YSY Medical EST EVOLUTION User manual

YSY MEDICAL Tel: [phone]
Zac Pole Actif Fax: [phone]
9 avenue de la Fontanisse E-Mail: [e-mail]
30660 Gallargues le Montueux Web: www.ysy-medical.fr
FRANCE
YSY EST
EVOLUTION
USER MANUAL
Version 2.3.6 EN

YSY MEDICAL – 9, Av. de la Fontanisse – 30660 GUALLARGUES LE MONTUEUX Tel : [phone] – Fax : [phone] – Web : www.ysy-medical.fr Page 2 / 88
SUMMARY
WARNING........................................................................................................................................................................3
MISCELLANEOUS .........................................................................................................................................................6
EMC Information – Guidance and Manufacture’s Declaration ................................................................................11
THE REHABILITATION DEVICE.............................................................................................................................13
START / STOP .................................................................................................................................................13
MOUSE USING................................................................................................................................................13
GENERAL DESCRIPTION............................................................................................................................14
COMPUTER CONNECTION.........................................................................................................................14
BACK SIDE ......................................................................................................................................................15
FRONT SIDE....................................................................................................................................................16
BIOFEEDBACK INFORMATIONS..............................................................................................................17
THE SOFTWARE..........................................................................................................................................................19
INTRODUCTION PAGE................................................................................................................................19
QUICK START ................................................................................................................................................20
PRACTITIONERS...........................................................................................................................................24
CREATION / PRACTITIONER ADVICE......................................................................................24
PATIENTS ASSIGNEMENT TO A PRACTITIONER .................................................................25
PATIENTS FILES............................................................................................................................................26
CREATION / PATIENT FILE ADVICE.........................................................................................27
ASSESSMENTS .................................................................................................................................28
HISTORICAL REGISTERED SESSIONS......................................................................................30
DICTIONARY *...............................................................................................................................................40
MAILS...............................................................................................................................................................41
MAIL CREATION / MODIFICATION...........................................................................................42
MOTOR POINTS.............................................................................................................................................44
ANATOMICAL BOARDS ..............................................................................................................................45
BACKUP ...........................................................................................................................................................46
RESTORATION...............................................................................................................................................47
EXPORTATION ..............................................................................................................................................48
IMPORTATION...............................................................................................................................................49
THE BIOFEEDBACK .....................................................................................................................................50
BIOFEEDBACK TESTING..............................................................................................................50
BIOFEEDBACK SCROLLING........................................................................................................52
PERSONALIZED WORK MODELS ..............................................................................................59
WORK MODEL CREATION / MODIFICATION ..........................................................60
MODEL SEQUENCES........................................................................................................61
BIOFEEDBACK PROTOCOLS.......................................................................................................63
PROTOCOL CREATION / MODIFICATION.................................................................64
BIOFEEDBACK LONG SCROLLING...........................................................................................65
BIOFEEDBACK CONTRACTION .................................................................................................66
BIOFEEDBACK LUDIC SCROLLING*........................................................................................67
BIOFEEDBACK LUDIC SCROLLING..........................................................................................68
SLOW FIBERS*.................................................................................................................................68
BIOFEEDBACK QUALITATIVE TESTING *..............................................................................70
THE STIMULATION......................................................................................................................................71
STARTING A STIMULATION........................................................................................................71
STIMULATION PROGRAM SELECTION ...................................................................................72
COMBINE SEVERAL PROGRAMS...............................................................................................73
STIMULATION SCREEN................................................................................................................74
STIMULATION PROGRAM CREATION.....................................................................................76
THE COMPOUND...........................................................................................................................................77
COMBINED SESSIONS....................................................................................................................77
SESSION CREATION / MODIFICATION.....................................................................................78
BIOFEEDBACK STEP......................................................................................................................79
STIMULATION STEP ......................................................................................................................80
THE FAVORITES ...........................................................................................................................................81
THE PARAMETERS.......................................................................................................................................84
SOFTWARE PARAMETERS ..........................................................................................................84
DEFAULT BIOFEEDBACK PARAMETERS................................................................................87
AVAILABLE CABLES AND ACCESSORIES...........................................................................................................88

