Schwa-medico Pierensymphony p User manual

HOLISTIC HEALTH

2-channel electrostimulation

device for paresis treatment

Instructions for use 10007405 Version 01 Last updated: 2022-12-08

PIERENSYMPHONY P

2INSTRUCTIONS FOR USE - PIERENSYMPHONY P

Contents

1. General ................................................................................................................................ 4

1.1 PIERENSYMPHONY P Intended purpose ..............................................................................4

1.2 Safety precautions ...................................................................................................................5

1.3 General contraindications ......................................................................................................7

1.4 Additional contraindications during pregnancy .................................................................7

1.5 Side effects ...............................................................................................................................8

2. Information about the muscle stimulation program(s)............................................... 8

2.1 Instructions for avoiding physical overload reactions due to muscle stimulation ........9

2.2 Contraindications due to muscle stimulation .....................................................................9

2.3 Side effects due to muscle stimulation ............................................................................. 10

3. Scope of delivery.............................................................................................................. 10

4. Description of the device................................................................................................ 11

4.1 Controls .................................................................................................................................. 11

5. Operating the PIERENSYMPHONY P ........................................................................................12

5.1 Connecting the cables and electrodes set ........................................................................ 12

5.2 Turn on the device ................................................................................................................ 12

5.3 Turn off the device ............................................................................................................... 12

5.4 Charging the battery ............................................................................................................ 12

5.5 Electrode connections ........................................................................................................ 13

5.6 Program selection ............................................................................................................... 13

5.7 Starting stimulation ............................................................................................................. 14

6. To the programs............................................................................................................... 14

6.1 Stimulation time ................................................................................................................... 14

6.2 Explanation and area of application of the programs .................................................... 15

7. Menu description............................................................................................................. 17

7.1 Main menu ........................................................................................................................... 17

7.2 Settings ................................................................................................................................... 17

7.3 Paresis .................................................................................................................................... 19

7.4 User programs ...................................................................................................................... 20

7.5 Examples ................................................................................................................................ 20

ENGLISH

8. Quick guide ....................................................................................................................... 22

9. Electrode placement ...................................................................................................... 24

9.1 Examples of electrode placement in cases of paralysis ................................................. 25

10. Technical information..................................................................................................... 26

10.1 Technical data ....................................................................................................................... 26

10.2 Explanation of the pulse shape icons on the display ...................................................... 26

10.3 Description of the symbols ................................................................................................. 26

10.4 Classification .......................................................................................................................... 27

10.5 Reporting Obligation ............................................................................................................ 27

10.6 Care and cleaning ................................................................................................................. 27

10.7 Combining ............................................................................................................................. 27

10.8 Maintenance/safety controls .............................................................................................. 27

11. Accessories ....................................................................................................................... 28

11.1 Charging/energy management .......................................................................................... 28

11.2 Surface electrodes ............................................................................................................... 28

11.3 Other accessories ................................................................................................................. 28

12. Disposal and return ........................................................................................................ 29

12.1 Battery return and disposal ................................................................................................ 29

12.2 Disposal of the Device ......................................................................................................... 29

13. Manufacturer’s declaration............................................................................................ 30

4INSTRUCTIONS FOR USE - PIERENSYMPHONY P

1. General

NOTE: In these instructions for use, "pa-

tient" means a person (both male, female

and diverse) on whom the PIERENSYMPHO-

NY P is used, even if the device is operated

by someone other than the patient. The

term "user" means the person operat-

ing the device. If the product is used inde-

pendently, "patient" and "user" are one and

the same person.

1.1 PIERENSYMPHONY P

Intended purpose

PIERENSYMPHONY P is intended for trans-

cutaneous electrical muscle stimulation for

peripheral paresis in humans. The PIEREN-

SYMPHONY P triggers contractions for par-

tially or fully denervated muscle, helping to

preserve it and its associated tissues and

structures such as tendons, ligaments and

joints, or restore it in the event of atrophy

and regression. Muscle stimulation also

promotes blood circulation in the stimulat-

ed areas. Stimulation can help prevent pres-

sure ulcers in the stimulated areas.

