schwa-medico TENStemeco basic Guide

TENStem eco basic
INSTRUCTION MANUAL and USER GUIDE
Appliance for the analgesic transcutaneous stimulation
of nerves and muscles
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Area of use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4
Important safety instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4
- contra-indications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4
Foreword to TENS stimulation
- what you should know, questions / answers . . . . . . . . . . . . . . . . . . . . . . .5
How many times a day can I use the TENS? . . . . . . . . . . . . . . . . . . . . . . . . . .5
QUESTIONS / ANSWERS
Answers to the most frequently asked questions . . . . . . . . . . . . . . . . . .6-7
What programme for what user symptom? . . . . . . . . . . . . . . . . . . . . . . . .8-11
• Programme 1: Gate Control 100 Hz
Symptom: acute nerve or joint pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
• Programme 2: Gate Control 80 Hz
Symptom: acute nerve or joint pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
• Programme 3: Endorphinic, known as acupuncture-type stimulation
Symptom: Diffuse nerve, joint or muscular pain
(sometimes not localisable) spasms, lower back pain, neck pain, fibromy-
algia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
• Programme 4: Gate Control 100 Hz channel1 + endorphinic channel2
Symptom: Joint pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
• Programme 5: Sequential TENS
Symptom: Particular lower back pain, lumbosciatalgia . . . . . . . . . . . . . . .9
• Programme 6: Professor Han TENS stimulation
Symptom: Joint pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
• Programme 7: Burst-type endorphinic stimulation
Symptom: Diffuse nerve, joint or muscular pain
(sometimes not localisable) spasms, lower back pain, neck pain, fibromy-
algia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
• Programme 8: Stimulation by frequency modulation
Symptom: Acute nerve or joint pain (to be used
alternately with programme 1 or 2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
• Programme 9: Muscle strengthening
Symptom: Prevention of muscular atrophy – muscle strengthening . . .10
• Programme 10: Slow analgesic massage by dynamic Gate Control
Symptom: Especially for acute back pain – lower back pain and lumbos-
ciatalgia - joint pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
• Programme 11: Fast analgesic massage by dynamic Gate Control
Symptom: Especially for heavy limbs: Calf venous return – joint pain . .11
CONTENTS
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• Programme 12: Ultra high frequency TENS . . . . . . . . . . . . . . . . . . . . . . . . .11
Starting the appliance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
Placing the electrodes: Photo guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-17
• Places for the analgesic programmes P1, P2, P3, P4, P5, P6, P7,
P8, P12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
• Placing and connecting the electrodes in dynamic stimulation
for programmes P10 and P11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14
• Programme 11: Placing for stimulation for heavy limbs – Venous return14
• Placing of electrodes in dynamic stimulation for the analgesic program-
mes P10 and P11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15
• Placing the electrodes for the excitomotor muscular re-education pro-
gramme P9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16-17
Changing the batteries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18
EC classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18
New settings, modifications and repairs to the appliance . . . . . . . . . . . . .18
Guarantee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18
Maintenance and cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19
Technical check . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19
Electrode compatibility and connection . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19
The machine is delivered with . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20
Consumables – Stimex re-usable self-adhesive electrodes . . . . . . . . . . . .20
The appliance data and technical specifications . . . . . . . . . . . . . . . . . . . . .22
Control panel key functions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23
Description of symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25
Manufacturer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26
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AREAS OF USE
The TENStem eco basic was designed for the analgesic stimulati-
on of nerves and muscles. This appliance should not be used in
any other case. It is used to treat the pain and for excitomotor
muscular re-education.
IMPORTANT SAFETY INSTRUCTIONS
Carefully read the instruction manual before using the appliance!
For first use without risk to the appliance
• The TENStem eco basic should only be used with its original
accessories.
• Keep the appliance away from water or any other liquid sub-
stance.
• Do not drop the appliance, store only at an adequate temperatu-
re of between 10oC and 40oC or at a humidity rate less than 90%.
• Do not use the appliance in the case of defective operation or if
it has been damaged.
• After use, replace the appliance in its original packaging to pre-
vent any possible deterioration.
Safety measures – contra-indications
Persons with cardiac pacemakers or persons with problems of a
dermatological nature in the areas where the electrodes should be
placed and pregnant women should not use the TENStem eco-
basic without first consulting their treating physiotherapist or doc-
tor. Only one person at a time can use the TENStem eco basic.
Warning!
