Physiomed PHYSIOMED-IF-Expert User manual

OPERATING INSTRUCTIONS
PHYSIOMED-IF-Expert
00904 GB

The technical data in this manual is as at the time of printing and subject to alteration.
Copyright © 2001 - 2013 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.
PHYSIOMED ELEKTROMEDIZIN AG
Hutweide 10
91220 Schnaittach / Laipersdorf (Germany)
Phone: + 49 9126 2587-0
Fax: + 49 9126 2587-25
E-Mail: [email protected]
Internet: http://www.physiomed.de
Operating Instructions last updated on February 8, 2013.

Instrument Overview
Front Panel
Rear Face
Legend
1 Mains Module 6 Intensity Control Circuit I 11 Output Indicator
2 Upper Status Bar 7 Pulse Indicator Circuit I 12 Patient Lead Connector
3 Display 8 Intensity Control Circuit II 13 Manual Release Key or
Therapy Pause Button
Socket
4 Lower Status Bar 9 Pulse Indicator Circuit II 14 SIM Socket
5 Data Selector 10 Patient Current Indicator 15 VAC Socket
Symbols
CAUTION!
Please refer to the operating instructions and consider the physiological effects!
Type BF component, not connected to protective ground wire!
2
3
4
6
5
8
7
11
9
10
14
15
1
12
13

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 Circuit I <6>......................................................................................................5
2.1.7 Pulse Indicator Circuit I <7> .........................................................................................................5
2.1.8 Intensity Control Circuit II <8>.....................................................................................................5
2.1.9 Pulse Indicator Circuit II <9> ........................................................................................................6
2.1.10 Patient Current Indicator <10> ....................................................................................................6
2.1.11 Output Indicator <11> ................................................................................................................6
2.1.12 Patient Lead Connector <12>......................................................................................................7
2.1.13 Manual Release Key Socket <13> ................................................................................................8
2.1.14 SIM Socket<14>..........................................................................................................................8
2.1.15 VAC Socket <15>........................................................................................................................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 Circuit I ..............................................................................................................10
2.3.2 Dual channel operation .............................................................................................................12
2.4 Characterisation of the Individual Current Modes ..............................................................15
2.4.1 Low-frequency Current Modes (LF)............................................................................................15
2.4.2 Medium-Frequency Currents .....................................................................................................17
3Notes on Operation......................................................................................................19
3.1 Connection and Start-up........................................................................................................19
3.2 Start-up ...................................................................................................................................19
3.3 Self-test ...................................................................................................................................19
3.4 Instrument Errors....................................................................................................................20
4Stimulation Current Therapy .......................................................................................21
4.1 General Information...............................................................................................................21
4.2 Safety Precautions when Attaching Electrodes...................................................................21
4.3 Safety Precautions for Stimulation Current Intensity .........................................................22
4.3.1 Recommended Intensities ..........................................................................................................22
4.4 Preparations and Attaching the Electrodes .........................................................................23
4.4.1 Modes of attaching the electrodes ............................................................................................23
4.5 Therapy using low-frequency current modes......................................................................24
4.5.1 Monophase and biphase current modes ....................................................................................24
4.5.2 Iontophoresis.............................................................................................................................24
4.5.3 Pain Therapy, Hyperaemisation, Detonisation ............................................................................25
4.6 Therapy using medium-frequency current modes ..............................................................26
4.6.1 Therapy using classic interference current IF:: ............................................................................26
4.6.2 Pain Therapy, Hyperaemisation, Detonisation using AMF Current ..............................................27
4.6.3 Muscle Stimulation using Medium-frequency Surge Currents ....................................................28

