Physiomed vocaSTIM-Master User manual

00910 GB
OPERATING INSTRUCTIONS
vocaSTIM®-Master

The technical data in this manual is as at the time of printing and subject to alteration.
Copyright © 2000 - 2012 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.
Operating Instructions last updated on January 16, 2012.

Instrument Overview
Front Panel
Rear Face
Right Side
Legend
1 Mains Module 6 Intensity Control 11 Manual Release Key
Socket
2 Upper Status Bar 7 Pulse Indicator 12 Foot Switch Socket
3 Display 8 Patient Current Indicator 13 Card Reader
4 Lower Status Bar 9 Output Indicator
5 Data Selector 10 Patient Lead Connector
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
10
7
9
1
11
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 <6> ..................................................................................................................5
2.1.7 Pulse Indicator <7>......................................................................................................................5
2.1.8 Patient Current Indicator <8> ......................................................................................................5
2.1.9 Output Indicator <9> ..................................................................................................................6
2.1.10 Patient Lead Connector <10>......................................................................................................6
2.1.11 Manual Release Key Socket <11> ................................................................................................7
2.1.12 Foot Switch Socket <12>.............................................................................................................7
2.1.13 Card Reader <13> .......................................................................................................................7
2.2 Overview of Parameters ..........................................................................................................8
2.2.1 Start Menu (1st level)....................................................................................................................8
2.2.2 Example Menu (2nd level) .............................................................................................................8
2.3 Operation ..................................................................................................................................9
2.3.1 Parameters ..................................................................................................................................9
2.4 Characterisation of the Individual Current Modes ..............................................................12
2.4.1 Low-frequency Current Modes (LF)............................................................................................12
2.4.2 Medium-Frequency Currents .....................................................................................................15
2.4.3 Current Modes of the Diagnostics Menu ...................................................................................16
3Notes on Operation......................................................................................................17
3.1 Connection ..............................................................................................................................17
3.2 Start-up....................................................................................................................................17
3.3 Self-test routine......................................................................................................................17
3.4 Instrument Errors....................................................................................................................18
4Therapy.........................................................................................................................19
4.1 General Information...............................................................................................................19
4.2 Safety Precautions when Attaching Electrodes ...................................................................19
4.3 Safety Precautions for Stimulation Current Intensity .........................................................20
4.3.1 Recommended Intensities ..........................................................................................................20
4.4 Preparations and Attaching the Electrodes..........................................................................20
4.4.1 Modes of Attaching the Electrodes............................................................................................21
4.5 Therapy using Low-frequency Current Modes ....................................................................21
4.5.1 Monophase and Biphase Current Modes ...................................................................................21
4.5.2 Iontophoresis.............................................................................................................................22
4.5.3 Pain Therapy, Hyperaemisation, Detonisation ............................................................................23
4.5.4 Muscle Stimulation using Low-Frequency Currents ....................................................................24
4.6 Therapy using Medium-Frequency Current Modes .............................................................26
4.6.1 Pain Therapy, Hyperaemisation, Detonisation using AMF Current ..............................................26
4.6.2 Muscle Stimulation using Medium-Frequency Surge Current .....................................................27
5Diagnosis: Accommodation Quotient .........................................................................29

6Indications Menu..........................................................................................................30
7Individual Programs .....................................................................................................33
7.1 Save Therapy Modes ..............................................................................................................33
7.2 Call Program............................................................................................................................34
7.3 Delete Program.......................................................................................................................35
8vocaCARD .....................................................................................................................35
8.1 Save Card Programs ...............................................................................................................35
8.2 Direct Access to Card Programs.............................................................................................36
8.3 Prescribe Therapies / Therapy Check ....................................................................................36
9Patient Device (Trainer)................................................................................................39
10 Basic Settings................................................................................................................40
10.1 Setup Menu.............................................................................................................................41
11 General Notes...............................................................................................................42
12 Service, Repairs, Maintenance .....................................................................................42
13 Cleaning and Disinfection............................................................................................43
14 Technical Data ..............................................................................................................43
15 Accessories....................................................................................................................44
15.1 Standard Accessories..............................................................................................................44
15.2 Additional Accessories ...........................................................................................................45
16 Manufacturer’s Recommendations..............................................................................47
Index....................................................................................................................................48

