Conversion mA 5 7 1 5 11 7 10 14 1 10 23 4 15 21 2 15 35 1 20 28 2 20 46 8 25 35 4 25 58 5 30 42 4 30 70 1 35 49 5 40 56 6 45 63 6 50 70 7 Hi Volt Monophasic Pre Mod IFC Interferential The Winner stimulators also have the capability to produce a Hi Pre M od IFC Interferential operates with a carrier frequency but Symmetric Square Wave M onophasic stimulation having two it is premodulated within the Winner stimulators This enables a equal positive phases per pulse T
10. less than five minutes to within 10 of the preset duration of emission for settings from five to ten minutes and to within one minute of the preset duration of emission for settings greater than ten minutes Ratio of Temporal Peak to Temporal Average Rtpa The ratios of temporal peak to temporal average intensities Rtpa will vary with the pulse rate of the device Depending upon the Rich Mar model of therapeutic ultrasound in use the duty cycle can be chosen between 5 and 95 duty The Rtpa is calculated in the following manner Rtpa 1 Duty 1 Example 5 duty 05 min duty max Rtpa Rtpa 1 05 1 Rtpa 20 1 Example 95 duty 95 max pulsed duty min Rtpa Rtpa 1 95 1 Rtpa 1 05 1 See the following chart for Duty cycle to Rtpa comparison Duty Cycle Rtpa Indicated on front panel of device 5 20 1 10 10 1 15 3 1 20 5 1 25 4 1 30 2321 35 2 86 1 40 25 1 45 2 22 1 50 2 1 55 1 82 1 60 1 66 1 65 1 54 1 10 1431 75 1 333 80 1 253 85 1 18 1 90 111 95 1 05 1 The Rtpa tolerance does not exceed 20 The temporal maximum intensity for each duty cycle as well as the 100 modulation is whatever is indicated on the meter The temporal average intensity for each duty cycle will be the meter indication multiplied by the percentage duty cycle Temporal Average Duty x Meter Indication Example 5 Watts 35 Duty Temporal Average 35 x 5 Watts 1 75 Watts The Spatial Average
11. usa trn eee 5 Stimulation Waveforms and 6 CM4 Models Panel lllustration eee 1 CM2 Models Panel Illustration 8 514 Models Panel Illustration 9 ST2 Models Panel 10 Stimulations Waveform Defaults amp Therapy Profiles 11 Sort Tester iaar 12 Ultrasound Operation CM Models 17 Combination Operation CM Models only enn 14 Electrode Site Preparation amp Guidelines 15 Patient Electrode 16 Stimulation Indications for 17 Microcurrent Indications for 17 Ultrasound Indications for 17 Stimulation Contraindications amp 5 18 Microcurrent Contraindications amp Warnings 18 Ultrasound Contraindications amp Warnings 19 Waveform 20 Ultrasound Calibration amp Tuning Procedures Models 23 Cleaning 1 24 Converting between 230 VAC and 115
12. with completely 5 different treatment parameters To start concurrent stim treatment press the desired waveform or Therapy Profile or channel for the second treatment If you pressed the Waveform or Profile button the green Selected LED light in the Ch 2 button Should now be illuminated If you pressed a channel button than that channel s Selected LED should be illuminated You will also notice that the green Selected LED light on Ch 1 went out but its green Active LED light is still illuminated This means that there is a treatment currently on Ch 1 but its parameters are not selected for display If you pressed the waveform or Profile button the treatment parameters Ch 2 are now displayed If you pressed a channel button you now need to select the waveform or Profile you want to use and its parameters will be displayed Any adjustments can now be made to the parameters for this second treatment Then set Intensity and press the Start Accept button to begin the treatment time countdown NOTE If the Quadpolar IFC therapy waveform is selected it requires both channels one and two or channels three and four and will subsequently set the same intensity level on both channels Once the intensity levels are set in Quadpolar IFC and the Start Accept button has been pressed you have the option of Balancing the output by pressing the Balance button When pressed the green LED light on the Balance button will illuminate and the green Adjus
13. Profile A or D The LED for that Profile should illuminate along with the waveform and parameters of the treatment Simply set the intensity level and press start to begin the treatment Advanced Therapy Profile Mode Set up To set a Profile in the Advanced mode you must first press the waveform and then press the desired Profile A B C or D For example press Quadpolar then profile A You will see that there is a treatment default already programmed To change the treatment simply select the parameters you want for that waveform profile set intensity and PRESS AND HOLD THE START ACCEPT BUTTON UNTIL YOU HEAR TWO CLICKS AND A LONG TRILL This indicates that the treatment is saved as a profile for that waveform You may want to name and note the treatment on the included waveform specific Profile Reference card Use the Advanced M ode Profile Reference cards In this case it would be the Quad Pre M od card There are also cards for Russian Hi Volt and M icro Support Advanced Therapy Profile Use Once you have set your Advanced Profiles simply press the desired waveform and then the desired Profile A B C or D The LED for that Profile should illuminate along w ith the waveform and parameters of the treatment Simply set the intensity level and press start to begin the treatment Lead Cord Tester The Winners have a set of lead jacks on the left side of the unit Plug in your lead cord and touch the tips together You shou
14. Rich M ar recommends that the self adhesive electrode NOT be used for more than 20 consecutive treatments Carbon Electrode Maintenance Rich Mar Corporation recommends that your carbon electrodes be replaced annually Electrode Types and Sizes Rich M ar Corporation recommends the use of our self adhesive electrodes with this device Either the BlueStim SuperStim or MultiStim self adhesive will provide the proper conductive properties The Blue Stim electrodes come in sizes of 1 75 x 1 75 or 3 75 x 3 75 The sizes of the Super Stim electrodes are 1 75 x 1 75 3 75 x 3 75 and a 2 diameter round electrode MultiStim sizes are 1 75 x1 75 and 1 75 x3 75 Patient Lead Cord Maintenance Rich M ar Corporation recommends that your patient lead cords be replaced annually Please note that your patient lead cords bear a label with a space provided to w rite in the date that the lead cord w as put into service Date in Service There is also a space to write in the replacement due date Replace By which will be one year from the date the lead cord was put into service Please take the time to write in these dates with a permanent marker This will serve as a convenient reminder of the age of your lead cords Some Rich Mar muscle stimulators are equipped with a feature that allows you to check lead cord continuity If your device is equipped with this feature it is recommended that the lead cords be checked at least monthly
