Richmar Winner EVO Series User manual

OPERATION MANUAL
Winner EVO Series

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CAUTION
The operator should read and be familiar with the precautions and operation of this device prior
to beginning treatments.
This device is not designed to be connected with any electrical equipment or accessories unless
manufactured and/or approved by Rich-Mar. This includes whirlpools, lead cords, probes, self-
adhesive electrodes and carbon electrodes NOT manufactured by Rich-Mar.
WARNING
Federal law restricts this device to sale by or on the order of a physician or any other practitioner
licensed by the law of the state in which said person practices.
For continued protection against fire hazard, replace fuses ONLY with those of the same type
and rating.
This equipment should always be grounded. Grounding reliability can only be achieved when
the equipment is connected to an equivalent marked, “Hospital Grade.”
This device should be kept out of the reach of children.
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TABLE OF CONTENTS
WARRANTY.......................................................................................................................................................................... 3
WINNER SERIES ILLUSTRATIONS............................................................................................................................ 4
INTRODUCTION ................................................................................................................................................................. 11
STIMULATION INDICATIONS FOR TREATMENT ...............................................................................................18
MICROCURRENT INDICATIONS FOR TREATMENT.........................................................................................18
ELECTRICAL STIMULATION WAVE FORMS .......................................................................................................19
ULTRASOUND INDICATIONS FOR TREATMENT ..............................................................................................21
ULTRASOUND CONTRAINDICATIONS & WARNINGS....................................................................................21
ULTRASOUND INTRODUCTION AND OVERVIEW.......................................................................................... 22
ULTRASOUND CALIBRATION & TUNING PROCEDURES (CM MODELS ONLY)..............................23
CLEANING RECOMMENDATIONS............................................................................................................................24
CONVERTING BETWEEN 230 VAC AND 115 VAC............................................................................................ 25
TROUBLE SHOOTING .................................................................................................................................................... 27
WINNER SPECIFICATIONS & ACCESSORIES LIST.......................................................................................... 27
APPENDIX A .......................................................................................................................................................................28
ULTRASOUND TECHNICAL INFORMATION .......................................................................................................29

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WARRANTY
The warranty period for the Ultrasound Applicators is one year (12 months).
To participate in warranty coverage, the Product's warranty registration card (included with the Product) must be filled out
and returned to Rich-Mar by the original owner within ten (10) business days from the date of purchase.
FROM THE END-USER TO VALIDATE THE WARRANTY PERIOD
RICHMAR SHALL RESERVE THE RIGHT TO REQUEST PROOF OF PURCHASE
Any modifications or repairs performed by unarthorized centers or groups will void this warranty.
This Warranty Does Not Cover:
~ Defects or damage caused by labor furnished by someone other than Rich-Mar, the selling dealer or a certified service
~ Replacement parts or labor furnished by anyone other than Rich-Mar, the selling dealer or a certified service technician.
technician .
~ Any malfunction in the Product caused by product misuse, including, but not limited to, the failure to provide reasonable and
required maintenance or any use that is inconsistent with the Product's User's Manual.
To Obtain Service from Rich-Mar or the selling dealer under this warranty:
Written claims made to Rich-Mar should be sent to:
1. A written claim must be made within the warranty period to Rich-Mar or the selling dealer.
Rich-Mar, Inc.
4120 South Creek Road
Chattanooga, TN 37406
Telephone [phone] / FAX[phone]
and
2. The Product must be returned to Rich-Mar or the selling dealer by the owner.
from the date on which the Product is returned to Rich-Mar.
Rich-Mar or the selling dealer will repair or replace the respective Product without charge within a period of Thrity (30) days
All repairs to the Product must be performed by Richmar or a Richmar Authorized Service Center.
This warranty gives you specific legal rights and you may also have other rights which vary from location to location.
Rich-Mar does not authorize any person or representative to create for it any other obligation or liability in connection
with the sale of the Product.
Any representative or agreement not contained in the warranty shall be void and of no effect.
THE FOREGOING WARRANTY IS IN LIEU OF ALL OTHER WARRANTIES, EXPRESSED OR IMPLIED,
INCLUDING ANY WARRANTY OR MERCHANT ABILITY OR FINESS FOR A PARTICULAR PURPOSE.
RICH-MAR SHALL NOT BE LIABLE IN ANY EVENT FOR INCIDENTAL OR CONSEQUENTIAL DAMAGES
may not apply to you.
Some states do not allow the exclusion or limitation of incidental or consequential damages, so the above limitation or exclusion
If these Products fail to funtion during the three year warranty period due to a defect in material or workmanship,
Rich-Mar warrants that our units are free of defects in material and workmanship.
This warranty shall remain in effect for (3) three years from the date of original customer purchase.
The warranty period for certain accessories is 90 days. These accessories consist of Lead Wires and Electrodes.
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WINNER EVO SERIES
FRONT VIEW
WINNER EVO COMBO WINNER EVO STIM
1. Ultrasound User Interface
2. E-Stim User Interface
3. Intensity Knob
4. 2 or 4 Channel Output
5. E-Stim User Interface
6. Intensity Knob
7. 2 or 4 Channel Output
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WINNER EVO SERIES
REAR VIEW
1. Ultrasound Applicator Cradle
2. Laser/Light Module (optional)
3. Ultrasound Applicator Plug (CM units)
4. Combo Mode Stim Lead Jack
5. Unit Power Module with ON/OFF Switch
6. Electrical Stim Lead Cord Test Jack
7. Cooling Fan
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USER INTERFACE
Winner EVO Combo

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USER INTERFACE
Winner EVO Stim

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USER INTERFACE
Ultrasound
E-Stim
1. Time Display and Adjust
2. Ultrasound Intensity Display and Adjust
3. W/cm or Watts Display Select
4. Ultrasound Pause/Resume
5. Ultrasound Start/Stop
6. Ultrasound Frequency
7. Ultrasound Duty Cycle
8. Applicator Select
1. Time Display and Adjust
2. Intensity Display
3. Pulse Rate Adjust
4. User Defined Profiles
5. Start Treatment
6. Stop Treatment
7. Pulse Rate Select
8. Channel Select
9. Time ON/OFF Select
10. Mode Select
11. Stim Output Modality Select
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Introduction
The Winner units are products that resulted from dedication to
research and development. The Winner units offer the most
flexible treatment possibilities in a convenient, easy-to-use
package. This manual is meant to familiarize the user with the
controls, operations, waveforms and ultrasound therapies
available in the Winner units. The simple control of the unit
allows the user to master the unit’s vast capabilities more
quickly and easily.
