TUR Isoforce User manual

5.2.1 User Manual Isoforce
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TUR Therapietechnik GmbH | Grubenstr. 20 | 18055 Rostock | Germany

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Considerations Before the first Use
Before you start working with Isoforce, please be sure that you have carefully read and considered the
following points.
The installation of the system has been performed by trained staff. You can check if your
supplier is part of our authorised world-wide network by browsing our web site: www.iso-
force.com.
Isoforce should be operated by users with sufficient professional expertise. Our system
demands apart from familiarisation with the positioning, knowledge of all the clinical
considerations, as well as the possible applications. In the current manual we offer all the basic
information, but you should seriously consider further reading, as well as attendance in the
seminars held by our company.
Ensure that there are not cables that could be stepped over.
Remove any strong electromagnetic sources (preferably out of the room), as the working
conditions of the electronic circuits could be affected. Sources such as mobile phones should
not be placed on the device, and the patients should not carry them on. However, mobile
phones don’t affect the operation of Iso-Force in distance more than 1m.
In the unlikely event of system failure, please contact immediately with the authorised supplier
of your district. Do not attempt any service action by yourselves.
Isoforce offers remote assistant both for technical, as well as for application issues. This
demands wireless internet connection and you are strongly advised to install one if not any
available.
Despite the detailed information about the testing and rehabilitation procedures performed with
Isoforce, one should keep in mind that every patient should be treated specifically for his/her
pathology. Therefore, you should also take into consideration the unique characteristics of your
patients.
The positioning suggestions, as well as the testing protocols are not obligatory to use. On the
other hand we would be happy to see our clients to expand the applications beyond our own
suggestions. Isoforce is a powerful tool that gives you all the resources to do so.
All the info presented here, is based on scientific proven evidence and on published data. We
would be happy to give you our bibliography.
Before putting the patient on, it is suggested that you have the system in the position appearing
in the photo 1.1. This position is called the initial position.
For technical, application and marketing support please address either to your authorised supplier or
contact Iso-Force personnel through one of the following ways
Via e-mail:
[email protected]m
Please consider that apart from these general considerations, there are Attention notes marked
with the symbol in the following paragraphs. Read carefully all of them.

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Content
Chapter 1 - Clinical Considerations.................................................................................................. 6
1.1 About contractions................................................................................................................... 7
1.1.1 Concentric......................................................................................................................... 7
1.1.2 Eccentric............................................................................................................................ 7
1.1.3 Isometric............................................................................................................................ 7
1.2 Exercise Types........................................................................................................................ 7
1.2.1 Isokinetic Mode................................................................................................................. 8
1.2.2. The Passive Mode........................................................................................................... 9
1.2.3. Isometric Mode.............................................................................................................. 10
1.2.4 Isotonic Mode.................................................................................................................. 11
1.3 Contraindications for Resistance Training .......................................................................... 12
1.4 Additional Considerations..................................................................................................... 13
1.5 General Considerations before and after Testing............................................................... 13
1.6 Safety Considerations........................................................................................................... 13
Chapter 2 - Mechanical Overview.................................................................................................. 15
2.1 Dynamometer Assembly....................................................................................................... 16
2.1.1.Dynamometer Rotation.................................................................................................. 16
2.1.2.Dynamometer Tilt........................................................................................................... 17
2.1.3. Dynamometer Lifting..................................................................................................... 17
2.1.4 Range of Motion (ROM) Ring & ROM Mechanical Stops........................................... 17
2.1.5 Hand-Held Emergency Button....................................................................................... 18
2.1.6 Input Arm Adaptor .......................................................................................................... 18
2.1.7 Laser Pointer................................................................................................................... 18
2.2 Chair Assembly...................................................................................................................... 19
2.2.1 Seat Rotation.................................................................................................................. 19
2.2.2 Chair Transfer................................................................................................................. 20
2.2.3 Seatback Tilt................................................................................................................... 20

