Physiomed PHYSIOTHERM-S User manual

00916 GB
OPERATING INSTRUCTIONS
PHYSIOTHERM-S

The technical data in this manual is as at the time of printing and subject to alteration.
Copyright © 2001 - 2009 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.
Last updated April 8, 2009.

Instrument Overview
Operator side
Legend
1 Power switch 6 Electrode connection cable
2 Graphic display 7 Extractable electrode arm
3 Data selector 8 Metal housing
4 Stop button 9 Locking castor
5 Plastic plate electrode
1
4
7
9
8
2
5
6
3

Patient side
10 Male end of electrode cable 14 Female end of electrode cable
11 Fuses 15 Adjusting element for electrode-skin distance
12 High-load non-heating appliance plug 16 Locking screw
13 Rating plate
Symbols
CAUTION!
Please refer to the operating instructions and consider the physiological effects!
Type BF component, not connected to protective ground wire!
13
10
11
12
14
16
15

Contents
1Introduction......................................................................................................................1
1.1 Instrument Description ............................................................................................................1
1.2 Application................................................................................................................................1
1.3 Contraindications .....................................................................................................................2
1.3.1 Absolute contraindications ..........................................................................................................2
1.3.2 Local contraindications ................................................................................................................2
1.3.3 Of particular importance..............................................................................................................3
2Controls and Indicators....................................................................................................4
2.1 Function of Controls and Indicators........................................................................................4
2.1.1 Display <2> .................................................................................................................................4
2.1.2 Data Selector <3>........................................................................................................................4
2.1.3 Stop Button <4>..........................................................................................................................5
2.2 Overview of Parameters ..........................................................................................................5
2.2.1 Start Menu ..................................................................................................................................5
3Installation........................................................................................................................6
3.1 Requirements for installation..................................................................................................6
3.2 Requirements of the installation location..............................................................................6
3.3 Transport of the unit................................................................................................................6
3.4 Unpacking the unit...................................................................................................................7
3.5 Inspection upon receipt ...........................................................................................................7
3.6 Damages....................................................................................................................................7
4Notes on operation ..........................................................................................................8
4.1 Preparing the unit ....................................................................................................................8
4.2 Check for operational safety ...................................................................................................8
4.3 Setting the Line Voltage ..........................................................................................................8
4.4 Instrument Errors......................................................................................................................9
4.4.1 Operator errors............................................................................................................................9
4.4.2 Internal errors..............................................................................................................................9
5Short Wave Therapy ......................................................................................................10
5.1 Positioning the electrodes .................................................................................................... 10
5.2 Setting the intensity.............................................................................................................. 12
5.2.1 Dosage levels according to Schliephake .................................................................................... 12
5.2.2 Effective Power......................................................................................................................... 12
5.3 General information on starting a short wave therapy..................................................... 13
5.3.1 Preparations ............................................................................................................................. 13
5.3.2 Beginning the treatment........................................................................................................... 13
6Indications Menu............................................................................................................15
6.1 Starting a treatment via the Indications menu................................................................... 15
6.2 Information on the selected treatment ............................................................................... 16
6.3 Selecting a medical field .......................................................................................................17
7Indications ......................................................................................................................18
7.1 Orthopaedics – Surgery / Neurology ................................................................................... 19
7.1.1 Osteoarthritis............................................................................................................................ 19
7.1.2 Chronic polyarthritis of the hip and shoulder joints................................................................... 20
7.1.3 Achillodynia.............................................................................................................................. 20