YSY MEDICAL – 9, Av. de la Fontanisse – 30660 GUALLARGUES LE MONTUEUX Tel : [phone] – Fax : [phone] – Web : www.ysy-medical.fr Page 3 / 88
WARNING
Before using your medical device, read the manual carefully and in its entirety.
Preamble:
This medical device has been designed to collect muscle signals through various probes, sensors or electrodes and can
generate currents of stimulation.
Version of the manual: May 2, 2016.
Date of first placing on the market: 2000 (Decree of March 15, 2010).
Contraindications:
Electrotherapy is contraindicated in the following cases:
•Epilepsy
•Cardiac deficiency (pacemaker and cardiac diseases)
•Pregnancy
•Persons with active deep vein thrombosis or thrombophlebitis
•Persons with actively bleeding tissue or to persons with untreated hemorrhagic disorders
•Persons with infected tissues, tuberculosis, or wounds with underlying osteomyelitis
•Persons with recently irradiated tissues
•Persons with an artificial limb (hip replacement)
•Persons with vesico ureteral reflux
•Persons with post-voiding residual over 100 ml
•Where the patient is insensitive to any feeling on the skin ;
•On damaged skin numb or region or with recent scares (natural or after a surgical operation)
•Where the patient is unable to understand the procedure or unable to distinguish between what is normal and
abnormal. And unable to express any inconvenience.
•The application of electrodes near the thorax may increase the risk of cardiac fibrillation
•Diagnostic of the pain is not clearly known by the MD/therapist
•Cancerous lesions
•Persons with genital prolapse with severe complete externalization of the vagina (for urology and perineal
practice only)
•Vesicoureteral Reflux , obstruction of the urethra, irradiated or fixed urethra for urology and perineal practice
only)
•Electrodes must not place on the carotid region (anterior neck), transcereberally (trough the head),
transthoracically (may cause cardiac arrhythmias).
The Biofeedback doesn’t not do anything in the body, but it is contraindicated in the following cases:
•Person with severe psychosis, depression or obsessional neurosis,
•Debilitated persons
•Psychopathic personalities
However, because resulting functional improvements can require strenuous physical effort, individuals interested in
Biofeedback may need to be aerobically fit.
Biofeedback is dangerous for diabetics and others with endocrine disorders, as it can change the need for insulin and
other medications. Please check with the doctor to see whether this is an appropriate treatment for you.
See Biofeedback and Electrotherapy section just after.
Security measures:
All operations related to patient (for example : connecting probes, connecting electrodes, and their use with the
patient) must be carried out in hygienic routine and mandatory requirements.
The therapist must check the area to be treated and must not impose any kind of therapeutic treatment which might
frighten the patient. He must also take into account any fear which the patient may express.
All the accessories supplied with YSY MEDICAL device (e.g. electrodes) are given as samples.
The use of monophasic stimulation in perineum rehabilitation is forbidden.

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If PC computer is furnished by the final customer, he must find a PC computer that conforms with its electrical safety
standard currently valid (for example: IEC/EN 60950-1).
Never connect other accessories than those delivered by the manufacturer. For example, in case of defected /damaged
wires, contact the manufacturer for the replacement. Never replace the damaged wires by yourself.
Any malfunction must lead to the stop of the device and the manufacturer must be immediately informed.
The technical data of this user manual can be subjected to any modifications without any advance notice.
The stimulator can provide rectangular positive pulses, negative pulses, or a zero average with duration of 30 to 5000µs
and a frequency between 1 to 4000 Hz. The stimulator provides a maximum intensity of 50 mA.
Testing is done with a load of 500 Ohms and a load impedance range between 300 and 3000 Ohms (without change in
amplitude or frequency), in conformity with the standard IEC/EN 60601-1 and IEC 60601-2-10.
Any partial or complete copy of this manual is strictly forbidden, except a writing agreement from YSY MEDICAL.
Any reproduction, modification, partial or full dismantling of internal or external software supplied with the device are
strictly forbidden by YSY MEDICAL.
During the session the patient must be made comfortable and must not be in contact with anything metallic (tables,
other rehabilitation device, etc.) and should be situated at a minimum distance of 1.50 m from the computer, screen and
printer.
For devices which have telemetry, the eye must be at least at 20 cm from the areas of emission and reception signals.
Those areas are located on the medical device and on the mobile unit of telemetry.
The eye must never have a look at the infrared beam or in the direction of the beam. Irreversible eye risks could happen
in case of non compliance with this safety instruction.
During a rehabilitation session, presence of therapist (qualified staff) is compulsory.
The device must be used by a person medically authorized to do it and this person must have received a full training on
the use before by an authorized distributor YSY MEDICAL. In case of doubt, please contact YSY MEDICAL. .
Don’t use the device in damp place (sauna, hydrotherapy…)
This medical device is not suitable for use in the presence of a flammable anaesthetic mixture with air or with oxygen or
nitrous oxide.
Never make the first stimulation session on standing patient.
In exceptional cases, very emotive patients could develop a vagal reaction. This psychological reaction is linked to the
fears of stimulation and loss of control of muscle contraction (contraction without the willing to do it).
This vagal reaction results weakness feeling with syncopal tendency (lipothymia), a slowdown of heart rate, a decrease
of blood pressure. In that case, all the therapist has to do is to stop the stimulation and to lay the patient down with his
legs up, during 5 to 10 minutes in order that weakness feeling disappears.
Never allow the movement that the muscular contraction results in a stimulation session. It is absolutely necessary to
stimulate in isometric.
Don’t use the device on a patient who is connected simultaneously to high frequency surgical equipment; because there
is a risk of provoking irritations or skin burns.
Make sure there is more than one meter between the device and short waves devices, or micro-waves devices, because
there is a risk of causing instabilities in the output currents of stimulator.
Don’t use the device in a place where other devices are used to emit intentionally electromagnetic radiations without a
protection. Mobile communication devices can affect the working of electrical medical equipments.
In case of using electrodes of stimulation which are exceeding 2 mA/cm2, it is requested to have a special attention from
the user.
Do not place the device under or on another device which can produce a temperature superior to the ambient
temperature. Do not put a laptop computer on the device. The device must be settled on a table or other supports, being
attentive to a good air flow below and over the device. The pads that elevate the case should remain in good condition.
All of accessories and cables supplied have been tested as same as the device and therefore are in compliance with
different standards referring to medical devices.
Use exclusively accessories and cables supplied by YSY MEDICAL. Safety of the patient and electric security cannot
be guaranteed by using others cables.
Don’t disconnect stimulation cables from the stimulator during a session when the device is still powered. Stop
beforehand the stimulator.