15. Winner BY RICH MAR Winner Operation and Service Manual For the Following Models CM4 4 CM4 5 CM4 5P 4 10 4 10 CM2 CM2P 2 5 CM2 5P CM2 10 CM2 10P ST4 4 ST2 ST2P rar n 7 e Ei MAKING WAVES IN THERAPY Part MN 2448 Rev Batch 001 600 762 4665 918 543 2222 CAUTION The operator should read and be familiar with the precautions and operation of this device prior to beginning treat ments This device is not designed to be connected with any electrical equipment or accessories unless manufactured and or approved by Rich Mar This includes whirpools lead cords probes self adhesive electrodes and carbon electrodes NOT manufactured by Rich M ar WARNING Federal law restricts this device to sale by or on the order of a pyhsician or any other practitioner licensed by the law of the state in which said person practices For continued protection against fire hazard replace fuses ONLY with those of the same type and rating This equipment should always be grounded Grounding reliability can only be achieved when the equipment is con nected to an equivalent marked Hospital Grade This device should be kept out of the reach of children TABLE OF CONTENTS Winner 4 etel ve ati p uit 5 Winner Operationen n git fp be und 5 5 Stimulation Operations
16. a 1 amp 3 MHz 5cm2 soundhead CM 4 10 CM 4 10P CM2 10 and CM 2 10P provide 10 2 1 MHz soundhead Stimulation Once the device is turned on you will notice that the green LED lights in the Waveforms Quadpolar IFC Pre M od IFC Russian Hi Volt and Micro and the Therapy Profiles are blinking This is to indicate that the unit is on and ready for treatment It is also a quick reference to determine if the device is in the Easy Therapy Profile mode or Advanced Therapy Profile mode see Therapy Profile section for more information NEW Feature If no treatments are running and no buttons are pressed the device will go into a sleep mode where the LEDs will not blink on the stimulator side Simply press any button to re activate the stimulator To Start a Stim Treatment Press the button of the desired Waveform or Therapy Profile Once you do this you will notice that the device has selected the first available channel s For example if you turn on the device and press the Pre M od IFC button the green LED next to Selected in the Ch 1 button will illuminate This indicates that the treatment will output from Ch 1 and you should use that lead cord to apply the electrodes Or NEW Feature You can now select the CHANNEL you want to use by first pressing that channel s button You will then notice that the Waveform Profile LEDs are blinking You then select the waveform or profile you w ould like to use by pressing it s b
17. aindications of the desired waveform For most patients the Micro amperage current will be sub sensory However if stimulation sensation is perceived be sure it is set at a level that is comfortable for the patient On all other muscle stimulation and interferential current therapies be sure that the intensity is set to a comfortable level DO NOT BRING UP THE INTENSITY UNTIL THE FOLLOWING PROCEDURES HAVE BEEN OBSERVED 2 Clean the area s of the skin to be treated with soap and water or an alcohol wipe 3 Excessive hair may be trimmed but shaving is not recom mended immediately prior to electrode placement 4 Choose the appropriate size electrode s for the body part being treated 5 Be sure that the electrodes are securely attached to the lead wires See the illustration on the follow ing page for the appropri ate patient lead wire connections 6 Avoid placing an electrode over areas of broken skin scars moles or unusual areas of skin discoloration Also avoid skin folds creases or areas of impaired sensation 7 The single patient self adhesive electrodes are well suited for most body areas in which electrical stimulation w ould be used Remove the electrodes from the pouch and save it for subse quent storage of the product Carefully peel the electrodes from the release backing and apply it to the chosen site Press firmly to ensure uniform and secure contact with the skin and begin stimulation treatment Carbon Electrode I
18. articular parameters The large and bright LED numerical displays show treatment time intensity and pulse rates Power Switch This power switch turns the unit on and off and is located on the rear side of the unit I represents the on position and 0 represents the off position Winner Operation Overview Overview The Winner Series offers a variety of different devices to fit your therapy needs The CM4 models CM 4 CM4P CM 4 5 CM4 5P CM 4 10 CM 4 10P are four channel multi therapy stimulation ultrasound combination units The Winner CM 2 models CM2 CM2P CM2 5 CM2 5P CM2 10 CM2 10P are the tw o channel combination version The ST4 and ST4P are the four channel multi w aveform stimulators and the ST2 and ST2P are the two channel versions The Winner units will output any one of the following waveforms Quadpolar IFC Classic Interferential Premod IFC Bipolar Interferential Russian Hi Volt and Microcurrent Depending upon the waveform in use any one of the following treatment modes can also be used Normal output Surge output Co Contraction output and Alternating channel output NOTE For more information on outputs see the Wave forms section The Winner CM4 and CM2 can also provide 1M Hz and 3M Hz ultrasound frequencies via the unique patented Therapy Hammer transducer with a 2cm soundhead on one side and a 5cm soundhead on the other CM4 5 CM 4 5P CM2 5 and CM2 5P provide