The PIERENSYMPHONY P works with medi-

cal programs designed for use by or under

the guidance of therapists as they require

medical expertise.

Treatment with the PIERENSYMPHONY P

can be administered several times a day

and as long-term use. Treatment can be car-

ried out in a clinical and home environment.

Before the first use, the patient must be

trained by a doctor or therapist.

The PIERENSYMPHONY P can be used to

treat anyone who is mentally and physically

capable of positioning the electrodes and

adjusting the current strength, taking into

account the contraindications, or who are

capable of expressing pain or want to mod-

ify or end treatment in the event of non-in-

dependent treatment.

Prior to treatment with the PIERENSYMPHO-

NY P, the instructions for use, in particular

safety information, warnings, contraindica-

tions and side effects, must be checked.

1.1.1 Indications

The spectrum of indications of the Pie-

rensymphony P includes incomplete and

complete peripheral, flaccid paresis. This

includes traumatic and atraumatic paresis,

e.g.

»post-traumatic, post-operative, post-in-

fectious

»with plexus lesions

»with nerve root lesions, e.g. after herni-

ated discs

»with cauda equina syndrome

»with polyneuropathy

ENGLISH

1.2 Safety precautions

Please read the instructions for

use carefully prior to using the pro-

duct! Keep for future reference!

1Caution: Consult a physician be-

fore applying electrodes over or

through the head, directly on the

eyes, covering the mouth, on the

front of the neck, (especially the caro-

tid sinus), or from electrodes placed

on the chest and the upper back or

crossing over the heart.

Warning: Application of electrodes

near the thorax may increase the risk

of cardiac brillation. In case of elec-

trode placement in the thorax area,

intensive high frequency stimulation

(above approx. 15 Hz) may lead to re-

spiratory disorders during stimulation.

2Warning: It is not allowed to use

the product during operating machi-

nes or during operations which requi-

re elevated concentration. Especially

don’t use it while using a vehicle!

The stimulation in the face (trigeminal

nerve stimulation) can lead to sleepi-

ness. That’s why you should continue

the above-mentioned activities only if

you don’t feel sleepy anymore. For an

optimal security you should stimulate

in the face only while sitting or lying.

3Never use the product if it functions

incorrectly or has been damaged. If,

contrary to expectations, malfunctions

occur, please contact our service team

or your dealer. Technical checks and

repairs may only be performed by

qualied and authorised persons in

order to keep the safety and warranty

(addresses can be found on the last

page of the instructions for use).

Caution: If the product is modied,

appropriate examinations and tests

must be carried out to ensure conti-

nued safe use. Otherwise, it leads to

the loss of any guaranty and warranty.

4The product may only be used with

original accessories. The use of ot-

her accessories (especially of electro-

des with a smaller surface than 2 cm

)

may lead to a decient operation. The

electrodes in the delivery amount can

be used without worries.

5Keep the product away from water

and other liquids as this may cause

uncontrolled current ows, electric

shocks and damage to the product.

6Caution: Simultaneous connection of

a patient to a high frequency surgical

ME (medical electrical) equipment may

lead to burns beneath the electrodes

and it may damage the product.

7Caution: Operation in the vicinity

(e.g. 1m) of a short wave or microwave

ME device for shortwave or microwa-

ve therapy may cause uctuations in

the output value of the product which

may turn into painful results.

8Caution: Keep a distance of min. 30

cm (12 inches) between the parts and

the wires of this product and a high

frequency communication device (mo-

bile phone or a radio device including

their accessories such as antenna ca-

ble or external antenna). Non-obser-

vance may result in a reduction of the

device’s performance characteristics

and a decient operation.

9Caution: Do not use this device next

to or stacked with other devices, as

this may result in decient operation.

If, however, use in the manner descri-

bed above is still necessary, this device

and the other devices should be ob-

served to ensure that they are working

properly.

10 Do not allow the product to be drop-

ped and handled incorrectly. Only

use at temperatures between 5 °C and

35 °C, at a relative humidity between

30 % and 75 % and a pressure bet-

ween 70 kPA and 106 kPA. So do not

use the product e.g. in bathroom or

similar humid environments.

