Tactile medical Flexitouch pd32-u User manual

FLEXITOUCH |USER GUIDE

User Guide

Model PD

-U (U.S.)

1Customer Service Toll-Free:

833.382.2845 (833.3TACTILE)

Chapter 1

Before You Get Started..............1

1.1 How to Contact

Tactile Medical .................. 1

1.2 Safety Precautions and

Explanation of Symbols.......... 1

1.3 Indications for Use............... 3

1.4 Contraindications ............... 4

1.5 Unpacking Instructions .......... 5

Chapter 2

The Flexitouch® System .............7

2.1 System Components ............ 7

2.2 Programmed Pressure Levels .... 8

2.3 Treating the Lower

Extremity ....................... 9

2.4 Treating the Upper

Extremity ...................... 12

2.5 Treating the Head and Neck .... 14

Chapter 3

Controller Set-Up..................15

3.1 Setting Up the Controller

Unit............................ 15

3.2 Select Your Settings ............ 16

Chapter 4

Garment and Accessory

Application–Lower Extremity ......18

4.1 Applying the Full Leg

Garment ....................... 18

4.2 Applying the Full Leg

Garment and

Trunk Accessory ................ 20

4.3 Applying the Calf-Foot

Garment and

Trunk-Thigh Accessory.......... 22

Table of Contents CHAPTER 1

Before You Get Started

Read the entire guide before attempting to connect or operate this product.

Keep this guide for future reference.

The Flexitouch system is designed for at-home treatment of lymphedema, chronic

edema and chronic wounds. When used daily, the Flexitouch system can help

you manage your condition, improve your health, and allow you to enjoy a better

quality of life.

This guide provides the information needed to set up and use your

Flexitouch system.

1.1 How to Contact Tactile Medical

If you have questions about the Flexitouch system or require service, contact

Tactile Medical.

Customer Service: 612.355.5100 or toll-free (U.S. only) at 833.382.2845

(833.3TACTILE), Monday through Friday, 7:00am – 7:00pm CT. You may also email

us at [email protected].

If you have medical questions, please contact your physician or healthcare provider.

1.2 Safety Precautions and Explanation of Symbols

IMPORTANT: Read Instructions Before Using

Before attempting to connect or operate this product, please read the entire

guide. Keep this guide available for future reference.

CAUTION

MANUFACTURER’S PART NUMBER

Rx Only

CAUTION: U.S. Federal law restricts this device to sale by or on the order of a licensed

healthcare professional. This device may only be used by individuals for whom it has been

prescribed.

Consult your physician or other healthcare provider for recommendations regarding your

therapy program, treatment cycles and/or duration of treatment. Use this product only at the

settings prescribed by your healthcare provider.

Chapter 5

Garment and Accessory

Application–Upper Extremity ......24

5.1 Applying the Arm Garment ..... 24

5.2 Applying the Trunk Accessory

and Arm-Shoulder Garment .... 25

Chapter 6

Garment Application–

Head and Neck ....................30

6.1 Applying the Head Garment

and the Vest for Head and Neck

Chapter 7

Connecting the Hoses to

the Controller .....................34

Chapter 8

Conducting a Therapy Session......37

8.1 Starting the Therapy Session.... 37

8.2 Pausing the Therapy Session .... 37

8.3

Completing the Therapy Session

. 38

8.4 Turning the Controller Unit O.. 38

8.5 Storing the Flexitouch System .. 38

8.6 Cleaning the Flexitouch

System ......................... 38

Chapter 9

Troubleshooting and

Specifications .....................40

9.1 Troubleshooting. . . . . . . . . . . . . . . . 40

9.2 Limited Warranty and

Service for Home Use........... 42

9.3 Limited Warranty and

Service for Facility Use .......... 42

9.4 Equipment Lifetime ............ 42

9.5 Return Policy ................... 43

9.6 Patents......................... 43

9.7 Technical Information .......... 43

For Additional Questions

...........49

23Customer Service Toll-Free:

833.382.2845 (833.3TACTILE)

Do NOT Dispose with General Household Waste

Tactile Medical complies with the Waste Electric and Electronic Equipment

Directive (WEEE) 2002/96/EC. Contact Tactile Medical at 612.355.5100 or toll-free at

866.435.3948 (U.S. only) to get disposal instructions.