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An additional mobile base multiple outlet or an extension wire must not be connected to the system.
Probes, electrodes, cables and enclosure of the medical device are the applied parts of the medical device.
The power cord is the disconnection device of the medical device. The medical device must be positioned so that it is
easy to operate the disconnection device.
The user must not touch the patient and the following parts simultaneously:
•The PC computer connected to the medical device,
•Any other electronic equipment,
•The USB cable connected to the medical device,
•The USB connector of the medical device.
It's forbidden to apply electrical stimulation from one side to the other of the head or through the head, directly on
eyes, on mouth, on the front of the neck (especially the carotid sinus), or from electrodes placed on the chest (thorax)
and upper back or through the heart.
Put the device on the scrapheap:
Conform to the directive 2002/96/CE in order to process your electrical or electronic wastes.
It is necessary to take into account following environmental aspects when you want to put your device and accessories
on the scrapheap.
•YSY device, cables, electrodes belong to little chemical wastes (or electrical and electronic wastes). These
components contain lead, tin, copper, iron, and various other metals, plastics…
•Packing materials could be recycled.
•Contact Ysy-Médical in order to get information about the several recycling options.
•Inform the supplier to put the device on the scrapheap.
Otherwise, the manufacturer will do what is necessary at his charges, according to the modalities of eco-tax.
Life span:
A device has a 10-year life span.
Beyond this limit (10 years), the manufacturer is not bound anymore to deliver spare parts, components, or accessories
of the device.
In case of cessation of manufacture, the 10-year delay is brought back to 5 years.
Maintenance of YSY MEDICAL devices
Apart from warranty periods, it is recommended to be sure of the good working of YSY devices, thanks to a checking
and an annual control.
In case of non compliance with this safety instruction, the manufacturer cannot be held responsible in any way and
whatever is the problem on the medical device.
It is recommended to replace Biofeedback/stimulation cables every 2 years minimum. Cables in good condition are
essential to the well working of the medical device and to respect its essential performances.
No maintenance/after sales services can be performed by the final user, except in an hospital where some
maintenance/after sales services can be performed (see "Service Manual") by qualified and authorized person.
No electronic schema is provided with the medical device.
After sales services is provided only by YSY MEDICAL.
No part can be repaired by the final user.
If the device is modified, a control and appropriate checking/testing should be performed to ensure that the medical
device is always usable safely.

