Physiomed IONOSON-Jubilee User manual

Revision: 1.0
Valid for Software Version: 1.0
TECHNOLOGY FOR THERAPY
OPERATING INSTRUCTIONS
IONOSON-Jubilee

The technical data in this manual is as at the time of printing and subject to alteration.
Copyright © 2003, 2004 by PHYSIOMED Elektromedizin AG ®
All rights, including rights of translation, reproduction by printing, copying or similar methods,
even of parts are reserved.
Offenders will be liable for damages.

Instrument Overview
Front Panel
Rear Face
Legend
1 Mains Module 6 Intensity Control 11 Patient Lead Connector
2 Upper Status Bar 7 Pulse Indicator 12 Ultrasonic Head Connector
3 Display 8 Dose Control 13 Manual Release Key
Socket
4 Lower Status Bar 9 Patient Current Indicator 14 VAC Socket
5 Data Selector 10 Output Indicator
Symbols
CAUTION!
Please refer to the operating instructions and consider the physiological effects!
Type BF component, not connected to protective ground wire!
1
14
13
10
7
8
1211
59 6
4
3
2

Contents
1Introduction......................................................................................................................1
1.1 Instrument Description..........................................................................................................................1
1.2 Application..............................................................................................................................................1
1.3 Contraindications...................................................................................................................................2
2Controls and Indicators ..................................................................................................3
2.1 Function of Controls and Indicators ....................................................................................................3
2.1.1 Mains Module <1>...................................................................................................................................3
2.1.2 Upper Status Bar<2>................................................................................................................................4
2.1.3 Display <3>..............................................................................................................................................4
2.1.4 Lower Status Bar<4> ...............................................................................................................................4
2.1.5 Data Selector <5>.....................................................................................................................................4
2.1.6 Intensity Control <6> ...............................................................................................................................5
2.1.7 Pulse Indicator <7> ..................................................................................................................................5
2.1.8 Dose Control <8>.....................................................................................................................................5
2.1.9 Patient Current Indicator <9>...................................................................................................................6
2.1.10 Output Indicator <10>..............................................................................................................................6
2.1.11 Patient Lead Connector <11>...................................................................................................................6
2.1.12 Ultrasonic Transducer Connector <12> ...................................................................................................7
2.1.13 Manual Release Key Socket <13> ...........................................................................................................8
2.1.14 VAC Socket <14>....................................................................................................................................8
2.2 Overview of Parameters ........................................................................................................................9
2.2.1 Start Menu (1st level)................................................................................................................................9
2.2.2 Example Menu (2nd level) ........................................................................................................................9
2.3 Operation ..............................................................................................................................................10
2.3.1 Parameters for Stimulation Current........................................................................................................10
2.3.2 Parameters for i/t-diagnostics.................................................................................................................13
2.3.3 Parameters for Ultrasound......................................................................................................................13
2.4 Characterisation of the Individual Current Modes...........................................................................14
2.4.1 Low-frequency Current Modes (LF)......................................................................................................14
2.4.2 Medium-Frequency Currents .................................................................................................................21
2.4.3 Current Modes of the Diagnostics Menu ...............................................................................................22
3Notes on Operation .......................................................................................................23
3.1 Connection and Start-up .....................................................................................................................23
3.2 Device Start-up.....................................................................................................................................23
3.3 Self-test routine ....................................................................................................................................23
3.3.1 Checking the Coupling Control of the Ultrasonic Transducer ...............................................................24
3.4 Instrument Errors................................................................................................................................24
4Stimulation Current Therapy ........................................................................................25
4.1 General Information ............................................................................................................................25
4.2 Preparations and Attaching the Electrodes .......................................................................................27
4.2.1 Modes of attaching the electrodes..........................................................................................................27
4.3 Therapy using low-frequency current modes ....................................................................................28
4.3.1 Monophase and biphase current modes..................................................................................................28