Type BF Applied Part

Device Serial Number

UL Certication Mark

Product Category: Medical Equipment

Product Category CCN: PIDF

Control Number: 86TN

CLASS II WITH RESPECT TO ELECTRICAL SHOCK, FIRE AND MECHANICAL HAZARDS

ONLY IN ACCORDANCE WITH UL60601-1

CE Mark Certication

The Flexitouch system, Model PD32-U conforms to the European Medical Device

Directive 93/42/EEC.

EU Authorized Representative

Emergo Europe, Prinsessegracht 20, 2514 AP, The Hague, The Netherlands

IP21

Flexitouch system complies with IEC60329 regarding degree of protection against water

and particulates.

EMC Precautions

The Flexitouch system is Medical Electrical Equipment that requires installation precautions

regarding electromagnetic compatibility (EMC). Installation is to be completed as specied

in the Technical Information Section. Beware that portable and mobile RF Communications

equipment can aect Medical Electrical Equipment.

WARNING: Risk of Electric Shock

• Do not attempt to service the controller. Such attempts could result in injury or damage

to the product, and will void any warranty.

• Do not disassemble the controller.

• Use of outlets and power cords that have a ground connection reduces the risk of

electric shock.

• Your controller unit may have been supplied with a hospital-grade power cord. If so,

hospital-grade is achieved only when connected to a hospital-grade electrical receptacle.

• The provided power cord is safe to be used with any residential grounded outlet.

• Unplug the controller when not in use.

• The Flexitouch system is to be used indoors only.

• Do not use the controller near water or while bathing.

• Do not reach for the controller if it falls into water. Unplug the controller at the electrical

outlet immediately.

WARNING: Risk of Personal Injury

• Use the controller only for its intended purpose, as directed in this guide.

• Use accessories only if recommended or supplied by Tactile Medical.

• Setup the controller in a manner that provides easy access to the power cord should it

become necessary to unplug quickly.

• Never operate the controller if the cord or plug is not working properly, if it has been

damaged, or if the controller has been dropped into water. Return it to Tactile Medical for

inspection or repair. Do not modify the cord or plug.

• Keep the power cord away from heated surfaces.

• Never operate the controller where the cord or tubing harness will present a strangulation

or tripping hazard.

• Strangulation potential: Power cord and tubing bundle should never be placed near or

around a person’s neck.

CAUTION: Risk of Device Damage

• Never block the ventilation openings on the back or the sides of the controller. Keep the

ventilation openings free of debris such as lint and hair.

• Never operate the controller on a soft surface, such as a bed, couch, or pillow, where the

ventilation openings may be blocked.

• Never drop or insert any object into any opening of the controller.

• Never use sharp objects, such as pins, scissors or clasps on or near the Flexitouch system.

• Never use hot devices such as irons or blow dryers, on or near the Flexitouch system.

• Do not attempt to replace the fuse in the device as damage to controller may occur if

improper fuse is used.

1. 3 Indications for Use

The Flexitouch system and garments for legs, arms, trunk, and chest are intended

for use by medical professionals and patients who are under medical supervision,

for the treatment of many conditions such as:

• Lymphedema

• Primary lymphedema

• Post mastectomy edema

• Edema following trauma and sports injuries

• Post immobilization edema

• Venous insuciency

• Reducing wound healing time

• Treatment and assistance in healing stasis dermatitis, venous stasis ulcers,

or arterial and diabetic leg ulcers

The Flexitouch system and garments for the head and neck are intended for use

by medical professionals and patients who are under medical supervision for the

treatment of head and neck lymphedema.