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2.2.4 Bottom Seat Tilt –Height................................................................................................ 20
2.2.5 Bottom Seat For/Aft........................................................................................................ 21
2.2.6 Cervical Support............................................................................................................. 21
2.2.7 Stabilization Straps......................................................................................................... 21
2.2.8 Hand Grips...................................................................................................................... 21
2.2.9 Receiving Tubes............................................................................................................. 21
2.3 Adapters................................................................................................................................. 23
2.3.1 Dynamometer and Chair Attachments/Adapters........................................................ 23
Chapter 3 - Set Up / Positioning / Operation................................................................................. 26
3.0 Set Up and Positioning ......................................................................................................... 27
3.1 Ankle....................................................................................................................................... 28
3.1.1 PlantarFlexion/DorsiFlexion........................................................................................... 28
3.1.2 Inversion/Eversion......................................................................................................... 32
3.2 Hip............................................................................................................................................ 35
3.2.1 Hip Abduction – Adduction (Lying on Side).................................................................. 35
3.2.2 Hip Extension – Flexion (Supine).................................................................................. 37
3.2.3 Hip Internal – External Rotation.................................................................................... 39
3.3 Knee Joint.............................................................................................................................. 40
3.3.1 Knee Extension – Flexion.............................................................................................. 40
3.3.2 Knee Internal-External Rotation.................................................................................... 43
3.4 Shoulder................................................................................................................................. 46
3.4.1 Flexion – Extension (Supine)......................................................................................... 46
3.4.2 Adduction – Abduction (Laying).................................................................................... 48
3.4.3. Shoulder Horizontal Adduction/Abduction, Supine..................................................... 51
3.4.3 Internal External Rotation Patterns............................................................................... 53
3.5 Elbow...................................................................................................................................... 56
3.5.1 Elbow Extension – Flexion............................................................................................. 56
3.5.2 Pronation – Supination................................................................................................... 58
3.6 Wrist........................................................................................................................................ 60

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3.6.1 Flexion / Extension......................................................................................................... 60
3.6.2 Radial / Ulna Deviation .................................................................................................. 62
Chapter 4 - Normative Data............................................................................................................ 64
1 Normative Data Lower Limb.................................................................................................... 65
4.2 Normative Data Upper Limb................................................................................................. 66
Chapter 5 - Parameters................................................................................................................... 67
Chapter 6 - Cleaning and Maintenance......................................................................................... 70
6.1 Cleaning................................................................................................................................. 71
6.1.1 Data Station.................................................................................................................... 71
6.1.2 Adapters.......................................................................................................................... 71
6.1.3 Upholstery....................................................................................................................... 71
6.2 Maintenance .......................................................................................................................... 71
Chapter 7 - Technical Specifications ............................................................................................. 72
7.1 Laser Pointer.......................................................................................................................... 73
7.2 Dynamometer Performance Specifications:........................................................................ 73
7.3 Operation Specifications....................................................................................................... 73
7.4 Data Station........................................................................................................................... 73
7.5 Mechanical Specifications.................................................................................................... 73
7.6 Electrical Requirements........................................................................................................ 74
7.7 Classification.......................................................................................................................... 74
7.8 Operating Conditions ............................................................................................................ 74
7.9 Transport and Storage Conditions....................................................................................... 74
7.10 Technical Description.......................................................................................................... 74
7.11 EMC Informations................................................................................................................ 74
Chapter 8 - Labelling....................................................................................................................... 75
8.1 Device Label.......................................................................................................................... 76
8.2 Laser Labeling....................................................................................................................... 77
8.3 Symbol Explanation............................................................................................................... 77

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Chapter 1 - Clinical Considerations

