Kolibri StarDevice User manual

User’s manual of the
shock-wave therapy device
StarDevice®
Version 1EN
UA.TR.099

TF.16 IFU StarDevice.003.10-EN 2021-01-12 prepared by Pulavskyi A., Kolyesnik O. 2
Scientific company
KOLIBRI LLC
Prov. Kinnyi 8a. Kharkiv,
61001, Ukraine
Tel.: [phone]
email: [email protected]
URL: https://kolibri.cloud
The official representative in the EU:
“ONKOCET Ltd.”
4 Kutuzova str., 90201 Pezinok, Slovakia,
tel.: [phone]
Email: [email protected]
URL: www.onkocet.eu
The user’s manual, including all its sections, is protected by the
copyright. Any use of materials from this manual that violates the
requirements of the current copyright law without the written
permission of the manufacturer is prohibited.
This provision concerns, copying, translating, micro photocopying,
and placing and processing in electronic systems
STARDEVICE®–the registered trademark

TF.16 IFU StarDevice.003.10-EN 2021-01-12 prepared by Pulavskyi A., Kolyesnik O. 3
CONTENTS OF THE USER’S MANUAL
Contents
3
Symbols and conventional signs
5
1 General review
6
1.1 Purpose of the device
6
1.2 Indications for use
6
1.3 Contraindications
7
1.4 Side Effects
8
2 Warnings and safety instructions
9
2.1 Safety signs on the device
9
2.2 Warnings and safety instructions
9
2.3 Measures to prevent damage of equipment and the device
11
3 A brief description of the device STARDEVICE®
11
4 Before using the device STARDEVICE®
12
4.1 The list of the preparatory actions
12
4.2 The operator’s qualification
12
5 An operating procedure of the device STARDEVICE®
13
5.1 The patient’s location
13
5.2 The operator’s position when performing therapy on a spine
14
5.3 Tips
14
5.4 How to hold the manipulator
15
5.5 Recommended treatment protocols
16
5.6 Switching the device on
32
5.7 Description of controls
33
5.8 Main menu
33
5.9 Submenu
34
5.10 Messages
36
5.11 Completion of work with the device
36
5.12 STARDEVICE-PC software StarDevice ver. 1.3
36
6 Service of the device STARDEVICE®
47
6.1 Cleaning of the device
47
6.2 Cleaning of the tips
47
6.3 Replacing a fuse
47
6.4 Maintenance and security check
48
6.5 Disposal and the environmental protection
48
6.6 Repairs
49
6.7 Shelf-life
50
7 Recommended cleaning materials
50
8 General view of the device
51
9 Technical descriptions
52
9.1 Classification of the device STARDEVICE®
52
9.2 Technical data
52
9.3 Storage and transportation
54
10 Warranty commitments
55

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11 Possible errors and malfunctions. Ways to resolve them.
56
12 Checklist
57
13 Product acceptance protocol
58
14 Packing list
59
15 The warranty certificate
60
16 Pictures of treatment procedures
61
17 Marking of the device STARDEVICE®
61
18 Decommissioning and disposal of software
62
19 The complete set of STARDEVICE®
62
20 Document history and version control
63

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SYMBOLS AND CONVENTIONAL SIGNS:
Warning
Prohibition
Obligatory action
Character pattern of
obligatory actions
Be sure to read the instruction
Degree of protection of the
device against penetration
of solid objects
Protective ground
Working part of type BF
To turn the power on
Supply voltage of the
device
To turn the power off
A fuse
To increase frequency
To increase force
To decrease frequency
To decrease force
Manufacturer
Enter a value
Date of manufacture
Serial number of the
device
It is disposed as used electronic
equipment

