Ultima 20 User manual

Ultima 20
User'smanual

User Manual for Ultima 20 T.E.N.SUNIT
PRESCRIBING INFORMATION
FOREWORD
Read this manual carefully before using your Ultima
20 T.E.N.S.unit.
The manufacturerstrongly recommendscarefully
reading the "Warnings and Cautions", and subsequent
chapters of this manual.
WARNINGS AND CAUTIONS
Prescription labeling:
Federal law restricts this device to sale orusebyoron
the order ofa practitioner s o licensed b ythe state.
Contraindications:
1 . Donot place the pads onthe carotids i n u s e slocated at
thetwo sides ofthe neck, (where a doctorfeels fora
pulse), or over the eyes.
2. Donotuse this T.E.N.S. unit ifyou have a heart
pacemaker or serious heartrhythmproblem.
3. Any electrode placement that causes current to flow
transcerbrally(through the head).
4. Theuseof T.E.N.S.wheneverpain syndromes are
undiagnosed, untiletiology is e s t a b l i s h e d .
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WARNINGS
1. Donotuse thisT.E.N.S.unit during the
pregnancy orat anytime onthe abdomenduring
pregnancy.
2. ThisT.E.N.S.unit isnot effective for pain of
central origin,includingheadache.
3. T.E.N.S.unitshould be usedonlyunder the
continued supervision ofa physician.
4. T.E.N.S.unit hasno curativevalue.
5. T.E.N.S. isa symptomatictreatment andas such
suppresses the sensation of pain, whichwould
otherwiseserve asa protective mechanism.
6. The usermustkeep the device outofthe reach
of children.
7. Electronic monitoringequipment maynot
operate properlywhen T.E.N.S. stimulation isin
use.
8. Donotuse T.E.N.S.unit ifyouare driving or
operatingmachinery.
9. Ifyou haveepilepsy,consultyourdoctor.
PRECAUTIONS
1. Isolated cases of skin irritation may occur atthe
site of electrode placement following long-term
application.
2. Effectiveness is highlydependentuponpatient
selection bya personqualified inthe
management of painpatients.
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ADVERSE REACTIONS
Skinirritation and electrodeburns are potential
adversereactions.
GENERAL WARNINGS
1. Donot immerse T.E.N.S. units in water.
2. Donot place the T.E.N.S.unitclose to excessive
heat.
3. Donotuseanypad whichsize is lessthan
40mm X40mm.
4. Use only the specified batteries: 2x 1.5volt AA
Alkaline (LR6). Theuseofany other battery
coulddamage the unit.
5. Removebatteries if unit isnot used fora long
period of time.
6. Do not use the unitwhileasleep.
7. Keep the unitawayfromsources of high
magnetic fieldssuch as TV'S, microwaveovens
and hi-fi speakers, as these may affect theLCD
screen.
8. Temperature & R.H. o f storage: -20°C--+80°C,
8%-80% R.H.
9. Temperature & R.H. of transportation:
-20°C--+80°C,8%--80%R.H.
-3-
CONTENTS
PrescribingInformation 1
Contents 4
OperatingInstruction for Physician 5
Instruction For Use6
Howto Assemble YourUnit 6
AfterUse 11
Operation ofthe T.E.N.S .Unit 12
Specification 13
Other Features 17
ElectrodesPlacement 20
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OPERATINGINSTRUCTIONS FOR PHYSICIAN
INTENDED USE
T.E.N.S. Stands for Transcutaneous ElectricalNerve
Stimulation.ThisT.E.N.S. system is used to provide
symptomaticpain relief for chronic, acute or
post-operativepain.
WHAT IS T.E.N.S. USED FOR
T.E.N.S. is commonly used to provide relieffrompain
associated with the following:
BACKACHE, CERVICALARTHROSIS,
TORTICOLLIS,ARTHRITIS,SCIATICA,
SPORTSINJURIES,ANKLESPRAINS,
MUSCULARSTRAINS,MYALGIA,
RHEUMATISM,NEURALGIA,LABOUR,
AFTER SURGERY,MIGRAINE,MENSES.