2797

45Customer Service Toll-Free:

833.382.2845 (833.3TACTILE)

1. 4 Contraindications

The Flexitouch system should not be used if you have one or more of the

following conditions:

• Pulmonary edema

• Thrombophlebitis

• Congestive heart failure

• Deep vein thrombosis

• Episodes of pulmonary embolism

• Infections and inammations

• Acute cancer

• Conditions in which increased venous and lymphatic return is undesirable

• During pregnancy (applies only to the Flexitouch trunk accessory)

The head garment and the vest for head and neck for the Flexitouch system

should not be used if you have one or more of the following conditions:

• Uncontrolled hyperthyroidism or parathyroidism (for which an

endocrinologist recommends against neck compression)

• Carotid sinus hypersensitivity syndrome

• Symptomatic carotid artery disease, as manifested by a recent transient

ischemic attack (within 30 days), ischemic stroke, or amaurosis fugax

(monocular visual ischemic symptoms or blindness)

• Symptomatic bradycardia in the absence of a pacemaker

• Internal jugular venous thrombosis (within 3 months)

• Increased intracranial pressure or other contraindication to internal or

external jugular venous compression

• Acute radiation dermatitis, unhealed surgical scar, unhealed or open

wound(s), surgical ap less than 6–8 week post-operative

• Facial or head and neck dermal metastasis

• Acute facial infection (e.g., facial or parotid gland abscess)

• Any condition in which increased venous and lymphatic return is undesirable

1.5 Unpacking Instructions

When your Flexitouch system arrives, allow the controller to reach room

temperature for one hour before using. It is important that you carefully

unpack the contents and ensure that you have all the equipment required to

begin operation.

Included in the box, you should nd the following:

• User Guide

• Controller unit

• Garments and accessories needed to treat your condition

• Power cord (10’ maximum)

• Welcome packet

The garments and accessories you receive will depend upon your individual

therapy requirements.

If you are missing any of the items listed for your prescribed treatment, please

contact Customer Service.

Lower Extremity Treatment

The garments and accessories needed for lower extremity treatment may include

the following:

• Full leg garment (available in short petite, short, medium or long)

• Trunk-thigh accessory (available in short, long or EXT)

• Calf-foot garment (available in reg or EXT)

• Trunk accessory

• Waist extender(s)

67Customer Service Toll-Free:

833.382.2845 (833.3TACTILE)

Upper Extremity Treatment

The garments and accessories needed for upper extremity treatment may include

the following:

• Arm/arm-shoulder garment

• Trunk accessory

• Waist extender(s)

Head and Neck Treatment

The garments needed for head and neck treatment may include the following:

• Head garment

• Vest for head and neck

Labels

Each label is located where the tubing attaches to the garment or accessory. It

indicates the body area the garment or accessory is to be applied (full leg, trunk,

calf-foot, trunk-thigh, chest, arm, head, and vest for head and neck). See Figure 1a.

Figure 1a. Label Examples

The Flexitouch®System

CHAPTER 2

The Flexitouch system is an advanced pneumatic compression device clinically

proven to stimulate the lymphatic system. The device helps direct and move excess

uid from an impaired lymphatic region to healthy regions, where uid can be

absorbed and processed naturally by your body. Flexitouch garment chambers

inate sequentially with each chamber inating before the adjacent distal chamber

fully deates. This creates a dynamic wave of therapy that directs uid into the

lymphatic capillaries while maintaining distal pressure to prevent distal backow.

NOTE: No special skills, training or knowledge is required to operate the

Flexitouch system.

2.1 System Components

The Flexitouch system consists of two primary components:

Controller

The controller is a programmable pneumatic compressor with four connector

outlets. Each connector has eight outow ports in which the garment hoses plug

into. Air passes through the hoses, delivering treatment through the sequential

ination and deation of up to 32 air chambers in the garments. By selecting the

appropriate treatment program, calibrated gradient pressure is delivered to the

chambers and assists in moving excess uid out of aected limb(s).

Garments and Accessories

The air-chambered garments and accessories are made of soft, pliable fabric. They

are designed to t the contours of your body by wrapping around the limb(s) and

attaching with hook and loop fasteners. A variety of upper and lower extremity

treatment options are available in order to address your specic needs.

The upper extremity garment(s) and accessories are used to treat the arm, or arm

and core. Depending on your clinical needs, you may be prescribed an arm

garment, or arm-shoulder garment and trunk accessory.

The head garment and the vest for head and neck are used to treat the head, neck

and chest. Depending on your clinical needs, you may be prescribed a head

garment and a vest for head and neck.