5Simultaneous Therapy .................................................................................................30
6Indications Menu..........................................................................................................30
7Individual Programs .....................................................................................................32
7.1 Save Individual Therapy Modes ............................................................................................32
7.2 Save Potpourri ........................................................................................................................33
7.3 Call Program............................................................................................................................34
7.4 Delete Program.......................................................................................................................34
8Basic Settings................................................................................................................35
8.1 Setup Menu.............................................................................................................................36
9Appendix ......................................................................................................................37
9.1 General Notes .........................................................................................................................37
9.2 Service, Repairs, Maintenance...............................................................................................37
9.3 Cleaning and Disinfection......................................................................................................38
9.4 Service Life and Disposal .......................................................................................................38
9.5 Electromagnetic Compatibility ..............................................................................................38
9.6 Training ...................................................................................................................................38
9.7 Connecting other Units ..........................................................................................................39
9.7.1 Vacuum Unit .............................................................................................................................39
9.7.2 Ultrasound Therapy Unit............................................................................................................39
9.8 Technical Data.........................................................................................................................40
9.8.1 Environment Conditions (Operation)..........................................................................................40
9.8.2 Environment Conditions (Transport and Storage).......................................................................40
10 Accessories....................................................................................................................41
10.1 Standard Accessories..............................................................................................................41
10.2 Additional Accessories ...........................................................................................................41
11 Manufacturer’s Recommendations..............................................................................45
12 Index .............................................................................................................................46

Introduction
PHYSIOMED-IF-Expert 1
1Introduction
With your PHYSIOMED-IF-Expert, you have acquired a high-quality and extremely versatile
unit for stimulation current 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 your-
self with the use of the instrument.
1.1 Instrument Description
PHYSIOMED-IF-Expert is a two-channel stimulation current therapy unit. You can apply all
medium-frequency current modes (including the classic interference current) and addi-
tionally the low-frequency current modes HV and TENS. The unit can also be used for si-
multaneous therapy (stimulation current and ultrasound in ONE treatment, page 30).
Therapy modes of PHYSIOMED-IF-Expert may be accessed
directly or, by a proposed
treatment, via the indications menu (page 30). Moreover, the unit enables you to memo-
rise up to 25 individual treatment programs or current sequences (
potpourris , page 32).
All functions of PHYSIOMED-IF-Expert 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.
Warning
Technical modifications to the instrument are not admissible and will inevi-
tably lead to loss of approval as a medical device.
1.2 Application
PHYSIOMED-IF-Expert was designed for the following applications:
Stimulation current therapy
•Pain therapy
•Circulatory stimulation
•Mobilisation and muscle stimulation
•Iontophoresis
Simultaneous therapy
•Simultaneous application of stimulation current and ultrasound
Warning
The instrument may only be operated by qualified personnel who have
undergone special training!

Introduction
2 PHYSIOMED-IF-Expert
1.3 Contraindications
Contraindications to stimulation current therapy and simultaneous treat-
ment:
•Highly inflammatory, fever-prone disorders
•Pregnancy
•Patients with cardiac pacemakers or other implanted stimulators
•Malignant tumours
•Spastic paralysis
•Skin lesions
•Implants containing metal parts within the area of treatment
Contraindications to 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.
Do not apply ultrasound or simultaneous therapy close to the brain, spinal cord and
eyes!

Controls and Indicators
PHYSIOMED-IF-Expert 3
2Controls and Indicators
As its LCD is divided in different function fields, PHYSIOMED-IF-Expert allows for
clear and easy operation.
The plastic housing and the front panel protect the electronic components and sim-
plify cleaning.
Safety-related components are continuously monitored by the microprocessor, erro-
neously initiated operating steps are suppressed, a self-test routine is performed af-
ter switching on and possible malfunctions are displayed. For safety reasons, the
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 PHYSIOMED-IF-
Expert. The numbers in angle brackets refer to the
Instrument Overview at the be-
ginning 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
manufacturer.
PHYSIOMED-IF-Expert is switched on and off using the integrated
mains switch. After switching on, a self-test is automatically car-
ried 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
voltage.

