EX N' Flex EF-100 User manual

EX N’ FLEX
Therapeutic Arm Exerciser
Model EF-100 Arm/
EF-100W Arm/Wrist
Instructions
for Use

Operating Instructions
Understanding the Control Unit
The Control Unit contains all of the electronics, switches and displays necessary to control the operation
of the EX N’ FLEX EF-100/100W Arm Exerciser.
* Plug the Power Cord into a 110/220 V.A.C. Wall outlet. PLEASE NOTE: Before attaching yourself
or anyone to the machine, it is recommended that you read these instructions thoroughly and
operate the Control Unit to familiarize yourself with the switching.*
The Main Power Switch:
The Main Power Switch is the black switch located on the right hand edge of the Control Box. When the
switch is turned on the Control Unit will light up. The Power Light comes on, zeros appear in the large LED
Display window and light appear in the side windows by the Mode Switch, Speed Switch and the F/Off/R
Switch. (Forward, Off. Reverse).
The Pressure Switches:
There are six different Pressure Switches on the Control Unit: On/Off, a Direction Switch (F/Off/R), Mode
Switch, Speed Switch and two Timer adjustment arrows.
When the side mounted Main Power Switch is on, you can start the machine by selecting forward or
reverse. You can stop the machine by pressing the F/Off/R switch once to move the switch to the
centre/Off position or you can also turn it off by pressing the On/Off switch on the bottom left of the face of
the Control Unit, near the Power Light. If you turn it off here you will resume movement in the same
direction the machine was turning when it was stopped.
Try this now: Turn on the Main Power Switch located on the right hand edge of Control Box. Press the
F/Off/R Switch. The Arm Rest should begin to turn in Forward or Reverse depending on your selection.
Leave the machine running then try the Speed Switch.
The Speed Switch:
The Speed Switch contains three indicator lights: Lo, Med and Hi. To choose a speed, press the switch to
change between Lo, Med and Hi.
Now turn the machine off by pressing the On/Off switch on the face of the Control Unit.
Understanding the Mode Switch:
The Mode switch has four positions; Timer, Biof or Biofeedback, Trip and Tot al . A red indicator light
shows the mode being used.
When the machine is first turned on the Mode Switch default position is Biof. The function of the
Biofeedback display is explained further on.
The Timer Switch
Press the Mode Switch once and it will change to “Time” mode. Once in “Time” mode you can adjust/set
the timer by pressing the up and down arrows. These switches are located just below the LED digital
readout window. Increase the amount of time in 5 minute increments each time you press the”up” arrow.
Decrease the amount of time by 1 minute, each time you press the “down” arrow. You can view the
amount of time selected in the LED display window located above the arrows. When the machine is
turned on the timer will begin counting down in seconds and once it reaches zero the machine will
automatically shot off and the F/Off/R switch will have moved to the Centre/ Off position.
Note: Once the timer is set you can switch between modes and the timer will still continue to count down.
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Odometer “Total “ Switch:
While still in the Time mode, press the Mode Switch 3 times and you will change the mode (the red
indicator light will move) to “Total”. “Total” display acts as an odometer and logs the distance travelled.
The total cannot be reset and continually accumulates ”revolutions” over time. Multiply the total shown
on the odometer by 1000 and divide by 2, this will give you the total number of revolutions to date.
Odometer “Trip” Switch:
Press the Mode Switch again and the red light will change the mode to “Trip”. “Trip” mode logs in
revolutions. Every trip count equals 1 revolution, for example, 1 registered on the trip odometer would
equal 1 revolution of the Arm Rest. To save and add the accumulated revolutions from a session to
the “total” turn the machine off using the On/Off Switch on the face of the Control Unit before
turning off the main power switch on the side.
Biofeedback Switch:
Press the Mode Switch again, or if the machine is turned off, turn it on and the red light will be in default
Biof position. “Biof “ or Biofeedback mode displays numbers on the digital display which fluctuate
between 0 and150. These numbers indicate the effort require to move a passive arm(s).
The Biofeedback mode is used to measure the User’s resistance and/or assistance. For example: if a
user has tone, stiffness, or spasticity in their arm, this would cause resistance and require the motor to
work harder to turn their limb. As the user becomes more relaxed and flexible the “Biof” numbers will
decrease. This display enables someone with little or no feeling or voluntary movement in their limb(s) to
seethat the movement is making a difference.
If the user is using the machine actively or applying some of their own strength and assisting/overriding
the motor then the LED display will show a decrease in the “Biof” numbers. This shows the
User/Caregiver that the User is assisting the machine and building strength. Refer to P.3 for istructions
on using the machine actively.
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0 0 10 0 1
Large Led
Display
Membrane
Switches (6)
Mode Switch
On/ Off Switch
Power Light F/Off/R
switch
Side Mounted
Black Switch
Timer Switches
Side Window
Displays
Speed
Switch
Control Unit