4.3.2 Iontophoresis..........................................................................................................................................28
4.3.3 Pain Therapy, Hyperaemisation, Detonisation.......................................................................................29
4.3.4 Muscle Stimulation using low-frequency currents.................................................................................30
4.4 Therapy using medium-frequency current modes ............................................................................32
4.4.1 Pain Therapy, Hyperaemisation, Detonisation using AMF Current.......................................................32
4.4.2 Muscle Stimulation using Medium-frequency Surge Currents ..............................................................33

Introduction
5Diagnosis using Stimulation Current...........................................................................34
6Ultrasound Therapy.......................................................................................................36
6.1 General Information ............................................................................................................................36
6.2 Therapy.................................................................................................................................................36
7Simultaneous Therapy ..................................................................................................37
7.1 General Information and Preparations..............................................................................................37
7.2 Therapy.................................................................................................................................................38
8Indications Menu ........................................................................................................... 40
8.1 Treatment Procedures with Stimulation Current .............................................................................40
8.2 Treatment Procedures using Ultrasound ...........................................................................................41
9Individual Programs ......................................................................................................43
9.1 Save individual therapy modes ...........................................................................................................43
9.2 Save Potpourri......................................................................................................................................44
9.3 Call Program ........................................................................................................................................45
9.4 Delete program.....................................................................................................................................45
10 Basic Settings ................................................................................................................46
10.1 Stimulation Current.............................................................................................................................46
10.2 Ultrasound ............................................................................................................................................47
10.3 Setup Menu...........................................................................................................................................48
11 General Notes ................................................................................................................49
12 Service, Repairs, Maintenance ..................................................................................... 49
13 Cleaning and Disinfection.............................................................................................50
14 Connecting a Vacuum Unit ........................................................................................... 50
15 Technical Data ...............................................................................................................51
16 Accessories....................................................................................................................52
16.1 Standard Accessories ...........................................................................................................................52
16.2 Additional Accessories .........................................................................................................................53
17 Manufacturer’s Recommendations ..............................................................................55
18 Test Certificate...............................................................................................................56
19 Index ...............................................................................................................................57

Introduction
1 Introduction
With your IONOSON-Jubilee, you have acquired a high-quality and extremely versatile
combination unit for stimulation current and ultrasound therapy.
The instrument will only show its true potential, however, if you are well informed about
its functions. For this reason, carefully read the Operating Instructions and familiarise
yourself with the use of the instrument.
1.1 Instrument Description
IONOSON-Jubilee is a single channel stimulation current and ultrasound therapy unit.
You can apply current modes from low to medium frequency. Moreover, the unit offers a
program for I/T-curve diagnosis. As for ultrasound therapy, both transducers (2.5 cm2/ 5
cm2) of IONOSON-Jubilee work with the frequency 1 MHz. The unit can also be used
for simultaneous therapy (stimulation current and ultrasound in ONE treatment, page 37).
Therapy modes of IONOSON-Jubilee may be accessed directly or, by a proposed treat-
ment, via the indications menu (page 40). Moreover, the unit enables you to memorise up
to 25 individual treatment programs or current sequences (potpourris, page 43).
All functions of IONOSON-Jubilee are controlled by a microprocessor, which also con-
tinuously monitors all important components and suppresses erroneously initiated operat-
ing steps. After switching on, all instrument functions are checked during an automatic
self-test routine. The instrument complies with all current safety standards.
The instrument meets the requirements of the EC directive concerning medical devices
(93/42/EEC) and is therefore CE-labelled.
1.2 Application
IONOSON-Jubilee was designed for the following applications:
Stimulation current therapy
• Pain therapy
• Circulatory stimulation
• Mobilisation and muscle stimulation
• Iontophoresis
Stimulation current diagnosis
• I/T-curve diagnosis
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Introduction
Ultrasound therapy
• Punctual heat therapy in the reach of joints, nerves, tendons and muscles
• Pain treatment in case of arthrosis and non-articular rheumatism
• Trophism improvement in case of posttraumatic conditions and ulcus cruris
• Supporting passive and active exercises
Simultaneous treatment
• Simultaneous application of stimulation current and ultrasound
Warning
The instrument may only be operated by qualified personnel who have
undergone special training!