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1.1 About contractions
1.1.1 Concentric
Concentric, when literally translated, means towards the middle. This type of contraction occurs when
the tension generated within the muscle is sufficient to overcome a resistance (in most cases at least
gravity) to move a body segment (or the attachment of the muscle on that body segment) towards
another segment (or the origin of the muscle in question) or vice versa. This type of contraction is
dependent on one end of the muscle having more stability than the opposite end. The term dynamic
shortening seems to be a more appropriate way of describing concentric contractions.
1.1.2 Eccentric
Eccentric, when literally translated, means away from the middle. Whenever a muscle lengthens it
generates a contractile force meaning all movements in the body occur with some muscular activity
(this is absolute). The term lengthening is actually misleading as in most instances the muscle does not
actually lengthen. In reality it returns from its shortened condition to its normal resting length. In most
instances in which muscles contract eccentrically they actually act as a brake or resistive force against
the moving force of gravity or other external force (like a weight). This work is often referred to as
negative work for reasons I do not understand. Eccentric actions produce greater loading of the elastic
musculoskeletal components and are used during many dynamic movements (like walking down stairs
or hitting a ball). As the majority of muscle tears are thought to occur during eccentric motions
improvements in this performance may be beneficial for injury prevention. However, eccentric motions
produced by active dynamometers are not considered to be like those seen during functional activities.
Short and rapid eccentric motions are normally produced during daily and sporting activities,
isokinetically this is not seen as the movements are usually long and through full range of motion.
1.1.3 Isometric
Isometric, when literally translated, means equal length. When a muscle is contracted without any
appreciable change in length this is referred to as isometric contraction. This term is abused by
researchers, exercise scientists and physiotherapists to describe many different situations in which a
muscle is contracted but cannot be said to be acting either concentrically or eccentrically.
1.2 Exercise Types
Different type exercise programs are available that apply Davis’ Law to produce better integrity of the
joint. There are three basic types outlined: isometric, isotonic, and isokinetic. Isotonics can be divided
into a concentric (positive) movement, an eccentric (negative) movement, and variable resistance. The
isokinetic type can also be divided into a concentric or eccentric movement or both.
These types of exercises can be defined and contrasted in terms of the speed of movement and the
resistance applied. In isometrics, we know that the speed of movement is zero and the resistance is
fixed. In isotonics, on the other hand, the speed is variable, generally fluctuating around 60° as
demonstrated in weight lifting where there often is a slowing of movement at the weak points in the
range of motion (ROM). The resistance in isotonics is fixed (the amount of weight lifted). In isokinetics,

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the speed is fixed but the resistance is variable. Thus we can see that isokinetics is the opposite of
isotonics.
These types of exercises can be designed in musculoskeletal rehabilitation to optimize joint integrity by
strength. Strength has been defined as the “maximum voluntary force exerted in a single muscular
effort.”
Mechanical muscle-strength testing has played a key role over the years in the prescription of exercise
programs, the identification of the sequence of orthopedic disabilities, and the prevention of
musculoskeletal injuries. The evaluation of strength is crucial in determining overall musculoskeletal
fitness. Indeed, the lack or impairment of strength can seriously affect an individual’s success in any
musculoskeletal endeavor.
“Active exercise may be either static or kinetic. Static (isometric) exercise is performed without
producing joint motion. The muscle exercised maintains a fixed length. Kinetic (isotonic) exercise is
performed to produce joint movement. Contracting muscles shorten, causing movement of the joint at
which they are attached. Isokinetic exercises produce joint motion at a controlled rate of speed.
Concentric contraction occurs when a muscle is contracted from an extended to a shortened position.
Eccentric contraction occurs when a tense-shortened muscle lengthens. Power is the ability to release
muscular work as a function of time. Endurance is the ability of muscles to perform work by holding a
maximum contraction for a given length of time or by continuing to move a submaximal load.”
Iso-Force offers a wide range of operation modes. Below you can find information regarding main
clinical implications and considerations for each one of them.
1.2.1 Isokinetic Mode
In the concentric isokinetic mode, the dynamometer acts to control velocity, allowing the subject to
accelerate up to, but no higher than, the maximum speed value selected for each direction of shaft
rotation (accommodating resistance). The subject may freely decelerate or change direction of
movement at any point within the range of motion.
In the eccentric isokinetic mode the dynamometer responds to torque exerted by the patient by moving
in the opposite direction of the applied torque.
The Isokinetic mode may be used at higher speeds in order to simulate functional or sports activities. It
can also be used early on in the rehabilitation process to prevent compression and translation in the
knee joint. Different bi-directional velocities can be set. Thus you can simulate physical activities. By
choosing different type of contraction con/ecc or ecc/con, you can isolate but also more precisely
simulate every functional patterns.
Keep in mind that it is possible to generate 30-40% more force eccentrically than concentrically. In
concentric isokinetic contractions the lower the velocity the higher the muscular tension. Therefore, the
torque produced is much higher. On the contrary in eccentric exercise, the force increases as the
velocity of contraction increases (up to a certain point)