Controls and Indicators
4 PHYSIOMED-IF-Expert
2.1.2 Upper Status Bar<2>
The upper status bar <2> shows indications or some of the corresponding pa-
rameters selected. For example: G IONTOPHORESIS .
2.1.3 Display <3>
On the display <3>, you can select all of the instrument’s menus and parameters
on different 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 pa-
rameters and to operate the instrument by means of
the cursor. After switching on the instrument, the
cursor is located at the current mode IF:: of the dis-
play <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 selec-
tor. After 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>.
upper status bar
display
lower status bar

Controls and Indicators
PHYSIOMED-IF-Expert 5
2.1.6 Intensity Control Circuit I <6>
The intensity control circuit I <6> serves to set the inten-
sity in circuit I in steps of 0.5 mA. When turning up the in-
tensity of intensity control circuit I <6> or intensity con-
trol circuit II <8>, the associated therapy timer in the dis-
play <3> will be started as well.
Whenever you have to turn down the intensity control
circuit I to “0”, the following turn-down signal is displayed
in the lower status bar <4>:
Automatic output current switch-off
PHYSIOMED-IF-Expert disposes of an automatic output current switch-off acti-
vated in case the current flow of the electrodes is interrupted (electrode falls off,
plug is disconnected from patient lead etc.). The message CHECK ELECTRODES I will
appear in the lower status bar<4> and the current will be automatically turned
down to a minimum basic current in circuit I. After eliminating the error, the current
in circuit I will automatically be surged to the previously set value and the message
will disappear.
2.1.7 Pulse Indicator Circuit I <7>
The pulse indicator circuit I <7> serves to visually monitor the cur-
rent modes and intensities of circuit I. It flashes whenever a pulse is
generated in circuit I by the processor, even in case of 0 intensity. It
will stop flashing however when the intensity is automatically re-
duced by the therapy timer. After turning down the intensity of cir-
cuit I to 0 with the intensity control circuit I <6> the indicator will
start flashing again. When changing the polarity of monophase cur-
rents in circuit I (display <3>) the indicator will show how the inten-
sity increases or decreases automatically.
2.1.8 Intensity Control Circuit II <8>
The intensity control circuit II <8> serves to set the cur-
rent intensity in circuit II in steps of 0.5 mA. When turning
up one of the two intensity controls circuit I <6> or cir-
cuit II <8>, the associated therapy timer on the display
<3> will be started as well.
Every time you have to turn down the intensity control
circuit II to 0, the following message will be displayed in
the lower status bar<4>:

Controls and Indicators
6 PHYSIOMED-IF-Expert
Automatic output current switch-off
PHYSIOMED-IF-Expert disposes of an automatic output current switch-off acti-
vated in case the current flow of the electrodes is interrupted (electrode falls off,
plug is disconnected from patient lead etc.). The message CHECK ELECTRODES II will
appear in the lower status bar<4> and the current will be automatically turned
down to a minimum basic current in circuit II. After eliminating the error, the current
in circuit II will automatically be turned up to the previously set value and the mes-
sage will disappear.
2.1.9 Pulse Indicator Circuit II <9>
The pulse indicator circuit II <9> serves to visually monitor the cur-
rent modes and intensities of circuit II. It flashes whenever an pulse
is generated in circuit I by the processor, even in case of 0 intensity. It
will stop flashing, however, when the intensity is automatically re-
duced by the therapy timer. After turning down the intensity of cir-
cuit I to zero with the intensity control circuit II <8>, the indicator
will start flashing again.
Note
Due to safety reasons increasing the ultrasound dose after the ultra-
sound has coupled (marker appears in the upper status bar <2>) is
only possible after prior turning down the dose with intensity control
circuit II/dose <8>.
2.1.10 Patient Current Indicator <10>
The diode at the left side of the symbol is attrib-
uted to circuit I, the diode at the right to circuit II.
The flashing of the indicators depends on the
resistance in the two circuits.
In most cases the diodes start flashing exactly at the moment when the patient
starts to have a clear sensation of the current in the corresponding circuit.
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 of the corresponding cir-
cuit should be checked and replaced if necessary.
2.1.11 Output Indicator <11>
The indicator tells you to be cautious when handling
the electrodes:
Warning! The patient lead connector <12> is under
voltage! Take care that the electrodes are by no
means touched after the current is turned up!