7.1.4 Bechterew's disease.................................................................................................................. 21
7.1.5 Bursitis...................................................................................................................................... 21
7.1.6 Distortions, dislocations, contusions ......................................................................................... 22
7.1.7 Epicondylitis.............................................................................................................................. 22
7.1.8 Facial paralysis (peripheral)........................................................................................................ 23
7.1.9 Fracture.................................................................................................................................... 23
7.1.10 Intercostal neuralgia ................................................................................................................. 24
7.1.11 Ischialgia................................................................................................................................... 24
7.1.12 Contracture.............................................................................................................................. 25
7.1.13 Lumbago.................................................................................................................................. 25
7.1.14 Myalgia .................................................................................................................................... 26
7.1.15 Neuralgia / neuritis ................................................................................................................... 26
7.1.16 Frozen shoulder........................................................................................................................ 27
7.1.17 Periostitis.................................................................................................................................. 27
7.1.18 Raynaud´s disease..................................................................................................................... 28
7.1.19 Spondylosis / osteochondrosis...................................................................................................28
7.1.20 Sudeck´s dystrophy ................................................................................................................... 29
7.1.21 Tendovaginitis .......................................................................................................................... 29
7.1.22 Cervical syndrome .................................................................................................................... 30
7.2 Dermatological indications ................................................................................................... 31
7.2.1 Furuncle, carbuncle .................................................................................................................. 31
7.2.2 Frostbite ................................................................................................................................... 32
7.2.3 Skin injuries .............................................................................................................................. 32
7.2.4 Hidradenitis .............................................................................................................................. 33
7.2.5 Panaritia ................................................................................................................................... 33
7.3 Gynaecology .......................................................................................................................... 34
7.3.1 Adnexitis (chronic) .................................................................................................................... 34
7.3.2 Amenorrhoea, dysmenorrhoea, ovarian insufficiency................................................................ 35
7.3.3 Mastitis..................................................................................................................................... 35
7.3.4 Myometritis (chronic)................................................................................................................ 36
7.3.5 Parametrism ............................................................................................................................. 36
7.4 ENT / dentistry and oral medicine........................................................................................ 37
7.4.1 Laryngitis.................................................................................................................................. 37
7.4.2 Otitis media (chronic)................................................................................................................ 38
7.4.3 Sinusitis max............................................................................................................................. 38
7.5 Internal medicine, urology.................................................................................................... 39
7.5.1 Bronchitis (chronic) ................................................................................................................... 39
7.5.2 Cholelithiasis ............................................................................................................................ 40
7.5.3 Hepatitis ................................................................................................................................... 40
7.5.4 Constipation............................................................................................................................. 41
7.5.5 Unspecific exudative pleurisy (chronic) ...................................................................................... 41
7.5.6 Prostatitis and vesiculitis ........................................................................................................... 42
8Individual Programs .......................................................................................................43
8.1 Setting program values......................................................................................................... 43
8.2 Call Program........................................................................................................................... 44
8.3 Delete Program...................................................................................................................... 44
9Basic settings ..................................................................................................................45
9.1 Changing the basic settings.................................................................................................. 45
10 General Notes.................................................................................................................46
10.1 Responsibilities ...................................................................................................................... 46
10.2 Personal safety ...................................................................................................................... 46
10.3 Protection of unit .................................................................................................................. 48
11 Service, Repairs, Maintenance ......................................................................................49

12 Cleaning and Disinfections............................................................................................49
13 Technical Data ................................................................................................................50
14 Accessories......................................................................................................................51
14.1 Standard................................................................................................................................. 51
14.2 Special Accessories ................................................................................................................ 51
15 Manufacturer’s Recommendations...............................................................................52
16 Index ...............................................................................................................................53