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1 GENERAL REVIEW
1.1 PURPOSE OF THE DEVICE
The shock-wave therapy the device STARDEVICE®(hereinafter - the device) is intended for the
treatment of the musculoskeletal system, rehabilitation of back and head injuries, including those
complicated by partial or complete paralysis. Also, the device can be used for other types of therapy,
which require forced stimulation of blood circulation in tissues.
The manipulator of the device generates mechanical shocks of a given frequency and force. A doctor
with the manipulator makes a mechanical (percussive) effect on ligaments, muscles or vertebral
segments of a patient.
The shock-wave therapy is recommended for patients from 23 years and older, according to the
recommendation of the Vertebrology and Rehabilitation Institute (Kiev, Ukraine).
1.2 INDICATORS FOR USE
The device can be used in various areas of therapy: orthopaedics, neurology, rheumatology,
cosmetology (getting rid of cellulite) and many others. The usage of the device, in those or other
cases, is limited only by the knowledge of the specialist. Main diseases and injuries in which the use
of the device STARDEVICE®is recommended:
•Pain in the shoulder girdle with calcification or without calcification;
•Pain in knee joints;
•Pain syndrome with ankle sprain or muscle strain after physical exertion;
•Achillodynia;
•The acetabular bursitis / friction syndrome or the otibial tract («a knee of arunner»)
•Lateral and medial epicondylitis («An elbow of a tennis player», «Agolfer's hand»);
•Tendonitis in various areas;
•Treatment of trigger zones in deep muscles;
•Treatment of trigger zones in the superficial muscles and myofascial trigger zones (Myofascial
syndrome);
•Chronic back pain (a cervical / a lumbar spine);
•Deforming osteoarthritis (arthrosis) of large joints;
•Osteochondrosis of different parts of a spine;
•Intervertebral hernia;
•Myofascial syndrome;
•Heel spurs (plantar fasciitis), flat feet;
•Sport injuries of the bone-ligament-articular union (during rehabilitation);
•Shoulder-scapular peri arthropathy;

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•Rehabilitation after injuries of the spinal cord and the brain, accompanied by paresis and paralysis;
•Rehabilitation during fractures (in the case of slow fusion of bones);
•Rehabilitation after an end oprosthetics operation of a joint (with persistent pain);
•Synovitis of various joints (not infectious);
•Trochanteritis;
•Osgood–Schlatter disease
•Osteochondrosis of the tubercle of the tibia;
•Syndrome of a chronic pelvic pain / prostatitis;
•Peyronie's disease;
•Trigger zones of the muscles of the pelvic floor;
•Vascular erectile dysfunction;
1.3 CONTRAINDICATIONS
Proper examination and diagnosis must be performed, before starting treatment with shock
waves. Please keep up to date with the latest developments and medical publications on
shock-wave therapy for detailed information on contraindications and side effects not
known at the time of the device's manufacture. Contraindications listed in this section are
given at the time of writing of the Instruction. No claims regarding the completeness or
unlimited duration of this list of contraindications are accepted. Before carrying out the
procedures, a medical specialist should be convinced of the expediency of using this
procedure, the responsibility for which he bears personally.
The use of the device is contraindicated in the following cases:
• Violation of blood clotting (hemophilia, hemorrhage, risk of bleeding, etc.);
• Deep vein thrombosis, phlebitis, varicose veins;
• The use of anticoagulants, especially marcoumar;
• Severe arterial obstruction (grade III and IV);
• Peripheral vascular disease, circulatory insufficiency;
• The presence of bleeding, open wounds, ulcers and (or) damage of the skin;
• Occlusive vascular diseases, such as obliterating arteriosclerosis and obliterating
thrombangiitis (Buerger disease), in which organic occlusion and ischemia are evident;
• In case of acute inflammation: it is prohibited to use the device on tissues that have swelling,
inflammation and traces of infection, skin rashes or other acute tissue lesions;
• In case of systemic or local infection is present (sepsis, osteomyelitis, tuberculosis) or if a
patient has a fever;
• For patients with malignant tumours, undiagnosed tumours and neoplasms;