6INSTRUCTIONS FOR USE - PIERENSYMPHONY P

Warning: Do not operate the device

in the vicinity of explosive and/or am-

mable substances or steam!

Caution: If you expose this device to

sudden temperature changes from

cold to warm, do not turn on the de-

vice until it reaches the same tempera-

ture as the environment in which it will

be used; wait at least 30 minutes. Ot-

herwise, condensation inside the unit

may result in electric shocks, re, and

damage to the device and/or personal

injuries.

11 Care must be taken when the pro-

duct is used on or in the proximity

of children. Store the product and its

packaging out of reach for children.

Danger of strangulation with the ca-

bles and wires of the device and/or its

accessories!

12 Placing of the electrodes:

a. The TENS device may only be con-

nected to just 1 patient.

b. Before applying the electrodes,

clean the skin surface on which the

electrodes are to be attached. Ot-

herwise incorrect operation cannot

be excluded.

c. Take care that metallic objects

(e.g. jewellery or piercings) do not

get in contact with the elec-

trodes during the stimulation

because otherwise isolated skin

burns may appear.

d. Tattoo colours may consist of me-

tallic pigments which – in coope-

ration with the current ow - can

lead in rare cases to too high cur-

rent densities and skin damages.

If possible, the stimulation should

not take place in body areas with

tattoos. If that is not possible, the

stimulation should be carried out

with raised attention and should be

immediately stopped in case of an

emergency.

e. Any electrodes with current densities

exceeding 2 mA/cm² may require

the special attention of the operator

as it may lead to painful results. The

electrodes in the delivery amount

can be used without worries.

f. Caution: Attach the electrodes to

the skin so that the electrode surfa-

ce has even and complete skin con-

tact. Additionally make sure that

the electrodes are placed at least

2 cm apart from each other. Other-

wise, high current densities may

occur at certain points on the skin,

resulting in painful skin lesions.

g. Special caution is required for pa-

tients with metallic implants who

have sensory loss in the area of the

metal. The sensory loss can tempt

to a raised setting of the stimulation

intensity; this could lead to skin irri-

tations, ush and pain in the area of

the metal. In this case the stimula-

tion has to be stopped at once.

13 Store the product in the original pa-

ckaging after use to protect it against

damage and soiling.

14 In the case of commercial use in Ger-

many, the operator is obligated to

carry out technical safety controls for

the product in regular and appropria-

te periods of time according to § 11

MPBetreibV. The manufacturer re-

commends to carry out technical safe-

ty controls for the product at intervals

of at least 24 months.

Please observe the applicable legal re-

gulations of your country.

15 Caution! Please also consider the

instructions for use, especially the

safety instructions, of the electrodes

you use.

16 General warnings about muscle sti-

mulation

During every muscle load, enzymes

(e.g. creatine kinase) and proteins

(e.g. myoglobulin) are released.

Warning: In the case of heavy mu-

scular load, but also due to genetic

factors or in combination with various

ENGLISH

medicines or drugs, it can lead in cer-

tain people to severe muscle break-

down (rhabdomyolysis). The amount

of enzymes and proteins released

and electrolyte shifts can also damage

internal organs such as the kidneys, li-

ver and heart. This danger also exists

with electrical muscle stimulation,

because it can be a form of intensive

muscle training. The muscles can qui-

ckly reach their load limit, especially

during the rst training sessions. This

is associated with the risk of muscular

overload, which can occur even in trai-

ned patients.

Muscular overload can manifest itself

during training through discomfort,

circulatory reactions, muscle pain and

other complaints. The most common

consequence of overload is pain in

the muscles after training. Pain and

irritation in tissues connected to the

muscles, such as ligaments, tendons,

joints and bones, are also possible.

The overloading of the musculature

by electrical muscular stimulation oc-

curs especially during the rst training

units. Within a regular training ses-

sion, the musculature usually adapts

to the to the load and the release of

muscle enzymes and muscle proteins

decreases signicantly.

1.3 General contraindications

On whom should the PIERENSYMPHONY P

not be used or only used after consultation

with the doctor?

