NeuroMove NM900 Instruction Manual

NeuroMove®
PATHWAY TO RECOVERY
Neur oM o v e
®
NM900
PROGRAMMING GUIDELINES

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Table of Contents
S af et y I nf or ma tion .................................................................................... 4
P rogramming the Neur oM o v e® .............................................................. 15
Adjust T hr eshold ..................................................................................... 11
Rest Period .............................................................................................. 12
Operational M odes ................................................................................. 13
Change P ar amet ers ................................................................................. 14
F r equency ............................................................................................... 14
Pulse W idth ............................................................................................. 15
S timula tion P er iod .................................................................................. 15
Ramp - On T ime ........................................................................................ 16
R amp - O ff T ime ........................................................................................ 16
S ensitivit y R ange .................................................................................... 17
T r ea tmen t T imer ...................................................................................... 18
Set Defaults............................................................................................ 18
Ba tt ery Charge S ta tus ............................................................................. 19
Audio Enable.......................................................................................... 19
Compliance Data.................................................................................... 20
Operational Mode Descriptions ............................................................ 21
S tr oke R ehabilita tion Mode ...................................................... 21
SCI Mode.................................................................................. 23
Manual Mode ............................................................................ 24
S timulation- Only mode ............................................................ 24
Audio P rompts ........................................................................................ 24
Warranty ................................................................................................ 25

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S af et y I nf or ma tion
Equipmen t Classification
As per the International Electrotechnical Commission standard IEC 60601-1,
and the E urop ean standard EN 60601-1, Medical Electrical E quipment, G ener al
Requirements for S afet y , the NeuroMove® is classified as follows:
Type BF E quipmen t
A Type BF piece of equipment is one that provides a particular degree
of protection
against electric shock , particularly regarding allowable
leakage cur r en t . A Type BF applied part is one that is floating above
ground
and is isola t ed from all other parts of the equipmen t .
Internally Powered Equipment
The Neur oM o v e® is classified as an internally powered devic e . Note:
Use only with supplied battery char ger :
Input range: 100-240 VAC, 50-60 Hz. Output: 12 VDC, 500 m A.
Electromagnetic Compatibility
Conforms to IEC 60601-1-2.
Temperature
Operating temperature range: 0° - 50° C (32° - 122° F)
S t or age temperature range: -20° - 70° C (-4° - 158° F)
Humidity
Operating relative humidity range: 0-95%, non-condensing
Transport and s t or age relative humidity range: 0-95%, non-condensing
Pressure
Operating pressure range: 500-1060 hPa
Transport and s t or age pressure range: 500-1060 hPa
Water I ngr ess
Ordinary equipmen t . This device has protection against
ingress of w a t er .
Flammable Anesthetics
This device is not suitable for use in the presence of a flammable
anesthetic mixture with air, or in the presence of a flammable
anesthetic mixture with oxygen or nitrous o xide .
Disinfection
The enclosure and patient cable may be disinfected and cleaned with
a 70% isopropyl alcohol solution.

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S ymbols
S ymb ols marked on the device are defined b elo w .
Type BF Equipment This symbol indica t es that the patient applied
parts (electrodes) are Type BF (floating from ground) offering the
user a specific level of saf et y .
Attention, consult accompanying documents The operator must
r ead , understand , and follow all instructions in the accompanying
documents including all w ar nings , cautions , and precautions before
using the medical devic e .
Standby/On This symbol indica t es that the labeled switch
electronically cycles the DC power on and off for part of the
equipment.
Note: to
disc onnec t the e x t er nal charger input , unplug the power
cord of the supplied AC adapter from the AC mains r ec eptacle .
Waste Electrical and Electronic Equipment (WEEE) This product
may contain substances known to be hazardous to the environment
or to
human health. It should be disposed of properly (for e xample ,
at your local waste collection administration or recycling plant) and
in accordance with local or dinanc es .
Refer to Instruction Manual/Programming Guidelines The
operator must r ead , understand , and follow all instructions in the
accompanying document including all w ar nings , cautions , and
precautions before using this medical devic e .