HOW DOEST.E.N.S.WORK
T.E.N.S. works by stimulatingyourbody's own natural
defenses againstp a i n .
The unitproduces a gentlestimulusthroughpads
normally placedover the area of pain.Thisstimulush el ps
the body to produce natural pain relievers called
endorphins.
The correctpositioning ofthe pads is important.Some
people feelimmediatebenefitfromT.E.N.S.However
some may onlyachievebenefit after repeatedtreatment
sessions and over an extended period of time.
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INSTRUCTIONS FORUSE
YourUltima 20 T.E.N.S.Pain Relief unit has been
designed tobe simple and easy to u s e .
CONTENT IN THE PACK
Your T.E.N.S.packshouldcontain the following:
• 1 x T.E.N.S. Unit
• 2 x Leads
• 4 x Self Adhesive Pads with Connectors
(Size:40mm x 40mm)
• 2 x Alkaline AA1,5V (LR6)Batteries
• 1 x InstructionBooklet (which youare reading)
Having checked allthe contents are correctplease
proceed to assemble the unit.
HOW TO ASSEMBLE YOUR UNIT
Assembly ofthe Ultima 20 T.E.N.S. PainRelief Unit is
verysimple and requiresonlyfivesteps.
STEP 7 BATTERIES
Remove the battery cover and insert two batteries, as
shown onthe diagram,inside the battery compartment.
Replace the batterycover.

©
Note: Yourunitwill not function ifthe batteries are
inserted incorrectly. To check,press the ON/OFF
key once andtheLCD displaywillstart up. Having
madethischeck,press the ON/OFF key again to
switch the unit o f f .
CAUTION
There isa riskof explosion ifthe batteries are fitted
incorrectly.Replacewith AA Alkaline 1.5 voltbatteries
(LR6). Donotmixoldandnew batteries. Donot dispose
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of the batteries ina fire and keepthem outof reach of
children. The batteriesmust be removedfrom the unit if
unit isnot used fora longperiod of time.
STEP2 LEADS
Decidewhether you wish tousethe unitwith one lead or
two.
If using two leads,insert the plugsintobothjacks onthe
plugs ofthe unit. If onlyusing one lead, insertinto one
jack.
©
®

STEP 3 PADS
Remove padsf r o m thebagand connect tothe leads.
STEP4 PLACEMENT OF PADS
Ensure wherever you intend to place the padswhere
skin is clean and thoroughlydry. Remove the pads
from the cleanplasticshield and position on yourbody
as required.
©
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STEP5 READING
Readsection on "Operation ofthe T.E.N.S. Uint", and
decide howtousethe T.E.N.S.unit forthe treatment.
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NOTE:AFTER USE
Alwaysensurethat the unit is switched OFF before
removing the pads. After use, return the pads tothe
clear plasticshields.There isno need to separate the
padsunitfrom the leads and pads.
Life ofthe pads: When the padsinitiallylosetheir
adhesivequality, itis possible to reactivate their
adhesiveness by applyingfinespray of water.Replace
the padswhentheylosetheiradhesive quality in order
not to affect the efficiency ofthe unit.
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OPERATION OFTHE T.E.N.S UNIT
Ultima 20 T.E.N.S.Unit is easy to operate by pressing
thekeyas following diagram.
WHAT DOES EACH KEYDO
;)The ON/OFF key- It allowsswitching the unit ON
and OFF. TheLCD display, located atthe front ofthe
unit will light up, therewill beno feelingfromeither
leads at thispoint asthe intensity alwaysstart at zero.
Pressthis key again andthe unitwillswitchOFF.
I****9! Pressthis keyto selectmode,between 12
PRESETmodes.They are identified onthe display, by
a smallpoint ora smallarrow,pointing tothe specific
pain area.Press and hold 5 seconds for switching to
the MANUAL modes (P12-P19). Simply press again
the MODE keyto select oneof them. Press and hold
the MODE key5 seconds for switching again tothe
PRESETmodes.