User Interface
The Winner units use a straight forward control panel with
each waveform therapy and parameter clearly labeled. Each
button requires only light pressure to be activated. You should
also hear an audible beep each time a button is pressed. LED
lights illuminate indicating the availability and/or selection of
particular parameters. The large and bright LED numerical
displays show treatment time, intensity and pulse rates.
Power Switch
This power switch turns the unit on and off and is located on
the rear side of the unit. “I” represents the on position and “O”
represents the off position.
Winner Operation Overview
The Winner Series offers a variety of different devices to fit
your therapy needs:
The CM4 models are four-channel, multi-therapy stimulation-
ultrasound combination units. The Winner CM2 models are
the two channel combination version.
The ST4 is a four-channel multi-waveform stimulator, and the
ST2 is a two-channel version.
The Winner units will output any one of the following
waveforms:
Quadpolar IFC (Classic Interferential)
Premod IFC (Bipolar Interferential)
Russian
Hi-Volt
Microcurrent
Depending upon the waveform in use, any one of the
following treatment modes can also be used:
Normal output
Surge output
Co-Contraction output
Alternating channel output
NOTE: For more information on outputs, see the
“Waveforms” section.
The Winner CM4 and CM2 can also provide 1MHz and
3MHz ultrasound frequencies.
Note: For more information, see the “Ultrasound” section.
Electrical Stimulation
Once the device is turned on, you will notice that the green
LED lights in the Waveforms (Quadpolar IFC, Pre-Mod IFC,
Russian, HiVolt and Micro) and the Therapy Profiles are
blinking. This is to indicate that the unit is on and ready for
treatment. It is also a quick reference to determine if the
device is in the Easy Therapy Profile mode or Advanced
Therapy Profile mode (see Therapy Profile section for more
information).
* If no treatments are running and no buttons are pressed the
device will go into a “sleep mode” where the LEDs will not
blink on the stimulator side. Simply press any button to
re-activate the stimulator.
To Start a Stim Treatment
Press the button of the desired Waveform or Therapy Profile.
Once you do this you will notice that the device has selected
the first available channel(s). For example, if you turn on the
device and press the Pre-Mod IFC button, the green LED next
to Selected in the Ch. 1 button will illuminate. This indicates
that the treatment will output from Ch. 1 and you should use
that lead cord to apply the electrodes, or you can now select
the CHANNEL you want to use by first pressing that
channel’s button.
You will then notice that the Waveform/Profile LEDs are
blinking. You then select the waveform or profile you would
like to use by pressing it’s button.
However you have selected to begin your treatment (either
picking the waveform first or the channel button first) you will
then notice that certain LEDs have been illuminated indicating
that they are currently selected. Using the example above of
Pre-Mod IFC, the LEDs are lit next to Normal, a High pulse
Rate and 15:00 minutes of treatment time. You can change
any of these parameters by pressing the appropriate button(s)
noticing that the LED lights change too. Once the desired
parameters are displayed, the Winner devices will prompt you
to set Intensity by flashing the Adjust LED light underneath
the Intensity dial. As you set the desired intensity level, you
will notice that the green Active light is illuminated in the Ch.
1 button to indicate that current is being output. Once the
desired intensity level has been set press the Start/Accept
button and the time begins counting down.
NOTE: When using Quadpolar IFC one of the channel pair’s
Selected light will blink. If you balance the treatment then the
intensity display will be different between the two channels.
Whichever channel’s Selected light is constantly illuminated
will display its intensity level.
Running Concurrent Stim Treatments
The Winner units have either four independent stimulation
channels (CM4 and ST4 models) or two independent
stimulation channels (CM2 and ST2 models). This allows you
to treat four or two different sites or patients at the same time
with completely different treatment parameters. To start a
concurrent stim treatment press the desired waveform or
Therapy Profile or channel for the second treatment. If you
pressed the Waveform or Profile button the green Selected
LED light in the Ch. 2 button should now be illuminated. If
you pressed a channel button than that channel’s Selected
LED should be illuminated.
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You will also notice that the green Selected LED light on Ch.
1 went out but its green Active LED light is still illuminated.
This means that there is a treatment currently on Ch. 1 but its
parameters are not selected for display. If you pressed the
waveform or Profile button the treatment parameters on Ch.2
are now displayed. If you pressed a channel button you now
need to select the waveform or Profile you want to use and its
parameters will be displayed. Any adjustments can now be
made to the parameters for this second treatment. Then, set
Intensity and press the Start/Accept button to begin the
treatment time countdown. NOTE: If the Quadpolar IFC
therapy waveform is selected, it requires both channels one
and two or channels three and four and will subsequently set
the same intensity level on both channels. Once the intensity
levels are set in Quadpolar IFC and the Start/Accept button
has been pressed, you have the option of Balancing the output
by pressing the Balance button. When pressed, the green LED
light on the Balance button will illuminate and the green
Adjust LED light will illuminate under the intensity
dial. Use the dial to balance the patient’s sensation. You will
see only the selected channel’s intensity level increase or
decrease, but understand that as it increases, the other Quad
IFC channel’s intensity decreases proportionately. Once the
balance has been completed, press the Start/Accept button.