19. crease intensity on the selected channel it will do the opposite onthe other channel in the pair Quadpolar IFC also allows you to turn an amplitude modulating Vector on or off The Vector provides a soothing massage effect and also helps to lessen patient accomodation The Pulse Rate available is either the High Low or a Hi Lo combination Pre Mod IFC will output pre modulated tw o pad Interferential Current in any of the desired Modes Normal Surge Co Cont and Alternating The Vector can be turned on or off in the Normal mode The Pulse Rates available in the Normal mode are High Low and Hi Lo scan If the Surge Co Contraction or Alternating mode is selected only the Fixed Pulse Rate is available Any of the six On Off timing options are available in the Surge or Co Cont modes In the Alternating mode the 10 10 or the 5 5 timing cycles are available Russian and Hi Volt Both waveforms are available in any of the Modes Normal Surge Co Cont and Alternating The Fixed Pulse Rate is only available for Russian NEW Feature The Hi Volt Pulse Rates now available in the Normal mode are High Low and Hi Lo scan If the Surge Co Contraction or Alternating mode is selected only the Fixed Pulse Rate is available Any of the six On Off timing options are available in the Surge or Co Cont modes In the Alternating mode the 10 10 or the 5 5 timing cycles are available NOTE The Hi Volt in the Winner is a non dispersiv
20. cro current is a pulsed waveform that produces 50mS phases from 1 1000 pulses per second The phases alternate from positive to negative every 2 7 seconds The amplitude 15 adjustable from zero to 1000mA Micro Current Q S ut Positie 2 7 second Negative 2 7 secands Microcurrent Parameters Carrier Frequency Not Applicable Pulse Rate Fixed 3 1000Hz Phase Duration 50mS Interphase Interval Dependent upon pulse rate Positive Negative Interval 2 7 seconds Alternating Rate Not Applicable Surge Rates Not Applicable Ramp On Not Applicable Ramp Off Not Applicable Russian Total Output Current 50 mA rms Russian is a 2500Hz time modulated waveform having a sinusoidal frequency that is burst modulated at 5096 duty Russian is available in normal surge co Russian TEES i Y y i Russian Parameters Carrier Frequency 2500Hz Beat Frequency Fixed 5 200Hz Pulse Rate 5 200Hz Fixed Surge and Co Cont rates 5 5 5 10 10 10 10 20 10 30 10 50 on off Seconds Alternating Rate 5 5 and 10 10 on off Seconds Vector Options Not Available Ramp On Fixed 3 seconds Ramp Off Fixed 1 seconds 22 Ultrasound Calibration and Tuning Procedure Ultrasound Service Information Rich Mar Corporation recommends that all Rich Mar ultrasonic therapy products be returned to the factory or to a servicing Rich Mar distributor for service or calibration It is recommended that th
21. e device be calibrated annually or when any major component is changed Caution Calibration and peaking adjustments must not be attempted unless the person performing these adjustments has the proper test equipment which must include an acceptable ultrasonic wattmeter such as the Ohmic UPM 30 or equivalent Degassed water must be used to obtain accurate readings Warning Use of controls or adjustments or performance of procedures other than those specified herein may result in hazardous exposure to ultrasonic energy NOTE The ultrasound calibration information applies only to the Winner CM devices Ultrasound Calibration and Tuning Procedure Tuning Frequency and Setting Voltage 5cm 1MHz applies to Winner CM4 CM4 5 CM2 CM2 5 and their P versions 1 Install the soundhead into the w attmeter making sure that only the face of the transducer is submerged Zero the wattmeter 2 Hold down the Start Stop switch and turn on the unit The softw are version should appear on the screen 3 Let off the Start Stop switch and the frequency will appear on the screen for 5cm 1MHz Find the frequency peak and add 5kHz Note Normal range of operation is 930 to 960 4 Press Start Stop switch and the voltage will appear Set maximum output to 10 watts 5cm 3MHz applies to Winner CM4 CM4 5 CM2 2 5 and their P versions 1 Press the Start Stop switch 2 Find the frequency peak for 3MHz and add 7
22. e first half using the High pulse rate scan and the second half using the Low pulse rate scan To set up a Hi Lo pulse rate scan set the High scan and then the Low scan and select the Hi Lo Pulse Rate Follow these steps Press the Pulse Rate button and select High pulse rate Press the Pulse Rate View Adjust button and set the desired High scan Press the Pulse Rate View button again Press the Pulse Rate Mode button to select the Low pulse rate Press the Pulse Rate View Adjust button and set the desired Low scan Press the Pulse Rate View button again Now press the Pulse Rate M ode button until the High Low is selected both LEDS will be lit for High and Low Set time and intensity and begin treatment NEW Feature The LED of the pulse rate that is currently running in the High Low scan will be constantly lit and while the other scan s LED will be blinking Example You start a treatment in the High Low Scan and the High LED is constant and the Low LED is blinking This indicates the that High scan is currently outputting You can verify this by pressing the Pulse Rate View Adjust Fixed Pulse Rate If Fixed pulse rate is selected and the Pulse Rate View Adjust button has been pressed the pulse rate is displayed in the Stim Time display and the Pulse 1 light is illuminted adjustments to the fixed pulse rate by using the up dow n arrow s or the dial After selecting Pulse Rate press the Pulse Rate
23. e frequency peak and add 5kHz Note Normal range of operation is 900 to 950 4 Press Start Stop switch and the voltage will appear Set maximum output to 20 watts 23 Complete calibration by Setting the Thermistor Value Setting the Thermistor Value 1 After the last frequency and voltage calibration has been made press Start Stop Verify that the soundhead temperature thermistor value is set at HO 73 If 50 press Start Stop to enter this number If not set at 73 using the or switches to obtain the correct reading Once setting is correct press Start Stop twice Cable Diagnostic Therasound units are equipped with a diagnostic feature that will detect a broken cable The diagnostic check is run when the device is powered on If the device detects a variation in cable connection it will display 7E 57 test on the display for 2 seconds If this occurs conduct the w ater test outlined in the Output Trouble section on page 9 If the water does not cavitate or bubble the device may have a broken cable or it may need to be tuned and calibrated If the device is outputting ultrasound there may have been a slight variation in the diagnostic Rich M ar recommends that the device be calibrated at least once every year 24 Cleaning Recommendations To disinfect the soundhead betw een therapy treatments Rich Mar recommends using an Ultrasound Disinfectant OSHA addresses the need for prudent infection con