I T i mer | Pressthiskey,before tosett h e stimulation
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levels, to select the treatment time (for Manual Modes).
If a presetmode is working, press the "timer" keyto
skip a phase (sub-programs ® ® ©).
Pfffr-q These two rotated knobswhichlocate on
the topofthe unitadjust the intensity of channels,left
side isforthe CM, rightside isforthe Ch2. Turn the
knob andthe intensityoverzero, the corresponding
LED light located atthetopofthe knob will light up.
/""A Pressthesekeys to increase or decrease the
VjY frequency, (for M a n u a lModes)
Press thesekeys to increase or decrease the
s7 pulse width, (forManualModes)
Havel Pressthiskeytochangethe form ofthe
stimulationwave (for manualmodesonly) andthe
change is directly felt bythe user.
| Lock | Press and holdthis keyf o r3 seconds; the unit
will be locked or unlocked in toggle.While the unit is
locked, all parameterscannot be adjusted except
timer and intensity. By removingbatteries or pressing
ON/OFF key cannotchange the status of
locked/unlocked.
SPECIFICATION
Model:
Channel:
Ultima 20
Dual
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Output:Maximum 130 mA (peakvalue)
across 500Ohm load
Pulse Width: From 50uS to 250uS adjustable
Pulserate:From 1Hzto 150Hz Adjustable
Waveform:SymmetricalBi-phasic rectangular
AsymmetricalBi-phasicrectangular
Monophasicrectangular
Mode: 12 PRESET programs
They are identified, onthe display,
directly through the area tobe treated
on the body; they a r e :
PO - NECKpain
P1- TORTICOLLIS
P2 - LOW BACKpain
P3 - SCIATICA
P4-EPICONDYLITIS
P5- WRISTPAIN
P6 - POST-SURGERYkneepain
P7- ANKLEsprain
P8- KNEEpain(gonalgia)
P9-HIP pain (coxalgia)
P10-MENSTRUAL pain
P11- NEURALGIA
The PRESET programapply a sequence of3
sub-programs ® (D ©, optimized to treat the
specificpainsituation. The characters ®, (§) or©
will flash,showing the phase inuseor will beONto
show the completed phase.
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8 MANUALModesAvailable
Mode Constant A- Both Pulse Rate and Pulse Width
will be freely adjustable.Default values are PR=3Hz
and PW=250us characterized bya decontracturating
effect. Use this program ifyou wantrelax the painful
area. The stimulation levelmust besetto produce a
gentlemuscular contraction.
ModeConstant B- BothPulseRate and Pu lse Width
will be freely adjustable.Default values are PR=10Hz
and PW=150us characterized byan endorphins
stimulatingeffect. Use thisprogram ifyou want
produce endorphins atthe painfularea. The
stimulationlevel may reach the muscular contraction.
If the PulseRatewill be increased, the stimulation
levelmust be set to avoid the muscularcontraction.
Mode Constant C- BothPulseRate and Pulse Width
will be freely adjustable.Defaultvalues are PR=70Hz
and PW=50us characterized byan endorphins
stimulating effect, through the Gate-control
mechanism. Use thisprogram in case of ACUTEPAIN.
The stimulation levelmust besetto avoid the
muscular contraction.
Mode MODulation SW (B)— PulseRate SWeep
modulation.Pulse Rate is automatically modulated
within F1=50Hz and F2=80Hz (adjustable); each
frequencystepwilllast 1 sec. F2canbe changedonly
if the intensitylevel of both channels aresetto0.The
PulseWidth is 200us (adjustablefrom 50uS to 250uS).
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ModeMODulation 2F(B)— PulseRateDual
Frequencies modulation.PulseRate is automatically
changed, any5 seconds, betweenF1=70Hz
(adjustable) and F2=5Hz. F1canbe changedonly if
the intensitylevel of bothchannels aresetto0.The
PulseWidth is 50us (adjustablefrom 50uS to 250uS).