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Eccentric contraction involves a “training” of the non-contractual elements of muscle so that the muscle
“learns” to function in a higher force environment. It has been suggested that eccentric exercise
produces the greatest force in the least amount of time, while it is said to enhance muscle force
production and are less costly metabolically than concentric contractions
There are a few things to consider when setting the angular velocity in isokinetic mode: Exercising
every 30 degrees/second will help you overcome the specificity of strength gain. Higher velocities are
ideal for endurance gains without putting too much pressure on joints.
The Reactive Eccentric mode may be used to work on proprioception. When torque limits are set, the
subject must exert at least one-tenth of the torque limit to keep the shaft moving. If the subject exceeds
the limits, the unit will stop.
1.2.2. The Passive Mode
The Iso-Force Passive mode allows the dynamometer to provide continuous motion at constant
velocity, with direction changes occurring only when range of motion limits are reached.
In Passive mode, the dynamometer initiates motion when the Start button is pressed, requiring no
active participation by the subject.
CPM acts to reduce blood and fluid accumulation in and around joints that have been traumatized or
undergone surgery. In this way, CPM is useful in avoiding the development of subsequent joint stiffness
in the first few hours or days. Avoiding stiffness in the early stages minimizes its chances of progression
to fibrosis of the joint and establishment of contracture. Long-term benefits, however, are predicated on
preventing the accumulation of blood and/or edema fluid in the joint or periarticular tissues. This is
accomplished by the immediate application of a full range of passive motion on CPM, or by briefly
elevating and splinting the limb in a position that keeps the periarticular tissues stretched before
instituting a full range of passive motion on CPM. In the event that the patient is temporarily prevented
from using the machine due to other medical or technical factors (if, for example, the machine breaks
down) and periarticular swelling does occur, it must be reduced by alternately stretching the joint at its
limits of flexion and extension to work the fluid out of the periarticular region.
CPM is indicated to prevent stiffness and to maintain motion obtained at the time of surgery,
particularly following joint replacement, synovectomy, contracture release, excision of heterotopic
ossification, and fixation of intra-articular fractures. This is particularly true for joints that were stiff
preoperatively. It is relatively contraindicated if the soft tissue constraints (ligaments) are insufficient, if
the joint is unstable, or if rigid fixation of fractures has not been attained. By following these guidelines
and adhering strictly to the principles of CPM use, one will increase the chances of obtaining maximum
range of joint motion following trauma or surgery. It would be anticipated that proper application of CPM
would, indeed, be cost effective, because it would decrease the need for physical therapy and joint
manipulation under anesthesia, and later rehabilitation or surgical intervention to treat stiffness.
The Passive mode may be used to exercise or test isokinetically. Subjects that cannot meet the speed
will be passively moved through this portion of the range. The mode can also be used to stimulate joint
and muscle mechanoreceptors to improve proprioception.

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Finally, the Passive mode may be used for passive stretching. When this is performed, the torque limits
in each direction should be set low and the time delay at least at the edge in interest should be set high.
It is not necessary to have a wide range of motion.
Attention! Ensure torque limits are set to overcome limb weight.
1.2.3. Isometric Mode
In this mode, the dynamometer maintains zero velocity at any selected point in the range of motion.
Significant change in joint angle and overall muscle length does not occur.
The interruption of normal function from musculoskeletal injury and immobilization leads to a loss of
strength not only in the muscles of a damaged extremity but also in those of uninjured extremities. This
loss can be largely avoided with the proper use of isometric exercise. In most cases, uninjured body
parts can be exercised even on the first day of immobilization of the injured part. The injured and
immobilized extremity can be isometrically tensed and thus exercised while still in a cast or in a splint
after the immediate pain has subsided. In this way, much of the potential loss of muscle strength can be
avoided. The muscle atrophy already setting-in can also be countered. A primary advantage of
isometric exercise in musculoskeletal rehabilitation lies in the opportunity for localized muscle exercise
without moving involved joints.
Strength increases more rapidly in isometric than in dynamic exercises. On the other hand, strength is
also lost more rapidly after cessation of exercise. A primary disadvantage is that the muscular
coordination necessary for many types of musculoskeletal activities is not integrated in this exercise,
which is why isometrics must, in time, be combined with dynamic exercises in the treatment of various
musculoskeletal conditions. Isometric exercise places great compression stress on the joint; thus,
people with arthritic conditions should not participate in intense isometric contractions. Also, people in
danger of heart attacks should not engage in intense isometric training because of the danger of
compression narrowing blood vessels.
There are thus unique advantages to isometrics due to the fact that they do not move a joint and
therefore can be used early in a rehabilitation program. Static strength increases, and atrophy retards.
Most other advantages to isometrics focus around the lack of special facilities and equipment needed to
perform them.
Disadvantages must also be carefully understood. A major disadvantage is a limited overflow of strength
development. Approximately 20° of overflow from the angle of application occur: strength gains will be
noticed for 10° on each side of the application. This is a small amount, and therefore, realistically,
isometric exercise at one point in a plane will not increase strength at another point in the plane. Other
problems also exist with isometrics such as difficulty with patient motivation, minimal gains of endurance,
and lack of eccentric workloads.
When we apply an isometric contraction, the general rule to follow is known as the “Rule of Tens,”
wherein we build tension in 2 seconds, hold the desired tension for 6 seconds, and then gradually relax
tension in 2 seconds. Applying this to isometrics, we usually recommend a 10-second contraction, 10
seconds of rest between each contraction, ten repetitions, and ten sets at ten different angles in the
ROM.