»Central and spastic pareses

»Patients with metallic implants in the area

of current flow

»»Patients with electronic implants such as

pacemakers or pumps in the area of cur-

rent flow

»Patients with cardiac arrhythmia

»Patients with seizure disorders (epilepsy)

» Patients with skin lesions/skin conditions

(such as wounds, eczema, radiation dam-

age) in the area of current flow

»Patients with malignant disorders in the

area of current flow

»Patients with pathogenic infections (e.g.

tuberculosis, osteomyelitis) in the area of

current flow

»Patients with phlebitis and blood clots

(thrombophlebitis and thrombosis) in the

stimulation area

»Patients with an increased risk of bleeding

as a result of illness or medications or with

fresh bleeding in the stimulation area

»Stimulation in the abdomen in the case of

hernias in this area

»Stimulation in the abdomen and pelvic

floor area in cases of uterine and vaginal

prolapses

»Patients with bone disorders at higher

risk of fracture, such as increased bone

decalcification (osteoporosis)

»Patients with a known high increase in

the serum levels of muscle enzymes and

proteins (creatinine kinase, myoglobulin)

following muscular stress.

»Patients who are not healthy enough to

carry out sports.

1.4 Additional contraindications

during pregnancy

The use of the PIERENSYMPHONY P during

pregnancy should always be agreed upon

with the attending doctor and the midwife,

taking into account the benefits and risks.

»The PIERENSYMPHONY P should not be

used during pregnancy in patients who

have experienced a miscarriage or a pre-

mature birth.

»The PIERENSYMPHONY P should not be

used on patients in early labour.

»The PIERENSYMPHONY P should general-

ly not be used or only after careful con-

sideration of the risks during the first 3

months of pregnancy. In particular, stim-

ulation near the womb should be avoid-

ed. It will affect all placements of the elec-

trodes in the abdomen, pelvis and lower

back.

8INSTRUCTIONS FOR USE - PIERENSYMPHONY P

»From the 4th month of pregnancy on-

ward PIERENSYMPHONY P should never

be used near the womb. It will affect all

placements of the electrodes in the abdo-

men, pelvis and lower back.

1.5 Side eects

Due to a higher current flow in connection

with the broad pulses and special pulse

shapes of the PIERENSYMPHONY P, and also

due to the frequently sensitive impairments

in peripheral nerve lesions, the following

side effects may occur:

»Pain aggravation: After extensive and in-

tense session, pain aggravation can occur.

Shorten the treatment time (not more

than 30 minutes) and choose a low inten-

sity of stimulation during the first treat-

ment sessions to avoid pain aggravation.

»Skin intolerance: Skin intolerance can re-

sult from the electrodes, the electrode gel

or the electric current impulses. A physi-

cian should be consulted in cases of lon-

ger lasting reddening, burning, itching or

blistering under the electrodes or in the

vicinity of the electrodes following the sti-

mulation. Slight skin reddening of short

duration in the area of the electrodes fol-

lowing stimulation is quite normal becau-

se blood circulation has been improved

by the effects of the stimulation.

»Muscular pain: After extensive and inten-

se muscle stimulation session muscular

aches in terms of sore muscle can occur.

Shorten the treatment time and choose

a low intensity of stimulation during the

first treatment sessions to avoid pain ag-

gravation.

2. Information about

the muscle stimula-

tion program(s)

Enzymes (e.g. creatine kinase) and proteins

(e.g. myoglobulin) are released during every

muscle strain.

In the case of severe muscle strain, but also

due to one‘s constitutional predisposition

or in conjunction with certain medications

or drugs, certain individuals may experien-

ce more severe muscle breakdown (rhab-

domyolysis). In rare cases (especially with

overtrained muscles or pre-existing conditi-

ons), the amount of enzymes and proteins

released as well as electrolyte imbalances

can also damage internal organs such as

the kidneys, liver and heart. This danger also

exists in the case of electrical muscle stimu-

lation, as it may be intensive muscle trai-

ning. This danger is generally very rare and,

in most cases, is avoided by observing the

information in the following chapter (“Mea-

sures for avoiding physical overload reac-

tions”). No such harm has occurred to date

with our products.

The muscles can quickly reach their stress

limit, especially during the first training ses-

sions. This is associated with the risk of mu-

scular overload, which can also occur in he-

althy and trained users. Muscular overload

may already manifest itself during training

through discomfort, circulatory reactions,

muscle pain and other complaints.