Controls and Indicators
PHYSIOMED-IF-Expert 7
2.1.12 Patient Lead Connector <12>
The patient lead connector <12> serves to plug in the pa-
tient 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 to the two circuits and to
their polarity.
Colour of the inner circle:
red = circuit I, blue = circuit II
Colour of the outer circle:
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 cur-
rent is turned up!
anode (+)
circuit I
anode (+)
circuit II
cathode (-)
circuit I
cathode (-)
circuit II

Controls and Indicators
8 PHYSIOMED-IF-Expert
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.
The use of a manual release key may be appropriate when
applying the current modes MT and KOTS. To activate it, the
function must display the following symbol:
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
following symbol appears on the display <3> after pressing the therapy pause but-
ton:
You can turn up the current only after setting the intensity control circuit I <6>
and/or intensity control circuit II/dose <8> to zero. The therapy time is interrupted as
long as the unit is standing by.
2.1.14 SIM Socket<14>
The SIM socket <14> serves to connect to a ultrasound ther-
apy unit PHYSIOSON
-
Expert (see also Simultaneous Therapy on
page 30).
2.1.15 VAC Socket <15>
The VAC socket <15> serves to connect to a vacuum applica-
tion unit PHYSIOVAC
-
Expert (also see Connecting other Units
on page 39).

Controls and Indicators
PHYSIOMED-IF-Expert 9
2.2 Overview of Parameters
2.2.1 Start Menu (1st level)
2.2.2 Example Menu (2nd level)
Current Mode G
indications menu
(therapy suggestions)
upper status bar <2>
setup menu
individual programs
(freely configurable)
lower status bar <4>
current modes with
medium frequencies
(direct access)
therapy timer (circuits I & II)
current mode
parameters
circuit I
back to
previous
menu
circuit I
selection
circuit II
individual programs
display electrodes
(plate electrodes/
vacuum electrodes)
setup menu
current modes with
low frequencies
(direct access)
selected
parameters
constant
voltage
operation

Controls and Indicators
10 PHYSIOMED-IF-Expert
2.3 Operation
Selecting a function (e.g. the current mode TENS) from the start menu (level 1) will
lead you to level 2 of the menu. Here you can set the desired parameters for the se-
lected 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 vac-
uum electrodes are enabled automatically when switching on the
vacuum device. When the vacuum device is switched off, the
current is released via plate electrodes.
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.
The parameters of the menus INDICAT. , INDIVID. and SETUP will be discussed later.
2.3.1 Parameters for Circuit I
The following paragraph will give you an overview of the meaning of the symbols in
the menus for the individual current modes in circuit I.
In General
The symbols below apply for all current modes with low frequencies:
Intensity display circuit I (mA), to be set with
intensity control I <6>. The sign (plus/minus) signifies the polar-
ity of the red plug of circuit I.
Exchange of polarity of the two electrodes;
the sign (plus/minus) of the intensity display will be changed re-
spectively.

Controls and Indicators
PHYSIOMED-IF-Expert 11
Current Mode G,
Switching from galvanic current to
medium-frequency inter-
rupted direct current
. The current setting is displayed in the up-
per status bar.
Toggling intensity ranges (0 – 3.5 mA or 0 –
25 mA). The current setting is displayed in the
upper status bar.
Current Modes HV, TENS
Switching from monophase to biphase pulse emission. The cur-
rent setting is displayed in the upper status bar.
Pulse time (possible values: 80 … 400 µs)
Bursts (possible values: OFF; 1 – 10 Hz)
Frequency bands (70 – 150 Hz or 1 – 150 Hz)
or fixed frequency (1 – 200 Hz)
Note
When selecting an additional therapy mode in circuit II, the pulse time
is limited to 300 µs for HV and TENS. If you select higher values (>300
µs) these will be restricted to 300 µs.
Current Mode IF::
Intensity display circuit I / II (mA), to be set with
intensity control I <6> and intensity control II <8>.
Vector function (dynamic function) ON/OFF
Basic frequency (range: 2.0 to 9.5 kHz)
Frequency bands: 4 fixed,
one free programmable,
fixed frequency (Select 1 – 250 Hz)
Interference vector display
Note
The current mode IF requires both circuit I and II simultaneously. You
cannot select any additional therapy for circuit II.