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One should exercise at various angles in the ROM because of the limited physiologic overflow. If we
apply isometrics only at one point, there is approximately a 10° overflow on each side. How then would
we apply isometrics when there is a painful point in an arc of motion? We would exercise at every 20°
using the Rule of Tens throughout the range of motion, beginning at 10° on each side of the painful
position. Thus we would get a physiologic overflow into the painful deformation and achieve our goal to
increase strength at that point and decrease related pain.
1.2.4 Isotonic Mode
Isotonic exercise involves work in a physical sense. This is called dynamic muscular work. For
example, when the biceps contracts and shortens and the lower arm is bent or a weight is lifted,
movement is accomplished. The physical formula of work = force Χ distance is fulfilled.
Dynamic muscular work does not involve lengthy contractions but instead is distinguished by the
alternation between contraction and relaxation. In the concentric contraction phase, individual muscle
fibers shorten, and their origin and insertion approximate. In the eccentric relaxing phase, individual
muscle fibers go through a lengthening process with their origin and insertion moving apart. In each
motion, the agonist and antagonist muscle groups are involved. In isotonic exercises, the prime mover
(agonist) produces a concentric muscular contraction (e.g., quadriceps producing knee extension). This
is followed by an eccentric contraction of the same muscle group (i.e., quadriceps slowly lowering the
leg toward flexion). When multiple repetitions are performed by the same muscle group concentrically
and then eccentrically, a transient muscle ischemia is produced that compromises blood flow.
From two to three times more force can be generated with eccentric contractions. The clinical
implications of this are evident when dealing with a patient who cannot initiate a concentric contraction.
An example may be the use of eccentric straight-leg raises in a knee rehabilitation program.
Immediately post surgery, after the patient can perform quadriceps isometric sets, immediate
progression to eccentric straight-leg raises is often effective using the iliopsoas. The clinician passively
assists with hip flexion, or a sling mechanism can be developed to allow the patient to work
independently after which active eccentric straight-leg lowering is performed by the patient. (Note: The
quadriceps can isometrically contract while the iliopsoas muscles eccentrically contracts.)
Although eccentric contractions are useful in early rehabilitation programs or in gaining muscle mass
and strength, there is a distinct disadvantage involving residual muscle soreness that may cause
decreased performance due to pain and biochemical changes in the involved muscle. Eccentric isotonic
exercises are thus used at the two extremes of a rehabilitation program. They generate more tension
early in rehabilitation and can perhaps help prevent a reflex disassociation by maintaining a
neurophysiologic pathway for muscle contraction. They are then used near the terminal stage of
rehabilitation to maximize the eccentric joint strength needed during daily activities.
Regarding circulation and isotonic exercise at the moment of contraction, the intramuscular pressure
increases. This forces blood into the veins and can be accomplished with only one-fifth of maximal
contraction. During relaxation, the increase in the capillary bed is then so extensive that the circulation
is 15—20 times greater than when the muscle is at rest. In this way, the circulation can supply the