To View Stimulation Treatment
If you are running two or more concurrent stim treatments,
you will only see one treatment’s parameters at a time. Press
the desired channel button to illuminate its Selected LED
light. You will then see all the parameters for that particular
channel’s treatment. Whichever channel button you press will
activate the Selected LED and display that treatment’s
parameters.
To Stop a Stimulation Treatment
If you only want to stop a single treatment without affecting
the other treatments, press and hold the desired channel button
and the stimulation Stop button at the same time.
NOTE: If you just press the stimulation’s Stop button it WILL
STOP ALL STIM TREATMENTS.
Waveform Parameter Options
Waveform choices include Quadpolar IFC, Pre-Mod IFC,
Russian, Hi-Volt (Monophasic), and Microcurrent.
Quadpolar IFC will only output classic Interferential current
in a Normal mode and it requires both Ch.1 and Ch. 2 or Ch. 3
and Ch. 4 (if applicable). The Balance button allows for better
patient sensation balance if that button is selected - as you
increase or decrease intensity on the selected channel it will do
the opposite on the other channel in the pair. Quadpolar IFC
also allows you to turn an amplitude modulating Vector on or
off. The Vector provides a soothing massage effect and also
helps to lessen patient accommodation. The Pulse Rate
available is either the High, Low or a Hi-Lo combination.
Pre-Mod IFC will output pre-modulated, two-pad
Interferential current in any of the desired Modes (Normal,
Surge, Co-Cont and Alternating). The Vector can be turned
on or off in the Normal mode. The Pulse Rates available in
the Normal mode are High, Low, and Hi-Lo scan. If the
Surge, Co-Contraction, or Alternating mode is selected, only
the Fixed Pulse Rate is available. Any of the six On/Off
timing options are available in the Surge or CoCont modes. In
the Alternating mode the 10/10 or the 5/5 timing cycles are
available.
Russian and Hi-Volt- Both waveforms are available in any of
the Modes (Normal, Surge, Co-Cont, and Alternating). The
Fixed Pulse Rate is only available for Russian.
* The Hi-Volt Pulse Rates available in the Normal mode are
High, Low, and Hi-Lo scan. If the Surge, Co-Contraction, or
Alternating mode is selected, only the Fixed Pulse Rate is
available. Any of the six On/Off timing options are available
in the Surge or Co-Cont modes. In the Alternating mode, the
10/10 or the 5/5 timing cycles are available.
NOTE: The Hi-Volt in the Winner is a non-dispersive style.
This means that for each channel, one of the electrodes is
positive and the other is negative. When using the Hi-Volt
waveform, the red pin is positive and the white pin is negative.
Microcurrent will only output in a Normal mode and its Pulse
Rate is only available as a Fixed output.
Stimulation Modes
Depending upon the waveform selected, the user can choose
from Normal, Surge, Co-Contract and Alternating modes.
Normal Mode is basic continuous, un-interrupted output of the
selected waveform.
Surge Mode is a single channel of output that is interrupted in
an “on/off” method of a certain time, in seconds, of output
followed by a certain time, in seconds, of no output. For
example, if Surge mode is selected and the “10/20” option is
selected, this means that for 10 seconds there will be output to
the set intensity level followed by 20 seconds of zero output.
The cycle continues until treatment time expires.
* NOTE: There is a built-in ramp up time of three seconds in
the “on” time and a ramp down of one second in the “off”
time.
Co-Contraction Mode is the same as the Surge mode except
that it will concurrently run two channels, either 1 and 2 or 3
and 4, to the same “on” and “off” time. Independent intensity
levels can be set.
Alternating Channel Mode will alternately turn one channel
“on” and then a second channel “on” as soon as the first
channel goes into the “off” time. For example, in an Alt mode
both Ch. 1 and Ch. 2 will be used. If the “10/10” option is
selected in the Time On/Off then, after intensity levels have
been set for each channel and treatment started, Ch. 1 will be
“on” for 10 seconds. Once Ch.1 goes “off”, Ch. 2 will be “on”
for 10 seconds. This alternating will continue until treatment
time expires.
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To Adjust Stimulation Intensity during Treatment
Intensity can be adjusted during treatment, even during the off
cycle in Surge or Alternating modes, simply by pressing the
desired Channel button.
Normal mode intensity adjustment- When in Normal Mode,
you will notice that the light in the Start/Accept button is
flashing. Once the level is adjusted, press Start/Accept and the
user will be prompted to do the same for channel two, if
applicable.
Timing Mode Intensity Adjustment- Surge, Co-Cont & Alt
Surge Mode Intensity Adjustment
In the Surge mode, press the Channel button and you will
notice that the Start button is blinking. Press the Start button
to access a change in intensity as a safety feature. You will
then notice that the time has stopped counting down and the
channel’s Active LED is illuminated. Make your intensity
adjustment and press the Start button when finished. The
timing cycle will now start over. This process is done as a
safety feature so that you cannot increase intensity during the
“off” cycle.
Co-Contract or Alternating Modes Intensity Adjustment
These modes use two channels so you need to press the button
for the Channel that you want to adjust. Once you do this,
notice that the Start button is blinking. You cannot change the
intensity until you press the Start button. Press the Start
button and the treatment’s other channel Active LED goes out,
the selected channel’s Active LED illuminates, and the Timer
stops counting down. Make your intensity adjustment and
press the Start button when finished. The timing cycle will
now start over. This process is done as a safety feature so that
you cannot increase intensity during the “off” cycle.