The most frequent consequence of overload

is pain in the muscles after the training. Pain

and irritation of tissues connected to the

muscles - such as ligaments, tendons, joints

and bones - are also possible. Muscle over-

load due to electrical muscle stimulation oc-

curs particularly during the first treatment

sessions. Over the course of regular training,

the muscles usually adjust to the demand

placed on them and there is a significant de-

crease in the release of muscle enzymes and

muscle proteins.

ENGLISH

2.1 Instructions for avoiding phy-

sical overload reactions due

to muscle stimulation

2.1.1 Before each treatment

»The patient and the user must have read

and understood the contraindications,

safety instructions, side effects and the

instructions for avoiding physical overlo-

ad reactions.

»Only undergo stimulation if you are fee-

ling calm and fit.

»Do not undergo stimulation if you have

a fever or any other symptoms that im-

pair your physical performance capacity.

If you have chronic, long-term conditions,

seek a doctor’s advice and approval befo-

re starting any training.

»The patient adjusts the stimulation inten-

sity to a comfortable level and readjusts it

themself if necessary. The aim is to trigger

non-painful muscle tension in the area of

the current flow. The intensity of the cur-

rent is perceived differently by individuals

and depending on the situation and may

vary from treatment to treatment.

»The stimulation and treatment must ne-

ver be painful.

»Only medically necessary medications

should be taken prior to treatment.

»Before/during treatment drink 2 glasses,

e.g. of water to support kidney function.

»Do not undergo stimulation on an

empty stomach. Instead, have a small

meal 1-2 hours before treatment to avoid

any drop in blood sugar.

2.1.2 After each treatment

»Severe muscle pain after treatment is a

sign of overload and should result in a re-

duction in the intensity and frequency of

treatment. Persistent or especially severe

muscle pain and muscle weakness follo-

wing treatment can also indicate muscle

breakdown (rhabdomyolysis). In these

cases, medical advice must be sought.

In the event of doubt (e.g. in the case of

discomfort or similar symptoms), medical

advice should always be sought.

»To support kidney function, after treat-

ment 1-2 glasses, e.g. of water should be

drunk.

2.1.3 Treatment in the acclimatisation

period (rst to seventh treatment)

»As the therapy begins, the muscles must

be given sufficient time to get used to the

strain. This also applies to trained musc-

les. Particularly during the first two

sessions, only light stimulation with

short periods of muscle tension may be

carried out, without full muscular strain.

In addition, during the first two sessions

the stimulation must not be applied for

more than 10 minutes at a time. The

device’s longer programs should be stop-

ped after this time. Programs with lower

frequencies and longer pause times are

preferable.

»There should be at least 4 days bet-

ween the first two sessions.

»In the next 5 training units, the intensity

of the training can be slowly increased

until the desired level of strain is reached

and a training duration of 20 minutes is

achieved. The interval between the treat-

ments can be gradually shortened.

2.1.4 Training after the familiarisation

phase

»The duration of training should not be

longer than 20 minutes per training ses-

sion.

»Muscle pain should not occur during the

training session; constant muscle tension

must be avoided.

2.2 Contraindications due to

muscle stimulation

The product should not be used or only

used after consulting the responsible

doctor in the following cases:

»Persons in whom muscle training leads

to a high release of muscle enzymes and

proteins (e.g. creatine kinase, myoglobu-

lin). This release can also be caused by the

simultaneous taking of medications, e.g.

10 INSTRUCTIONS FOR USE - PIERENSYMPHONY P

cholesterol-lowering drugs (e.g. statins),

and requires medical supervision.