1.3 Contraindications
Contraindications to stimulation current therapy or simultaneous treatment:
• Highly inflammatory, fever-prone disorders
• Pregnancy
• Patients with cardiac pacemakers or other implanted stimulators
• Malignant tumours
• Skin lesions
• Implants containing metal parts within the area of treatment
Contraindications to ultrasound therapy or simultaneous treatment:
• Fever-prone disorders and acute inflammatory processes
• Pregnancy
• Tuberculosis, gastric ulcers
• Vascular disorders of the extremities (thrombophlebitis, thrombosis, varicosis)
• Tumours
• Circulatory insufficiency, coronary diseases, cardiac dysrhythmias
• Acute articular rheumatism
• Diabetes mellitus
• Septic inflammations
• Conditions following radiothorium treatments, X-ray therapy
• Conditions following laminectomy
• Skin lesions (infections, inflammatory processes, naevi)
• Tumescences at all stages (pre-/postoperative)
• Blood coagulation diseases.
Warning
Do not apply ultrasound or simultaneous therapy close to the brain, spinal
cord and eyes!
2
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Controls and Indicators
2 Controls and Indicators
As its LCD is divided in different function fields, IONOSON-Jubilee allows for clear and
easy operation.
The plastic housing and the front panel protect the electronic components and simplify
cleaning.
Safety-related components are continuously monitored by the microprocessor, errone-
ously initiated operating steps are suppressed, a self-test routine is performed after
switching on and possible malfunctions are displayed. For safety reasons, the ultrasound
and stimulation current output is automatically cut off in case of malfunction.
2.1 Function of Controls and Indicators
In the following section we will introduce the individual controls of IONOSON-Jubilee.
The numbers in angle brackets refer to the Instrument Overview at the beginning of this
manual.
2.1.1 Mains Module <1>
The mains module <1> with mains supply, fuses and mains switch is
situated at the rear side of the instrument.
For mains supply do only use the mains cable provided by the manu-
facturer.
IONOSON-Jubilee is switched on and off using the integrated mains
switch. After switching on, a self-test and the calibration of the trans-
ducers are automatically carried out by the instrument (cf. Notes on
Operation on page 26).
Set the Line Voltage
After replacing the fuses, you can run the instrument with 230 V as well as 115 V simply
by using the rotatable fuse carrier at the mains module <1> (refer to section Technical
Data on page 56). The fuses are situated under the cover of the mains module <1> in a
fuse carrier.
Replace 1 A fuses with 2 A fuses, turn the fuse carrier by 180° and insert it again, so that
the “red window” of the mains module <1> reads “115 V”, after the cover has been
closed again.
Warning
Set the line voltage at the mains module to match the incoming line volt-
age!
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Controls and Indicators
2.1.2 Upper Status Bar<2>
The upper status bar <2> shows indications or some of the corresponding parameters
selected. For example: G IONTOPHORESIS .
2.1.3 Display <3>
upper status bar
On the display <3>, you can select all of the instrument’s menus and parameters on dif-
ferent levels except for the intensity. The selection is carried out with the data selector
<5>.
2.1.4 Lower Status Bar<4>
In the lower status bar<4>, messages and prompts are issued, e.g.:
PLEASE SELECT A FUNCTION .
2.1.5 Data Selector <5>
Use the data selector <5> to select the therapy parame-
ters and to operate the instrument by means of the cur-
sor. After switching on the instrument, the cursor is lo-
cated at the current mode Gof the display <3>.
You can move the cursor to the other menu items by
turning the selector to the right or left. To select a menu,
simply press the selector.
To select a parameter, move the cursor to the respective field by turning the selector. Af-
ter pressing the selector, the cursor will start flashing. You will then be able to select the
parameters by turning the selector and confirm the selected value by pressing the selector
again (cursor stops flashing). The modified values are displayed in the upper status bar
<2> or at the respective position of the display <3>.
display
lower status bar
4
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Controls and Indicators
2.1.6 Intensity Control <6>
The intensity control <6> serves to set the therapy dose (inten-
sity) in steps of 0.5 mA. When turning up the intensity of inten-
sity control <6>, the associated therapy timer on the display
<3> will be started as well.
Whenever you have to turn down the intensity control to “0”,
the following turn-down signal is displayed in the lower status
bar <4>:
Automatic output current switch-off
IONOSON-Jubilee disposes of an automatic output current switch-off activated in
case the current flow of the electrodes is interrupted (electrode falls off, plug is discon-
nected from patient lead etc.). The message CHECK ELECTRODES will appear in the
lower status bar<4> and the current will be automatically turned down to a minimum
basic current. After eliminating the error, the current will automatically be surged to the
previously set value and the message will disappear.