Stimulation Pulse Rates
Depending upon the waveform selected, the user can use
either a Scan (High, Low or Hi-Lo) or a Fixed pulse rate.
Once the type of pulse rate has been selected (High, Low, Hi-
Lo or Fixed), press the Pulse Rate View/Adjust button. If a
Scan is selected, the low end of the Scan will be displayed in
the Stim Time display but note that the Pulse 1 light is
illuminated. The high end of the Scan will be displayed in the
Stim Intensity display but note that the Pulse 2 light is
illuminated now. At this point you can make adjustments to
either end of the Scan by using the up/down arrows for Pulse 1
and the dial for Pulse 2. Once the Pulse Rate has been
selected press the Start/Accept button.
The High Scan and Low Scan will make a complete cycle
through the selected pulse rate range in 30 seconds. For
example, if a 100-120 scan is selected it will start at 100 Hz
and scan up to 120Hz and back down to 100Hz every 30
seconds.
The High-Low Scan pulse rate mode will split the treatment
time in half with the first half using the High pulse rate scan
and the second half using the Low pulse rate scan.
To set up a Hi-Lo pulse rate scan set the High scan and then
the Low scan and select the Hi-Lo Pulse Rate. Follow these
steps:
-Press the Pulse Rate button and select High pulse rate.
-Press the Pulse Rate View Adjust button and set the desired
High scan.
-Press the Pulse Rate View button again. -Press the Pulse Rate
Mode button to select the Low pulse rate. -Press the Pulse
Rate View Adjust button and set the desired Low scan.
-Press the Pulse Rate View button again.
-Now press the Pulse Rate Mode button until the High-Low is
selected (both LEDS will be lit for High and Low.
-Set time and intensity and begin treatment.
* The LED of the pulse rate that is currently running in the
High-Low scan will be constantly lit and while the other
scan’s LED will be blinking.
Example: You start a treatment in the High-Low Scan and the
High LED is constant and the Low LED is blinking. This
indicates the that High scan is currently outputting. You can
verify this by pressing the Pulse Rate View Adjust.
Fixed Pulse Rate
If Fixed pulse rate is selected and the Pulse Rate View/Adjust
button has been pressed, the pulse rate is displayed in the Stim
Time display and the Pulse 1 light is illuminated. Make
adjustments to the fixed pulse rate by using the up/down
arrows or the dial. After selecting Pulse Rate press the Pulse
Rate View/ Adjust button.
Stimulation Treatment Time
Treatment time for the Winner stimulation is adjustable from
199 minutes. You can adjust treatment time in one minute
increments at any time by pressing the increase or decrease
buttons below the treatment time during the displayed
treatment.
Setting Waveform Defaults and Therapy Profiles
Waveform Defaults-
To set particular parameters so that they are defaults for a
Waveform button, select the Waveform and set all the
parameters as desired: Treatment time, Mode, Time On/ Off
(if applicable) and Pulse Rate. Once all parameters are
selected, set the Intensity and PRESS AND HOLD THE
START/ ACCEPT BUTTON UNTIL YOU HEAR TWO
CLICKS AND A LONG TRILL. When this occurs, it has
stored those displayed parameters as the default for that
waveform. Repeat this process for each waveform.
For example, if you wanted to change the Pre-Mod defaults to
a Surge treatment:
- Press the PreMod IFC button,
- Select the Surge Mode,
- Select the 10/10 Timing Cycle.
- Press the Pulse Rate View Adjust and set a 65 Hz pulse rate
and press the Pulse Rate View Adjust again
- Set the Treatment Time for 8 minutes.
- Turn the dial to set the intensity and PRESS AND HOLD
THE START BUTTON UNTIL YOU HEAR TWO CLICKS
AND A LONG TRILL.
Now, whenever you press the PreMod IFC button, it will
come up with the above treatment.
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Therapy Profiles –
The Winner devices will allow you to use either the Easy
Therapy Profile mode or the Advanced Therapy Profile mode.
The Easy Therapy Profile mode allows you to set a total of
four different therapies so you can start a treatment with one
touch. The Advanced Therapy Profile mode will allow you to
have four different profiles for each waveform, giving you a
total of 20 Therapy Profiles. If the device is in the Easy
Therapy Profile mode, the Profile
LEDs will blink along with the waveform LEDs when the
device is first powered on.
If the device is in the Advanced Therapy Profile mode, the
Profile LEDs will not blink when the device is first turned on.
To switch from one Therapy Profile mode to another, turn the
device off, press and hold any of the Therapy Profiles, and
turn the device on. You should hear a series of beeps and
notice that the Profile LEDs are now in the opposite mode.
Easy Therapy Profile Mode Set-Up
To set a Profile in the Easy mode, press the desired Profile
button (A, B, C, or D) TWICE. Then, select the desired
waveform and all its parameters. Set the intensity and PRESS
AND HOLD THE START/ACCEPT BUTTON UNTIL YOU
HEAR TWO CLICKS AND A LONG TRILL. This indicates
that the treatment is stored under that Therapy Profile and can
be accessed by pressing that Profile button. You may want to
name and note the treatment on the included Easy Mode
Profile Reference card under Waveforms/ Profiles.
Easy Therapy Profile Use
Once you have set your Easy Profiles, simply press the desired
Profile (A, B, C, or D). The LED for that Profile should
illuminate along with the waveform and parameters of the
treatment. Simply set the intensity level and press start to
begin the treatment.
Advanced Therapy Profile Mode Set-Up
To set a Profile in the Advanced mode, first press the
waveform and then press the desired Profile (A, B, C or D).