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• Pregnancy;
• With severe somatic pathology;
• Areas of epiphyseal growth zone closure of children;
• For patients who have been treated with hormones - up to 6 weeks before the first procedure;
• Over pacemakers and defibrillators, cochlear implants;
• In the presence of stimulators of bone growth and neurostimulants (brain, spinal cord and other
stimulants of nerves);
• In the area where the implants are installed / were installed, above the surface endoprosthesis and the
metal implants;
• Above the open plate (after laminectomy, splitting of the spine);
• In the eye area;
• In the field of reproductive organs;
• Directly above the carotid artery, the stellate ganglion or a vagus nerve, located in the triangle on the
front of the neck;
1.4 SIDE EFFECTS
The use of the device can cause the following side effects:
• Swelling, redness, bruises;
• Spot haemorrhages;
• Pain;
• Skin infection after previous cortisone therapy.
These side effects usually depart after 5-10 days.
After a course of shock-wave therapy, the pain syndrome can be increased, the chronic process
exacerbated, which depends solely on the strength and intensity of the exposure and the individual
susceptibility of patients.

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2 WARNINGS AND SAFETY INSTRUCTIONS
2.1 SAFETY SINGS ON THE DEVICE
The manipulator is protected by reinforced insulation and has no galvanic connection to
the ground.
IP20 –A degree of protection against penetration of solid objects.
2.2 WARNINGS AND SAFETY INSTRUCTIONS
The user must have the proper technical and medical qualifications and know the user’s
manual of this device in order to use this device. All maintenance procedures recommended
by the manufacturer must be performed by personnel with appropriate approvals.
It is allowed to use the device in medical centres, in rehabilitation and sports medicine
centres, SPA centres, massage rooms for adult patients (23 years and older).
The operator must inspect the housing of the electronic unit, the manipulator and the tips,
as well as the power cord and the manipulator cable before using the device, to ensure there
is no external damage. Operation of the device with a damaged housing of the electronic
unit or a manipulator, a damaged manipulator cable or a power cord is prohibited!
This device complies with the requirements of the electrical safety standard EN
60601-1: 2010.
It is necessary to connect the device to the mains supply in accordance with the national
electrical safety regulations.
The device must be placed beyond the reach of a patient,
especially children, as the device has small working tips,
moving parts and removable parts that can cause injury (small
elements can be swallowed).
Certified and safe materials are used for the device. Potentially, a patient's allergic reaction
to parts that come in contact with the skin surfaceduring the treatment procedure is possible.

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ATTENTION! Modification of the product is not allowed!
CAUTION! To avoid the risk of electric shock, the product must only be connected to a
mains supply that has a protective ground.
Disconnect the device from the power supply, before performing any cleaning or
maintenance work. The means of simultaneous electrical separation of the supply circuits
of the device from the circuits of the supply network is the mains switch of the device.
Connect the device only to a working socket with a rated voltage within the range 100 -
240V 50-60Hz. The location of the device should ensure that there is no tension on the
power cord and the manipulator cable, unhindered connection and disconnection of the
power cord from the mains to quick disconnection of the device from the mains in
emergency situations.
Do not allow humidity to enter the electronics housing and the manipulator. Do not expose
the device to dampness, vibration, or shock.
It is prohibited to use the device in a potentially explosive atmosphere, i.e. in the presence
of a mixture of flammable anaesthetic gas with air, oxygen or nitrogen oxide.
It is prohibited to use the device in rooms where flammable and potentially explosive
substances are stored or used.
There is a risk of transmission of germs! Disinfect the tips before and after each use!
It is forbidden to impulse organs containing gas, in particular, lungs.
Therapy with shock waves can make an undesirable effect on a heart. It is necessary to
continuously monitor a patient's condition during the procedure. The patient is allowed to
act no more than 3000 shocks per a treatment session.