YSY MEDICAL – 9, Av. de la Fontanisse – 30660 GUALLARGUES LE MONTUEUX Tel : [phone] – Fax : [phone] – Web : www.ysy-medical.fr Page 6 / 88
Liability:
The manufacturer declines to be liable towards the therapist, the patient or the device for damages of:
Wrong diagnostic
Bad manipulation and bad use of the device or its accessories
Bad interpreting or unknowing of instructions for use.
Negligence, forgetting of procedure towards the patient
Lack of maintenance of the device
Maintenance or repairing done by people or authorities unauthorized by the manufacturer.
The device can be delivered or not with accessories (electrodes or probes for example)
These consumables are delivered initially with new device as sample.
The user must respect the user guide and/or the labelling on packaging for each consumable delivered with device
Each type of electrodes corresponds to a special kind of treatment. Follow exactly the recommendations which are
mentioned on the packaging.
Check with attention if the consumable is for a unique use or personal use (reusable by only one and same person)
All of the accessories must be delivered in a closed packaging
In case of doubt, before use, please contact the manufacturer of medical devices concerned
THE MANUFACTURER CAN’T BE LIABLE IN CASE OF INFECTION TRANSMISSIONS BY CONSUMABLES
DELIVERED AS SAMPLES WITH THE DEVICE.
Training to use:
Training to use the medical device is required. It is provided by the seller during the installation of the medical device,
generally in the medical place of the user.
Training is provided at least once, according to the needs of the user.
This document is used as training support.
MISCELLANEOUS
Windows configuration :
It is imperative to respect the following configurations to ensure the good running of the medical device:
Screen resolution: 1024 x 768 for 4/3 screen, 1280 x 720 for 16/9 screen.
Do not install an economizing device, a screen saver, nor any background programs. Adjust the options of
supply on high Performances.
In case of using a laptop computer, do not use the battery mode during the time of the séance (connect the sector
charger).
Cleaning of the medical device :
Switch off the device and remove the plug from the main electricity supply before handling it.
Recommended for cleaning of the medical device are as follows: mild soap, water, ethylene and acetaldehyde.
The recommended solutions for cleaning of cables are as follows: liquid BURATON, MIKROZID, ETHANOL
70%, SPORACIDIN, CIDEX, STERANIOS.
The cleaning must be done with a soft, dry cloth and a thinner non-caustic detergent recommended above.
Do not pour liquid onto the device, accessory or device to clean or immerse it in a liquid.
Otherwise, contact the manufacturer and discontinue use of the device.
Be sure to remove all traces of cleaning solution remaining after cleaning.
In case of necessary disinfection of the medical devices, use a cleaning product with atomizer specific for
medical devices.
Follow the instructions of use which appears on the cleaning product used.
In any case of doubt, before use it, please contact the manufacturer to get more information.
Example : SURFA’SAFE (ANIOS) – Disinfectant composition: didecyldimethylammonium chloride 1.4 mg/g
and hydrochloride polyhexamethylene biguanide 0.96 mg/g.
Never sterilize the device, nor an accessory or a peripheral.

YSY MEDICAL – 9, Av. de la Fontanisse – 30660 GUALLARGUES LE MONTUEUX Tel : [phone] – Fax : [phone] – Web : www.ysy-medical.fr Page 7 / 88
Accessories and consumables :
Use good quality electrodes in order to obtain a good acquisition and good stimulation.
Use electrodes exceeding 2mA/cm2 must cause a particular attention on the part of the operator.
It is advisable to disinfect the electrodes before use (refer to the procedure specified by the manufacturer of the
electrodes), or even to use a pair of electrodes per patient for a total hygiene.
Similarly, a probe will be used per patient.
The banana red and black cables are used to connect the skin electrodes (known as active) or probe.
The yellow banana plug is used to connect the reference electrode (see chapter reference electrode page 18).
When using the cable acquisition in temperature, place a finger cot on the temperature sensor (single use).
Changing the fuse :
The fuse is located on the rear face of the medical device, near the power switch.
Switch off the device and remove the plug from the main electricity supply before handling it.
Use a flat-head screwdriver to access the fuse holder.
Fuse references are: 800 mA T.
Close the fuse holder before switching on.
Welded fuses:
Nominal
current
Nominal
tension
Breaking capacity
Permissible maximum
voltage difference
Dissipated
power
50 mA
250 Volts
35 A/ 230 V AC - 50-60Hz - Cos φ = 1.0
500 mV
70 mW
315 mA
250 Volts
35 A/ 230 V AC - 50-60Hz - Cos φ = 1.0
140 mV
160 mW
Conditions of warranty and after-sale service :
The device is guaranteed for 1 year + 1 year, parts and labour if returned to YSY MEDICAL (referring to
conditions on the warranty period in the part of guarantee validation) from the shipping date in our warehouse,
for any vice of manufacturing.
The details and the terms of the warranty are the following :
•Intervention / Repair provided in the YSY MEDICAL office, parts and labour : 2 years
•Lending of material if reparation necessary : first year warranty :
•Software updating : first year warranty
•Cable: 1 month
•Accessories: 1 year (for example: pressure case)
For an extension of the warranty conditions, maintenance agreements are at your disposal at the end of the first
year warranty.
Are excluded: the shipment, the accessories, the wires, the shocks, the electric damages, and in general all the
external elements and or failures coming from a bad using of the medical device.
If repairs involved in YSY MEDICAL workshops, repatriation of the equipment is the responsibility of the
customer. No schema is provided with the medical device.
No maintenance/after sales services can be performed by the final user, except in an hospital where some
maintenance/after sales services can be performed (see "Service Manual") by qualified and authorized person.
The after sale service must be provided by YSY MEDICAL.
The medical device must not be opened.
If the device is opened in a place other than the YSY MEDICAL workshop, the warranty is automatically
cancelled.
Red labels, black writing on screws guaranty the inviolability.
No part can be repaired by the user.