For example, press Quadpolar then profile A. You will see
that there is a treatment default already programmed. To
change the treatment, simply select the parameters you want
for that waveform profile, set intensity and PRESS AND
HOLD THE START/ACCEPT BUTTON UNTIL YOU
HEAR TWO CLICKS AND A LONG TRILL. This indicates
that the treatment is saved as a profile for that waveform. You
may want to name and note the treatment on the included
waveform specific Profile Reference card. Use the Advanced
Mode Profile Reference cards. In this case, it would be the
Quad/Pre-Mod card. There are also cards for Russian/Hi-Volt
and Micro/Support.
Advanced Therapy Profile Use
Once you have set your Advanced Profiles, simply press the
desired waveform and then the desired Profile (A, B, C, or D).
The LED for that Profile should illuminate along with the
waveform and parameters of the treatment. Simply set the
intensity level and press start to begin the treatment.
Lead Cord Tester
The Winners have a set of lead jacks on the left side of the
unit. Plug in your lead cord and touch the tips together. You
should hear a beep to let you know your leads are good. If
you hear no beep then you need to replace your lead cord.
Ultrasound - CM Models Only
The ultrasound function of the Winner CM4 and CM2 is very
easy to use. Once the machine is turned on, the last
treatment’s parameters will be displayed. If this is the desired
treatment set the intensity with its up/down arrows and press
the Start button.
The Ultrasound Active light illuminates and the Time is
blinking indicating that ultrasound is being output and time is
counting down.
coupling agent and place the appropriate soundhead on the
patient. Remember to always move the soundhead,
approximately 4cm/second either in a circular or back and
forth motion. If you want to change ultrasound parameters
select from the following list:
Frequency
Select from 1MHz or 3MHz. Remember that the
lower the frequency, the deeper the penetration, if
intensity levels are equal. 1MHz is a lower
frequency than the 3MHz.
Ultrasound Wattage (Output)
The Winner will display output in either W/cm² or
Watts. Select the output display by pressing the
Select button next to the intensity up/down arrows.
Duty Cycle
Pulsed outputs can be selected from 10%, 20% or
50%, or 100%.
Treatment Time
Select the desired treatment time between 1 and 99
minutes.
To Adjust Ultrasound Parameters During Treatment
You can adjust Treatment Time, Intensity, Transducer, Duty
Cycle and Frequency at any time during the treatment by
using the appropriate control.
To Pause an Ultrasound Treatment
Once an ultrasound treatment is running, pause it by pressing
the Pause/Resume button. The time will stop flashing, the
Ultrasound Active light will go out and the Intensity will start
flashing - indicating a paused treatment. To resume treatment,
press the Pause/ Resume button.
CAUTION: Do not operate the soundhead in an unloaded
condition (without Aloe-Sound coupling Lotion/Gel and
patient contact). This can cause the transducer to get very hot
and may cause unrepairable damage.
NOTE: When administering an ultrasound treatment, be sure
that the treatment area of the patient has an ample quantity of
Rich-Mar Aloe-Sound Lotion or Gel Plus as a coupling
medium. The quantity and quality of the coupling medium
used has a direct bearing on the amount of ultrasonic energy
transmitted to the treatment area.
Transducer
*NOTE: Be sure to use Aloe-Sound Lotion as a
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Combo - CM Models Only
The Winner CM4 and CM2 units allows the user to combine a
stim treatment with an ultrasound treatment by emitting
stimulation and ultrasound through the soundhead at the same
time.
Quick and easy “self-jacking” can be accomplished by taking
the lead cord from the stim channel you want to use and plug
the desired lead tip into the special ultrasound jack for
combination therapy.
- Plug the lead cord into the red jack of whatever channel you
are using for stim.
- Apply the electrode to the desire lead tip (figure 2) and put it
on the patient.
- Then, plug the pin end of the other side of the lead into the
small silver stim jack on the right side of the ultrasound cable
(figure 3). This makes the soundhead function as that
electrode.
- Apply the Aloe-Sound Coupling Lotion or Gel to the site
and apply the soundhead to the patient. This completes the
stimulation circuit(figure 4) and the stimulation component of
the treatment may now be set up.
Once the parameters are selected, set the stim intensity level.
The patient should feel the stimulation. Set the ultrasound
parameters making sure to move the soundhead once you are
outputting ultrasound (Ultrasound Active light comes on).
You are now providing a combination therapy treatment.
Figure 1
Figure 2
Figure 3
Figure 4
All Rich-Mar Ultrasound Applicators can be used
in the Combo mode.
NOTE: Both contraindications for ultrasound and
stimulation should be observed when using the device in
combination.
* Therapy Hammer Applicator shown in pictures.
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Electrical Stimulation Site Preparation, Electrode
Attachment, and Maintenance Guidelines
1) Know the stimulation characteristics, indications, and
contraindications of the desired waveform. For most
patients, the Micro amperage current will be sub-
sensory. However, if stimulation sensation is
perceived, be sure it is set at a level that is
comfortable for the patient. On all other muscle
stimulation and interferential current therapies, be
sure that the intensity is set to a comfortable level.
NOTE:DO NOT BRING UP THE INTENSITY UNTIL
THE FOLLOWING PROCEDURES HAVE BEEN
OBSERVED.
2) Clean the area(s) of the skin to be treated with soap
and water or an alcohol wipe.
3) Excessive hair may be trimmed, but shaving is not
recommended immediately prior to electrode
placement.
the lead wires. See the illustration on the following
Also avoid skin folds/creases or areas of impaired
7) The single patient self-adhesive electrodes are well
suited for most body areas in which electrical
stimulation would be used. Remove the electrodes
from the pouch and save it for subsequent storage of
the product. Carefully peel the electrodes from the
release backing and apply it to the chosen site. Press
firmly to ensure uniform and secure contact with the
skin and begin stimulation treatment.