89Customer Service Toll-Free:

833.382.2845 (833.3TACTILE)

The lower extremity garment(s) and accessories are used to treat the leg or the leg

and core. Depending on your clinical needs, you may be prescribed a leg garment,

or both a leg garment and trunk accessory.

Table 1: Treatment Programs and Therapy Times

Program Options and

Program Code

Program

Display

Body Regions

Treated

Single

Cycle Time

(min.)

Avail-

able

Cycles

Primary Upper

Extremity Treatment

Programs

U1 Full arm & core Trunk, chest, biceps,

forearm and hand 60 1

U4 Arm-shoulder Biceps, forearm and hand 47 1–5

U7 Full arm Arm 30 1–5

Supplemental Upper

Extremity Treatment

Programs

U2 Trunk ONLY-UPPER Trunk 12 1–5

U3 Trunk & chest Trunk and chest 24 1–5

U5 Forearm & hand Forearm and hand 24 1–5

U6 Hand only Hand 12 1–5

Primary Head and

Neck Treatment

Program

H1 Head neck & vest Head, neck & chest 32 1

Supplemental Head

and Neck Treatment

Program

H2 Head only Head, neck 15 1

Primary Lower

Extremity Treatment

Programs

L1 Full leg & core Trunk, thigh, calf and foot 60 1

L4 Full leg plus Thigh, calf and foot 45 1–5

L5 Half leg plus Calf and foot 30 1–5

L7 Half leg Calf and foot 30 1–5

L8 Full leg Thigh, calf and foot 45 1–5

Supplemental Lower

Extremity Treatment

Programs

L2 Trunk ONLY-LOWER Trunk 15 1–5

L3 Trunk & thigh Trunk and thigh 30 1–5

L6 Foot only Foot 15 1–5

2.2 Programmed Pressure Levels

Programmed pressure levels in each of the air chambers are based on

physiological principles of how lymph uid moves through the lymphatic system.

Your healthcare provider will determine what individual programs are appropriate

for you. In certain medical circumstances, your healthcare provider may wish to

increase pressure to the treated area of the body. The Flexitouch controller allows

for manual pressure control in 5 chambers of the arm, 8 chambers of the leg and

head & neck garments. By selecting INCREASED pressure, patients can elevate the

pressures in the individual segments of the arm, leg and head & neck garments.

Please consult with your healthcare provider before changing those settings. For

technical assistance on how to manually adjust the gradient pressures delivered to

various treatment areas of the body, please call Tactile Medical at 1.866.435.3948.

2.3 Treating the Lower Extremity

Figure 2a: Full Leg

Treatment Program L8

Providing traditional leg treatment, this option moves excess

lymphatic uid in a distal to proximal (foot to top of thigh) direction

via multiple chambers in a continuous wave-like motion.

(Approximate treatment time: 45 minutes)

Full Leg

directs uid from toes

to top of thigh in one

continuous motion

Upper ExtremityLower Extremity

10 11 Customer Service Toll-Free:

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Figure 2b: Full Leg and Core

Treatment Program L1

This treatment option provides the ability to deliver therapy to both the leg and trunk regions

when clinically appropriate. Incremental proximal clearing of lymphatic uid in the trunk, thigh,

calf and foot regions is followed by delivery of the traditional full leg treatment.

(Approximate treatment time: 60 minutes)

1. Trunk

directs uid from

top of the thigh

to waist

4. Foot

directs uid

from toes

to ankle

3. Calf

directs uid

from ankle

to knee

2. Thigh

directs uid from

knee to top

of the thigh

5. Full Leg to Trunk

directs uid from

toes to top of waist

in one continuous

motion

Figure 2c: Full Leg Plus

Treatment Program L4

This treatment option provides the ability to deliver expanded therapy to the leg

when clinically appropriate. Incremental proximal clearing of lymphatic uid in the

thigh, calf and foot regions is followed by delivery of the traditional full leg treatment.