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tissues with oxygen and remove metabolic wastes. Dynamic muscular work thus promotes circulation
and metabolism and eases the pumping work of the heart. Thus, isotonic exercise is accomplished
aerobically.
It is emphasized that strengthening exercises increase muscular performance. Without them, an
improvement in performance in any functional activity is impossible. A proper system of exercise is
necessary for the preservation and restoration of muscles after injury. However, strength-building
exercises alone would leave much to be desired in developing endurance.
1.3 Contraindications for Resistance Training
Training and Testing should be by any means avoided in case of the following factors being present:
Bone Fractures or Non Unions
Severely impaired ROM (not for isometric)
Cardiac Insufficiency
Epilepsy
Severe Vascular diseases
Use of Anticoagulants
Malignancy
Pregnancy
A physician should be advised prior to exercising / testing when any of the following conditions:
Anemia
Osteoporosis
Recent Surgery
Effusions
Pain
Limited ROM
Rheumatoid Arthritis

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1.4 Additional Considerations
Very often clinicians use the following progression during the rehabilitation process: Passive mode,
isometrics, multi-angle isometrics, sub-maximal eccentrics, and concentric isokinetics.
Electrical stimulation may be used in conjunction with any of the tests or exercise modes on the Iso-
Force.
Consider ending a rehabilitation set by work or time, especially if the goal is to improve endurance.
Giving to a subject copies of their rehabilitation reports can help since he/she are more motivated.
Submaximal exercise prevents neural dissociation, promotes articular cartilage nourishment and
proprioception, and retards muscular atrophy.
Delayed Onset Muscle Soreness (DOMS) is not usually apparent until one to two days after treatment.
Work sub maximally to minimize and develop protocols accordingly.
The Iso-Force is a versatile piece of equipment, making it difficult to document every possible setup
position. If a non-documented position is used, please document it by yourself. We would be happy to
make your preferences part of our standard configuration.
1.5 General Considerations before and after Testing
1. Test the dominant or the uninvolved side first
2. Perform stretching exercises, as they have been found to improve muscle performance
3. Ideally 4-5 submaximal and 1 maximal repetitions should be performed as warm-up.
4. Put some ice on the joint involved after exercise or testing
1.6 Safety Considerations
The Laser Pointer placed on the center of the dynamometer axis is used for easy and quick
alignment of the joint to be tested.
Avoid eye exposure to direct or scattered radiation.
To avoid the risk of electric shock, this equipment must only be connected to a supply mains
with protective earth.

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Would at any point the subject feel uncomfortable or any not normal operation would it be
observed, immediately press the emergency stop. Also, refer to 2.15.
After the activation of the emergency stop the start-up procedure of the system must be
repeated.
Immediately release the patient in case he/she feels uncomfortable by pressing the emergency
and removing the straps that keep the adapter in contact with the limb.
Use of Uninterrupted Power Supply is encouraged although not related to safety issue. It
prevents loss of data due to sudden power cut. Suggested Power of UPS 1,2kW.
Movement of the ME Equipment or its parts is possible only by the continuous activation of the
control by the operator
IEC 60417-5638
Emergency Stop Label

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Chapter 2 - Mechanical Overview

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2.1 Dynamometer Assembly
You can easily and comfortably make the following dynamometer’s translations.
2.1.1.Dynamometer Rotation
You can rotate the dynamometer in the horizontal plane, both clockwise and counter-clockwise. In order
to do so, just lightly step on the dynamometer release pedals, DR pedals. While pressing them you can
rotate the dynamometer either directions. On the rotation scale, which is placed under the
dynamometer yoke, and around the vertical tube, you can read the dynamometer’s position.
1
Dynamometer Release pedals (DR)
2
Input adaptor tube
3
Adaptors’ knob
4
Range of motion mechanical stops
5
Dynamometer Tilt Level (DT)
1
2
3
4
5
Pic 2.1 Dynamometer Assembly