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Only procedures recommended in this manual areallowed! The user must correctly position
the tip and correctly select a place of exposure according to the user’s manual.
2.3 MEASURES TO PREVENT DAMAGE OF EQUIPMENT AND THE DEVICE
Connect the device to the mains through a circuit breaker with the characteristic "C" and a rated current
of not more than 6A.
The placement of the device must ensure uninterrupted connection and disconnection of the power cord
from the mains. Do not allow the situation where the manipulator cable or power cord is under the feet of
a user or patient! Do not squeeze, stretch, attack, etc. mechanical stress on the manipulator cable and
power cable!
There are ventilation slots in the walls of the electronic unit that can’t be closed by other objects. Do not
cover the device during operation.
It is forbidden to disconnect the manipulator from the electronic unit of the device during operation and
when the power is on. Hold the manipulator either in hand or in the holder. Do not allow the manipulator
to be on the floor!
This device complies with the requirements of the EMC standard (IEC 60601-1: 2005-12 3rd ed.). As a
rule, the level of emitted electromagnetic interference is not sufficient to disrupt an operation of the most
devices. However, it should exclude an operation of the device in close proximity to sensitive equipment.
It is recommended to place the device no closer than 1m to such equipment.
The tips for the device must be stored in a place protected from direct sunlight’s.
It is necessary to exclude contact of the tips with various solvents, gasoline, kerosene and other substances
that destroy rubber and polyurethane.
It is forbidden to install the device on slippery surfaces to prevent the device from falling.
3 A BRIEF DESCRIPTION OF THE DEVICE STARDEVICE®
The device STARDEVICE®is intended for the treatment of the musculoskeletal system, rehabilitation of
back and head injuries, including complicated partial or complete paralysis. Also, the device
STARDEVICE®can be used in other types of therapy, that require forced stimulation of blood
circulation in tissues.
The device STARDEVICE®consists of the electronic unit and the manipulator, that is the working part
of the device. Mechanical pulses of a specified frequency and force are generated by the manipulator. A

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doctor with the help of the manipulator makes a mechanical (percussive) effect on ligaments, muscles or
vertebral segments of a patient. The frequency of shocks is set in the range from 4 to 12 beats / sec., in
increments of 0.1 beats / sec. Force / intensity of shocks can be varied within the limits of 4.54 kg / cm2 -
15.87 kg / cm2 in 2.2 kg / cm2 increments, which corresponds to a scale from 10 to 35 points. There are
appropriate tips in the set of the device to influence different areas or organs of a body.
4 BEFORE USING THE DEVICE STARDEVICE®
4.1 THE LIST OF PREPARATORY ACTIONS
Before using the device STARDEVICE®, you should:
• To make sure that the power supply network is used with a protective ground; that the voltage in the
network is in the range 100 - 240V, 50 - 60 Hz. The device STARDEVICE®is intended for connection to
type F (Schuko) sockets (European socket with CEE 7/4 grounding, DIN 49440 standard). Suitable
adapter is required to connect to other types of sockets; in any case, the presence of a protective ground
in the power socket is mandatory!
• To ensure the presence and storage of 70 - 96% hydroalcoholic solution to clean the tips;
• To ensure the presence and storage of medical alcohol wipes or cotton discs for cleaning the tips.
• To ensure the presence and storage of wet wipes for a screen that do not contain alcohol to clean the
display of the device STARDEVICE®!
• To organize the workplace of the operator so that the device is placed on a solid, smooth, dry and not
slippery surface, and to comply with the measures listed in the paragraph 2.3.
• Remove the device from its packaging. Check if there is no damage to the electronics housing, the
manipulator, the power cord and the manipulator cable. Switch the main switch to the "Off" position.
• Connect the manipulator cable to the corresponding connector on a back panel of the electronic unit.
• Connect the power cord to the power connector on a back panel of the electronic unit, plug the power
cord into a power socket.
4.2 THE OPERATOR’S QUALIFICATION
The device STARDEVICE®is intended for use by the operators having special knowledge in the field of
application of this device and the operators who has been trained how to use properly the device, as well
as the operators who has practical skills in working with similar medical procedures. The operator must
have basic physical and cognitive prerequisites, such as sight, hearing and literacy.
Besides, the operator must take into account the manufacturer's recommendations (Chapter 1, item 1.2
"Indications for use" and item 1.3 "Contraindications") to be aware of the latest developments and
medical publications on shock-wave therapy for detailed information on contraindications and side effects,
not known at the time of manufacture.
It is forbidden to use the device STARDEVICE®for operators with disabilities (disabled people), whose
physical or mental deficiencies do not allow to actually monitor and perform a treatment procedure.
The operator must pass the appropriate training regarding the correct operation of the device before
working with the device STARDEVICE®:

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• Targeted use of the device with practical exercises;
• The mechanism of action and function of the device;
• Settings of all components;
• Indications for use of the device;
• Contraindications and side effects of the shock-wave therapy;
• An explanation of safety signs in all modes of operation;
• Method of functional verification of the device.
Further recommendations for training may vary depending on the country. Please contact your local
representative of SC KOLIBRI LLC for more information on training the operation of this device.
5 AN OPERATING PROCEDURE OF THE DEVICE STARDEVICE®
The user is obliged to be healthy and vigorous (rested) during the use of the device because
a patient's health and even his life is highly dependent on the user during the procedures,
before the application the user must not take psychotropic substances, analgesics, opiates,
sleeping pills, drugs or alcohol for at least 48 hours, half of which is wakefulness.
5.1 THE PATIENT’S LOCATION
Before you start you need to place a
patient correctly:
The patient must be located in a C-shaped
position, during treating a spine and upper
extremities for stretching vertebral joints and
general relaxation. This posture is the most
effective for the shock-wave therapy of a spine.
The lower extremity therapy is performed lying
on a couch, except for special procedures.

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5.2 THE OPERATOR’S POSITION WHEN PERFORMING THERAPY ON A SPINE
The operator must be at the back of the patient. If the operator is
working with his right hand, then his left foot should be pointed
forward towards the support of the patient's head, and the right leg
is directed perpendicular to the left (the so-called L-pillar). If the
doctor works with his left hand - the location should be mirrored.
5.3 TIPS
It is necessary to use certain tips to treat different areas and segments. The tips are
inserted into the manipulator with pushing the rod of the tips into the hole of the
manipulator. Before use and after use, wipe the tip with a water-alcohol solution.
The surface of the patient's skin should be dry and clean to avoid slipping of the tips.
Used tips and their recommended usage:
TIP #1
TIP #2
TIP #3
It is used to correct all the
segments of the spine.
A small nozzle is used to
correct all the segments of the
spine
It is used only for certain
protocols.
TIP #4
TIP #5
TIP #6
A pediatric tip is used to correct
all the segments of the spine.
A tip with a bulging head. It is
used for therapy of trigger
points and acupuncture
massage.
They are used for correction
and treatment of small joints
and muscles
TIP #7
TIP #8
TIP #9

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They are used for medium to
large joints and muscle
correction and treatment
They are used for correction
and treatment of medium and
large joints, and muscles.
They are used for correction
and treatment of large joints,
and muscles.
5.4 HOW TO HOLD THE MANIPULATOR
Hold the manipulator in either hand or in the holder. Do not allow the manipulator to be
on the floor!
An angle of application
The manipulator must be applied at an angle of 43 ° to the spine
during the correction of the vertebral segments - this angle excludes
the load and injury of the facet joint. In all other cases, the angle of
application is chosen by the doctor at his own discretion, based on the
tasks assigned.
Stabilization of the tip
It is also necessary to stabilize the tip to prevent it from slipping and to prevent the stretching of the tissues
during the correction procedure in addition to observing the angle of inclination.
Stabilization is performed by using three fingers of the left hand (if the doctor works with his right
hand):
1. The index finger should be placed on the spinous process of the vertebra.
2. To put the middle and thumb on the top of the tip in the place where the rubber caps are attached
to the metal part of the tip. Do not press down the metal part of the correction tip. Do not put your
fingers in front of the tip or on the upper tips of the rubber caps of the tip.
The angle of the manipulator application is 90 ° when correcting other anatomical areas.