24. e style This means that for each channel one of the electrodes is positive and the other is negative When using the Hi Volt waveform the red pin is positive and the white pin is negative Microcurrent will only output in a Normal mode and its Pulse Rate is only available as a Fixed output Stimulation Modes Depending upon the w aveform selected the user can choose from Normal Surge Co Contract and Alternating modes Normal ode is basic continuous un interrupted output of the selected waveform Surge Modeis a single channel of output that is interrupted in an on off method of a certain time in seconds of output follow ed by a certain time in seconds of no output For example if Surge mode is selected and the 10 20 option is selected this means that for 10 seconds there will be output to the set intensity level follow ed by 20 seconds of zero output The cycle continues until treatment time expires NOTE There HANT Fachno Apo fima pue pul e eve ATO dO BAD OT BAD n Lupe e oe Ao dGHAD x ws m iv Ea 1NO CO 01701 250 m 3943 HVW HOIH B n eap uroseij GedOL AAD OL TAD 3d HAND S EOEXU PUM HANT Fachno Apo pue aogeomur e AO dOL
25. his results in a net charge Single channel two electrode system to be used Pre M od IFC effect The polarity of monophasic will be positive forthe red pin Interferential can select a pulse rate or a beat frequency for each channel and negativel for the white pin Total Output betw een five and 200Hz Current for the Hi Volt 200 mA Pre Mod IFC Interferential Parameters Carrier Frequency 5000Hz Beat Frequency Fixed 2 200Hz Pulse Rate 2 200Hz Fixed Hi Volt Monophasic Parameters Carrier Frequency Not Applicable Beat Frequency Scan Low 2Hz to 200Hz Beat Frequency Scan High 2Hz to 200Hz Vector Options On or Off Surge and Co Cont rates 5 5 5 10 10 10 10 20 10 30 10 50 on off Seconds Alternating Rate 5 5 and 10 10 on off Seconds Ramp On Fixed 3 Seconds Ramp Off Fixed 1 Second Scan Low 2Hz to 200Hz Scan High 2Hz to 200Hz Phase Duration 50uS Interphase Interval 100uS Surge and Co Cont rates 5 5 5 10 10 10 10 20 10 30 10 50 on off Seconds Alternating Rate 5 5 and 10 10 on off Seconds Pre Mod IFC Interferential The Total Output Current 50mA rms The meter shown on the screen of the Theramini is listed as rms current To convert rms to peak current multiply rms by 2 34 1 414 707 Examples are given below 21 Ramp Fixed 3 Seconds Ramp Off Fixed 1 Second Micro Current Mi
26. kHz Note Normal range of operation is 3050 to 3150 3 Press the Start Stop switch and the voltage will appear Set maximum output to 10 watts If Winner CM 4 5 CM 2 5 or their P versions you are almost finished see Setting Thermistor Value on next page to complete calibration 2cm Q 1MHz applies to Winner CM4 CM2 and their versions only 1 Press the Start Stop switch 2 Find the frequency peak for 2cm 1M Hz and add 5kHz Note Normal range of operation is 950 to 980 3 Press the Start Stop switch and the voltage will appear Set maximum output to 4 watts 2cm 3MHz applies to Winner CM4 CM2 and their P versions only 1 Press the Start Stop switch 2 Find the frequency peak for 2cm 3M Hz and add 5kHz Note Normal range of operation is 3050 to 3150 3 Press the Start Stop switch and the voltage will appear Set maximum output to 4 watts If Winner CM 4 CM2 or their P versions you are almost finished see Setting Thermistor Value on next page to complete calibration 10cm Q 1MHz applies to Winner CM 4 10 CM2 10 and their P versions only 1 Install the 10cm soundhead into the w attmeter making sure that only the face of the transducer is submerged Zero the wattmeter 2 Hold down the Start Stop switch and turn on the unit The softw are version should appear on the screen 3 Let off the Start Stop switch and the frequency will appear on the screen for 10cm 1M Hz Find th
27. ld hear a beep to let you know your leads are good If you hear no beep then you need to replace your lead cord Ultrasound CM Models Only The ultrasound function of the Winner CM 4 and CM2 is very easy to use Once the machine is turned on the last treatment s parameters will be displayed If this is the desired treatment set the intensity with its up down arrow s and press the Start button The Ultrasound Active light illuminates and the Time is blinking indicating that ultrasound is being output and time is counting down NOTE Besureto use Aloe Sound Lotion or Gel Plus as a coupling agent and place the appropriate soundhead on the patient Remember to always move the soundhead approximately 4cm second either in a circular or back and forth motion If you want to change ultrasound parameters select from the follow ing list Transducer CM4 CM2 CM2P Select either the 2cm or 5cm transducer 4 5 4 5 2 5 CM2 5P 5cm transducer only CM 4 10 CM 4 10P CM2 10 CM2 10P 10cm2 transducer only Frequency Select from 1M Hz or Hz Remember that the lower the frequency the deeper the penetration if intensity levels are equal 1M Hz is a lower frequency than the Hz CM 4 10 CM4 10P CM 2 10 CM2 10P are 1M Hz only Ultrasound Wattage Output The Winner will display output in either W cm or Watts Select the output display by pressing the Select button next to the intensity up dow n arrow s