YSY MEDICAL – 9, Av. de la Fontanisse – 30660 GUALLARGUES LE MONTUEUX Tel : [phone] – Fax : [phone] – Web : www.ysy-medical.fr Page 8 / 88
Validation of Warranty:
The device is delivered with a warranty card, of which supplier copy must be integrally full completed and
return to us, in an envelope provided with the device.
A defect of this registration document, within the 15 days after the delivery, will lead to a nullity of the second
year of warranty and also the impossibility to access to our technical assistance. On the other hand, all card
which is not correctly and full completed won’t be taken into consideration.
YSY MEDICAL software supplied on CD with your device is limited to 50 openings.
Beyond you couldn’t use it.
From reception of your warranty card, fully completed, we will validate your warranty by the registration and
henceforth you could access to our after sales assistance. Within 2 working days, you will receive on your
email address given on the card, your activation key, which will allow you to use totally your software.
Windows printing :
The colour printing of the several software results have been successfully tested with some kind of printer.
We are unable to guarantee a good quality of printing for all existing printer.
In case of printing problems, use the export function, and print the image file with external software.
Description of graphical symbols indicated for using, storage and transport:
SYMBOL Description
Fragile. Handle with care.
Protect from moisture.
Refer to the operating instructions.
Warning.
Temperature limits. + 10 To + 40 ° C / 50°F to 104°F

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Restrictions for the use of the medical device:
Humidity limits: from 30 to 90% humidity.
Temperature limits: +10 to +40 ° C / 50°F to 104°F.
Atmospheric pressure limits: from 700 to 1060 PA
Restrictions for storage of the medical device:
Humidity limits: from 30 to 90% humidity.
Temperature limits: +10 to +40 ° C / 50°F to 104°F.
Atmospheric pressure limits: from 700 to 1060 PA
Restrictions for the transport of the medical device:
Humidity limits: from 30 to 90% humidity.
Temperature limits: -50 to +40 ° C / -58°F to 104°F.
Atmospheric pressure limits: from 200 to 1060 PA
Unpacking the device:
After having unpacked of device, place it in a room with an ambient temperature (around 20°C and 30°C) and
then wait 1 hour at least. If there is condensation when unpacking the device, don’t switch on the device.
Wait for at minimum 12 hours before switching it on to remove condensation.
Referred software:
This manual referred to the YSY EST EVOLUTION 2 and YSY EST EVOLUTION 4 software.
Version : 3.7.7 EN.
If some elements appears on this manual and not in your software, that means they are optional. All of the
options are available for purchase to your YSY MEDICAL distributor.
Telemetry:
Never look at the infra red beam.
Battery used : Alkaline LR6 9V - classification BF. Never use different battery from the one recommended
above. In the event of non use of the device, withdraw the battery of its case.
Uninterruptible Power Supply (UPS):
The use of an UPS with the device is fully recommended. To settle an UPS, follow with attention the manual
of installation delivered with the UPS.
Humidity limits. 30-90% Humidity.
Atmospheric pressure limits: from 700 to 1060 PA
Do not store or transport the device in places at high temperatures or sunlight directly.

YSY MEDICAL – 9, Av. de la Fontanisse – 30660 GUALLARGUES LE MONTUEUX Tel : [phone] – Fax : [phone] – Web : www.ysy-medical.fr Page 10 / 88
Medical device class and symbols:
2012
Manufacturer Symbol with full address and year of conception
Serial number of medical device
Waste processing
Warning Security symbol. Read with attention the user manual
Class II device
Functioning instructions. Read the user manual
BF type device.
Protection index IP 40
Medical Device (DM) certified CE by the notify body SGS (number 0120).
Model
Model of Medical device
Output
Output
BIPH./MONO
Biphasic / Monophasic
Frequency
Frequency of the pulse