The simultaneous use of the TENStem eco basic with a high-fre-
quency surgical instrument can cause burns under the TENStem-
eco basic electrodes Use of the TENStem eco basic close (appro-
ximately up to 1 metre) to a short-wave or microwave appliance
can cause variations in the current output parameters.
The surface of the electrodes should not be less than 2 cm2.
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Foreword to TENS stimulation – what you should
know, questions / answers
The advantage of the TENS technique is that it does not have a
secondary effect. Further on, we advise you as to what program-
me to use and how to place the electrodes based on the area to
be stimulated and the programme selected: You should be aware
that the placing of the electrodes is only indicative and that you
can place the electrodes similarly to the locations shown in the
photos without placing them exactly as shown in the photos.
There is no risk involved, even if the electrodes are completely
wrongly placed; at worst there will be no analgesic effect. Do not
hesitate to try various programmes and then use the one that is
most effective for you. In addition, you should also try various
locations for the electrodes to find the ones that are the most
effective for you. Pains are individual to everybody and their treat-
ment does not allow for excessive standardisation. The following
chapters cover the choice of programmes by symptom and the
placing of the electrodes based on the choice of programme; we
have tried to provide you with the maximum of information to
achieve a strong analgesic effect, from first use; these instructi-
ons are not, however, exhaustive: Do not hesitate to vary and use
trial and error in placing the electrodes to find the location for the
electrodes and the programme that provides you with the maxi-
mum analgesic effect.
How many times a day can I use the TENS?
You can use the appliance any time you have an attack of pain, at
any time of the day. The stimulation time is pre-set and the machi-
ne will stop automatically at the end of the programme. In order to
avoid your tolerance developing too quickly, do not sequence sti-
mulation sessions, try to spread up to 3 half-hour sessions over
each day. (1 morning, 1 midday and 1 evening).
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QUESTIONS / ANSWERS
Answers to the most frequently asked questions
Q: What level should I set the intensities at to stimulate me?
A: Do not try to achieve an ever-increasing level (milli-amperes) of
intensity; only adjust the intensities so as to always feel comforta-
ble stimulation (pins and needles or pulses depending on the pro-
gramme or frequency used). Adjust to intensities to a painful thres-
hold and then reduce them just below it to achieve a pleasant
level. You will note that this level of setting is often different, even
on identical areas that you stimulate at different times. This phe-
nomenon is normal because a number of factors affect the tole-
rance to the current and the level thereof:
• cutaneous resistance: Dry skin does not conduct the current as
well as damp skin (state of perspiration). Skin does not have a
uniform resistance to the current: for example, the difference
between hard skin and the skin of the popliteal space (the hol-
low behind the knee) is generally double. The innervation is also
different depending on the area, also explaining the difference
in sensitivity.
• Volume of muscular or fatty mass: The greater the volume of a
muscle, the greater the intensity of equal parameters that can
be applied to it.
• The state of muscular fatigue: The more fatigued the muscle,
the less it can support the intensity.
• The state of used electrodes: The re-usable self-adhesive elec-
trodes are not everlasting (between 30 and 60 uses, depending
on the quality). The ageing of the electrodes leads to an increa-
se in their resistance and a reduction in their conductivity.
Remember to change them every 15 days.
• The nervous system becomes accustomed to the current very
quickly: particularly during the first 5 minutes of a programme,
when you will find that your sensitivity to the stimulation redu-
ces. This is normal: the current applied does not reduce, your
nervous system simply gets used to the stimulation very quick-
ly. This effect is more limited for the dynamic®stimulation pro-
grammes. Don’t hesitate to re-adjust the intensity on one or
more channels to achieve a stronger, but always pleasant level
of stimulation.
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• The variation in the number of pulses and their width is not the
same for the programmes, which explains the different levels of
intensity on identical stimulation areas from one programme to
another.
The higher the frequency is raised the less the intensity can be;
the greater the impulse width, the lesser the intensity can be
raised.
Q: Is it possible to stimulate before going to sleep?
A: This is possible with the TENStem eco basic TENS model on
which a precise stimulation time can be programmed (a half-hour,
for example). It is desirable that when the patient is asleep, their
partner remove the electrodes and cables.
Q: I have been using my TENS for 2 months and I feel that the sti-
mulation is less effective.
A: This may be due, in particular, to the following two reasons:
- the condition of your electrodes has deteriorated, they should be
changed.
- Your body has become accustomed to a repeated stimulation.
We recommend that you change the programme (switch to
Programme No. 10 or 11 on the TENStem eco basic) or change the
stimulation mode.
Q: Can the electrodes adhere to hair?