(Approximate treatment time: 45 minutes)

3. Foot

directs uid

from toes

to ankle

2. Calf

directs uid

from ankle

to knee

1. Thigh

directs uid

from knee to

top of thigh

4. Full Leg

directs uid from

toes to top of thigh

in one continuous

motion

12 13 Customer Service Toll-Free:

833.382.2845 (833.3TACTILE)

2.4 Treating the Upper Extremity

Figure 2d: Full Arm

Treatment Program U7

Providing traditional arm treatment, this option moves excess

lymphatic uid in a distal to proximal (hand to top of bicep) direction

via multiple chambers in a continuous wave-like motion.

(Approximate treatment time: 30 minutes)

Arm

begins at ngertips and

ends at top of bicep in

one continuous motion

Figure 2e: Full Arm and Core

Treatment Program U1

This treatment option provides the ability to deliver therapy to the arm, chest and trunk regions

when clinically appropriate. Incremental proximal clearing of lymphatic uid in the trunk, chest,

bicep, forearm and hand regions is followed by delivery of the traditional full arm treatment.

(Approximate treatment time: 60 minutes)

1. Trunk

directs

uid from

waist

toward top

of thigh

2. Chest

directs

uid from

shoulder

toward

waist

5. Hand

directs uid

from ngers

toward wrist

4. Forearm

directs uid

from wrist

toward elbow

3. Biceps

directs uid

from elbow

toward

shoulder

6. Full Arm

and Trunk

directs uid

from ngers

to the top of

thigh in one

continuous

motion

14 15 Customer Service Toll-Free:

833.382.2845 (833.3TACTILE)

Controller Set-Up

CHAPTER 3

The Flexitouch system uses a controller and a set of garments and accessories to

provide therapy. In this chapter you will learn how to set up the controller and

select the proper settings prior to receiving therapy. You will learn how to apply

the garments in Chapter 4.

3.1 Setting Up the Controller Unit

Follow the steps outlined below:

1. Find an appropriate location for the controller unit. Place the controller on a

sturdy, at surface near an electrical outlet. Position the device so you have

easy access to the plug.

2. Plug the supplied power adapter into the power adapter inlet on the back

of the controller. Then, plug the two- or three-pronged plug into an electrical

outlet. (Figure 3a depicts a three-pronged plug. Figure 3b depicts a two-pronged

plug. Review the appropriate gure based on the supplied power adapter.)

NOTE: There are three adapter options, so the versions depicted below may be

dierent than the one you received. The three versions are:

• Three (3) prong medical grade power cord

• Meanwell GSM36U12-P1JNX

• Fuhua UE36LCP1-120300SPA

2.5 Treating the Head and Neck

Figure 2f: Head and Neck

Treatment Program H1

This treatment option provides the ability to deliver therapy to the head and neck

and chest when clinically appropriate.

(Approximate treatment time: 32 minutes)

1. Chest

directs uid from

the chest toward

under arm area

2. Neck

directs uid from

neck toward chest

4. Full Head,

Neck and Chest

directs uid from

head to the under

arm area in one

continuous motion

3. Head

directs uid from

head toward neck

NOTE: A plug adapter

may be necessary for

use outside the U.S.

Figure 3a. Three-Pronged Plug Figure 3b. Two-Pronged Plug

Grounded Outlet

Three-Pronged Plug

WARNING: RISK OF ELECTRIC SHOCK

Only use the three-pronged medical grade plug, Meanwell GSM36U12-P1JNX or Fuhua

UE36LCP1-120300SPA power adapter with your Flexitouch system. These power adapters are

designed for use with either 120 Volt AC or 230 Volt AC outlets.

16 17 Customer Service Toll-Free:

833.382.2845 (833.3TACTILE)

3.2 Select Your Settings

Follow the steps outlined below to select the settings prescribed by your

healthcare provider:

NOTE: The controller unit will store the settings used for the last therapy session

and will automatically recall these settings. Therefore, in most situations the

following settings will not need to be modied from one treatment to the next.

1. Turn the controller ON.

Turn the controller unit on by pressing the brown ON/OFF button located on

the front panel. See Figure 3c on next page.

2. Select the program.

Press the left or right PROGRAM arrow buttons to scroll through the available

programs, until the desired program is displayed. (See Table 1 for a list of all the

available programs.)