2.1.7 Pulse Indicator <7>
The pulse indicator <7> serves to visually monitor the current modes
and intensities. It flashes whenever a pulse is generated by the processor,
even in case of 0 intensity. It will stop flashing however when the inten-
sity is automatically reduced by the therapy timer.
After turning down the intensity to 0 with the intensity control <6> the
indicator will start flashing again. When changing the polarity of mono-
phase currents (display <3>), the indicator will show how the intensity
increases or decreases automatically.
2.1.8 Dose Control <8>
The dose control <8> serves to set the ultrasound dose in steps
of 0.1 W/cm2for ultrasound or simultaneous therapy. When
turning up the dose control <8>, the associated therapy timer
on the display <3> will be started as well.
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Controls and Indicators
2.1.9 Patient Current Indicator <9>
The flashing of the indicators depends on the resistance
in the circuit. In most cases the diodes start flashing ex-
actly at the moment when the patient starts to have a clear
sensation of the current.
If the indicator does not flash during treatment, you have to carry out a self-test routine
and observe whether or not the indicator flashes. If the indicator still does not flash during
treatment after the check, the accessories should be checked and replaced if necessary.
2.1.10 Output Indicator <10>
The indicator tells you to be cautious when handling the
electrodes:
Warning! The patient lead connector <11> is under
voltage! Take care that the electrodes are by no means
touched after the current is turned up!
2.1.11 Patient Lead Connector <11>
The patient lead connector <11> serves to plug in the patient lead. You can plug plate
electrodes, adhesive electrodes or other types of electrodes into the patient lead.
Patient Lead - Mode(s) of Attachment
The colours of the connectors facilitate easy and correct
attachment of the electrodes according to their polarity.
Colour of the female plug:
red = anode (+), blue = cathode (-)
Type BF component, not connected to
protective ground wire.
Warning
Take care that the electrodes are by no means touched after the current is
turned up!
11 12
Anode (+) Cathode
(
-
)
6
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Controls and Indicators
2.1.12 Ultrasonic Transducer Connector <12>
The ultrasonic transducer is connected to the instrument by means of the ultrasonic
transducer connector <12>. The transducer is automatically calibrated after it has been
connected or when choosing the ultrasound option for the first time after switching on the
instrument.
Replacing the ultrasonic transducer during treatment will not affect the selected mode of
treatment. The dose, however, will automatically be turned down to 0 and has to be in-
creased again when continuing the treatment.
If no transducer has been plugged in, the message Plug in head will appear in the lower
status bar<4>.
Ultrasonic Transducer
The ultrasonic transducer (2.5 cm² and 5 cm²)
works with the frequency 1 MHz. The transducer
is automatically calibrated after connecting or
switching on the instrument.
The transducer is watertight and can be used for
underwater treatment.
Automatic Coupling Confirmation
Both transducer and instrument have an optical coupling confirmation, which guarantees
constant and efficient treatment. If the coupling to the tissue of the patient is not efficient
enough, the light at the transducer will start flashing. You can choose between counting
only the effective treatment time or running the timer independently of the coupling
(Setup Menu).
Warning
The transducer contains a fragile ceramic piezo-resonator. Avoid shocks to
the surface and take special care that the transducer is not dropped. Hand-
ling malpractice can change the physical characteristics of the transducer!
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Controls and Indicators
2.1.13 Manual Release Key Socket <13>
The manual release key socket <13> serves to connect a manual
release key for manually triggering the current pulse or as a
therapy pause button. The use of a manual release key may be ap-
propriate when applying the current modes FaS, HVS, T/R, and
KOTS. To activate it, the function display must be at the following
position:
The manual release key can be used as a therapy pause button for all other current
modes. When pressing the release key, the current is switched off immediately. The fol-
lowing symbol appears on the display <3> after pressing the therapy pause button:
You can turn up the current only after setting the intensity control <6> to zero. The ther-
apy time is interrupted as long as the unit is standing by.
2.1.14 VAC Socket <14>
The VAC socket <14> serves to connect to a vacuum application
unit PHYSIOVAC-Jubilee or PHYSIOVAC-Expert (also see After
treatment, always remove remaining ultrasound gel from the
transducer.
Clean your accessories and instrument on a regular
basis with a disinfecting agent based on aldehyde. By
any means, switch off the device prior to this and pull
the mains plug.