A: In the case of excessive hair growth it is preferable to shave the
skin on the stimulation area. This is not necessary for normal hair
growth.
Q: What are the advantages of the principle of dynamic stimulati-
on?
A: The principle: The stimulation is not systematically applied
simultaneously on all the channels, but moves in progressive
waves under the 4 electrodes. The stimulation comfort is clearly
better than standard neuro-muscular stimulation. The sharing of
the movement between the 2 channels enables analgesic stimula-
tion by Gate-control without the effect of becoming accustomed
and is often felt as being more comfortable. It corresponds to the
natural reflex Gate control that is achieved by rubbing with the
hand to obtain rapid relief.
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What programme for what user symptom?
Programme 1: Gate Control 100 Hz
Symptoms: Acute nerve or joint pain
This programme is used for all acute neuropathic and joint pain,
e.g. pain caused by the nerves or the joints. It relieves the pain
immediately. Adjust the stimulation intensity power of each chan-
nel so that you feel pins and needles under the electrodes that are
fairly strong and always pleasant. If you don’t feel the stimulation
under the electrodes after a few minutes, increase the intensity of
the channel involved by pressing the + key to increase the intensi-
ty for the channel concerned.
Placing the electrodes: Place the electrodes (2 or 4 depending on
the extent of the painful area) directly on the painful area - please
refer to the photos of the electrode placing on page 13.
Programme 2: Gate Control 80 Hz
Symptoms: Acute nerve or joint pain
This programme is used exactly as programme 1 described above.
Its stimulation frequency is simply lower than for the previous pro-
gramme and may be felt as more pleasant during stimulation.
Placing the electrodes: Place the electrodes (2 or 4 depending on
the extent of the painful area) directly on the painful area - please
refer to the photos of the electrode placing on page 13.
Programme 3: Endorphinic, known as acupuncture-type stimulation
Symptoms: Diffuse nerve, joint or muscular pain (sometimes not
localisable) spasms, lower back pain, neck pain, fibromyalgia
This programme is used, on the one hand, to relax a painful con-
tracted muscular area by stimulating it with muscular oscillation,
and, on the other hand, to provoke a secretion of endorphins by
the brain to provide you with a durable analgesic effect After the
stimulation; this effect will be notable after at least thirty sessions
based on a minimum of one session per day with a maximum of 3
sessions per day (morning, midday and evening).
After placing the electrodes directly on the painful area (spasms,
lower back pain, neck pain and, fibromyalgia), adjust the intensi-
ties so as to feel a pulsating oscillation visible to the naked eye and
always pleasant.
Placing the electrodes: Place the electrodes (2 or 4 depending on
the extent of the painful area) directly on the painful area - please
refer to the photos of the electrode placing on page 13.
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Programme 4: Gate Control 100 Hz channel 1 + endorphinic channel 2
Symptoms: Joint pain
This programme simultaneously couples the effects of program-
mes 1 and 3, when the immediate analgesic effect of programme
3 is not strong enough.
Placing the electrodes: After placing the electrodes of channel 1
on the nerve course and the electrodes of channel 2 directly on
the painful area, set the intensity of channel 1 so as to feel power-
ful and pleasant pins and needles under the 2 electrodes of this
channel, and then set the intensity of channel 2 so as to feel a pul-
sing oscillation visible to the naked eye and always pleasant under
the electrodes of channel 2. Please refer to the placing guide on
page 13.
Programme 5: Sequential TENS
Symptoms: Especially for lower back pain, lumbosciatalgia
This programme starts with high-frequency stimulation, a pins and
needles type stimulation for 10 minutes, to provide an immediate
analgesic effect and then automatically switches to a low-fre-
quency stimulation using acupuncture-type impulses for a lasting
postsecondary effect through the secretion of endorphins for
20 minutes.
Placing the electrodes: Place the electrodes (2 or 4 depending on
the extent of the painful area) directly on the painful area - please
refer to the photos of the electrode placing on page 13.
Programme 6: Professor Han TENS stimulation
Symptoms: Joint pain
This programme also couples the analgesic effects of high-fre-
quency stimulation simultaneously with the endorphinic effects of
low frequency by alternating pins and needles and pulsation sti-
mulations every 3 seconds.
Placing the electrodes: Place the electrodes (2 or 4 depending on
the extent of the painful area) directly on the painful area - please
refer to the photos of the electrode placing on page 13.