Mode Burst A - One train any3 seconds, 1s on,2s off.
Both PulseRate and PulseWidth will befreely
adjustable.Default values are PR=30Hz and
PW=250us, The stimulationlevelmust besetto
produce a gentlemuscular contraction.
Mode Burst B - One train any1.5 seconds, 0.5s on,
1s off.BothPulseRate and Pulse Widthwill be freely
adjustable. Default values are PR=50Hz and
PW=200us. The stimulationlevelmust besetto
produce a gentlemuscular contraction.
Mode Burst C - One train any 0.75seconds, 0.25s on,
0.5soff.BothPulseRate and PulseWidth will be
freely adjustable. Default values are PR=100Hz and
PW=150us. The stimulationlevelmust besetto
producea gentle muscularcontraction.
TreatmentTimer: Continuous,15min, SOmin, 45min,
60min, 90minselectable
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OTHER FEATURES
1. LabelsMANUAL and PRESET ontheLCD display,will
switch on according the program;
2. LabelsACUTE and CHRONICwillswitch on according
to the Pulse Width (50us= Gate Control, thenmost
suitable to ACUTEpain - Above 50us= Endorphins
then most suitable to chronic pain), regardless thePW
is manually or automaticallyadjusted.
3. Symbols ® ® © willshow the o c c u r r i n gphase ( i f
blinking) orthe passed phase (if permanently ON)of
the PRESETprograms.
4. LabelsCONT, MODand BURSThave nottobe shown
during the PRESET programs.
5. Whenmodechanges, the intensitywillautomatically go
down to zero;
6. When the unit is turned on,it willautomatically enter
the modethat the unit had worked in before the unit
was turnedoff;
7. When the treatmenttimer is set, it willbegin to count
down one minute byone minute;Once it countdown to
zero, the unitwillautomaticallyshutoff;
8. When the pulse rate,pulse width or intensity is being
adjusted, the auto-repeat function is available,when
thekeyis held downover 1 second, it will
automatically increased or decreased 1 step per1/4
second.
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9. The treatmenttimewill be accumulativerecordedwhen
the output level is abovezero, by pressing"Timer" key
and "PR-" keyfor4 seconds the treatmenttime
accumulated in minute canbe displayed, or return
back tothe previousnormaldisplay in toggle; by
pressing "Timer" keyand "PW-" keyfor4 secondswill
clear the treatmenttime to zero.
10. When the unit intensity levels are0 on both channels,
andithasnot been inusefor5 minutes, the unitwill be
shut off automatically.
Detail information regarding tothe Waveform,
Pulse duration, Pulse frequency, Output voltage
range, and Peak pulse output current:
A. Waveform
There are3 types of waveforms:
(1). SymmetricalBi-Phasic rectangular waveform
Amplitude
>-Time
(2).AsymmetricalBi-Phasicrectangularw a v e f o r m
Amplitude
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(S).Mono-Phasic waveform
Amplitude
nn
ELECTRODES PLACEMENT
.Time
B. Pulsed u r a t i o n
Except MANUALModes,whichpulseduration cannotbe
adjusted, by pressing PW+orPW- key, the pulsewidth can
be adjustedf r o m 50pS to 250uS in step of 10uS.
C. Pulse frequency
Except MANUALModes,with a pulse rate, by pressing
PR+orPR- key, the pulsewidth canbe adjusted t ooneof
the followingv a l u e s( H z ) :
1,2,3,4,5,10,12,14,16,18,20,25,
30, 35,40,45, 50,60, 70,75, 80,90,
100,110,120,130,140,150.
D. Outputvoltager a n g e
The outputvoltage oftwo channels canbe adjusted
individually in20 steps. For 500Dload, the outputvoltage
canbe changedf r o m 6Vto 73V.
E. Peakpulseoutputcurr en t
The peakpulseoutputcurrent oftwo channels canbe
adjusted individually in20 steps. For 500D load, the output
voltage canbe changefrom12mA to 150mA in steps of
7mA roughly.