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Warnings
The device does not function as a medical device when e x t er nal battery charger is
plugged in and battery is being r echar ged .
The device does not incorporate a power switch to isola t e the system from the
AC mains . Unplug the power cord of the AC battery charger from the AC mains
outlet in order to positively disc onnec t from the A C mains .
The device is capable of generating current densities for electrodes exceeding 2
mA rms/cm
2
which may require special attention of the operator.
Do not exceed 2 watts/cm
2
with recommended elec tr odes , assuming a load of
1000 Ω .
· 1” round: Maximum stimulation setting = 28 mA
· 2” round: Maximum stimulation setting = 100 mA
· 2” square: Maximum stimulation setting = 100 mA
Output waveform/power information
When delivering stimulation energy, the Neur oMo v e ® is a constant current output
device. Therefore its output
v oltage , current, and power is dependent upon the load as
well as the pulse width and frequency of the
output waveform. The maximum peak
voltage that the Neur oMo v e ® can pro duc e is 100 V (1 KΩ load). The maximum peak
current that the Neur oMo v e ® can produce is 100 mA (1 KΩ load). The maximum output
power
that the Neur oMo v e ® can produce is 1.28 W (1 KΩ load).
· Maximum peak output voltage (1 KΩ load) = 100 V
· Maximum peak output current (1 KΩ load) = 100 mA
· Maximum peak output voltage (500 Ω load) = 50 V
· Maximum peak output current (500 Ω load) = 100 mA
· Maximum peak output voltage (2 KΩ load) = 100 V
· Maximum peak output current (2 KΩ load) = 50 mA
· Pulse width range: 50 - 400 µs
· Pulse frequency range: 2 - 160 Hz
· Maximum RMS voltage (1 KΩ load) = 35.78 V
· Maximum RMS current (1 KΩ load) = 35.78 mA
· Maximum output power (1 KΩ load) = 1.28 W
· Maximum RMS voltage (500 Ω load) = 17.89 V
· Maximum RMS current (500 Ω load) = 35.78 mA
· Maximum output power (500 Ω load) = 0.64 W
· Maximum RMS voltage (2 KΩ load) = 35.78 V
· Maximum RMS current (2 KΩ load) = 17.89 mA
· Maximum output power (2 KΩ load) = 0.64 W
The device is capable of generating currents and voltages in excess of 10 mA
RMS and 10 V RMS, respectively, into a 1000 Ω load as shown above. A

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yellow LED indicator is provided on the front panel to show that the unit is
delivering energy for any non-zero value of stimulation output (1-100 mA).
Patients with an implanted electronic device (for example a cardiac
pacemaker) should not be subjected to stimulation unless specialist medical
opinion has first been obtained
.
Stimulation should not be applied transthoracically in that the introduction of
electrical current into the heart may cause cardiac arrhythmias.
Simultaneous connection of a patient to high frequency surgical equipment may
result in burns at the site of the stimulator electrodes and possible damage to the
stimulator.
Operations within close proximity (within 1 m) of shortwave or microwave therapy
equipment may produce instability in the stimulation output.
The safety of this device for use during pregnancy or birth has not been
established.
This device should only be used under the continued supervision of a trained
physician.
This device does not have a curative value.
The user must keep this device out of the reach of children.
Electronic monitoring equipment (such as ECG monitors and ECG alarms) may not
operate properly when this device is in use.
The long-term effects of chronic electrical stimulation are unknown.
Stimulation should not be applied over swollen, infected or inflamed areas of skin,
eruptions, e.g. phlebitis, thrombophlebitis, varicose veins, etc.
Stimulation should not be applied over, or in proximity to, cancerous lesions.
Simultaneous connection of a patient to high frequency surgical equipment may
result in burns at the stimulator electrodes and possible damage to the stimulator.
Operations within close proximity (with one meter) of shortwave or microwave
therapy equipment may produce instability in the stimulation output.
STRANGULATION HAZARD. The lead wire included with this product presents a
potential strangulation hazard. Keep this cord out of the reach of children.

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Indications for U se
• Maintaining or increasing range of motion for stroke rehabilitation
by muscle re-education.
• Relaxation of muscle spasms, prevention or retardation of disuse
atrophy, increasing local blood circulation.
• Biofeedback and relaxation.
C on tr aindica tions
Receptive or global aphasia to the degree that the patient can not
understand the process involved in using the NeuroMove®.
Powered muscle stimulators should not be used on patients with
cardiac demand pacemakers.
Powered muscle stimulators should only be used under medical
supervision for adjunctive therapy for the treatment of medical diseases
and conditions.
Powered muscle stimulators should not be used on carotid sinus (neck)
region or transcerebrally (through the head).
Powered muscle stimulators should not be used whenever pain syndromes
are undiagnosed until etiology is established.
Precau tions
Isolated cases of skin irritation may occur at the site of the electrode placement
following long-term application.
Effectiveness is highly dependent upon patient selection by a person qualified in
management of pain patients.
Safety of powered muscle stimulators for use during pregnancy has not been
established.
Caution should be used for patients with suspected or diagnosed heart problems.