Programme 7: Burst-type endorphinic stimulation
Symptoms: Diffuse nerve, joint or muscular pain (sometimes not
localisable) spasms, lower back pain, neck pain, fibromyalgia
The Burst programme covers the same symptoms as programme
3, but the stimulation is often felt as gentler and more pleasant
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than the standard low frequency stimulation at 2 Hz (2 pulses per
second).
Placing the electrodes: Place the electrodes (2 or 4 depending on
the extent of the painful area) directly on the painful area - please
refer to the photos of the electrode placing on page 13.
Programme 8: Stimulation by frequency modulation
Symptoms: acute nerve or joint pain (To be used alternately with
programme 1 or 2)
Programme 8 is used to avoid becoming accustomed to program-
mes 1 and 2: When you feel that the analgesic effects of
Programmes 1 and 2 are reducing, alternate the use of these pro-
grammes with programme 8 so that your body does not become
accustomed to constant stimulation of the same type.
Placing the electrodes: Place the electrodes (2 or 4 depending on
the extent of the painful area) directly on the painful area - please
refer to the photos of the electrode placing on page 13.
Programme 9: Muscle strengthening
Symptoms: Prevention of muscular atrophy – muscle strengthening
This programme is used on the muscles when they are immobili-
sed in order to prevent muscle wastage (muscle maintenance) or
on atrophied muscles (that have lost their volume) in order to
regain their initial volume. In this case, do not exceed one session
daily for the first month. If you notice stiffness in the muscle after
stimulation it, follow programme 8 with programme 2 using a low
intensity (light pulses).
You can also use programme 9 to strengthen a healthy muscle (not
atrophied), simply to strengthen it.
Placing the electrodes: Place the electrodes (2 or 4 depending on
the size of the muscle) directly on the muscle extremities as shown
in the photo guide to placing the electrodes on page 16, 17.
Programme 10: Slow analgesic massage by dynamic Gate Control
Symptoms: Especially for acute back pain – lower back pain and
lumbosciatalgia – joint pain
This programme is particularly effective for para-vertebral (along
the vertebral column) pain. The effect of the movement and the
massage improves the comfort of the stimulation. In addition the
effect of becoming accustomed is very limited due to this stimula-
tion in to and fro movements. This stimulation is the most similar to
the natural analgesic manual rubbing that everybody knows very
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well (the reflex of strongly rubbing yourself to calm an acute pain).
To achieve the massage wave effect it is essential that you use 2
stimulation channels, e.g. the 4 stimulation electrodes. It should
be noted that one channel alone (only 2 electrodes) can be used
for joint pain, in particular tendonitis of the elbow or knee: A sen-
sation of suction under the electrodes.
Placing the electrodes: Place the electrodes (2 or 4 depending on
the extent of the painful area) directly on the painful area - please
refer to the photos of the electrode placing on page 14 and 15
(dynamic stimulation).
Programme 11: Fast analgesic massage by dynamic Gate Control
Symptoms: Especially for heavy limbs: Calf venous return - Joint
pain
This programme is similar to programme 10, but the movement of
the massaging wave is quicker. It is also used for heavy limbs to
facilitate venous return: In this case place the 2 electrodes of
channel 1 on the right calf, and the 2 other electrodes of channel
2 on the left calf. (Please refer to page 14). For use on the joints,
place the electrodes directly on the joint.
Please refer to Placing the electrodes: Place the electrodes (2 or
4 depending on the extent of the painful joint) directly on the pain-
ful joint – please refer to the photo guide to the placing of the elec-
trodes on page 13.
Programme 12: Ultra high frequency TENS
This programme is used as a last recourse when the analgesic
effect of all the other programmes is not adequate. Often felt as
less pleasant in its pins and needles stimulation it has the draw-
back of consuming more energy.
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Starting the appliance
Press here until the chosen
programme is displayed on the screen
to
increase
to
reduce
Channel 1
intensity
With the machine switched off, firstly connect the
2 millimetre diameter male connectors (red connector
and white connector of each cable) to the black female
connectors on the electrodes (always 2 per cable).
Then connect the white plug on the other extremity of
cable to the sockets located on the upper front face of
the appliance. You can use it with one cable with
2 electrodes or with two cables (4 electrodes in total) to
stimulate a larger area.
After having connected the electrodes and
cables (always 2 electrodes per cable)
Switching on/off
Programme choice
Setting the intensities,
Starting the stimulation
Stopping the stimulation
to
increase
to
reduce
Channel 2
intensity
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Placing the electrodes: Photo guide
Placing for the analgesic programmes P1, P2, P3, P4, P5, P6, P7,
P8, P12
Ankle Wrist
Nape of the neck Deltoid Shoulder
Knee Elbow Hip
1
1
22
11
2
2
1
1
2
21
1
2
2
11
1
1
1
12
2
1
1
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Placing and connecting the electrodes in dynamic stimulation
for programmes P10 and P11
The placing of the electrodes is different: Depending on the direc-
tion of the stimulation That you want to achieve, the channels are
placed one after the other from top to bottom for a vertical stimu-
lation movement.