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5.5 RECOMMENDED TREATMENT PROTOCOLS
The protocols for the treatment of certain diseases include a brief information of recommended treatment
algorithm: the choice of a tip force and frequency of shocks, the position of the patient.
Temporomandibular joint
Force
Frequency
Load line
The number of shocks
per point:
10
12
90° to the surface
25
Tip:
(Tip No.8) a large rubber protocol tip
Note
* Treatment without preload. How to level the preload: Take the head in the hand, move the
moving part of the tip with the thumb and index finger. So you can remove a threekilogram load
before percussion.
Test a patient with a 75% opened mouth, the side with the changes being the side
of the correction. The place of contact is the entire mandibular joint.
IMPORTANT: Instruct the patient NOT TO CLOSE his mouth and clench his
teeth. The patient quickly opens and covers his mouth so that only 50% of the
movement of the joint is involved (25% -75%) in the process of correction.
Repeat the previous steps, check the movement of the lower jaw joint. Do not
make more than three sessions per visit. Repeat the protocol three times a week
for one to three weeks. Instruct the patient at home to apply ice for 20 minutes,
then remove ice for 40 minutes. Repeat the procedure three times a day on a day
of treatment.
Sinus
Force
Frequency
Load line
The number of shocks
per point:
10
12
90° to the surface
10-15
Tip:
(Tip No.6) a small rubber protocol tip
Note
* Treatment without preload. How to level the preload: Take the head in the hand, move the
moving part of the tip with the thumb and index finger. So you can remove a threekilogram load
before percussion.
Point 1: frontal process. Point 2: supraorbital fossa. Point 3: nasal bone, anterior
edge of the orbital plate. Point 4: the middle of the malar bone. Point 5: glabella.
Point 6: 12mm above the glabella. Point 7: 25mm above the glabella. Percuss the
points mentioned above and then repeat the procedure again. Perform as
necessary for 1-4 weeks.
Cervical ROM

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Force
Frequency
Load line
The number of shocks
per point:
20-25
12
90° to the surface
50
Tip:
(Tip No.6) a small rubber protocol tip
Note:
* The number of shocks per point depends on the patient's tolerance.
Test the range of motion of the cervical region.
Point 1: middle-upper part of the trapezius muscle. Percussion while the patient turns his head in the opposite
direction. Direct the movement with your free hand. Point 2: 13 mm lateral to point 1 on the trapezius muscle,
the patient repeats the active rotation of the head with maximum force. Point 3: 26 mm lateral to point 1, the
patient repeats the active turn of the head. Point 4: 26 mm lateral to point 3, the patient repeats the active turn of
the head with maximum effort. Repeat the procedure on the other side. Test the range of movement of the neck
in both directions, pay attention to the improvement. Repeat the protocol three times a week for one to three
weeks. Instruct the patient at home to apply ice for 20 minutes, then remove ice for 40 minutes. Repeat the
procedure three times on a day of treatment.
Cervical Extension
Force
Frequency
Load line
The number of shocks
per point:
20-25
12
varied angle
25
Tip:
(Tip No.1) a middle rubber protocol tip
Note
Test the range of motion of the cervical region.
Begin with the head down, attach the tip to the middle of the neck (point 1) and percussion while the patient
raises his head and throws it back. Follow the curve of the neck throughout the movement during the procedure.
Repeat the procedure at points 2 and 3. Require the greatest effort from the patient for maximum results. Give
the patient a short rest and repeat the whole process again at points 1, 2 and 3. Repeat the protocol three times a
week for one to two weeks. Instruct the patient to apply ice for 20 minutes at home, then to remove the ice for
40 minutes. Repeat the procedure three times on a day of treatment.

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treatment.
Bridge
Force
Frequency
Load line
The number of shocks
per point:
25
12
90° to the spine
100
depend’s on the patient’s
tolerance
Tip:
(Tip No.3) a tip long horn
Note
Put your fingers on the patient's forehead so that he reclines his head back as much as possible. Do not
apply force to the reclined head. Start with a neutral position. Once the patient's head began to retreat back,
you should percuss paravertebral muscles at the level of T1 (point 1), let the patient recline maximum his
head back. Return his head to the neutral position. Repeat the procedure at the level of T2 and T3 (points 2
and 3), each time returning the patient to a neutral position. Finally, place the tip on the very back of the
thoracic region (point 4). Instruct the patient to stick out his chest, while maximally to throw back his head
and to bend back. Percuss point 4 to maximize proprioceptive changes, then return the patient to a neutral
position. Repeat the protocol three times a week for one to four weeks. Instruct the patient at home to
apply ice for 20 minutes, then to remove the ice for 40 minutes. Repeat the procedure three times on a day
of treatment.
C.T.S.
Force
Frequency
Load line
The number of shocks
per point:
30-35
4
90° to the spine/a limb
10-15
Tip:
(Tips No1, 6) a medium standard and a small rubber protocol tips.