Introduction
vocaSTIM®-Master
1Introduction
With your vocaSTIM®-Master, 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 yourself with the use of the instrument.
1.1 Instrument Description
vocaSTIM®-Master is a single channel stimulation current therapy unit. It disposes
of low and medium frequency current modes. Moreover, the unit offers you
programs for stimulation current diagnosis.
Therapy modes of vocaSTIM®-Master may be accessed directly or, by a proposed
treatment, via the indications menu. Furthermore, the unit enables you to memorise
up to 25 individual treatment programs or current sequences (
Individual Programs
page 33). In addition, you may save treatment modes for each patient on a
chipcard, the vocaCARD (cf. page 35).
All functions of vocaSTIM®-Master are controlled by a microprocessor, which also
continuously monitors all important components and suppresses erroneously
initiated operating 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
vocaSTIM®-Master was designed for the following applications:
Stimulation current therapy
•Circulatory stimulation
•Mobilisation and stimulation of small muscles
•Iontophoresis
•Phonation exercises
Stimulation current diagnosis
•Faradic excitability test
•Medium-frequency test according to Lange
•Accommodation quotient
Caution
The instrument may only be operated by qualified personnel who have
undergone special training!

Introduction
2 vocaSTIM®-Master
1.3 Contraindications
Contraindications to stimulation current therapy:
•Highly inflammatory, fever-prone disorders
•Pregnancy
•Patients with cardiac pacemakers or other implanted stimulators
•Malignant tumours
•Spastic paralysis
•Skin lesions of the area to be treated
•Implants containing metal parts within the area of treatment

Controls and Indicators
vocaSTIM® - Master 3
2Controls and Indicators
As its LCD is divided in different function fields, vocaSTIM®-Master 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,
erroneously initiated operating steps are suppressed, a self-test routine is performed
after 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 vocaSTIM®-
Master 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
manufacturer.
vocaSTIM®-Master is switched on and off using the integrated
mains switch. After switching on, a self-test is automatically
carried out by the instrument (cf.
Notes on Operation on page 17).
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> (cf.
Technical
Data
on page 43). 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.
Caution
Do run the instrument only with the indicated line voltage!

Controls and Indicators
4 vocaSTIM®-Master
2.1.2 Upper Status Bar<2>
The upper status bar <2> shows indications or some of the corresponding
parameters selected. For example: GALVANISATION .
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
parameters and to operate the instrument by
means of the cursor. After switching on the
instrument, the cursor is located at the current
mode Gof the display <3>.
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 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
vocaSTIM® - Master 5
2.1.6 Intensity Control <6>
The intensity control <6> serves to set
the intensity in steps of 0.1 mA. When
turning up the intensity control <6> the
therapy timer on the display <3> will be
started as well.
Every time you have to turn down the
intensity control to 0, the following
message will be displayed in the lower
status bar <4>:
Every time this message appears, turn down the intensity control.
Automatic output current switch-off
The vocaSTIM®-Master disposes of an automatic output current switch-off
activated 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. After eliminating the error, the current will
automatically be surged to the previously set value and the message will disappear.
Note
While turning up the intensity for the current mode T/R, a pulse needs
to be triggered at least every 5 mA (automatic or manual). Otherwise,
a message and an acoustic signal will be issued.
2.1.7 Pulse Indicator <7>
The pulse indicator <7> serves to visually monitor current
modes and pulses. It flashes whenever a pulse is generated by
the processor, even in case of 0 intensity. It will stop
flashing, however, when the intensity 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 monophase currents
(display <3>) the indicator will show how the intensity
increases or decreases automatically.
2.1.8 Patient Current Indicator <8>
Flashing of the indicator depends on the resistance.
In most cases the diodes start flashing exactly at the moment
when the patient starts to have a clear sensation of the
current.
If the indicator does not flash during treatment, even with higher intensities, 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