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EMC Information – Guidance and Manufacture’s Declaration
Guidance and manufacturer’s declaration - electromagnetic emissions
The equipment YSY EST EVOLUTION 4 is intended for use in the electromagnetic environment specified
below. The user must ensure of the use in such special environment.
Emission Test Compliance Electromagnetic environment - Guidance
RF Emissions
CISPR 11 Group 1
The equipment of reference YSY EST EVOLUTION 4
uses only the energy of frequency emissions for its
internal functions. In that way, emissions RF are very
low and do not provoke any interference with electronic
equipments which are close to.
RF Emissions
CISPR 11 Class A The equipment of reference YSY EST EVOLUTION 4
can be used in domestic offices including those are
directly connected to the public low voltage power
supply network that supplies buildings used for
domestic purposes.
Harmonic Emissions
IEC 61000-3-2 Class A
Voltage fluctuations / Flicker
emissions IEC 61000-3-3 Complies
Guidance and manufacturer’s declaration – electromagnetic immunity
The equipment YSY EST EVOLUTION 4 is intended for use in the electromagnetic environment specified
below. The user must ensure of the use in such special environment.
Immunity Test IEC 60601
test level Compliance level Electromagnetic Environment -
guidance
Electrostatic
discharge
IEC 61000-4-2
±6 kV contact
±8 kV air
±6 kV contact
±8 kV air
Floors should be wood, concrete or
ceramic tile. If floor
are covered with
synthetic material, the relative humidity
should be at least 30%.
Eclectrical fast
transient/burst
IEC 61000-4-4
±2 kV for power
supply lines
±1 kV for input
/output lines
±2 kV for power
supply lines
±1 kV input/output
lines
Mains power quality should be that of a
typical commercial or hospital
environment.
Surge
IEC 61000-4-5 ±1 kV line to line
±2 kV line to ground
±1 kV line to line
±2 kV line to ground
Mains power quality should be that of a
typical commercial or hospital
environment.
Voltage dips, short
interruptions and
voltage variations
on power supply
input lines
IEC 61000-4-11
•<5% UT– during 10
ms
•40% UT– during
100 ms
•70% UT– during
500 ms
•<5% UT– during
5 s
•<5% UT– during 10
ms
•40% UT– during
100 ms
•70% UT– during
500 ms
•<5% UT– during
5 s
Mains power quality should be that of a
typical commercial or hospital
environment. If the user of
YSY EST
EVOLUTION 4 requires continued
operation during
power mains
interruptions, it is
recommended that
YSY EST EVOLUTION 4
be powered
from an uninterruptible power supply or
a battery.
Power frequency
(50Hz/60Hz)
magnetic field
IEC61000-4-8
3 A/m 3 A/m
Power frequency magnetic fields should
be at levels characteristic of a typical
location in a typical commercial or
hospital environment.
Note : UTis the a.c. mains voltage prior to application of the test level.

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Guidance and manufacturer’s declaration – electromagnetic immunity
The equipment YSY EST EVOLUTION 4 is intended for use in the electromagnetic environment specified
below. The user must ensure of the use in such special environment.
Immunity test IEC 60601 test
level Compliance
level
Electromagnetic Environment - Guidance
Portable and mobile RF communications equipment
should be used no closer to any part of
F3 Fetal
Monitor including
cables, than the recommended
separation distance calculated from the equation
applicable to the frequency of the transmitter.
Recommended separation distance
Conducted RF
IEC 61000-4-6 3 Vrms 150 kHz to 80 MHz V
[ ]
Pd 17,1=
Radiated RF
IEC 61000-4-3
3 V/m
80 MHz to 2,5 GHz
V/m
[ ]
Pd 17,1=
80 MHz to 800 MHz
[ ]
Pd 33,2=
800 MHz to 2,5 GHz
Where P is the maximum output power rating of the
transmitter in watts (W)
according to the transmitter
manufacturer and d is the recommended separation
distance in meters (m).
Field strengths from fixed RF transmitters, as
determined by an electromagnetic site surveya, should
be less than the compliance level in each frequency
rangeb.
Interference may occur in the vicinity of equipment
marked with the following symbol:
Note 1. At 80 MHz and 800 MHz, the higher frequency range applies.
Note 2. These guidelines may not apply in all situations. Electromagnetic propagation is affected
by absorption and reflection from structures, objects and people.
a Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless)
telephones and
land mobile radios, amateur radio, AM and FM radio broadcast and TV broadcast
cannot be predicted
theoretically with accuracy. To assess the electromagnetic environment due to
fixed RF transmitters, an
electromagnetic site survey should be considered. If the measured field strength in the location in which
YSY EST EVOLUTION 4 is used exceeds the applicable RF compliance level above,
YSY EST
EVOLUTION 4 should be observed to verify normal operation. If abnormal
performance is observed,
additional measures may be necessary, such as reorienting or relocating F3 Fetal Monitor.
b Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 3 V/m.