Introduction
PHYSIOTHERM-S
1
1Introduction
With your PHYSIOTHERM-S, you have acquired a high-quality and extremely versatile
unit for short wave 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.
Warning
Safe operation of the short-wave therapy unit requires knowledge
of both medicine and electricity.
For this reason, the short-wave therapy unit may be used only by
persons with the appropriate knowledge and practical experience
necessary to ensure proper handling of the unit and who have been
properly trained in the use of the unit based on these operating
instructions!
1.1 Instrument Description
The PHYSIOTHERM-S short-wave therapy unit can produce dielectric warming by
means of electric or electromagnetic fields of varying intensity in practically any
region of the body and can therefore be used for a wide variety of applications.
Treatments can be carried out using either the capacitor (dielectric field) or the coil
(induction field) method.
In the dielectric field method, the body part to be treated is within the electric field
between two plate electrodes. The “radiation” produces a warming of the body
part located within the field. Fat layers are warmed considerably more than muscle
tissue. When applying the induction field method, the body part is within a
magnetic field, which warms especially tissue containing liquid located near the
surface, such as muscles.
1.2 Application
The short-wave therapy unit is suitable for nearly all heat therapy processes for use
in clinics and private practices.
Classical therapy applications can be conducted with the induction-field and
dielectric-field methods in continuous or pulsed mode.
The application of high-frequency energy in heat therapy has the advantage of
greater depth penetration as opposed to simpler methods, such as packs, baths,
infrared light and heat cushions.
The endogenous heat that is formed triggers a series of physiological processes,
producing a spasmolytic effect on muscles, tendons and other structures containing
connective tissue, increasing the cell metabolism and the enzyme reaction speed
and stimulating perfusion in the treated zone.

Introduction
2 PHYSIOTHERM-S
The capability of applying the high-frequency energy in short, intense pulses (pulsed
mode) can further increase the depth effectiveness, especially the stimulation of
perfusion, while the heat generation is hardly felt in the skin, which is more sensitive
to heat.
The applications for the high-frequency therapy are diverse. This therapy is especially
effective in treating rheumatic disorders of the joints and muscles, inflammatory
disorders of the respiratory organs, the kidneys and bile ducts and all disorders due
to insufficient perfusion. The pulsed mode is advantageous in the treatment of
acute conditions.
1.3 Contraindications
The following list of contraindications (which is by no means to be regarded as
being comprehensive) should always be observed when applying short-wave
treatment for therapeutic purposes!
•Always be sure to ask the patient about these contraindications, as not all
contraindications are immediately recognizable by the therapist (e.g.
pregnancy)!
•In addition, any external signs that might point to the existence of
contraindications (e.g. scars, etc.) should always be reason enough to ask the
patient about contraindications!
•As a rule, any short-wave therapy must be strictly based on an accurate
diagnosis!
1.3.1 Absolute contraindications
The following indications are absolute contraindications to short-wave therapy:
•Patients with a cardiac pacemaker may under no circumstances be subjected to
short-wave therapy. The effects of the applied high frequency on the pacemaker
could cause ventricular fibrillation. Any other persons with pacemakers must also
remain outside of the treatment area during the short-wave therapy!
•Patients whose condition could be negatively affected by heat
•Patients with tuberculosis
•Patients with haemorrhages or risk of haemorrhage
•Patients with septic conditions and emphysemas
•Patients with malignant tumours and tumours that are not yet identified1
1.3.2 Local contraindications
The following indications are local contraindications to short-wave therapy:
•Implants or metal inclusions2
1According to Schneider (in ELEKTROMEDIZIN 7/62): Tissue and organ sections with inflammations, necroses, pus
formation and abscesses. In such cases, the therapist must choose between the application of cold or heat in accor-
dance with general pathological considerations, depending on the degree of inflammation. Inflammatory conditions
that are still in statu nascendi are treated with cold. Inflammatory conditions with necroses and a cavitary tendency
are treated with therapeutic means that generate heat and hyperemia. Chronic and unspecific inflammations are
treated in the same way (heat and hyperemia), as this supports resorption, reparation and regeneration. Specific
chronic inflammations (such as tuberculosis), however, are activated by heat. Accordingly, they represent a contrain-
dication. The same applies in the case of malignant tumorous conditions. Heat application in the case of a tumorous
disease can only be regarded as malpractice. Moreover, cardiac congestions must be removed prior to any heat appli-
cation.