»Muscle disease (myopathies)

»Drug use (e.g. alcohol) or those taking

medications (e.g. lipid-lowering agents,

muscle relaxants, cortisone) that lead to

the increased release of muscle enzymes

and muscle proteins in the blood serum

»Diseases, such as of the kidneys or the

liver as well as heart diseases, which are

associated with a reduced compensation

of increased values of muscle enzymes,

muscle proteins and electrolyte imba-

lances

2.3 Side eects due to muscle

stimulation

»Muscle cramps with possible damage

to the muscle and neighbouring muscle

structures such as connective tissue, liga-

ments, tendons and bones

»Muscular overload reactions with

-Muscle pain that may last for several

days

-Muscle weakness that may last for se-

veral days

-The release of muscle enzymes and

muscle proteins as well as electrolyte

shifts due to muscle strain and muscle

breakdown (rhabdomyolysis)

»The consequences of long-term electri-

cal muscle stimulation (for more than 6

weeks at a time) are not known, so ne-

gative long-term effects cannot be ruled

out. We are not aware of any such cases

when handling our products.

»Notice: Especially when stimulating with

user programme settings, make sure to

stimulate carefully with large pulse ran-

ges and not for too long in order to avoid

musculare overloads or skin irritations!

3. Scope of delivery

Art.-Nr. Article Quantity

10003568 109200 PIERENSYMPHONY P 1 pc.

10003563 106370 Charger cradle 1 pc.

10005868 104796 Power supply unit (USB charger 5V 2000mA) 1 pc.

10005866 104795 USB charger cable for power supply unit 1 pc.

10002245 106351 Electrode cable type 5.15 2 pcs.

10003976 462042 Surface electrode = (Sponge patch 50 x 70 mm

Silicone rubber electrode 48 x 68 mm)

2 pcs.

10002362 104781 Belt strap (400x50 mm) 2 pcs.

10002363 104782 Belt strap (600x50 mm) 2 pcs.

10007405 - Instructions for use 1 pc.

- - Storage box 1 pc.

ENGLISH

4.1 Controls

4. Description of the

device

The PIERENSYMPHONY P is a 2-channel

electrostimulator with various stimulation

and therapy modules, which have been de-

signed specifically for each user's applica-

tions in terms of the software. Individual up-

grades can be used to expand or combine it

at any time with specific modules required

for the therapeutic purpose.

The PIERENSYMPHONY P contains low-fre-

quency stimulation programs.

A treatment diary is an ideal and meaning-

ful companion to the manifestation of the

treatment defined by the doctor/therapist

following a thorough diagnosis and thus al-

lows a personal observation of the progress

of treatment, for example, in reducing pain

or building muscles.

BButton 1

Epointingup

Gto the left

A On/off, standby

C Button 2

D Button 3

I Intensity control

channel 1

H to right

F pointing down

J Intensity control

channel 2

K OK / confirm,

pause stimulation

12 INSTRUCTIONS FOR USE - PIERENSYMPHONY P

5. Operating the

PIERENSYMPHONYP

5.1 Connecting the cables and

electrodes set

Refer to the chapter "Application of the elec-

trode set".

5.2 Turn on the device

Press the on/off button A for 2 seconds.

The PIERENSYMPHONY P turns on and the

main menu is displayed with the individual

menu items that can be selected (see main

menu).

5.3 Turn o the device

Press the on/off button A for 3 seconds.

The PIERENSYMPHONY P will then turn off.

If the battery power is not strong enough,

the device switches off automatically.

5.4 Charging the battery

Only charge PIERENSYMPHONY P with the

charger provided.

Plug the micro USB cable into the micro USB

port on the charger.

To charge the battery, connect the micro

USB cable to a USB port, or use a mobile

phone charger to connect to a 230V socket.

Remove the electrode cables from the PIE-

RENSYMPHONY P...

... and place it in the charger.

ENGLISH

Check that the device is lying correctly on

the charging slot, it must lie flat in the charg-

er.

When the device lies switched off in the

charger, the display shows the following

charging indicator:

The voltage of the battery is shown on the

display in the header on the right by means

of an icon.

Battery full

Battery half full

Battery almost empty

Charging

Attention! Stimulation is not possi-

ble during charging.

Important! After charging, disconnect the

charger from the 230V socket and only then

remove the PIERENSYMPHONY P from the

charger.

5.5 Electrode connections

The electrode connections are located be-

low the control buttons. Connect the appro-

priate electrodes here.

Due to the fit of the electrode sets included

as accessories, the connection is protected

against reverse voltage. Only use original

accessories.