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Recommended separation distances between portable and mobile RF communications equipment and the
equipment reference YSY EST EVOLUTION 4
Equipment reference YSY EST EVOLUTION 4 is intended to be used in an electromagnetic environment in
which radiated RF disturbances are controlled. The user of the equipment reference YSY EST EVOLUTION 4
can help prevent electromagnetic interference by maintaining a minimum distance between portable and
mobile RF (transmitters) communications equipment and the equipment referenced YSY EST EVOLUTION 4
as recommended below, according to the maximum output power of the communications equipment.
Maximum output power
rating of the transmitter
W
Separation distance depending on the frequency of the transmitter m
150 kHz to 80 MHz 80 MHz to 800 MHz 800 MHz to 2,5 GHz
[ ]
Pd 17,1=
[ ]
Pd 17,1=
[ ]
Pd 33,2=
0,01 0,12 0,12 0,23
0,1 0,37 0,37 0,74
1 1,17 1,17 2,33
10 3,70 3,70 7,37
100 11,7 11,7 23,3
For the transmitters whose maximum output power is not listed above, the recommended separation distance
d in meters (m) can be determined using the equation applicable to the frequency of the transmitter, where P
is the maximum output power of the transmitter in watts (W) assigned by the transmitter manufacturer.
Note 1 At 80 MHz and 800 MHz, the separation distance given in the higher frequency band applies.
Note 2 These recommendations may not apply in all situations. The propagation of electromagnetic waves is
modified by absorption and reflection from structures, objects and people.
L'APPAREIL DE REEDUCATION
THE REHABILITATION DEVICE START / STOP
Switch on the rehabilitation device by using the button located at the back side of the medical device. Position
1: On ; position 0 : Off. When the device is ON, a green light appears automatically on the front side of the medical
device (the left to M/A inscription).
Microsoft Windows start automatically by the starting on the computer. Once started, and once the software
installed, double click with the mouse left button on the « YSY » icon, used as a short cut.
To switch off the device, choose “File" then "Quit" in the main menu. Once back to the Microsoft Windows
office, press on "Start", then "Stop", then choose "Turn off the computer". Once this message appears press the Stop
button (setting not under tension) located on the front side of the medical device (except for the computer with an
automatically stop – ATX Box ). You can switch off the medical device.
USING THE MOUSE
The mouse cursor, visible on the screen, moves with the movements of the mouse on the desk.
All those actions are available with on pressure on the mouse left button (except opposite indications).

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GENERAL DESCRIPTION
The rehabilitation device YSY EST EVOLUTION is delivered with the following equipments:
YSY EST EVOLUTION 2 :
2 Acquisition cables CAB-EMG333 (input grey plug, output 3 male banana plugs 2 mm, red, black and yellow)
1 Acquisition cable CAB-EMG115 (input 2 female banana plugs 2 mm red and black, output DIN 5 female)
1 Unit Air Pressure Air/Muscle 1 channel
YSY STIM 4 :
4 Cables CAB-EMG333 (input grey plug, output 3 male banana plugs 2 mm, red, black and yellow)
1 Cable CAB-EMG115 (input 2 female banana plugs 2 mm red and black, output DIN 5 female)
YSY EST EVOLUTION 4 :
4 Acquisition cables CAB-EMG333 (input grey plug, output 3 male banana plugs 2 mm, red, black and yellow)
1 Acquisition cable CAB-EMG115 (input 2 female banana plugs 2 mm red and black, output DIN 5 female)
1 Unit Air Pressure Air/Muscle 2 channels
Common to all devices:
1 Pack of electrodes (2mm female banana plug) - Sample
1 bipolar sector cable
1 USB-Serial Converter HL-340 OR 1 M/F Serial cable.
1 software installation CD-rom (keep this support safe from the light and moisture).
Optional:
1 temperature cable with temperature sensor.
For the medical devices delivered with a PC computer, the Microsoft Windows licence is automatically furnished
COMPUTER CONNECTION
The YSY EST EVOLUTION software is compatible with the following operating systems:
Microsoft® Windows® XP (Service Pack 1 or 1a, Service Pack 2, Service Pack 3),
Microsoft® Windows® Vista,
Microsoft® Windows® Seven.
Microsoft® Windows® 8 or 8.1
Microsoft® Windows® 10
Please contact the YSY MEDICAL technical service for a use with another operating system.

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BACK SIDE
The bipolar sector plug that permits the plug in of the device has to be connected on the sector.
Position 1: On.
Position 0: Off.
When the device is ON, a green light appears automatically on the front side of the device (left to M/A inscription).
Do not disturb the air evacuation from the rear side.
Do not place objects on top of the medical device.
Do not remove the pads beneath the medical device, allowing it to raise.
The DB 9 Female connector allows the connection to the PC computer by USB-Serial Converter OR the serial cable.
Button
ON (1)
OFF (0)
Fuse
Sector
DB 9 F
Connector
Ventilator
(present in certain
cases)