Carbon Electrode Information
CAUTION: When using carbon electrodes with any Rich-Mar
stimulator, a moistened interface (cloth or sponge) MUST be
utilized between these electrodes and the patient to avoid skin
irritation and/or electrical burns.
Electrode Storage and Maintenance
IMPORTANT: The adhesive properties of these electrodes
may be affected by ambient or patient skin conditions. While
out of the package, extreme variations in humidity levels may
affect the adhesive properties of these electrodes.
To increase the adhesive properties of the electrodes, add a
few drops of water to the electrodes conductive surface and
spread evenly. Allow a couple of minutes for the increase in
tack.
Removal and Storage of Electrodes
Turn off the stimulation device and disconnect the cabling.
Remove the electrodes from the skin and reapply to the plastic
backing. Place in the pouch and reseal for storage to maintain
proper adhesive quality when not in use. If possible, store the
electrodes in a refrigerator to maintain adhesive.
CAUTION: In multiple, consecutive treatments of a patient,
the electrodes should be discarded and replaced if damaged, or
when proper adhesive tack or comfort can no longer be
achieved. Electrodes should be replaced when they lose their
adhesive quality, or when a change in stimulation intensity is
noticed, or if the gel is separated. If in doubt about the
integrity or proper function, replace the electrode before
proceeding. In any instance, Rich-Mar recommends that the
self-adhesive electrode NOT be used for more than 20
consecutive treatments.
Carbon Electrode Maintenance
Rich-Mar Corporation recommends that your carbon
electrodes be replaced annually.
Patient Lead Cord Maintenance
Rich-Mar Corporation recommends that your patient lead
cords be replaced annually. Please note that your patient lead
cords bear a label with a space provided to write in the date
that the lead cord was put into service (“Date in Service”).
There is also a space to write in the replacement due date
(“Replace By”), which will be one year from the date the lead
cord was put into service.
Please take the time to write in these dates with a permanent
marker. This will serve as a convenient reminder of the age of
your lead cords.
Some Rich-Mar muscle stimulators are equipped with a
feature that allows you to check lead cord continuity. If your
device is equipped with this feature, it is recommended that
the lead cords be checked at least monthly. Checking lead
cords on a routine basis, and replacing them annually, will
ensure your patient’s comfort, safety, and the effectiveness of
the treatment.
4) Choose the appropriate size electrode(s) for the body Rich-Mar Corporation recommends the use of our self-
part being treated. adhesive electrodes with this device.
5) Be sure that the electrodes are securely attached to conductive properties.
SuperStim or MultiStim self-adhesive will provide the proper
page for the appropriate patient lead wire
connections.
6) Avoid placing an electrode over areas of broken skin,
scars, moles, or unusual areas of skin discoloration.
sensation.
Recommended Electrode Types
SALES DEPARTMENT at 1-888-549-4945
ELECTRODES, CONTACT YOUR LOCAL
FOR MORE INFORMATION ON RICH-MAR
RICH-MAR DEALER or THE RICH-MAR
16

15
Patient Electrode Connection
Plug shielded ends of lead cord into the output jacks on the device
(red end into red jack and white end into white jack for each channel)
Red Shielded Plug
Black Shielded Plug
Insert pin end of lead firmly into the electrode
MAKE SURE THERE IS NO BARE METAL SHOWING
BETWEEN PATIENT ELECTRODE and PIN
Patient Electrodes
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16
Rich-Mar Muscle Stimulator
Indications for Treatment
Contraindications and Warnings for Quadpolar IFC, Pre-
Mod IFC, Hi-Volt (Monophasic), & Russian Waveforms
WARNING - Federal law restricts this device to sale by or on
the order of a physician or any other practitioner licensed by
the law of the state in which said person practices.
Contraindications
This device should not be used in the following areas:
1) On persons wearing a cardiac pacemaker.
2) On persons who have known or suspected malignant
lesions. This includes cancer patients.
3) Over the cartoid sinus area. 4) Trancerebrally. 5) Over the
pregnant uterus.
Warnings
1) The long-term effects of chronic electrical
stimulation are unknown.
2) Adequate precautions should be taken when
stimulation is used on persons with suspected heart
problems.
3) Adequate precautions should be taken when
stimulation is used on persons with suspected or
diagnosed epilepsy.
4) Severe spasm of the laryngeal and pharangeal
muscles may
5) occur when the electrodes are positioned over the
neck or mouth. The contractions may be strong
enough to close the
6) airway or cause difficulty in breathing.
7) Electrical stimulation should not be used in
electrically sensitive areas.
8) Electrical muscle stimulation (EMS) should not be
used over swollen, infected, or inflamed areas of skin
eruptions (e.g., phlebitis, thrombo phlebitis, varicose
veins).
9) Caution should be used in the transthoracic
application of electrical muscle stimulation (EMS) in
that the introduction of
10) electrical current into the heart may cause arrythmias.
11) Electrical muscle stimulation (EMS) devices should
be kept out of the reach of children.
12) Safety has not been established for use of electrical
stimulation during pregnancy.
13) This device should be used only under the continued
supervision of a physician.
14) Transcutaneous Electrical Nerve Stimulation (TENS)
is a symptomatic treatment and as such suppresses
the sensation of pain, which would otherwise serve as
a protective mechanism.
Precautions
Precautions should be taken when using a Rich-Mar muscle
stimulator in the presence of one or more of the following
conditions:
1) When there is a tendency to hemorrhage following
acute trauma or fracture.
2) Following recent surgical procedures when muscle
contrac-
3) tions may disrupt the healing process.
4) Over the menstruating uterus.