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Caution should be used for patients with suspected or diagnosed epilepsy.
Caution should be used in the presence of the following:
1. When there is a tendency to hemorrhage following acute trauma or fracture.
2. Following recent surgical procedures when muscle contraction may disrupt the
healing process.
3. Over the menstruating or pregnant uterus
4. Over the areas of the skin which lack normal sensation.
Some patients may experience skin irritation or hypersensitivity due to the electrical
stimulation or electrically conductive medium. The irritation can usually be reduced by
using an alternate conductive medium, or alternate electrode placement.
Electrode placement and stimulation settings should be based on the guidance of the
prescribing physician.
This device should be kept out of reach of children.
This device should be used only with the leads and electrodes recommended for use
by the manufacturer.
This device should not be used while driving, operating machinery, or during any
activity in which involuntary muscle contractions may put the user at undue risk of
injury.

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Adverse Reactions
Skin irritation and burns beneath the electrodes have been reported with the
use of powered muscle stimula t ors .
M ain t enanc e and C alibr a tion
Do not remove the c o v er . There are no user serviceable par ts . Refer all ser vic e
to authorized Zynex Medical personnel .
No preventative inspections are r equired . Factory testing ensures equipment
accuracy and response.

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P r og ramming the Neur oM o v e
®
S ettings normally do not need to be adjusted . See below on how to change
from the
default S tr oke R ehab mode to the more sensitive Spinal Cord Injury
(SCI) mode .
The unit is programmed by stepping through the various programming
functions . Each programming function is described in sequence belo w . T o
program a particular function, press the Program button in sequence un til
the
desired function is display ed . Pressing the Program button in consecutive
fashion will skip over any programming functions that are not desir ed . To exit
the programming mode , consecutively press the Program button until the
programming mode is e xit ed .
Note: The
unit will automatically exit the programming mode after 20
seconds if a key press is not detected.
Adjust T hr eshold
To change
the thr eshold , press the program button onc e .
The threshold is the signal level at which stimulation is tr igger ed . If the
patient
is able to produce enough signal strength to meet or exceed this
thr eshold , an electrical muscle stimulation signal will be fed to the electrodes
in order to produce a contraction.
The threshold is shown by a horizontal line on the display . In S tr oke R ehab
and SCI modes the threshold is automatically adjusted upward or downward
every 15 seconds in order to track the pa tien t ’ s pr ogr ess . In Manual mode the
threshold remains at a fixed lev el . See Operational Modes setting belo w .
To increase the thr eshold , press the Up button. The threshold will increase as
shown belo w .
Adjust Threshold ↑↓

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To decrease the thr eshold , press the Down button. The threshold will
decrease as shown belo w .
Adjust Threshold ↑↓
When in S tr oke R ehab or SCI mode , the threshold will adjust automatically
during the next sampling period (15 seconds). In Manual mode the threshold
will
remain as set. See Operational Mode settings belo w .
Rest Period
To change the rest per iod , press the program button once again.
The rest period is the time after stimulation ends during which the patient is
encouraged to relax as much as possible . The rest period can be adjusted in
the
range from 0.1 - 60 sec onds . The default is 15 sec onds . Note: the word
“R elax ” flashes in the upper right corner of the display during the rest per iod .
Rest Period:
15
sec.
To increase the rest per iod , press the Up button. To decrease, press the Down
butt on.

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Operational M odes
To change the operational mode , press the program button once again.
The Neur oM o v e® has four different operational modes .
Stroke Rehabilitation
This is the normal mode for the Neur oM o v e®. It has good low-level
sensitivity and a wide dynamic r ange . The range is 1.25-1000 micro-
volts (58 decibels). It is intended primarily for stroke rehabilitation.
SCI (Spinal Cord Injury)
This mode is similar to S tr oke R ehabilita tion but has more low-level
sensitivity and less r ange . It is intended primarily for spinal cord injury
rehabilitation.
There are two sensitivity ranges available: 0.25- 25
microvolts (40 decibels) and 0.50-50 microvolts (40 decibels). S ee
Change Parameters programming below for range selection
pr oc edur e .
Manual
This mode is similar to S tr oke R ehabilita tion, but requires manual
setting of the thr eshold .
Stim Only
In this mode , the unit acts like a stimulator only . S ee “Operational
Modes Descriptions” belo w .
Mode:
Stroke
Rehab
Use Up and Down buttons to selec t the desired mode .

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Change P ar amet ers
To change paramet ers , press the program button once again. Then press the
Down butt on.
Change
Parameters?
↓
F r equenc y
The frequency is the r a t e at which stimulation pulses are sen t . For e xample ,
for a 50 Hz fr equenc y , pulses are sen t at a r a t e of 50 per second or one every
0.020 sec onds . The frequency can be selec t ed in the range of 2 - 160 Hz. T he
default is 50
H z.
Frequency:
50
Hz
To increase the fr equenc y , press the Up button. To decrease, press the Down
button.
This parameter normally does not need to be changed by the user .