3. Select the accessory size.

Press the GARMENT SIZE arrow button to toggle between the sizes. Select the

appropriate size of garment or accessory that you will use and indicated on

the label. *(See Table 2 on next page for a partial list of available garment and

accessory sizing combinations).

4. Select the pressure settings.

In most cases, select the NORMAL pressure setting. If your healthcare provider

prescribes increased treatment pressure specically in your hand or foot,

press the PRESSURE SETTING arrow button to toggle between NORMAL and

INCREASED to select the appropriate setting.

5. Select the therapy cycles.

The THERAPY CYCLES setting species the number of times the selected

program will repeat without interruption. Press the THERAPY CYCLES arrow

button until it reaches the correct number of cycles as directed by your

healthcare provider. For programs L1 and U1, you will only be able to select a

THERAPY CYCLE of 1.

During and throughout therapy selection, the approximate therapy time

remaining will be displayed in the lower right-hand corner of the controller screen.

After you have selected the necessary settings, you are ready to apply the garments.

Table 2: Garment and Accessory Size Selections

Lower Extremity Upper Extremity Head & Neck

LONG FULL LEG SHORT ARM SMALL HEAD/SMALL VEST

MEDIUM FULL LEG LONG ARM SMALL HEAD/MEDIUM VEST

SHORT FULL LEG SZ 1 CHEST/SHORT ARM SMALL HEAD/LARGE VEST

TRUNK/SHORT FULL LEG SZ 1 CHEST/LONG ARM MEDIUM HEAD/SMALL VEST

TRUNK/MED FULL LEG SZ 2 CHEST/SHORT ARM MEDIUM HEAD/MEDIUM VEST

TRUNK/LONG FULL LEG SZ 2 CHEST/LONG ARM MEDIUM HEAD/LARGE VEST

SHORT TRUNK/REG CALF SZ 3 CHEST/SHORT ARM LARGE HEAD/SMALL VEST

SHORT TRUNK/EXT CALF SZ 3 CHEST/LONG ARM LARGE HEAD/MEDIUM VEST

LONG TRUNK/REG CALF SZ 4 CHEST/SHORT ARM LARGE HEAD/LARGE VEST

LONG TRUNK/EXT CALF SZ 4 CHEST/LONG ARM

EXT TRUNK/REG CALF

EXT TRUNK/EXT CALF

*NOTE: The short petite full leg garment utilizes the short full leg garment size

setting on the controller.

Program

Garment

Pressure

Therapy Cycles

Start/Pause

On/Off

Time

Remaining

Connector

Number

Figure 3c. Controller Unit Front Panel

18 19 Customer Service Toll-Free:

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Garment and Accessory Application—

Lower Extremity

CHAPTER 4

Before starting, be sure you are using the recommended garments and accessories

for your condition. Before applying the garments and accessories, prepare yourself

for an uninterrupted therapy session — these typically last about one hour.

4.1 Applying the Full Leg Garment

If you have only received a garment labeled full leg, follow the preparation and

application instructions below.

Full Leg Garment Preparation:

1. Unfold and place the full leg garment on the bed or sofa so that the hose seam

will run along the back of your leg.

Full Leg Garment Application:

2. Sit down and place your leg on the garment. Center your heel between the

second set of fabric notches (when counting from the toe of the garment).

3. Begin by wrapping the foot section snugly around your toes and the arch

of your foot. Secure the fabric in place with the hook fastener tabs.

4. Next wrap your ankle, following its contours. Secure the fabric with the

hook fasteners.

5. Continue up your leg, wrapping the calf next and the thigh last. When

wrapping, try to minimize any bunches or folds in the fabric and adjust the

hook fastener tabs as necessary to get a well-contoured t.

6. Finally, place a couple of pillows under your calf and foot to elevate them just

above your hips for optimal treatment. Place the hoses alongside your body

so they are easy to reach when attaching them to the controller unit.

You are now ready to attach the hoses to the controller. See Chapter 7 for

further instructions.

Figure 4.1.a. Applying the Full Leg Garment

CAUTION

Donning or wearing garments may cause patient overheating. Do not smoke while wearing the

garments due to the re hazard risk. Do not wear wet garments, as there is risk for potential shock.