Controls and Indicators
6 vocaSTIM®-Master
accessories of the corresponding circuit should be checked and replaced if
necessary.
2.1.9 Output Indicator <9>
This indicator tells you to be cautious when handling the
electrodes:
Warning!
The patient lead connector <10> and the electrodes are
under voltage! Attach or remove the electrodes only
after the intensity control <6> has been turned down to
0 and the output indicator <9> is no longer flashing!
2.1.10 Patient Lead Connector <10>
The patient lead connector <10> 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 to their
polarity.
Colour of the connector:
red = anode (+), blue = cathode (-)
Type BF component, not connected to protective ground wire.
Caution Take care that the electrodes are by no means touched after the
current is turned up!
Cathode (-)
Anode (+)

Controls and Indicators
vocaSTIM® - Master 7
2.1.11 Manual Release Key Socket <11>
The manual release key socket <11> 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 FaS, T/R or
MT. To activate it, the function display must be at the
following position:
2.1.12 Foot Switch Socket <12>
The foot switch socket <12> serves to plug in
the foot switch for diagnosis.
2.1.13 Card Reader <13>
The card reader <13> serves for inserting the
vocaCARD on which individual treatment
programs can be saved.
Insert the vocaCARD with the chip on top.

Controls and Indicators
8 vocaSTIM®-Master
2.2 Overview of Parameters
2.2.1 Start Menu (1st level)
2.2.2 Example Menu (2nd level)
Current Mode G
Diagnostics Menu
Indications Menu
Upper Status Bar <2>
Patient Device Mode
Individual Programs
Lower Status Bar <4>
Low-frequency
Current Modes
(direct access)
Therapy Timer
Selected
Current Mode
Possible
Parameters
Back to
previous
Menu
Save Menu
Setup Menu
Medium-frequency
Current Modes
(direct access)
Selected
Parameters
Prescriptions
Basic Settings
Direct Access
vocaCARD
(only with
vocaCARD
inserted)
Number of prescriptions on the
vocaCARD (only with vocaCARD
inserted)

Controls and Indicators
vocaSTIM® - Master 9
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.
Prescriptions; here you are able to prescribe
treatments and check executed treatments (only with
vocaCARD inserted)
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.
Direct access vocaCARD;
Programs can be saved and called (only with
vocaCARD inserted)
The parameters of the menus DIAGNOS. , INDICAT. , INDIVID. , SETMENU and TRAINER
will be discussed later.
2.3.1 Parameters
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.

Controls and Indicators
10 vocaSTIM®-Master
Current Mode G
Switching from galvanic current to medium-frequency
interrupted direct current
. The current setting is
displayed in the upper status bar.
Current Modes UR, IG 30, IG 50, FM
Switching from monophase pulses with galvanic basis
to biphase pulses. The current setting is displayed in
the upper status bar.
Current Mode FaS
Switching from monophase pulses with galvanic basis
to biphase pulses. The current setting is displayed in
the upper status bar.
Acoustic signal, makes every current pulse audible
t: Pulse time, possible values: 0.1 -5 ms
Relation contraction (
T
ension ) / pause (
R
elease ),
possible values T = 1 – 60 s, R= 1 – 60;
manual release key (only if R > 1s, then set T to the
far left)
Ramp (5 settings m1to m5) with different rise times.
The current setting is displayed in the upper status
bar.
Current Mode T/R
Switching between monophase and medium-
frequency pulses
Pulse time (possible values: 1s – 0.1 ms)
Release time (possible values: 5s – 1s, manual release
key or EMG trigger)
Pulse shapes (possible settings: square-wave pulse, 4
trapezoidal pulses t1– t4, 2 triangular pulses d1– d2, 2
exponential pulses e1 and e2). The current setting is
displayed in the upper status bar.
Acoustic signal, makes every current pulse audible
Current Mode AMF
Intensity display, to be set with intensity control <6>