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2.1.2.Dynamometer Tilt
The dynamometer tilt is actually the rotation of the dynamometer in the vertical plane. To perform this
move, you should loosen the Dynamometer Tilt Lever in a counter-clockwise direction, DT Lever, and
rotate the dynamometer vertically to the desired position. While keeping it steady, use your other hand
to firmly tighten the DT knob, by turning it clockwise. If the dynamometer is not in the vertical position (0
degrees tilt), you should also support the dynamometer while loosening the DT knob. The tilt position of
the dynamometer can be read on the tilt scale.
2.1.3. Dynamometer Lifting
The Iso-Force system offers the easiest possible
way to lift the dynamometer. Step on the DR pedals
and press the up and down arrows that are placed on the
handheld control. When pressing the up button, the
dynamometer rises. On the contrary when pressing the down
arrow the dynamometer lowers and finally returns to its
initial position. Please note that unless you have completely
pressed the DR pedals down the motor that lifts the
dynamometer will not work.
2.1.4 Range of Motion (ROM) Ring & ROM Mechanical Stops
You can adjust the mechanical stops by pulling the knob at their back side. The stops are released and
you can move them around the dynamometer ring. Once you find the desired position gently leave the
knob.
Attention! Although the software of Isoforce applies software stops, you are asked to always place
the mechanical stops slightly beyond the software stops. This is an extra safety feature.
2.2 Dynamometer Lift Button

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2.1.5 Hand-Held Emergency Button
By pressing the red emergency button the patient or the user can instantly terminate the operation of
Iso-Force, no matter in which mode the system works. The dynamometer shaft stops moving or
applying resistance. One should be particular careful when pressing the emergency button, as the
kinetic energy already acquired (particularly in isotonic and concentric isokinetic mode) by the subject
could result in continuation of the movement towards an undesired position or direction. After pressing
the emergency button, the user should manually get the patient’s limb in a safe position. Also, please
note that after terminating operator this way, the system should be reset.
2.1.6 Input Arm Adaptor
You can find the input arm adaptor at the front of the dynamometer. Attachment and adaptors are
placed in it by sliding them in. Always firmly secure the attachments by turning the knob counter
clockwise.
Hold the adaptors when you are removing them. You are advised not to have them in vertical
position as the can fall off the input.
Mounted on the centre of the dynamometer rotation axis you can find the laser pointer, which is used
for easy joint alignment. The connected battery case carries a magnet and can be attached at the side
of the input adapter. To replace the batteries follow the steps below:
2.1.7 Laser Pointer
Remove the battery compartment cover and lift it off
Place 2 1,5V batteries of AAA size into the battery
compartment with the correct polarity.
Put back the battery cover.
2.3 Battery Case

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TUR Therapietechnik GmbH | Grubenstr. 20 | 18055 Rostock | Germany
2.2 Chair Assembly
2.2.1 Seat Rotation
You can rotate the chair 360 degrees in the horizontal plane. To allow rotation turn the Rotation Chair
Handle (RCH) in counter clockwise direction and place the chair in the desired position. Firmly tighten
the RCH by turning it clockwise. There are two RCHs, one at each side, right under the seat. Record
the rotation position by reading the Seat Rotation Scale located around the tube of the chair.
1
Seat Back Tilt Handle (STH)
2
Rotation Chair Handle (RCH)
3
Cervical Support
4
Shoulder Support
5
Belts
6
Receiving Tube
7
Hand Grips
8
Belts
4
2
1
3
3
4
2.4 Chair Assembly
7
6
7
80

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TUR Therapietechnik GmbH | Grubenstr. 20 | 18055 Rostock | Germany
2.2.2 Chair Transfer
You can allow for/aft adjustment of the positioning chair
in relation to the dynamometer by pressing the left/right buttons
placed on the hand-held control panel. Iso-Force offers electric
transfer of the chair in the horizontal plane. The Chair Transfer
Scale can be found on the rail.
2.2.3 Seatback Tilt
This adjustment allows stepless change of the seat back tilt. To adjust the seat back tilt rotate the Seat
back Tilt Handle (STH) counter clockwise. Be careful as the seat back returns to the initial position
because of the supporting gas spring. Hold the back firmly by the support located at the rear side of the
back seat and adjust the tilt. Once you reach the desired position tighten firmly the STH by turning it
clockwise. Read the new position on the Seatback Tilt Scale place next to the STH.
2.2.4 Bottom Seat Tilt –Height
The seat allows gas-spring assisted change
in the height of the bottom seat. The adjustment
can be set with patients placed on it. In order to
adjust the height press the button of the hand control with
the relevant button (see the picture next to the text)
2.5 Chair Transfer
2.6Bottom Seat Tilt