Use a soft sponge cloth for cleaning. Be careful that
no liquid substances invade the instrument. Prior to
cleaning, switch off the instrument and disconnect the
power lead.
Clean and disinfect the sponge and sponge bags after
every treatment, and then rinse them well with fresh
water, so that no residue remains on the material
Regularly check your accessories and replace any
sponges and sponge bags which are contaminated,
damaged or worn out through use, and which are no
longer sufficiently thick.Use a soft sponge cloth for
cleaning. Be careful that no liquid substances invade
the instrument.
Note
The transducer contains a fragile ceramic piezo-resonator! Avoid sho
c
the surface and take special care that the transducer is not dropped. H
a
ling malpractice can change the physical characteristics of the resonat
o
Connecting a Vacuum Unit on page 49).
8
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Controls and Indicators
2.2 Overview of Parameters
2.2.1 Start Menu (1st level)
ultrasound menu
(direct access)
upper status bar<2>
2.2.2 Example Menu (2nd level)
Current mode G
diagnostics menu
current modes with
low frequencies
(direct access) indications menu
(therapy suggestions)
setup menu
individual programs
(freely configurable)
lower status bar<4>
current modes with
medium frequencies
(direct access)
therapy timers
current mode
parameters
circuit I
back to
previous
menu
circuit I
ultrasound
therapy
individual programs
(memory menu)
electrodes display
(plate electrodes/
vacuum electrodes
)
setup menu
parameter
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Controls and Indicators
2.3 Operation
Selecting a function (e.g. the current mode G) from the start menu (level 1) will lead you
to level 2 of the menu. Here you can set the desired parameters for the selected current
mode.
The following functions are available on level 2:
Memory menu; individual programs (single treatments or current
modes) can be memorised.
Display electrodes: Indicates whether the current is released via plate
electrodes (this symbol) or via vacuum electrodes. The vacuum elec-
trodes are enabled automatically when switching on the vacuum de-
vice. When the vacuum device is switched off, the current is released
via plate electrodes (switching is slightly delayed).
Setup menu (settings)
Back to level 1
Therapy timer with selected therapy time; the therapy current
will be reduced to 0 and an acoustic signal will be issued
every 10 seconds after the countdown (left timer: stimulation
current, right timer: ultrasound).
The parameters of the menus DIAGNOS. , INDICAT. , INDIVID. and SETUP will be discussed
later.
2.3.1 Parameters for Stimulation Current
The following paragraph will give you an overview of the meaning of the symbols in the
menus for the individual current modes.
In General
The symbols below apply for all current modes with low frequencies:
Intensity display (mA), to be set with intensity control <6>.
The sign (plus/minus) signifies the polarity of the red plug.
Exchange of polarity of the two electrodes; the sign (plus/minus) of
the intensity display will be changed respectively.
Switching from galvanic current to medium-frequency interrupted
direct current. The current setting is displayed in the upper status bar.
Toggling intensity ranges (0 – 3.5 mA or 0 – 25
mA). The current setting is displayed in the up-
per status bar (only for G).
Current Mode G
10
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Controls and Indicators
Current Modes DF, MF, CP, LP
Switching in a galvanic basis (5%).
The current setting is displayed in the upper status bar.
Current Modes UR, IG 30, IG 50, FM, STOCH
Switching from monophase to biphase pulse emission. The current
setting is displayed in the upper status bar.
Current Modes HV, TENS
Switching from monophase to biphase pulse emission. The current
setting is displayed in the upper status bar.
Pulse time (possible values: 40 µs – 400 µs)
Burst frequency (possible values: OFF; 1 – 10 Hz),
Frequency bands (for HV and TENS 70 – 150
Hz or 1 – 150 Hz) or fixed frequency (1 – 200
Hz). The currently selected frequency is dis-
played in the upper status bar.
Switching from monophase to biphase pulse emission. The current
setting is displayed in the upper status bar.
Acoustic signal, makes every current pulse audible
Ti: Pulse time, possible values: 0,1 – 10 ms
Ri: Release time , possible values: 10 – 250 ms
Pulse shape (triangle, rectangle)
Basic settings: T = 1ms, R = 20 ms, triangular pulse
Relation contraction (Tension, 1 s) / pause (Release, 1 s),
possible values T = 1 – 60 s, R= 1 – 60;
manual release key (only if R > 1s)
Ramp (4 settings m1to m4) with different rise times. The current set-
ting is displayed in the upper status bar.