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Pleasestudy the bodymaps in thisguide,whichshow
correct positioning ofthe electrodes depending on your
symptoms.
RED & B L A C KF A S T E N E R S O N L E A D S
At theendofthe leadssuppliedwithyourunit, you will
find redand blackadapters.These are Cathode and
Anoderespectively. The followinggeneralpoints are
made for yourinformation:
1. Moresensationtends to comefrom the black
adapter(Cathode).
2. Whereapplicableplace the blackadaptercloser to
the spinalcolumn; e,g.ifthearmistobe treated,
place the blackadaptorhigher upthearmthered
adaptor.
If youare applying a SymmetricalBi-phasicrectangular
or an AsymmetricalBi-phasicrectangularwave, the
aboveconceptwill be exactlyreversed.
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PO - NECKPAIN
Usingbothleads, place the electrodes atthe back of the
neck and over thetopof yourshoulders.
Note: Donot placeelectrodes onthe side or front ofthe
neck.
P1 - TORTICOLLIS
By using a singlechannel,place the couple of
electrodes,over the area of maximumpain.
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-22-

P2 - LOW BACKPAIN
Usingbothleads,placeelectrodeseitherside ofthe
spine,crossing the channels, atthe site of pain.
P3 - SCIATICA
Usingbothleads,take the firstlead and place the
electrodewith the blackadapter on yourlowerback one
side of yourspine andthe secondelectrode with thered
adapter atthetopofthe back ofyou leg. Repeat forthe
secondlead,placing the secondelectrodelowerdown
the leg.
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P4 - EPICONDYLITIS
Usingbothleads,placeelectrodeseitherside ofthe
elbow.
P5 - WRISTPAIN
By using a singlechannel,place the couple of
electrodesover the area of maximumpain,involving
bothsides ofthe wrist.
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P6/P8 - KNEEPAIN(GONALGIA)
Usingbothleads,placeelectrodesover thetopand
base ofthe knee.Avoid to placedirectly onthe
kneecap.
P7-ANKLE SPRAIN
Usingbothleads,place the electrodesfrom one lead
either side ofthe spine, on yourankle, the othercouple
will be placedalong the involvenerve.
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P9 - HIP PAIN(COXALGIA)
Using bothleads,place one electrode from eachlead a
side ofthe spine, on yourlowerback. The remaining
electrodesmust be placed onthe area of pain, on your
hip.
P10-MENSTRUAL PAIN
Using bothleads,placeelectrodesover the tummy
area.
1R
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P11-MIGRAINE
Using 2 padsonly,placebothpads onthe back ofthe
neck.
Note: Donot placepads onthe side or front ofthe neck.
MIGRAINE(ADDITIONALPOSITION)
Using 2 pads only,place onepadonthe lefttemple, and
the other onthe back of yourrighthandbetweenyour
thumb and firstfinger.
Note: If only 2 padsbeingused,connect both pads tothe
2-lead single-channell e a dwire.
-31 - -32-

PADS
The padsthat are supplied with your Ultima 20 T.E.N.S.
Unit are self-adhesive andcanbe usedseveraltimes.
Skin must be allowed to breathe, sothe padsshould be
removedperiodically.When notin use, the padsshould
be placedonto the clearplasticshield.
The condition ofthe padsdoes affect the conductivity
and,therefore, the performance ofthe unit.When the
pads initiallylosetheiradhesivequality, itis possible to
reactivatetheiradhesiveness by applying a finespray of
water.Once the padshavefinallylost their adhesive
quality, new padsshould be purchased.
WARNINGS
Do notuseanypad whichsize is less than 40mm X
40mm.
Allergic reactions tothe self-adhesive pads can occur,
eventhoughthey are hypoallergenic:
•Don o t apply to brokenskin.
•Donot applypads to skinthat donot havenormal
sensation.If the skin is numb, stimulationwill notbe felt
andtoo great an intensitymightthen be used
accidentally.
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Manufactured for:
PainManagementTechnologies