5) When sensory damage is present by a loss of normal
skin sensation.
6) When using this device at current outputs above
40mA, extra caution should be observed to avoid
burns by using an adequate conductive medium and
by frequently using an alternate electrode placement.
7) Isolated cases of skin irritation may occur at the site
of electrode placement following long-term
application.
Adverse Reactions
Adverse reactions to electrical stimulation are usually limited
to sensations of discomfort. Excessive stimulation can cause
muscle spasms as well as soreness such as can be expected
with excessive natural exercise. In all cases, treatment should
not exceed the patient’s comfortable tolerance to the
stimulation level.
NOTE: Skin irritation and burns beneath the electrodes have
been reported with the use of muscle stimulators
Contraindications and Warnings for Microamperage
Pulsed Current Waveform/ Microcurrent
Contraindications
This device should not be used in the following areas:
1) On persons wearing a cardiac pacemaker.
2) On persons who have known or suspected malignant
lesions. This includes cancer patients.
3) Over the cartoid sinus area.
4) Trancerebrally.
5) Over the pregnant uterus.
6) Whenever pain syndromes are undiagnosed, until
etiology has been established.
Warnings
1) This device is not effective for pain of the central
origin (this includes headaches).
2) The long-term effects of chronic electrical
stimulation are unknown.
3) Safety has not been established for the use of
Microcurrent during pregnancy.
4) Adequate precautions should be taken in the cases of
persons with suspected or diagnosed seizures or heart
problems.
5) This device is to be used as asymptomatic treatment
for pain and has no curative value.
6) Patients should be cautioned and their activities
regulated if pain is suppressed that would otherwise
serve as a protective mechanism.
7) Electronic monitoring equipment (such as ECG
monitors and ECG alarms) may not operate properly
when the stimulation is on.
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17
8) This device should be used only under the continued
supervision of a physician.
9) The user MUST keep the device out of the reach of
children.
Precautions
1) Isolated cases of skin rash may occur at the site of
electrode placement, following long-term application.
The irritation can usually be reduced by use of an
alternate electrode placement and/or an alternative
conductive medium.
2) Effectiveness of this treatment is dependent upon
patient selection.
Adverse Reactions
Skin irritation and burns beneath the electrodes have been
reported with the use of transcutaneous nerve stimulators.
NOTE: Both contraindications for ultrasound and stimulation
should be observed when using the device in combination.
Waveforms
The Winner units represent the most sophisticated electrical
waveform generation ever developed in electrotherapy. The
waveforms are software generated by an extremely sophisti-
cated computer that resides in each Winner unit.
Each waveform has particular characteristics that are
particularly well suited to a physiological response. Classic, or
Quadpolar Interferential, is the most conventionally thought to
provide the smoothest “feeling” current available for sensory
stimulation. Hi-Volt (Monophasic) current provides a net
charge effect, when needed, provides low current density
stimulation, and historically has been used when an ultrasound
combination is utilized. The Russian waveform is thought to
be the best waveform for motor contraction. Microcurrent
provides subsensory stimulation.
Within each waveform, a particular pulse rate or “beat’
frequency can be chosen. Low pulse rates (0-10) are thought
to be the best for indications involving chronic problems,
while higher pulse rates (80-200) are thought to be best for
indications involving acute problems. A pulse rate of 50Hz is
thought to provide the best motor stimulation (contraction)
without rapid fatigue.
Broad base protocol conventions exist for all electrical
stimulation as described above, but within each waveform,
certain parameters are the key to eliciting a particular
response.
The Winner units have been programmed to have the most
common treatment options as factory waveform default
settings. However, the Winner units are designed to provide
the most sophisticated and customized treatments imaginable.
Helpful Hint: If you desire further information regarding
waveform descriptions, recommended reading to supplement
this section is ELECTROTHERAPEUTIC TERMINOLOGY
in Physical Therapy, published by the American Physical
Therapy Association. For more information, contact the
APTA, 1111 North Fairfax Street, Alexandria, VA 22314-
1488.
Quadpolar Interferential (four pads)
Electrical stimulation at higher frequencies (5000Hz)
penetrates the skin easily (due to capacitive effects of the skin)
but has little therapeutic effect. Lower frequencies (0-200) are
therapeutic, yet produce irritation or even pain if applied
directly.
Interferential current utilizes two high frequencies to pass
through the skin barrier and then mixes the two frequencies to
produce a low frequency within the tissues.
Quadpolar mode is named such because two channels totaling
four (quad) electrodes work in conjunction to provide
treatment of one site. The Winner stimulators can provide
Quadpolar Interferential by producing two separate sine wave
outputs. By crossing these electrodes, the two sine waves mix
and produce a “beat” frequency within the tissue. This beat is
the difference in the two sine wave outputs.
The Winner stimulators produce 5000Hz sine waves from
channel one and produce between 5000 and 5200Hz sine
waves and channel two. Channels one and two operate in
concert to treat one site. The user may select a fixed “beat” or
pulse rate between zero and 200. The user may also select a
scan setting which scans between a low “beat” and a high
“beat” setting.
Quadpolar Interferential Parameters:
Carrier Frequency: 5000Hz
Beat Frequency Fixed: 0-200Hz
Beat Frequency Scan Low: 0Hz to 200Hz
Beat Frequency Scan High: 0Hz to 200Hz
Vector Options: On or Off
Alternating Rate:* Not Available
Surge Rates: * On: Not Available, Off: Not Available
Ramp On: Fixed 3 Seconds
Ramp Off: Fixed 1 Second
Quadpolar Interferential The Total Output Current = 50mA
rms. The meter shown on the display of the Winner units is
listed as rms current. To convert rms to peak current, multiply
rms by 1.414. Examples are given below.