28. licator surface to the location of the most distant intensity maximum In this area Maxima and minima of intensity are located close to each other This is the area in which most therapeutic application occurs This is shown in the following figure measured 0 5cm from the transducer face 505 oe auem s Near Field Distribution Beyond this point the beam has a more uniform intensity and is called the far field Below is shown the far field distribu tion at 16cm from the transducer face oo a v ZZ BEER 44 ON teres as gst ir Ora un E s Ue Ue OO BOO Ae 29 49 7 9 ON SORRY SORE e XU 3 X BEES Far Field Distribution The preceding descriptions apply for radiation emitted into the equivalent of an infinite medium of distilled degassed water at 30 C Transducer Parameters and Tolerances The Rich M ar ultrasound units operate at frequencies of either 1MHz or 3MHz 10 The effective radiating areas ERA of the transducers are ten five or two square centimeters depending upon the size of the transducer being used The tolerance for the ERA 26 is 25 onthe 2 and 5 square centimeter transducers The tolerance for the 10 square centimeter transducers is 0 25 The Beam Nonuniformity Ratio BNR for any Rich M transducer is 5 5 1 or less 100 Mode When operated in
29. n set for each channel and treatment started Ch 1 will be on for 10 seconds Once Ch 1 goes off Ch 2 will be on for 10 seconds This alternating will continue until treatment time expires To Adjust Stimulation Intensity during Treatment Intensity can be adjusted during treatment even during the off cycle in Surge or Alternating modes simply by pressing the desired Channel button Normal mode intensity adjustment When in Normal M ode you will notice that the light in the Start Accept button is flashing Once the level is adjusted press Start Accept and the user will be prompted to do the same for channel two if applicable Timing Mode Intensity Adjustment Surge Co Cont amp Alt Surge Mode Intensity Adjustment the Surge mode press the Channel button and you will notice that the Start button is blinking Press the Start button to access a change in intensity as a safety feature You will then notice that the time has stopped counting down and the channel s Active LED is illumi nated Make your intensity adjustment and press the Start button w hen finished The timing cycle will now start over This process is done as a safety feature so that you cannot increase intensity during the off cycle Co Contract or Alternating Modes Intensity Adjustment These modes use two channels so you need to press the button for the Channel that you want to adjust Once you do this notice that the Start button is blinking You can
30. nd by frequently using an alternate electrode placement 6 Isolated cases of skin irritation may occur at the site of electrode placement follow ing long term application Adverse Reactions Adverse reactions to electrical stimulation are usually limited to sensations of discomfort Excessive stimulation can cause muscle spasms as well as soreness such as can be expected With excessive natural exercise In all cases treatment should not exceed the patient s comfortable tolerance to the stimulation level NOTE Skin irritation and burns beneath the electrodes have been reported w ith the use of muscle stimulators Contraindications and Warnings For Microamperage Pulsed Current Waveform Microcurrent Contraindications This device should not be used in the follow ing areas 1 On persons wearing a cardiac pacemaker 2 On persons w ho have known or suspected malignant lesions This includes cancer patients 3 Over the cartoid sinus area 4 Trancerebrally 5 Over the pregnant uterus 6 Whenever pain syndromes are undiagnosed until etiology has been established Warnings 1 This device is not effective for pain of the central origin this includes headaches 2 The long term effects of chronic electrical stimulation are unknow n 3 Safety has not been established for the use of microcurrent during pregnancy 4 Adequate precautions should be taken in the cases of persons 18 with suspected or diagnosed seizures
31. nformation CAUTION When using carbon electrodes with any Rich M ar stimulator a moistened interface cloth or sponge MUST be utilized betw een these electrodes and the patient to avoid skin irritation and or electrical burns Electrode Storage and Maintenance IMPORTANT The adhesive properties of these electrodes may be affected by ambient or patient skin conditions While out of the package extreme variations in humidity levels may affect the adhesive properties of these electrodes To increase the adhesive properties of the electrodes add a few drops of water to the electrodes conductive surface and spread evenly Allow a couple of minutes for the increase in tack REMOVAL AND STORAGE OF ELECTRODES Turn off the stimulation device and disconnect the cabling Remove the electrodes from the skin and reapply to the plastic backing Place in the pouch and reseal for storage to maintain proper adhesive quality when not in use If possible store the electrodes in a refrigerator to maintain adhesive CAUTION In multiple consecutive treatments of a patient the electrodes should be discarded and replaced if damaged or when proper adhesive tack or comfort can no longer be achieved Electrodes should be replaced when they lose their adhesive quality or when a change in stimulation intensity is noticed or if the gel is separated If in doubt about the integrity or proper function replace the electrode before proceeding In any instance
32. ng bone in children 8 Where the skin suffers from any sensory impairment 9 Over areas of malignancies 10 In the area of visceral plexus and large autonomous ganglion 11 Over the thoracic area if the patient is using a cardiac pacemaker 12 Over a healing fracture 13 Over ischemic tissues in individuals with vascular disease where the blood supply w ould be unable to follow the increase in metabolic demand and tissue necrosis might result Precautions Precautions should be taken when used 1 Over anesthetized areas 2 On patients with hemorrhagic diastheses 3 Ultrasound treatment should not be performed over an area of the spinal cord following laminectomy i e when major covering tissues have been removed Caution 1 Excessive doses of ultrasound may cause damage to tissue Periosteal pain is an indication of excess intensity and if it occurs the power should be reduced the transducer should be moved more rapidly over the area being treated or a low er pulsed duty cycle should be used 2 If the soundhead has been operated unloaded for an extended period of time the transducer will get hot If the soundhead is applied to the patient while the transducer is hot a burn may result Warning Do not operate the soundhead in an unloaded condition It is possible that unrepairable damage may occur to the transducer in an unloaded state Waveforms The Winner units represent the most sophisticated electrical