Active Mode is achieved by the User by overriding /assisting the motor (using any residual strength they
have in their limbs) in either Forward or Reverse motion. The results ofActive use will show on the LED
Display when the Mode Switch is in “Biof” setting. Active use shows a decrease in these numbers being
displayed.
The more voluntary movement applied the greater the decrease in numbers. If an individual is able to
apply a consistent amount of voluntary movement with enough strength to hold the Biofeedback at 0,
then it would be considered time for him/her to use a manual device ( recumbent or exercise bicycle) for
exercise therapy
Instructions for use of the Active Mode
for the EX N’ FLEX Arm Exercisers
Leave the machine turned on and the Motor running
Active does not mean Manual
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Introduction
The Ex N’ FLEX Model EF-100/100W therapeutic Arm Exerciser provides a sustained range of rhythmic
movement to the muscles, joints and tendons of an immobilized arm. This machine is physically and
psychologically beneficial as an adjunct to physiotherapy or where physiotherapy is unavailable.
Operating Instructions:
1. Plug Power Pack into110/220 v.a.c. Outlet.
2. Adjust the machine for Horizontal motion by using the Rotation
Release Knob, (P.5, Fig.#3).
3. Sit on a wheel chair, lounge chair or kitchen chair. (The foot
rest on a wheelchair may have to be swung away or removed to
access the machine). The machine may be used directly in front
or positioned to the right or left side. Sometimes placing the
caster wheels between the wheelchair wheels (with the base
frame at 45° to wheelchair) allows better positioning. The large
casters make it easy to move the machine to an optimum position.
4. Using the Height adjustment Knob (P.5 Fig.#5), set the height
so that the bottom of the Casing is slightly higher than the top of
the knees, see Fig #1.
5. Place one arm onto the Arm Rest and secure it in place with the
neoprene strap and velcro.
6. Turn on the machine with Side Mounted Black Switch. Set the
machine to low speed, the Mode switch to Biof and slowly turn
the ON/OFF switch through one revolution, allowing the entire
machine to move on its casters if required. When a comfortable
position for use is found, lock the casters so that the wheels are in
line with the pontoons. Rotate the arm through a further
revolution to be sure that no discomfort is experienced.
7. As soon as the Arm Rest starts to rotate, some numbers will
appear on the Control Unit Display. Refer to section on P.2
Understanding the Control Unit, subsection Biofeedback Display
Mode for information on the meaning of these numbers.
8. Make sure that the arm is in a slightly bent position, ie: not fully
extended when the Arm Rest is furthest away from the body.
9. If extreme Tone/Contractures in the arm make it difficult to
complete the turn or tend to cause the machine to stall , be sure to
have the Crank Arm on the Inner Hole for small amplitude. Using
the F/Off/ R Switch, work arm back and forth between F and R in
1/2 turns to permit some stretching of muscles and tendons to
occur. After a few of these 1/2 stretches are completed a full turn
can be accomplished. 3 or 4 turns is usually enough initially.
This method can be used until an individual can do numerous
turns without stalling the machine and thus work into a regular
program.
Horizontal Movement orbits the arm
in a Plane which is parallel to the floor
Large
Display
Side Mounted
Black Switch
Set Timer
Switches
Side Window
Displays (3)
Speed
Switch
F/Off/R
Switch
Power
Light
On/Off
Switch
Inner Hole
for small Amplitude
Outer
Hole
Arm Strap
Velcro Closure
Crank
Arm Arm
Rest
EF-100
Mode
Switch
Hand
Grip
4
Fig. #1
Fig.#2
Fig #3