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Note
Be careful with the heavy loads in this protocol. You can use smaller force of a shock wave at
the beginning, gradually increasing it as the tolerance of the patient increases. The cervical and
forearm are involved in the process.
The cervical spine: put the chin on the chest from the neutral position, with the greatest possible arching of the
neck. Percuss the cervical spine in the indicated areas (C3, C4, C5), marking the point with the largest shoulder
reaction. Percuss this point again, keeping the angle of 90 degrees to the surface.
Forearm: Percuss the posterior surface of the semilunarbone (a small rubber
tip). Percuss the extensors of the hand andfingers. Follow the protocol three
times a week for 1-4 weeks. Instruct the patient at home to apply ice for 20
minutes, then remove ice for 40 minutes. Repeat the procedure three times
on a day of treatment.
Elbow
Force
Frequency
Load line
The number of shocks
per point:
15-20
12
90° to the surface
15-20
Tip:
(Tip No.6) a small rubber protocol tip
Note
The lateral side of the elbow: Point 1 is the head of the radius, Point 2 is 26 mm further from the head of the
radius, Point 3 is 52 mm further from the head of the radius, Point 4 is far end of the lateral head of the triceps,
Point 5 is distal end of humerus, from behind inner side of elbow: Point 6 is inside the distal end of humerus.
Perform the protocol three times a week for 1-4 weeks. Instruct the patient at home to apply ice for 20 minutes,
then remove ice for 40 minutes. Repeat the procedure three times a day on a day of treatment.

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Shoulder Extension
Force
Frequency
Load line
The number of shocks
per point:
20
12
90° to the surface
15-20 or up to an
automatic stop
Tip:
(Tip No.6) A small rubber protocol tip
Note
The load line goes into the head of the humerus through the deltoid and subscapular
muscles, the short head of the biceps and the beak-brachial muscle. The patient holds
his arm elongated and bent at the elbow by 90 degrees, pulls the forearm as far back
as possible, percuss point 1. The doctor passively stretches the shoulder to the end
when the active limit of the range of motion is reached. Repeat the procedure twice.
Follow the protocol three times a week for 1-4 weeks. Instruct the patient at home to
apply ice for 20 minutes, then to remove the ice for 40 minutes. Repeat the procedure
three times a day on a day of treatment.
Shoulder
Force
Frequency
Load line
The number of shocks
per point:
20
12
90° to the surface
15-20 or up to an
automatic stop
Tip:
(Tip No.6) A small rubber protocol tip
Note
Percuss by points, making sure not to slip off the clavicle contact points.
Before: Point 1 is a sternoclavicular joint of the shoulder, Point 2 is to 26 mm lateral to the sternoclavicular joint,
the lower side of the clavicle, Point 3 is to 52 mm lateral to the sternoclavicular joint, the lower side of the
clavicle, Point 4 is middle of the clavicle, the lower side of the clavicle, Point 5 is 26 mm from the
acromioclavicular joint, Point 6 is front side of the acromioclavicular joint. Back: Point 7 is back of the shoulder
joint Point 8 is joint of the clavicle and shoulder blade Points 9-13 are back of the trapezius muscle, move to the
middle step in 26 mm until you reach the bases of the neck. Follow the protocol three times a week for 1-3 weeks.
Instruct the patient at home to apply ice for 20 minutes, then to remove the ice for 40 minutes. Repeat the
procedure three times a day on a day of treatment.