Current Mode FaS
Switching from monophase to biphase pulses. The current setting is
displayed in the upper status bar.
Acoustic signal, makes every current pulse audible.
Current Mode HVS
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Controls and Indicators
Frequency (possible values: 2 – 200 Hz)
Relation contraction (Tension, 1 s) / pause (Release, 1 s),
possible values T = 1 – 60 s, R= 1 – 60;
manual release key (only if R > 1s)
Ramp (4 settings m1to m4) with different rise times. The current set-
ting is displayed in the upper status bar.
Pulse time (possible values: 1s – 0.1 ms)
Release time (possible values: 7 s to 1 ms; manual release key)
Pulse shapes (square-wave pulse r1, trapezoidal pulses t1– t3, triangu-
lar pulses d1– d3, exponential pulse e1). The current setting is dis-
played in the upper status bar.
Current Mode T/R
Intensity display (mA), to be set with intensity control <6>
5 pre-set frequency bands,
fixed frequency (Select 0 – 250 Hz)
Basic frequency (possible values: 2.0 – 9.5 kHz)
Current Mode AMF
Intensity display (mA) to be set with intensity control I <6>
Tension time (possible values: 1 to 60 s in steps of 1s;
manual release key (only if R > 1s)
Release time (possible values: 1 to 60 s) in steps of 1s
Ramp (4 settings m1to m4) with different rise times. The current set-
ting is displayed in the upper status bar.
Modulation frequency (selectable: 0 – 95 Hz)
Pulse shape (sine, triangle, rectangle)
Pulse length T
(possible values: 2 ms, 4 ms, 6 ms, 8 ms, 10 ms, auto)
Current Mode KOTS
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Controls and Indicators
Basic frequency (possible values: 2.0 – 9.5 kHz)
Acoustic signal, makes every current pulse audible
2.3.2 Parameters for i/t-diagnostics
Exchange of polarity of the two electrodes;
the sign (plus/minus) of the intensity display will be changed respec-
tively.
Acoustic signal, makes every current pulse audible
Pulse forms:
Select between rectangular pulse r1 and triangular pulse d1
Pulse time:
Selecting the pulse time (steps from 1000 ms – 0,1 ms)
Pause time:
Selecting the time between the pulses (steps from 2-5 s)
Trigger pulses with manual release key
Confirm muscular reaction
Delete stored values
2.3.3 Parameters for Ultrasound
After choosing the option SONO from the menu (ultrasound therapy), you can set the fol-
lowing parameters:
Intensity control (dose) from 0.1 to 3.0 W/cm2in steps of 0.1 W/cm2,
adjustable with dose control <8>
Mode of treatment
adjustable parameters are 1/10 , 1/5 , 1/3 , 2/5 , cont.
Simultaneous therapy ON/OFF
Acoustic coupling confirmation ON/OFF
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Controls and Indicators
2.4 Characterisation of the Individual Current Modes
Note
All current modes of the unit are emitted in the constant current mode,
with the exception of simultaneous treatment (see page 37). Here, the de-
vice is automatically switched to a mixed mode consisting of constant cur-
rent and constant voltage mode to avoid unpleasant current sensations
when the contact between skin and transducer is interrupted.
2.4.1 Low-frequency Current Modes (LF)
(G) Galvanisation
Direct current without any interruption or break
Variation:
Medium-frequency interrupted direct current (8 kHz; duty cycle 95%).
Application: Iontophoresis, basic therapy for paralysis and atrophy treatment, evok-
ing hyperaemia
Note
You have to take special care when applying galvanic current. The mois-
tened viscose covers must be well attached to the skin surface. The inten-
sity must not exceed 0.1 mA/cm² of active electrode surface!
(DF) Diadynamic Current Diphasé Fixe
acc. to Bernard
Fixed parameters Adjustable
Pulse shape: sinusoidal half-waves Galvanic basis (5%)
T = pulse time: 10 ms
R = release time: 0 ms
Frequency: 100 Hz
Galvanic basis ON OFF
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IONOSON-Jubilee