Introduction
PHYSIOTHERM-S
3
•Implants that could be impaired by short-wave irradiation
•Swellings that still feel warm
•Thermohyperesthesia
•Thermohypesthesia
•Acute inflammations
•Severe arterial obstructions (stage III and IV)
•Gynaecological disorders involving acute inflammation3
•Wetness, perspiration or damp bandages
•Permeating irradiation of the thorax in cases of severe heart diseases (heart valve
diseases, myocardial insufficiency, myocardiac infarct, severe coronary sclerosis)
•Pregnancy, since irradiation of the abdomen could cause teratogenous damage
due to alterations of blood circulation and diffusion
•During the menstrual cycle
•Sudeck’s syndrome, stage I and II
•Basedow’s disease (irradiation could cause serious states of agitation)
•Varicose veins (irradiation could cause congestive pain)
1.3.3 Of particular importance
Particular care must be taken if the patient’s clothing is wet or damp, since the
garments may heat up faster and more intensely than the patient’s body. Synthetic
fibres (perlon, nylon, etc.) are characterized by low absorbency, which can cause the
skin beneath such fabrics to quickly become moist. Therefore, it is recommended
that the body areas to be treated be completely unclothed and the patient’s skin
dried, particularly where perspiration accumulates in folds of the skin. This applies
especially when a higher dosage is being applied. There is no danger, however,
when applying short-wave irradiation to bandaged areas as long as the bandages
are completely dry.
•When treating small children, particular care is obviously required, due to the
low body weight. Very careful dosing and constant observation (manual checks
of the skin temperature while the unit is switched off) are necessary.
•Since the effects of high-frequency fields on unborn life have not yet been
sufficiently researched, we recommend that operators who are pregnant do not
remain in the immediate vicinity of the applicator when the unit is activated.
•The output power must always be set according to the subjective response of
the patient! Therefore, special care must be taken in case of patients with a
diminished capacity for perception of heat (refer to section
Dosage levels
according to Schliephake
on page 12).
Warning
We would like to point out that it is advisable to post warnings for
wearers of pacemakers in the rooms where high-frequency
therapy (e.g. short-wave therapy) is applied.
Moreover, a distance of at least 6 meters must be maintained
between the unit and any low-frequency therapy that is being
carried out at the same time!
2The higher conductivity of metals causes concentration of the field, producing a high temperature in the border area
of the tissue. This in turn can cause excessive local heat, leading to (irreparable) third-degree burns. Therefore, caution
is also necessary in case of long-existing metal inclusions, such as shell fragments.
3Further contraindications relating to gynaecological disorders include (see Möbius, Gynaecological University Clinic,
Jena): genital tuberculosis, endometriosis, pyosalpinx or pyo-ovarium, tubal carcinoma.

Controls and Indicators
4 PHYSIOTHERM-S
2Controls and Indicators
As its LCD is divided in different function fields, PHYSIOTHERM-S allows for clear
and easy operation.
The metal housing protects the electronic components and simplifies cleaning.
Safety-related components are continuously monitored by the microprocessor,
erroneously initiated operating steps are suppressed, a self-test routine is performed
after switching on and possible malfunctions are displayed.
2.1 Function of Controls and Indicators
In the following section we will introduce some of the controls of PHYSIOTHERM-S.
The numbers in angle brackets refer to the
Instrument Overview at the beginning of
this manual.
2.1.1 Display <2>
On the display <2>, you can select all of the instrument’s menus and parameters
on different levels. The selection is carried out with the data selector <3>.
2.1.2 Data Selector <3>
Use the data selector <3> to select the therapy
parameters and to operate the instrument by means
of the cursor. 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. 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 at the respective
position of the display <3>.

Controls and Indicators
PHYSIOTHERM-S
5
2.1.3 Stop Button <4>
The stop button <4> is used to interrupt a therapy session. Press
the stop button <4> if you want to stop treatment before the
selected therapy time has elapsed.
2.2 Overview of Parameters
2.2.1 Start Menu
effective power
therapy parameters
indications
menu
transmission
programming
mode