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FRONT SIDE
This front face (see following schema) concerns all devices with the following characteristics:
•2 EMG channels
•2 Stimulation channels (for YSY EST EVOLUTION 2)
•1 manometric channel (for YSY EST EVOLUTION 2)
•4 Stimulation channels (for YSY EST EVOLUTION 4 or STIM 4)
•2 manometric channels (for YSY EST EVOLUTION 4)
Led 1: yellow colour. Switched on when the stimulation channel 1 is activated.
Led 2: yellow colour. Switched on when the stimulation channel 2 is activated.
Led 3: yellow colour. Switched on when the stimulation channel 3 is activated.
Led 4: yellow colour. Switched on when the stimulation channel 4 is activated.
Led 5: green colour. Switched on when the device is ready to use.
Do not disturb the air evacuation from the above and lower part of the device.
*Telemetry is optional.
Telemetry Window
Manometric
Channel
Channel 3 and 4
(Stimulation and
EMG)
Potentiometer of
Stimulation Channel 1
Channel 1
(Stimulation
and EMG)
Channel 2
(Stimulation
and EMG)
Leds
1 - 2 - 3 - 4 - 5
Potentiometer of Stimulation
Channels 3 and 4
Potentiometer of
Stimulation Channel 2
Symbol “Caution, please
consult the accompanying
documents”

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BIOFEEDBACK INFORMATIONS
•Reference electrodes
The reference electrode is the same for EMG 1 and EMG 2.
It should be connected mandatory for proper operation of the device in biofeedback.
The reference electrode is useless when using a probe with an incorporated reference (3 rings probes for example).
The reference electrode is connected on the yellow banana plug from the cable EMG1 and EMG2.
When a probe with DIN plug is used with the cable EMG1, the reference electrode must be connected on the yellow
banana plug of cable EMG2.
For biofeedback, it is imperative to use biofeedback electrodes.
•Pressure unit
Using the 3 ways tap
Once the pressure probe filled with air
(inflated), make swivel the tap of 180° (see
diagram below)
•Zero - Calibration
Using protocol to perform the calibration:
-Connect the probe on cable EMG1 (red and black plugs) and the electrodes on cable EMG2 if necessary
(red and black plugs).
-connect a reference (on a bony point of the patient) on a yellow plug electrode (cable channel 1 or cable
channel 2)
-Ask the patient not to make any contraction. The curve must go down and be stabilized.
-Make the zero if necessary (remove the base tonus).
-Verify the measured value is between -1 and 1.
-When the patient contracts, the curve goes up instantaneously.
-Press the "Auto" button to adjust the sensitivity of both channels with the value of maximum contraction
of the patient.
See the "Quick start" section for more information.
Pressure channel
1 2 3
Medical device
Pressures Unit
Tap 3
Channels
Pressure
Probe
Pressure
Unit
Pressure
Probe
Filling probe
(Air) with
syringe

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•Perisize probe
The Perisize probe allows many connections with 1 channel of EMG or 1 channel of stimulation.
There are 2 wires: 1 short and 1 long, for each side of the probe.
-Simple connection EMG / Stimulation :
OR
On the 2 short wires On the 2 long wires.
-Total connection EMG / Stimulation :
Utilization of Y dedoubler : It allows to use the 4 rings of the
Perisize probe with only 1 channel.
OR
Red: connection to the 2 short wires.
Green: connection to the 2 long wires.
To learn how to use the probe, contact the manufacturer of the medical device.

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THE SOFTWARE INTRODUCTION PAGE
To reach the wanted program, click with the mouse left button on the main menu above the upper window, then click on
the program to be executed.
Some icons used as shortcuts are located around the YSY MEDICAL logo (see the above screen picture).
The left part concern the administration, the right part, the treatments.
Icons description:
Anatomical boards Biofeedback Testing
Sessions history (patient concerned) Biofeedback Scrolling
Assessments (patient concerned) Biofeedback Long Scrolling
Patients files access Biofeedback Contractions
Practitioner access Biofeedback Ludic Scrolling
Access to this user manual Biofeedback Qualitative Testing
Favourites access Stimulation
Combined sessions
The others software opportunities are reachable through the main menu on the top of the window screen.
The programs or icon in grey colour are not available, except the administration icons, on the left part (Patients files,
Assessments and Sessions history) which are automatically activated when a practitioner and then a patient are selected.
To quit the program, select "Quit" in the menu "File", or click the red cross above on the right side of the window.
Main
Menu

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QUICK START
Step 1 : Selection of practitioner to acces to his patients files :
To start a session without select a patient file, go to step 3
(page 22).
Click on the button of practitioner access.
Click on the button "Create"
to open the window creation o
the practitioner.
Enter the practitioner information.
Then click on the button "Register".
Select the practitioner in the list, then click on the button
"Select".
The practitioner is now selected and you have access to his
patients’ files.