Controls and Indicators
12 PHYSIOMED-IF-Expert
Current Mode AMF
Intensity display for circuit I, (mA), to be set with
intensity control I <6>
5 pre-set frequency bands,
fixed frequency (SELECT 0 – 250 Hz)
Basic frequency (possible values: 2.0 – 9.5 kHz)
Current Modes MT, KOTS
Intensity display circuit I, 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
setting is displayed in the upper status bar.
Modulation frequency
Pulse shape (sine, triangle, rectangle)
Pulse length T
(possible values: 2 ms, 4 ms, 6 ms, 8 ms, 10 ms, auto)
Basic frequency (possible values: 2.0 – 9.5 kHz)
Acoustic signal, makes every current pulse audible
2.3.2 Dual channel operation
For all current modes except IF:: you can select additional current modes (dual
channel operation) in circuit II.

Controls and Indicators
PHYSIOMED-IF-Expert 13
2.3.2.1 For all current modes except IF and G
The current mode set in circuit I (except for G) can also be selected with the same
parameters in circuit II. AMF and MT can always be selected.
2.3.2.2 For the MT and KOTS current modes
The current mode set in circuit I can also be selected in circuit II, whereby individual
parameters can be set independently for both circuits. With circuits I and II, stimula-
tion can be either simultaneous or alternating. Carry out the following operational
steps:
(1) Select the desired current mode in both circuits.
(2) With the data selector <5>, first click on the selection field and turn
the selector to the left until the desired icon appears (e.g. for simultaneous
stimulation). The parameter R will acquire the appropriate value.
Simultaneous stimulation
Circuits I and II stimulate simultaneously with the same pa-
rameters. The polarity and ramp of the surge current can be
freely selected in each circuit.
To adjust the threshold time and threshold interval, carry out the operational steps
1-2 described above, and then proceed as follows:
(3) With the data selector <5>, first click on the selection field in circuit
I.
(4) In the new window, click on the selection field, turn the selector to the
right and select the duration of the surge interval.
(5) In the same window, click on the selection field, turn the selector to
the right and select the duration of the surge time.
(6) Leave the window via the button.
Simultaneous stimulation can also be initiated with the manual release key. Carry
out the above-described operational steps 1-5, and then proceed as follows:
(3a) With the data selector <5>, first click on the selection field in circuit I.
(4a) In the new window, click on the selection field, turn the selector at least one
step to the right and confirm this.
(5a) In the same window, click on the selection field and turn the selector to the
left until the manual release key icon appears.
(6a) Leave the window via the button.
(7a) Insert the manual release key into the manual release key socket <14> at the rear
of the equipment.
The length of the surge currents in circuits I and II is determined by the pressure on
the manual release key.
If you have set up the manual release key in both circuits, then simultaneous stimu-
lation will also follow.

Controls and Indicators
14 PHYSIOMED-IF-Expert
Alternating stimulation (continuous transition between circuits I and II)
Circuits I and II provide alternating stimulation, one directly after
the other.
A surge cycle follows, consisting of:
•Surge current in circuit I in the selected length
•No pause
•Surge current in circuit II in the selected length
•Pause for the selected length
To set the surge time and surge pause, carry out steps 1-6, described above.
Alternating stimulation can also be controlled with the manual release key. To do
this, carry out steps 1-2 and 3a-7a, described above.
Alternating stimulation (defined pauses between circuits I and II)
Circuits I and II provide alternating stimulation, with defined
pauses between the surges in circuits I and II.
The surge times and surge pauses are adjusted in circuit I. To do this, carry out steps
1-6, described above.
Alternating stimulation can also be controlled with the manual release key. To do
this, carry out steps 1-2 and 3a-7a, described above.