10. Relax, sit back and let the machine do the work. If a higher
speed is required, adjust the Speed Switch. If some active
exercise is desired refer to the section on the Active Mode.
11. For best results, time should be divided equally between
forward and reverse motion. Reverse motion is achieved by
pressing the F/Off/R Switch.
12. To turn the machine off, press On/Off Switch. If you do not
want the Power Light to remain on, turn off the side Mounted
Black Switch.
13. Motion in other planes is possible using the Rotation Release
Knob. Hold the Upper Unit by one of the handles an pull the
Rotation Release Knob (located on the back of the machine, see
(fig.#3) outwards about ¼ “. Rotate the machine and release the
Knob. When the 45° position is reached, the knob will click into
place and lock the Upper Unit in position.
14. If motion in the Vertical Plane is desired, pull the Rotation
Release Knob out again, rotate the Upper Unit and release the
Knob so that the machine is locked in a position which will
provide Vertical motion for the arm. In this plane it is necessary
to adjust the height of the machine as described in 15.
15. Height Adjustment: Release the Height Adjustment Knob
and raise the spring loaded Height Adjustment Bar to the desired
height. Tighten the HeightAdjustment Knob before use.
16. For further information on using the Arm Exerciser, please
refer to the section on Features of the Arm Exerciser.
NB: The Crank Arm is provided with an Inner Hole to allow
reduced amplitude. This is useful for people who initially require
a smaller Range of Motion to overcome Tone/Contactures or
Spasm before working up to afull amplitude range with their
exercise program.
5
Horizontal Movement
orbits the arm in a plane
which is parallel to the floor
Fig. #4
45O
Movement
Fig. #5
Rotation
Release
Knob
Fig. #6
Vertical Movement
orbits the arm in a plane
perpendicular to the floor
Fig. #7
Arm Strap
Foam Grip
Arm Rest
Crank Arm
Control Unit
Rotation
Handle
Rotation Release
Knob
Power Cord Height Adjustment
Bar
Height Adjustment
Knob
Transporting
Wheels
Fig. #8

Instructions for Use EF-100W Arm/Wrist, Arm Cradle
Introduction: The EF-100W Arm Cradle with WristAttachment
has two upright posts with foam grips. The hand is wrapped
around the Hand Grip and rests on the 4” diameter Hand Stop.
The arm rests against the other post. The following instructions
will provide information in the use of this unique feature. The
basic operating instructions for the EF-100/100W
, so please read that section thoroughly before
proceeding to this section, the Wrist application.
1. Attach the Crank Arm to the Steel Boss protruding through
hole in the Casing, first rotating the Crank Arm until the hole at the
end of the Crank Arm is exposed. Then place 9/16” bolt and lock
washer through hole and into the Boss. Tighten bolt securely to
hold arm mechanism in place, Fig. #2.
2. Under The Arm Cradle you will see the White Wrist Movement
Selection Lever (Fig.#2). This White Plate sits on a circular,
slotted plate, (Fig.#1) into which 5 slots have been cut (Fig. #1).
These slots are numbered from zero to four. When the Selection
Lever on the White Plate is in the “ position there is no Wrist
movement. In this position the Hand Grip is stationary.
4. To apply Wrist movement, lift the White Lever until the lever
clears slot “0” and slide the White Lever across the Black Plate
and allow the pin to drop into Slot “1”. This will provide the
minimum wrist movement. Moving the lever to a slot with a higher
number (ie: 2,3 or 4) increases the degree of wrist movement. It
is suggested that you start with Slot 1 and work up to the other
settings gradually to avoid any discomfort. The various settings
may be applied before or after placing your arm in the arm Rest.
Using the Wrist/Hand Strap EF-100WArm /Wrist
5. Attach the neoprene Hand Strap to the wrist of the affected arm
and fasten around wrist (Fig # 3 ) . Secure with velcro closures.
6. Open the Arm Straps on Arm Cradle.
on the previous
pages apply
0”
Second Closure
of Wrist Strap
(after hand is placed
around Gripping Post) First Closure
of Wrist Strap
Fig #3
Hand
Grip
Arm
Rest
Arm
Cradle Arm
Strap
EF-100
Casing
Crank
Arm
Fig. #2
Boss
White Wrist
movement
Selection Lever
Arm
Strap
Hand
Grip
Arm
Rest
Arm
Cradle
Wrist
Mechanism
5 Adjustment slots
Control
Unit
EF-100
Casing
Fig #1
Hand
Stop
6

7. Place the affected Arm onto the Arm Cradle, work the
fingers around Hand Grip, then pull remaining flap of neoprene
strap back over the hand and attach it to the exposed velcro at
the wrist (Fig # 4 ). This Strap will prevent the hand from
slipping off the Hand Grip. The affected hand may need
some assistance in holding on to the Hand Grip while
attaching the final strap. Secure Arm toArm Cradle by Pulling
Arm Straps over wrist and attach on other side, Fig. #5.
8. Please refer to Understanding the Controller (P.2) to
become familiar with the Controller before you start using the
machine.
9. If you wish more extreme wrist movement, place the
provided bean bag in front of or behind the wrist. This of
course is a more advanced movement once the muscles and
tendons have become flexible, Fig. #6 & #7.
Hand
Grip
Second Closure
Hand Strap
Velcro
Closure
Arm
Rest
Arm
Cradle
Wrist
Mechanism
EF-100
Casing
Arm
Strap
Fig. #4
Hand
Grip
Arm
Rest
Arm
Strap Hand Strap
Velcro
Closure
Wrist
Mechanism
EF-100
Casing
Fig. #5
Fastened
in Position
Hand
Grip
Arm
Rest
Arm
Strap
Bean
Bag
Arm
Cradle
Wrist
Mechanism
EF-100
Casing
Fig #7
Hand
Grip
Arm
Rest
Arm
Strap
Bean
Bag
Ef-100
Casing
Arm
Cradle
Wrist
Mechanism
Fig. #6
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**Important:
When the EF-100W is set in the 90 degree (Vertical ) position
be sure you have the Wrist Movement set to Zero.