33. not change the intensity until you press the Start button Press the Start button and the treatment s other channel Active LED goes out the selected channel s Active LED illuminates and the Timer stops counting down Make your intensity adjustment and press the Start button w hen finished The timing cycle will now start over This process is done as a safety feature so that you cannot increase intensity during the off cycle Stimulation Pulse Rates Depending upon the w aveform selected the user can use either a Scan High Low or Hi Lo or a Fixed pulse rate Once the type of pulse rate has been selected High Low Hi Lo or Fixed press the Pulse Rate View Adjust button If a Scan is selected the low end of the Scan will be displayed in the Stim Time display but note that the Pulse 1 light is illuminated The high end of the Scan will be displayed in the Stim Intensity display but note that the Pulse 2 light is illuminated now At this point you can make adjustments to either end of the Scan by using the up down arrows for Pulse 1 and the dial for Pulse 2 Once the Pulse Rate has been selected press the Start Accept button The High Scan and Low Scan will make a complete cycle through the selected pulse rate range in 30 seconds For example if a 100 120 scan is selected it will start at 100 Hz and scan up to 120Hz and back down to 100Hz every 30 seconds The High Low Scan pulse rate mode will split the treatment time in half with th
34. or heart problems 5 This device is to be used as asymptomatic treatment for pain and has no curative value 6 Patients should be cautioned and their activities regulated if pain is suppressed that would otherwise serve as a protective mechanism 7 Electronic monitoring equipment such as ECG monitors and ECG alarms may not operate properly when the stimulation is on 8 This device should be used only under the continued supervi sion of a physician 9 The user MUST keep the device out of the reach of children Precautions 1 Isolated cases of skin rash may occur at the site of electrode placement following long term application The irritation can usually be reduced by use of an alternate electrode placement and or an alternative conductive medium 2 Effectiveness of this treatment is dependent upon patient selection Adverse Reactions Skin irritation and burns beneath the electrodes have been reported with the use of transcutaneous nerve stimulators NOTE Both contraindications for ultrasound and stimulation Should be observed when using the device in combination Ultrasound Contraindications Winner CM Models Only Contraindications Ultrasound should not be used in the follow ing areas 1 Near or over the heart 2 Near or over the eyes 3 On the head 4 Near or over reproductive organs 5 On the lower back during pregnancy or over the pregnant uterus 6 Directly over the spinal column 7 Over growi
35. plished by taking the lead cord from the stim channel you want to use and plug the desired lead tip into the special ultrasound jack for combination therapy Plug the leadcord into the red jack of whatever channel you are using for stim Apply the electrode to the desire lead tip figure 2 and put it on the patient Then plug the pin end of the other side of the lead into the Small silver stim jack on the right side of the ultrasound cable figure 3 This makes the soundhead function as that electrode Apply the Aloe Sound Coupling Lotion or Gel to the site and apply the soundhead to the patient This completes the stimulation circuit figure 4 and the stimulation component of the treatment may now be set up Once the parameters are Selected set the stim intensity level The patient should feel the stimulation Set the ultrasound parameters making Sure to move the soundhead once you are outputting ultra sound Ultrasound Active light comes on You are now providing a combination therapy treatment NOTE Both the 2cm and 5cm sides of the Therapy Hammer will emit stimulation in the combo setup CM 4 CM2 CM2P only NOTE Both contraindications for ultrasound and stimulation should be observed w hen using the device in combination Figure 4 14 Electrical Stimulation Site Preparation Electrode Attachment and Maintenance Guidelines 1 Know the stimulation characteristics indications and contr
36. pment in accordance with earlier specifica tions This warranty will be honored only if the enclosed card is filled out and returned to the factory This warranty is valid only to original purchaser This warranty is expressly in lieu of all other warranties expressed or implied including the warranties of merchantabil ity and fitness for use and all other obligations on our part and we neither assume nor authorize any other person to assume for us any other liability in connection with the sale or use of this equipment In no event shall we be liable for consequential or special damages We make no warranty whatsoever in respect to accessories or parts not supplied by US Introduction The Winner units are products that resulted from dedication to research and development The Winner units offer the most flexible treatment possibilities in a convenient easy to use package This manual is meant to familiarize the user with the controls operations waveforms and ultrasound therapies available in the Winner units The simple control of the unit allows the user to master the unit s vast capabilities more quickly and easily User Interface The Winner units use a straightforward control panel with each waveform therapy and parameter clearly labeled Each button requires only light pressure to be activated You should also hear an audible beep each time a button is pressed LED lights illuminate indicating the availability and or selection of p