Controls and Indicators
vocaSTIM® - Master 11
5 pre-set frequency bands,
fixed frequency (SELECT 0 – 250 Hz)
Basic frequency (possible values: 2.0 – 9.5
kHz)
Current Mode MT
Intensity display, to be set with intensity control <6>
Tension time T (possible values: 1 to 60 s in steps of
1s;
manual release key (only if R > 1s)
Release time R (possible values: 1 to 60 s) in steps of
1s
Ramp (5 settings m1- m5) with different rise times.
The current setting is displayed in the upper status
bar.
Modulation frequency (possible values: 0 -125 Hz)
Basic frequency (possible values: 2.0 – 9.5 kHz) The
current setting is displayed in the upper status bar.
Acoustic signal, makes every current pulse audible
Diagnosis/Accommodation quotient
Exchange of polarity of the two electrodes
the sign (plus/minus) of the intensity display will be
changed respectively.
Acoustic signal, makes every current pulse audible
Interrupt the emission of pulses
Pulse time (possible values: 1000 ms or 500 ms)
Confirmation that muscle contracted
Pulse shapes (possible shapes: square-wave pulse,
triangular pulse). Depending on the selected pulse
shape, another acoustic signal will be issued.
Calculation of the
accommodation quotient
Indication of the degree of
damage

Controls and Indicators
12 vocaSTIM®-Master
2.4 Characterisation of the Individual Current Modes
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,
evoking hyperaemia
Note
You have to take special care when applying galvanic current. The
moistened viscose covers must be well attached to the skin surface.
Caution The intensity must not exceed 0.1 mA/cm² of active electrode
surface!
(UR) Ultrastimulation Current
acc. to Träbert
Fixed parameters Adjustable
Pulse shape: square Mono-/biphase
T = pulse time: 2 ms
R = release time: 5 ms
Stimulation frequency: approx. 143
Hz
monophase biphase
with galvanic basis 5%
T R T
T R
Application: Pains caused by hypertonic muscles,
arthrosis and osteochondrosis.

Controls and Indicators
vocaSTIM® - Master 13
(IG 30) Pulse Galvanisation 30
acc. to Jantsch
Fixed parameters Adjustable
Pulse shape: triangular Mono-/biphase
T = pulse time: 30 ms
R = release time: 50 ms
Stimulation frequency: approx. 12
Hz
monophase biphase
with galvanic basis 5%
Application: Circulatory stimulation, analgesia
(IG 50) Pulse Galvanisation 50
acc. to Jantsch
Fixed parameters Adjustable
Pulse shape: triangular Mono-/biphase
T = pulse time: 1 ms
R = release time: 20 ms
Surge time: 50 ms
Surge pause: 70 ms
Stimulation frequency: approx. 8 Hz
monophase biphase
with galvanic basis 5%
Application: Shiver-inducing frequency for circulatory stimulation, analgesia,
relaxing muscle tension, haematoma reduction.
T R T T R T
T R T R

Controls and Indicators
14 vocaSTIM®-Master
(FM) Frequency-Modulated Current
Fixed parameters Adjustable
Pulse shape: triangular Mono-/biphase
T = pulse time: 1 ms
R = release time: 70 -142 ms
Stimulation frequency: 7 -14 Hz
monophase biphase
with galvanic basis 5%
T R T R
Application: Shiver-inducing frequency with automatically altered stimulation
cycles for circulatory stimulation, relaxing muscle tensions,
analgesia with little sensitive strain
(FaS) Faradic Surge Current
Fixed parameters Adjustable
Pulse shape: triangular t = pulse time: 0.1 - 10 ms (classic: 1 ms)
Mono-/biphase
T = contraction: 1 - 60 s; manual
triggering (manual release key)
R = pause: 1 – 60 s
Ramp (surge time): 4 modes
monophase biphase
with galvanic basis 5%
Application: Treatment of muscle atrophies, intentional exercises according to
Förster, electrogymnastics, muscle training in sports, co-ordination
exercises
T R T R