How Long Should I Stay on the EX N’ FLEX
As with any exercise program, the best results are achieved with a gradual approach. (Resist the
temptation to spend more than five minutes on the machine to start with). Slow speed is a good way to
start. In extreme cases, only one or two revolutions may be achieved because of muscle/joint
resistance or spasm. Sometimes by switching between Forward and Reverse and the speed switch set
to High, it is possible to achieve several partial revolutions. With repeated sessions this should result in
increased flexibility in the muscles and tendons to a point where full revolutions should be achieved.
Any excessive resistance will show on the Biofeedback display as high numbers. As flexibility improves,
the numbers shown on the Biofeedback will decrease. Once flexibility is regained and no discomfort is
experienced the following day, the amount of time on the machine may be increased one minute per
session to a maximum of 30 minutes per session. The time should be equally divided between Forward
and Reverse. The EX N’ FLEX may be used for more than one session per day. If discomfort is
experienced as a result of unaccustomed exercise, discontinue use of the machine until discomfort
subsides, then resume program.
**** To assure that the arm is not over extended, make sure that the machine is close enough that the
User has a partial bend in the arm at all times during use.
How to Exercise both arms at the same time:
With the machine adjusted for motion in the Horizontal plane:
---- Place the unattached arm over the wrist in the Arm Cradle, so that both arms rotate together. This
movement has the added benefit of providing a significant amount of Trunk movement.
---- For more shoulder movement in this plane, adjust height of machine to desired level and use from the
side.
---- In the vertical plane arms must be exercised independently.
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Features of the EX N’ FLEX EF-100 Arm/
100W Arm/Wrist Exerciser
1. The arm has many more complex movements than the leg and for that reason it can initially be a little
more challenging for the caregiver to position the compromised individual to the machine. It is usually
necessary to work the machine into an optimum position for use by sometimes placing it either inside or
outside of the wheelchair wheels. Once you have the machine in position, either in front of or beside the
wheel chair and the User is comfortable you can commence operation of the machine. Follow operating
instructions on previous pages. The EF-100/100W provides a wide range of movement for the arm,
trunk and shoulder. We also suggest that all planes movements not be attempted on the same day.
This permits the body to adjust to the different directions of movement. When a user has good flexibility
all 3 planes can be used at any time. In long term care settings the machine is usually used in a single
plane per day to avoid having to rotate and change the height only once on a given day.
2. Sometimes a small pillow can be use behind the individual in order to achieve the optimum position.
3. The unique Arm Rest supports frequently painful, subluxated shoulders by supporting the arm
preventing sag from the shoulder.
4. The Rotation Release Knob allows the EF-100/100W machine to permit movement of the arm,
trunk and shoulder in three different planes, Horizontal, 45° and Vertical.
t is necessary to adjust the height of the machine by releasing the Height Adjustment
Knob and raising the Height Adjustment Bar The height may also be adjusted in the 45° mode if
required. These variables provide a wide range of movement for an individual with a compromised
arm.
In the Horizontal Plane an free arm may be placed over the secured arm,(Fig #4 Page 5). This
provides significant trunk movement. The circular rotating motion provides a shifting of weight from
one side to the other which is very helpful in establishing balance in recovering Stroke patients. This
can also be achieved if the User has the ability to grip both posts and allow the arms to rotate with the
posts either close to them or away from them.
5. The Arm Rest rotates either to the left or to the right .
6. The circular interface of the machine permits it to be used from any angle. The Top Unit section of
the machine may be placed at any angle to the wheelchair. The base may be placed either outside the
wheels of the wheelchair or one base pontoon in between the wheels. Experimentation is usually
required in order to find the best position and best results for each individual.
7. The machine may be placed to the side of the wheelchair and used from this position for 45° or
Vertical movement.
8. The machine may also be placed at the side for use in the Horizontal plane.. In this position
increased shoulder movement may be obtained.
9. The EF-100/100W is very mobile and easily moved from place to place. It is easily locked into
position with locking castor wheels.
10. Full Biofeedback features are available on this machine.
When using the In the
Vertical mode i
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