37. rasound Indications for Treatment Winner CM Models only Therapeutic Ultrasound Rich M ar Ultrasound devices are indicated to produce therapeutic deep heat for the following conditions 1 Relief of pain 2 Muscle spasms 3 J oint contractures But not for the treatment of malignancies 17 Rich Mar Muscle Stimulator Contraindications and Warnings All Winner Devices For Quadpolar IFC Pre Mod IFC Hi Volt Monophasic amp Russian Waveforms WARNING Federal law restricts this device to sale by or on the order of a physician or any other practitioner licensed by the law of the state in which said person practices Contraindications This device should not be used in the following areas 1 persons wearing a cardiac pacemaker 2 On persons who have known or suspected malignant lesions This includes cancer patients 3 Over the cartoid sinus area 4 Trancerebrally 5 Over the pregnant uterus Warnings 1 The long term effects of chronic electrical stimulation are unknown 2 Adequate precautions should be taken when stimulation is used on persons with suspected heart problems 3 Adequate precautions should be taken when stimulation is used on persons with suspected or diagnosed epilepsy 4 Severe spasm of the laryngeal and pharangeal muscles may occur when the electrodes are positioned over the neck or mouth The contractions may be strong enough to close the airw ay or cause difficulty in breathing
38. rodes 1 75 x 1 75 PD1071 2 Round PD1072 1 75 x 3 75 PD1073 Aloe Sound Lotion case of four gal L01901 Aloe Sound Gel Plus case of four 5 liters L01946 Banana to Pin adapter set of two LC1720 Pin to Banana adapter set of two LC1721 Carbon electrodes 3 round PD1044 Sponges for PD1044 PD1055 Micro Current Probe PR6713 Ultrasound Technical Information Applicator Type The ultrasonic radiation fields produced by Rich M ar thera peutic ultrasound transducers are of the plane wave type and are essentially cylindrical in shape This type of applicator is referred to as a collimating applicator Applicator Label Each Rich M applicator is labeled to provide the user with information on its applicable parameters The following abbreviations are used on the label Gen The Rich M ar ultrasonic generator for which the applicator is intended f The operating frequency in MHz for the applicator Area The effective radiating area of the applicator in square centimeters BNR The Beam Nonuniformity Ratio Type Coll means collimating applicator Near Field Far Field If measurements are made of the sound intensity along the central axis of the beam produced by the applicator the intensity distribution shows maxima and minima near the applicator and then a gradual decline beyond the last maximum intensity The interference or near field is the area in the ultra sound beam from the app
39. rofile mode or the Advanced Therapy Profile mode The Easy Therapy Profile mode allows you to set a total of four different therapies so you can start a treatment with one touch The Advanced Therapy Profile mode will allow you to have four different profiles for each waveform giving you a total of 20 Therapy Profiles If the device is in the Easy Therapy Profile mode the Profile LEDs will blink along with the waveform LEDs when the device is first powered on If the device is in the Advanced Therapy Profile mode the Profile LEDs will not blink when the device is first turned on To switch from one Therapy Profile mode to another turn the device off press and hold any of the Therapy Profiles and turn the device on You should hear a series of beeps and notice that the Profile LEDs are now in the opposite mode Easy Therapy Profile Mode Set up To set a Profile in the Easy mode press the desired Profile button A B C or D TWICE Then select the desired waveform and all its parameters Set the intensity and PRESS AND HOLD THE START ACCEPT BUTTON UNTIL YOU HEAR TWO CLICKS AND A LONG TRILL This indicates that the treatment is stored under that Therapy Profile and can be accessed by pressing that Profile button You may want to name and note the treatment on the included Easy M ode Profile Reference card under Waveforms Profiles Easy Therapy Profile Use Once you have set your Easy Profiles simply press the desired
40. t LED light will illuminate under the intensity dial Use the dial to balance the patient s sensation You will see only the selected channel s intensity level increase or decrease but understand that as it increases the other Quad IFC channel s intensity decreases proportionately Once the balance has been completed press the Start Accept button To View Stimulation Treatments If you are running two or more concurrent stim treatments you will only see one treatment s parameters at a time Press the desired channel button to illuminate its Selected LED light You will then see all the parameters for that particular channel s treatment Whichever channel button you press will activate the Selected LED and display that treatment s parameters To Stop a Stimulation Treatment If you only want to stop a single treatment without affecting the other treatments press and hold the desired channel button and the stimulation Stop button at the same time f you just press the stimulation s Stop button it WILL STOP ALL STIM TREATMENTS Waveform Parameter Options Waveform choices include Quadpolar IFC Pre Mod IFC Russian Hi Volt M onophasic and M icrocurrent Quadpolar IFC will only output classic Interferential current in a Normal mode and it requires both Ch 1 and Ch 2 or Ch 3 and Ch 4 if applicable The Balance button allows for better patient 6 sensation balance if that button is selected as you increase or de
41. the 10096 mode the generator produces a non interrupted sinusoidal waveform of one or three MHz The peak power and average pow er are therefore the same The error in indication of radiated power in intensity for the continuous mode does not exceed 14 allow ing for a 6 error in the wattmeter which equals 20 Pulsed Mode When operated in the pulsed mode the generator produces a square w ave burst of sinusoidal waveform of 1MHz or 3MHz of 2 5 milliseconds in duration Depending upon the Rich Mar model of therapeutic ultrasound in use the duty cycle can be chosen betw een 5 and 95 duty This then implies the repetition rate is selectable between 20 and 380 pulses per second This is computed by taking the inverse of the duty Cycle 1 380 95 1 20 05 The tolerance for the pulsed mode is 20 See the following chart for second comparison on Duty cycle to pulses Duty Cycle Pulses S econd Indicated on front panel of device 5 20 10 40 15 60 20 80 25 100 30 120 35 140 40 160 45 180 50 200 55 220 60 240 65 260 70 280 75 300 80 320 85 340 90 360 95 380 27 The error in indication of radiated power in intensity for the pulsed mode does not exceed 14 allowing for an allowable 6 error in the wattmeter which equals 20 Timer Accuracy The Food and Drug Administration requires that the treat ment timer accuracy is to within 0 5 minutes for the preset duration of emission for settings