Installation
6 PHYSIOTHERM-S
3Installation
3.1 Requirements for installation
Before the unit can be installed and put into operation, certain requirements must
be fulfilled in the building where the unit is to be operated.
If the unit cannot be installed immediately after delivery, the unit and its external
components or accessory elements must be stored in their original packaging in a
dry place!
Do not store or operate the unit in a dusty environment!
3.2 Requirements of the installation location
The unit must be installed so that there is no danger to the patient, the operator or
other persons!
Therefore, you must read the safety instructions in section
General Notes on page
46 and the following information:
•By selecting a suitable location for setting up the unit or by means of structural
measures, contact during the treatment by the personnel or the patient with
conductive materials that are earthed or have a high capacity to earth must be
prevented (e.g. heating pipes, water faucets, metal chairs, metal beds or other
earthed devices).
•The unit must be set up so that the (normal) release of electromagnetic radiation
during operation does not hinder the function of other devices or data media.
The minimum distance to other devices or their power supplies or data transfer
lines is 6 meters! Please note that the radiation can easily pass walls, ceilings and
floors.
•The room and the installation location must be large enough so that the unit
can be operated from the front even if the electrodes are positioned
inconveniently.
3.3 Transport of the unit
Measures concerning the transport of the unit from the manufacturer to the
operator are based on the individual circumstances and are defined in the general
terms of business.
In the event of subsequent transport of the unit, the dealer or the operator is
responsible for the unit and for compliance with the safety and accident prevention
regulations.

Installation
PHYSIOTHERM-S
7
3.4 Unpacking the unit
The unit is generally delivered with the packaging material supplied by the
manufacturer. Since the unit weight is about 60 kg, it must be unpacked by at least
2 persons!
Proceed as follows:
(1) Position the transport packaging so that the UP mark is pointing upward.
(2) Remove the safety bands from the transport packaging.
(3) Remove the transport packaging upward.
(4) Remove the remaining foam material.
(5) Lift (at least two persons) the unit from the lower packaging element.
3.5 Inspection upon receipt
Immediately after unpacking the unit you should:
(1) Verify the delivery documents to make sure that the delivery is complete.
(2) Check the external components and accessories for possible damage due to
transport.
Warning
In case of damage from transport that could endanger personal
safety, the unit must not be connected to the power supply!
3.6 Damages
Claims for damages resulting from damage due to transport are valid only if the
carrier and the manufacturer are notified without delay. The remedy of damages is
generally carried out by the manufacturer (refer to
Service, Repairs, Maintenance on
page 49).
Prepare a damage report at once and send it to the carrier and to the dealer.
When returning the unit, include the following information:
•Name and address of the sender and receiver
•Type and serial number of the unit
•Description of the defect (damage report)
•Date and signature

Notes on operation
8 PHYSIOTHERM-S
4Notes on operation
4.1 Preparing the unit
The unit has been completely assembled in the factory and is ready for use except
for connection of the electrodes.
Proceed as follows in order to prepare the unit for operation:
(1) Make sure that the voltage rating on the rating plate conforms to the system
voltage of the building.
(2) Insert the required electrodes into the recesses at the end of the electrode arms
and fasten the electrodes with the locking screws.
(3) Plug the electrode connection cable into the socket on the back of the unit.
Attach the connecting cable in the cable holders on the electrode arms.
(4) Set the power switch to the off position.
(5) Plug the high-load connector for non-heating appliances into the corresponding
socket on the back of the unit.
4.2 Check for operational safety
For your personal safety you should:
•Check the condition of the housing and the insulation of electrodes, electrode
connection cable and the power supply cable. Also make sure that the cables
have been routed correctly.
•Insert the power plug into an earthed (!) socket outlet.
Warning
The unit and the electrodes must be positioned so that there is no
danger of personal injury! Therefore, you must read and observe the
safety instructions in section
General Notes on page 46 and the
Contraindications on page 2 before putting the unit into operation!
4.3 Setting the Line Voltage
The instrument is equipped with a line voltage selector on
the rear side (next to the line fuses). Use this selector to
switch the line voltage of the instrument to 230 VAC or 115
VAC. It is not necessary to change the line fuses T16A.