Diagram:
Movement of the stimulation
Rising/falling
The most often used Transversal movement
For lumbar stimulation, place an electrode from each channel to
the right and left of the vertebral column (please refer to the pho-
tos of the placing of the electrodes on page 15).
Programme 11: Placing for stimulation for heavy limbs – venous
return
Channel 1
Channel 2
Channel 1 Channel 2
movement
of the dynamic
stimulation
Channel 1 Channel 2
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Placing of the electrodes in dynamic stimulation for the analge-
sic programmes P10 and P11
Dorsal pain Neck pain
Para-vertebral Lumbar muscles
11
2
2
11
22
1
1
22
1
1
2
2
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Carpal extensors Carpal extensors
Biceps Triceps
Placing of the electrodes for the P9 excitomotor re-education
programme
1
1
1
1
1
1
2
2
1
1
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Back Quadriceps
Leg ischium Fibular triceps
Anterior tibial External and internal gemellus
1
1
12
1
1
1
1
1
1
1
1
12
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Changing the batteries
The machine checks the battery charge. When it is less than 4
volts, the battery warning symbol then appears on the screen. You
must then change the 4, 1.5 V type, batteries (AAA LR03).
Switch off the machine.
• Slide off the cover located on the back of the appliance to gain
access to the batteries.
• Remove the used batteries.
• Insert the 4 new batteries (pay attention to the battery polarity)
• Replace the cover.
Remove the batteries in the case of prolonged non use.
You can use rechargeable type AAA batteries (not supplied with
the appliance): In this case, carefully read the instruction manual
supplied with the charger (not supplied with the appliance).
DO NOT THROW your used batteries in the bin: Bring them to your
local recycling centre.
EC classification
The TENStem eco basic is referenced in category IIa for medical
equipment.
New adjustments, modifications and repairs to the ap-
pliance
In order to guarantee safe and correct operation, any new adjust-
ments, modifications or repairs to the TENS DOLOPATCH®can
only be carried out by a technician approved by the manufacturer,
in accordance with the instruction manual.
Guarantee
The appliance is guaranteed for 2 years from the date of invoi-
cing. The cables, electrodes and batteries are excluded from the
guarantee, together with any breakage or breakdown caused by
use not in compliance with the instruction manual.
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Maintenance and cleaning
No special product is required for the maintenance and cleaning
of the TENStem eco basic.
Simply clean the appliance with a soft cloth. Take care not to al-
low damp to enter the appliance. If this occurs, have the applian-
ce checked by one of our approved technicians before any further
use.
Technical check
The TENStem eco basic should be checked every 24 months.
The technical checks consist of:
1. Verification of all the appliance documents (product instruction
manual and technical sheet)
2. Verification of all the appliance equipment.
3. Verification as to any mechanical deterioration, verification of
cables and plugs/sockets.
4. Operating safety:
– Verification of the output signal with a resistance of 1 kW (cur-
rent and voltage)
– Verification of the frequency
– Verification of the impulse width.
Technical checks can only be performed by approved technicians.
These checks are set out in the product technical sheet and spe-
cify the date and name of the person who performed the checks.
Electrode compatibility and connection
The TENStem eco basic can only be used with the following elec-
trodes and cables.
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TENStem eco basic INSTRUCTION MANUAL
20
The machine is delivered with:
Quantity Item Reference
1TENStem eco basic Stimulator 104051
2 Type 7 cables 104741
1 pack of 50 x 50 mm electrodes 283400
4 1.5 V LR03 Micro (AAA) Batteries 450780-0011
Consumables – Stimex re-usable self-adhesive elec-
trodes Stimex
Your appliance was delivered to you with a pack of 4 square elec-
trodes measuring 5cm x 5cm. These should be changed after 50
uses, due to the loss of their conductivity.
The list below shows the different electrodes that you can re-or-
der directly from us at the most competitive prices on the market.
Manufactured from multi-use gel, the Stimex self-adhesive elec-
trodes have substantial longevity in terms of the number of re-
uses, are very comfortable to use in terms of conductivity, and
have flexibility and adhesiveness for perfect contact with the skin,
and all this at an unbeatable quality/price ratio.
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