5.6 Program selection

After you have started the PIERENSYMPHO-

NY P, you are taken directly to the main

menu.

Use the button and the button to se-

lect the desired menu item.

14 INSTRUCTIONS FOR USE - PIERENSYMPHONY P

The menu item currently selected is indicat-

ed by a light-coloured rectangle. Press the

button to access one of the submenus

“Paresis”, “Treatment memory”, or “Set-

tings”.

Select the "Paresis" submenu.

Now select the program group "Paresis"

and the following screen will appear:

Program

Program 1

Program 2

Program 3

Program 4

Program 5

Program 6

back delete edit

The respective functions of the buttons 1 ,

2 and 3 are displayed directly above

them.

5.7 Starting stimulation

Once a program has been selected, start

stimulation by pressing the intensity

control +.

If channels 1 and 2 are to be used, these can

be adjusted up and down together with the

buttons ~.

6. To the programs

The PIERENSYMPHONY P has six programs

that differ mainly in terms of the pulse

shape.

Programs with rectangular pulses

(Program 1, program 4)

Programs 1 and 4 are, in principle, the first

choice, especially in the case of incomplete

or more recent paresis. Stimulation should

firstly be attempted with program 1. Pro-

gram 4 can also be used as an alternative

to program 1.

Programs with trapezoidal pulses

(Program 2, program 5)

If rectangular pulses (program 1 and 4) fail

to trigger adequate muscle tension, stimu-

lation with a trapezoidal impulse (program

2) can be attempted. Program 5 can also be

used as an alternative to program 2.

Programs with triangular pulses

(Program 3, program 6)

If trapezoidal pulses (program 2 and 5) fail

to trigger adequate muscle tension, stimu-

lation with a triangular impulse (program 3)

can be attempted. Program 6 can also be

used as an alternative to program 3.

6.1 Stimulation time

The programs stimulate over 15 minutes.

However, the stimulation time depends on

the clinical situation and, if there is a mus-

cular degeneration reaction, can initially be

only a few minutes per session. If the mus-

culature has a positive reaction, the session

duration can then be slowly increased over

the course of treatment.

ENGLISH

6.2 Explanation and area of application of the programs

6.2.1 Program 1

Rectangular pulse current with alternating polarity

DPulse width 50 ms

EPause 500 ms (E = 10 x D)

Treatment time 15 min

Usage Treatment of minor damage (paralysis)

Alternatively Program 4

6.2.2 Program 2

Trapezoidal pulse current with alternating polarity

DPulse width 150 ms

ARising time (A = 1/4 x D)

BWorking time (B = 2/4 x D)

CFalling time (C = 1/4 x D)

EPause 1.5 s (E = 10 x D)

Treatment time 15 min

Usage Treatment of moderate paralysis

Alternatively Program 5

B C E

6.2.3 Program 3

Triangular pulse current with alternating polarity

DPulse width 300 ms

EPause 3.0 s (E = 10 x D)

Treatment time 15 min

Usage Treatment of severe paralysis

Alternatively Program 6

D E

16 INSTRUCTIONS FOR USE - PIERENSYMPHONY P

6.2.4 Program 4

Rectangular pulse group with alternating polarity

DPulse width 50 ms

EPause 500 ms (E = 10 x D)

FPulse group pause 1.5 s (F = 3 x E)

Treatment time 15 min

Usage Treatment of mild paralysis, alternatively to P1

DEF

6.2.5 Program 5

Trapezoidal pulse group with alternating polarity

DPulse width 150 ms

ARising time (A = 1/4 x D)

BWorking time (B = 2/4 x D)

CFalling time (C = 1/4 x D)

EPause 1.5 s (E = 10 x D)

FPulse group pause 4.5 s (F = 3 x E)

Treatment time 15 min

Usage Treatment of moderate paralysis, alternatively to P2

B C E

Program 6

Triangular pulse group with alternating polarity

DPulse width 300 ms

EPause 3.0 s (E = 10 x D)

FPulse group pause 9.0 s (F = 3 x E)

Treatment time 15 min

Usage Treatment of severe paralysis, alternatively to P3

C E

ENGLISH

7. Menu description

The menu description contains the selection

and navigation through the menu items.

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