Notes on operation
PHYSIOTHERM-S
9
4.4 Instrument Errors
If a functional error is detected during the automatic self-test routine or during
operation, a corresponding note will be displayed on the LCD. A numeric error code
will be shown, e.g. E02. Both operator errors and internal errors in the unit are
displayed as an error code with text information.
4.4.1 Operator errors
The following operator errors might be displayed:
E01: Please check electrodes and cables
Cause: An optimum tuning point could not be found; therefore, the applicators,
their ESD and the correct connection to the electrode cable should be
checked again.
E02: Matching...Please wait!
Cause: For reasons of safety, the effective output must not be set higher than
100 W, as long as the tuning process is still in progress. The reason for
this is that if tuning takes place at a higher effective output, heat can be
clearly felt.
4.4.2 Internal errors
With the exception of temperature errors, the treatment must be stopped
immediately in case of internal errors in the unit. The unit can only be switched off
and on again by means of the power switch <1>. If the error message appears
again, make a note of the error code, switch the unit off again and notify your
authorized service partner.
In case of display failure or other obvious defects, switch the unit off immediately by
means of the power switch <1> and notify your authorized service partner!

Short Wave Therapy
10 PHYSIOTHERM-S
5Short Wave Therapy
This chapter provides you with notes on positioning the electrodes and general
information on starting a short wave therapy.
5.1 Positioning the electrodes
Electrodes have to be positioned on the part of the body to be treated according to
the medical indication (refer to
Indications on page 18).
The electrodes must be positioned so as to avoid overheating due to edge effects.
The surfaces of the electrodes must be nearly parallel to the area being treated. It is
possible, however, to use these edge effects for therapeutic purposes.
Warning
If such an effect is desired, the dosage must be controlled very
carefully!
correct incorrect
Positioning of electrodes – edge effect
Local overheating can occur in the electric field due to one-sided application of
electrodes or the presence of metal objects (e.g. earrings, metal implants).
incorrect incorrect
Positioning of electrodes – edge effect and metal objects

Short Wave Therapy
PHYSIOTHERM-S
11
Local overheating can also occur due to electrode constrictions. This can be
prevented by increasing the distance (e.g. with pillows, felt layers) of the affected
body part.
correct incorrect
Positioning of electrodes – electrode constriction
Surface warming can be reduced by increasing the electrode distance. The use of
the diode is recommended for local applications. It is also possible to achieve this,
however, by using different electrode sizes and varying the positions.
Below you will find several examples for correct placement of electrodes:
Even irradiation of extremities in the
transverse field
Even irradiation of extremities in the
longitudinal field
Uneven irradiation by the use of different
electrodes
Even irradiation of areas of the trunk, the head
or the extremities with a large electrode-skin
distance
Positioning of electrodes – normal cases

Short Wave Therapy
12 PHYSIOTHERM-S
5.2 Setting the intensity
5.2.1 Dosage levels according to Schliephake
The treatment instructions use the following dosage levels according to Schliephake:
Dosage Level Sensation Description
1 No perceptible heat athermal, subliminal
2 Slight warming heat just perceptible
3 Pleasantly warm pleasant, tolerable
perception of warmth
4 Strong warming strong but still
tolerable perception
of heat
Treatment dosage
Heat
perception 1 2 3 4
none
low
medium
strong
Dosage scheme according to Schliephake
Warning
Always begin the treatment with an initially low dosage! After the
treatment has been in progress for 1 – 2 minutes you can make the
final setting based on the subjective response of the patient!
5.2.2 Effective Power
In order to prevent unbearable warming of tissue, the effective output power, as
summarized in the following table, must not be exceeded!
Type of electrode max. effective power
Diode 120 Watt
Diplode 200 Watt
Plate electrode ∅80 mm 80 Watt
Plate electrode ∅120 mm 200 Watt
Plate electrode ∅165 mm 400 Watt
Rubber capacitor electrode 120 x 180 mm 250 Watt
Rubber capacitor electrode 145 x 250 mm 400 Watt