42. trol OSHA Instruc tion CPL 2 2 44C to include decontamination of equipment betw een patients We recommend cleaning of the device with a non abrasive cloth and soapy water We also recommend that the carbon elec trodes and sponges be cleaned betw een patients with sopy hot water Converting to 230 VAC and or 115 VAC Please visit the Service section of our w ebsite at www richmarweb com for information how to convert the Winner devices betw een 230 VAC and 115 VAC Trouble Shooting Rich M ar Corporation takes pride in its Technical Support Hotline 1 800 762 4665 We have an outstanding staff ready to take your calls and help with diagnosing and troubleshooting problems You can also access service manuals and informationon our website ww w richmarw eb com under the Service tab Listed below are several options for troubleshoot ing the Winner units Since there are microprocessor computers driving the Winner devices they may occasionally lock up Although this will rarely occur if the machine seems to lock up or if the display seems odd at all turn the machine off for a moment and then turn it on again If you are having any consistent quality problems please call your local distributor for service WARNING Prior to opening your Winner device for service or repair please obtain the procedure from www richmarweb com or by contacting the factory Failure to use this procedure may result in
43. units are designed to provide the most sophisticated and customized treatments imaginable Helpful Hint If you desire further information regarding waveform descrip tions recommended reading to supplement this section is ELECT ROTHERAPEUTIC TERMINOLOGY in Physical Therapy published by the American Physical Therapy Association For more information contact the APTA 1111 North Fairfax Street Alexandria VA 22314 1488 Quadpolar Interferential four pads Electrical stimulation at higher frequencies 5000Hz penetrates the skin easily due to capacitive effects of the skin but has little therapeutic effect Lower frequencies 0 200 are therapeu tic yet produce irritation or even pain if applied directly Interferential current utilizes two high frequencies to pass through the skin barrier and then mixes the two frequencies to produce a low frequency within the tissues Quadpolar mode is named such because two channels totaling four quad electrodes work in conjunction to provide treatment of one site The Winner stimulators can provide Quadpolar Interferential by producing two separate sine wave outputs By crossing these electrodes the two Sine waves mix and produce a beat frequency within the tissue This beat is the difference in the two sine wave outputs Quadpolar interferential Iw bhosncb Hour AVAVAVAY The Winner stimulators produce 5000Hz sine waves from channel one and produce betw
44. utton How ever you have selected to begin your treatment either picking the waveform first or the channel button first you will then notice that certain LEDs have been illuminated indicating that they are currently selected Using the example above of Pre Mod IFC the LEDs are lit next to Normal a High pulse Rate and 15 00 minutes of treatment time You can change any of these parameters by pressing the appropriate button s noticing that the LED lights change too Once the desired parameters are displayed the Winner devices will prompt you to set Intensity by flashing the Adjust LED light underneath the Intensity dial As you set the desired intensity level you will notice that the green Active light is illuminated in the Ch 1 button to indicate that current is being output Once the desired intensity level has been set press the Start Accept button and the time begins counting down NOTE When using Quadpolar IFC one of the channel pair s Selected light will blink If you balance the treatment then the intensity display will be different between the two channels Whichever channel s Selected light is constantly illuminated will display its intensity level Running Concurrent Stim Treatments The Winner units have either four independent stimulation channels 4 and ST4 models or two independent stimulation channels 2 and ST2 models This allows you to treat four or two different sites or patients at the same time
45. waveform generation ever developed in electrotherapy The waveforms are software generated by an extremely sophisti cated computer that resides in each Winner unit Each waveform has particular characteristics that are particu larly well suited to a physiological response Classic or Quadpolar Interferential is the most conventionally thought to provide the smoothest feeling current available for sensory stimulation Hi Volt M onophasic current provides a net charge effect when needed provides low current density stimulation and historically has been used when an ultrasound combination is utilized The Russian waveform is thought to be the best waveform for motor contraction Microcurrent provides sub sensory stimulation Within each waveform a particular pulse rate or beat frequency can be chosen Low pulse rates 0 10 are thought to be the best for indications involving chronic problems while higher pulse rates 80 200 are thought to be best for indications involving acute problems A pulse rate of 50Hz is thought to provide the best motor stimulation contraction without rapid fatigue Broad base protocol conventions exist for all electrical stimula tion as described above but within each waveform certain parameters are the key to eliciting a particular response The Winner units have been programmed to have the most common treatment options as factory waveform default settings How ever the Winner
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