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Pulse Width
To change the stimulation pulse width, press the program button once again.
The pulse width can be selec t ed in the range from 50 - 400 µs (micr osec onds)
in 5
microsecond incremen ts . The default is 200 micr osec onds . T his
parameter normally does not need to be changed by the user .
Pulse Width:
200
uS
To increase the pulse width, press the Up button. To decrease, press the Down
butt on.
Stimulation Period
To change the stimulation per iod , press the program button once again.
The stimulation period is the time during which unit delivers electrical energy
to the patient to
cr ea t e a muscle contraction. The stimulation time can be
selec t ed in the range from 0.5 - 30 sec onds . The default is 5 sec onds .
Note: the word “ S tim ” along with the intensity appears in the upper lef t
corner of the display during the stimulation period.
Stim. Period:
5
sec.
To increase the stimulation per iod , press the Up button. To decrease, pr ess
the Down butt on.

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Ramp - On T ime
To change the ramp on time , press the program button once again.
When stimulation is initially delivered to the pa tien t , the output pulse level in-
creases from zero to full intensity during a specified period of time . This effect
provides a more comfortable transition for the patient rather than delivering
full output from the beg inning . For e xample , if the ramp on time is one
sec ond , it takes one second for the output pulse level to increase from zero
intensity to full in t ensit y . The ramp-on time is adjustable in the range from
0.1 - 6 sec onds . The default is one sec ond . This parameter normally does not
need to be changed by the user .
Ramp On Time:
1 sec.
To increase the ramp on time , press the Up button. To decrease, pr ess
the
Down button.
Ramp-Off Time
To change the ramp off time , press the program button once again.
Similar to ramp on time , when the stimulation period is o v er , the unit
gradu
ally turns off the intensity from full intensity to zero during a specified
period of time . For e xample , if the ramp off time is one sec ond , it takes one
second for the output pulse level to decrease from full intensity to zero
in t ensit y . Again, this effect provides a more comfortable transition for the
patient rather than abruptly removing the stimulation. The ramp-off time is
adjustable in the range from 0.1 - 6 sec onds . The default is one sec ond . This
parameter normally does not need to be changed by the user .

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Ramp Off Time:
1
sec.
To increase the ramp off time , press the Up button. To decrease, press the
Down button.
Sensitivity Range
To change the sensitivity r ange , press the program button once again.
The sensitivity range describes the range of signal levels from the patient tha t
the Neur oM o v e® can det ec t .
When in S tr oke R ehab operational mode there is only one r ange ,
1.25 – 1000 µV (microvolts). S wit ch to SCI operational mode if S tr oke R ehab is not
sensitive
enough (displayed signal levels are at a very low level or bottomed out).
In SCI mode , two ranges are selectable: 0.25 - 25 µV and 0.50 - 50 µV. Use the
latter if the
former is too sensitive (levels are reaching maximum).
Sensitivity:
1.25-1000
uV
Press the Up or Down key to selec t the desired r ange .

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Treatment Timer
To change the treatment time , press the program button once again.
The Neur oM o v e® can time therapy sessions. The selectable treatment times are
from 10 - 90 minut es , in ten-minute incremen ts . The default time is
con tinuous . The unit will automatically shut off after the selec t ed amount of
time
. In continuous mode , the unit never turns off .
Treatment Time:
Continuous
To increase the treatment time , press the Up button. To decrease, press the
Down butt on.
Set Defaults
To set the factory defaults , press the program button once again.
If any of the parameters are mistakenly set, the Neur oM o v e® provides a way t o
return to factory default c onditions .
Set Defaults? ↓
To set defaults press the Down button. The display will sho w “DefaultsSet” .
Press the programming button again to exit the Change Parameters
subfunction.

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Battery Charge Status
The charge sta t e of the built-in, r echargeable , 7.4 V, 2000 mAH, lithium-ion
battery is provided during charging or dischar ging . The battery is charging
when the AC adapter is plugged in. The battery is discharging when the A C
adapter is not plugged in. The value provided indica t es percentage of full
char ge . 100% means that the battery is fully char ged . It is recommended t o
charge the battery at least once every 2-3 w eeks .
Battery
Charge:
100%
Audio Enable
To disable or enable audio pr ompts , press the program button once again.
The Neur oM o v e® provides audio prompts to help guide the user in the opera-
tion of the
machine . See the “Audio P rompts ” section for a detailed
explanation of each audio pr ompt . Audio prompts are on by default .
Audio: On
Press the Up or Down button to turn audio prompts on or off .

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Compliance Data
To view the compliance data, press the program button once again.
The unit keeps track of the number of times and amount of time it ’ s been
used at stimulation level g r ea t er than 5 mA (milliamps).
Compliance Data ↓
Press the Down button to view the compliance data.
21 hrs., 30 min.
43
times
Press the P rogramming once again to exit the programming mode . The dis-
play will sho w “Restarting Ready Mode … ”.