Take care when donning or wearing garments so that the tubing does not become kinked.

To avoid skin irritation that may result from contact with the nylon material, wear lightweight,

loose-tting (non-elastic) cotton clothing, (example: scrubs, stockinette); for head and neck garments

a face mask or balaclava. If skin irritation develops, consult with your doctor.

Lymph uid is moved through the vessels in the skin. It is important to avoid wearing anything

during therapy that may hamper the lymph ow. These items include:

• Belts • Jewelry • Restrictive clothing such as:

- Elastic-banded underwear - Compression bandaging - Bra

- Elastic-banded socks - Compression garments

CAUTION

The Flexitouch garments should not be placed in direct contact with an open wound. It is

recommended that wounds be properly dressed before the garment is applied. Contact your

healthcare provider if you have any questions.

20 21 Customer Service Toll-Free:

833.382.2845 (833.3TACTILE)

4.2 Applying the Full Leg Garment and Trunk Accessory

If you have received garments and accessories labeled full leg and trunk, follow

the preparation and application instructions below.

Full Leg Garment and Trunk Accessory Preparation:

NOTE: If you are treating both legs, you will only receive one trunk accessory,

which is designed to treat either side of the body. You will have to follow these

directions for both sides.

1. Unfold and place the trunk accessory and leg garments on a bed or sofa.

2. Position the trunk accessory so that when you sit on it, the hose seam will run

along the side of your hip and the tubing harness will be at your waist.

3. Position the leg garment so that the hose seam will run up the back of your leg.

4. When using both the leg garment and trunk accessory, make sure they overlap

near the thigh by a couple of chambers. This ensures they are properly applied

so there will be no gap in treatment.

5. If you need a waist extender, attach it to the trunk accessory.

Full Leg Garment Application:

6. Sit down and place your leg on the garment, centering your heel between the

second set of fabric notches (when counting from the toe of the garment).

7. Begin by wrapping the foot section snugly

around your toes and the arch of your

foot. Secure the fabric in place

with the hook fasteners.

8. Next wrap your ankle, following its

contours. Secure the fabric with the

hook fastener tabs.

Figure 4.2.a. Applying the Full Leg

Garment and Trunk Accessory

WAIST EXTENDER

Figure 4.2.b. Fully Applied Full Leg Garment and Trunk Accessory

9. Continue up your leg, wrapping the calf next and the thigh last. When

wrapping, try to minimize any bunches or folds in the fabric and adjust the

hook fastener tabs as necessary to get a well-contoured t.

10. Finally, place a couple of pillows under your calf and foot to elevate them just

above your hips for optimal treatment. Place the hoses alongside your body

so they will be easy to reach when you are ready to attach them to the

controller unit.

Trunk Accessory Application:

To receive a full therapy treatment, the full leg garment and trunk accessory must

overlap at the thigh by a couple of chambers.

11. Before you begin wrapping the trunk accessory, check to make sure the

U-shaped notch (see 11 below) on the accessory will be centered at the groin

area when properly applied.

12. Begin applying the trunk accessory by starting with the thigh section. Bring

the fabric up between your thighs, wrapping snugly as you follow the crease

where your thigh meets your trunk. Use the hook fastener tabs to secure the

fabric in position.

13. Lay back with your head on the pillow. Grasp the top of the trunk fabric,

wrapping it over your abdomen. Bring the fabric with the hook fasteners

over your abdomen, in an upward direction for the best t. Attach the hook

fastener tabs so the fabric is securely in place.

You are now ready to attach the hoses to the controller. See Chapter 7 for

further instructions.

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4.3 Applying the Calf-Foot Garment and Trunk-Thigh

Accessory

If you have received garments and accessories labeled calf-foot and trunk-thigh,

follow the preparation and application instructions below.

(The labels applicable to this section could read: EXT trunk-thigh, long trunk-thigh or

short trunk-thigh and EXT calf-foot or reg calf-foot.)