Meter Reading (rms)
Milliamps (ma)
Peak Current Conversion
5
7.1
10
14.1
15
21.3
20
28.2
25
35.4
30
42.4
35
49.5
40
56.6
45
63.6
50
70.7
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Pre-Mod IFC Interferential
Pre-Mod IFC Interferential operates with a carrier frequency
but it is premodulated within the Winner stimulators. This
enables a single channel (two-electrode) system to be used.
Pre-Mod IFC Interferential can select a pulse rate or a “beat”
frequency between five and 200Hz.
Pre-Mod IFC Interferential Parameters:
Carrier Frequency: 5000Hz
Beat Frequency Fixed: 2-200Hz
Beat Frequency Scan Low: 2Hz to 200Hz
Beat Frequency Scan High: 2Hz to 200Hz
Vector Options: On or Off
Surge and Co-Cont rates: 5/5, 5/10, 10/10, 10/20,
10/30, 10/50 “on/off” Seconds
Alternating Rate: 5/5 and 10/10 “on/off” Seconds
Ramp On: Fixed 3 Seconds
Ramp Off: Fixed 1 Second
Pre-Mod IFC Interferential
The Total Output Current = 50mA rms. The meter shown on
the disply of the Winner units is listed as rms current. To
convert rms to peak current, multiply rms by 2.34
(1.414/.707). Examples are given below:
Meter Reading (rms)
Milliamps (ma)
Peak Current Conversion
5
11.7
10
23.4
15
35.1
20
46.8
25
58.7
30
70.1
Hi-Volt (Monophasic)
The Winner stimulators also have the capability to produce a
Hi-Volt Symmetric Square-Wave Monophasic stimulation
having two equal positive phases per pulse. This results in a
net charge effect. The polarity of monophasic will be positive
for the red pin for each channel and negative for the white pin.
Total Output Current for the Hi-Volt = 200 mA.
Hi-Volt (Monophasic) Parameters:
Carrier Frequency: Not Applicable
Pulse Rate: 2-200Hz Fixed
Scan Low: 2Hz to 200Hz
Scan High: 2Hz to 200Hz
Phase Duration: 50uS
Interphase Interval: 100uS
Surge and Co-Cont rates: 5/5, 5/10, 10/10, 10/20,
10/30, 10/50 “on/off” Seconds
Alternating Rate: 5/5 and 10/10 “on/off” Seconds
Ramp On: Fixed 3 Seconds
Ramp Off: Fixed 1 Second
Micro Current
Micro current is a pulsed waveform that produces 50mS
phases from 1-1000 pulses-per-second. The phases alternate
from positive to negative every 2.7 seconds. The amplitude is
adjustable from zero to 1000mA.
Microcurrent Parameters:
Carrier Frequency: Not Applicable
Pulse Rate: Fixed .3-1000Hz
Phase Duration: 50mS
Interphase Interval: Dependent upon pulse rate
Positive/Negative Interval: 2.7 seconds
Alternating Rate: Not Applicable
Surge Rates: Not Applicable
Ramp On: Not Applicable
Ramp Off: Not Applicable
Russian
Total Output Current = 50 mA rms. Russian is a 2500Hz
timemodulated waveform having a sinusoidal frequency that is
burst modulated at 50% duty. Russian is available in normal,
surge, co-contraction and alternating modes.
Russian Parameters:
Carrier Frequency: 2500Hz
Beat Frequency: Fixed 5-200Hz
Pulse Rate: 5-200Hz Fixed
Surge and Co-Cont rates: 5/5, 5/10, 10/10, 10/20,
10/30, 10/50 “on/off” Seconds
Alternating Rate: 5/5 and 10/10 “on/off” Seconds
Vector Options: Not Available
Ramp On: Fixed 3 seconds
Ramp Off: Fixed 1 seconds
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Ultrasound Indications for Treatment
(Therapeutic Ultrasound)
Rich-Mar Ultrasound devices are indicated to produce therapeutic deep heat for the following condi-
tions:
1) Relief of pain.
2) Muscle spasms.
3) Joint contractures.
WARNING - Federal law restricts this device to sale by or on the order of a physician or any other practitio-
ner licensed by the law of the state in which said person practices.
1) Near or over the heart.
2) Near or over the eyes.
3) On the head.
4) Near or over reproductive organs.
5) On the lower back during pregnancy or over the pregnant uterus.
6) Directly over the spinal column.
8) Where the skin suffers from any sensory impairment.
9) Over areas of malignancies.
10) In the area of visceral plexus and large autonomous ganglion.
11) Over the thoracic area if the patient is using a cardiac pacemaker.
12) Over a healing fracture.
13) Over ischemic tissues in individuals with vascular disease where the blood supply would be unable to
follow the increase in metabolic demand and tissue necrosis might result.
Precautions
Precautions should be taken when used:
1) Over anesthetized areas.
2) On patients with hemorrhagic diastheses.
3) Ultrasound treatment should not be performed over an area of the spinal cord following laminectomy (i.e.-
when major covering tissues have been removed).
Caution
1) Excessive doses of ultrasound may cause damage to tissue. Periosteal pain is an indication of excess
intensity and if it occurs, the power should be reduced; the transducer should be moved more rapidly over the
area being treated; or a lower pulsed duty cycle should be used.
2) If the soundhead has been operated unloaded for an extended period of time, the transducer will get hot. If
the soundhead is applied to the patient while the transducer is hot, a burn may result.
Warning
Do not operate the soundhead in an unloaded condition. It is possible that unrepairable damage may occur to
the transducer in an unloaded state.
Ultrasound Contraindications
Contraindications
Ultrasound should not be used in the following areas:
But not for the treatment of malignancies.
7) Over growing bone in children.
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