Calf-Foot Garment and Trunk-Thigh Accessory Preparation:

1. Unfold and place the trunk-thigh accessory on the bed or sofa, positioned so

when you sit on it, the seam will be along the outside of your leg.

2. If you need a waist extender, attach it to the trunk accessory.

3. Place the calf-foot garment on the bed so that it overlaps the trunk-thigh

accessory by a couple of chambers and so the hose seam will run along the

back of your leg.

Calf-Foot Garment Application:

4. Sit down and place your heel into the heel cup area of the garment.

5. Begin wrapping the foot section with the non-hook fastener side of the fabric.

Snugly wrap the arch of the foot and the toes. Secure the fabric with the hook

fastener tabs.

6. Grasp the non-hook fastener side of the calf fabric. Wrap this section by

starting mid-calf then move up and down your leg making sure the fabric is

smooth and there are no gaps around the toes, ankle and knee. Secure the

fabric with the hook fastener tabs,

starting at the midpoint of the

calf and continuing to attach

the hook fasteners up and down

your calf.

7. If necessary, readjust the fasteners

to obtain a well-contoured and

comfortable t.

Figure 4.3.a. Applying the Calf-Foot Garment

WAIST EXTENDER

Figure 4.3.b. Fully Applied EXT Lower Extremity Garment Set

8. Place a couple of pillows under your calf and foot to elevate them just above

your hips for optimal treatment. Place the hoses alongside your body so they

are easy to reach when you are ready to attach them to the controller unit.

Trunk-Thigh Accessory Application:

9. Check to make sure the U-shaped notch on the trunk accessory will be

centered on the groin area when fully applied.

10. Hold the non-hook fastener side of the thigh accessory at the midpoint and

bring it up between your thighs. Starting mid-thigh, wrap this section over

your thigh so that the fabric is snug and follows the crease where your thigh

meets your trunk.

11. Grasp the hook fastener side of the thigh accessory at the midpoint wrapping

it over the non-hook fastener fabric. Secure the hook fastener tabs starting

at the midpoint and working up and down your thigh. Adjust the hook

fastener tabs as necessary to ensure a snug t without gaps, paying particular

attention to where the trunk-thigh accessory and calf-foot garment meet.

12. Lay back and snugly wrap the non-hook fastener side of the trunk fabric over

your abdomen. Bring the hook fastener side of the fabric as far as you can

over your trunk. Secure the hook fastener tabs.

You are now ready to attach the hoses to the controller. See Chapter 7 for further

instructions.

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Garment and Accessory Application—

Upper Extremity

CHAPTER 5

Before starting, be sure you are using the recommended garment(s) and

accessory(ies) for your condition. Before applying the garments and accessories,

prepare yourself for an uninterrupted therapy session — these typically last about

one hour.

5.1 Applying the Arm Garment

If you have only received a garment labeled arm, follow the preparation and

application instructions below.

Arm Garment Preparation:

1. In preparation for donning the arm garment, loosely form the garment into a

cone shape and fasten the hook tabs.

NOTE: Adjust the tabs so that you will be able to slide your aected arm into

the garment easily.

2. Next fold the four hook fastener tabs on the top of the arm garment back so

they are secured to the arm garment itself.

Arm Garment Application:

3. Slide your arm into the pre-shaped cone, making sure the tabs run along the

side of the garment closest to your torso.

4. Pull the arm garment up toward your biceps making sure that your ngertips

remain fully enclosed in the garment.

5. Readjust the tabs on the inside of the arm garment to obtain a well-contoured

t around the arm. Pay particular attention to snugly tting the contours of the

wrist and elbow areas.

You are now ready to attach the hoses to the controller. See Chapter 7 for

further instructions.

Figure 5.1.a.

Preparing the

Arm Garment

Figure 5.1.c.

Fully Applied

Arm Garment

Figure 5.1.b.

Adjusting the Arm

Garment for a Snug Fit

5.2 Applying the Trunk Accessory and

Arm-Shoulder Garment

If you have received garments and accessories labeled trunk and arm-shoulder,

follow the preparation and application instructions below.

The upper extremity garments and accessories work together to deliver eective therapy.

It is easiest to apply them in the order presented: trunk rst, and arm-shoulder last.