Enraf Nonius TensMed S84 Operating Manual
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Enraf Nonius TensMed S84 Operating Manual

Enraf Nonius TensMed S84 Operating Manual

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PASSION FOR MOTION
TensMed S84
Operating Manual

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Summary of Contents for Enraf Nonius TensMed S84

  • Page 1 PASSION FOR MOTION TensMed S84 Operating Manual...
  • Page 2 TensMed S84 Operating Manual Enraf-Nonius...
  • Page 3 Enraf-Nonius B.V. P.O Box 12080 3004 GB Rotterdam The Netherlands Tel: +31 (0)10 – 20 30 600 Fax:+31 (0)10 – 20 30 699 Info@enraf-nonius.nl www. enraf-nonius.com Art. Number: 1427.781_40 January 2009 Enraf-Nonius...

  • Page 4: Table Of Contents

    Contents FOREWORD ..................5 This Manual ................... 5 PRODUCT LIABILITY ................5 INSTALLATION ..................6 PRECAUTIONARY MEASURES ............6 INTENDED USE ..................7 TENS for Pain Management ..............7 5.1.1 Indication/ Contraindications ............7 NMES ....................8 5.3.1 Indication/Contraindications for NMES ......... 9 OPERATION ..................
  • Page 5 15.2 SPORT .................... 37 15.2.1 MAXIMUM FORCE ..............38 15.2.2 RESISTANCE FORCE ..............40 15.2.3 RECOVERY ................42 15.2.4 TONING ..................44 15.2.5 DRAINAGE .................. 47 15.2.6 UROLOGY .................. 49 15.2.7 HEMIPLEGIA ................51 INTRODUCTION TO TENS ..............56 16.1 Placement of electrodes ..............

  • Page 6: Foreword

    FOREWORD This Manual This manual has been written for the owners and operators of the TensMed S84. It contains general instructions on operation, precautionary practices, maintenance and parts information. In order to maximize the use, efficiency and lifespan of your unit, please read this manual thoroughly and become familiar with the controls as well as the accessories before operating the unit.

  • Page 7: Installation

    Keep the stimulator, battery compartment and charger free of foreign matter (soil, water, metal, etc.) • Do not use the TensMed S84 if any of the elements are damaged (case, cables, etc.) or if the battery compartment is open. There is a risk of electric shock. •...

  • Page 8: Intended Use

    • Do not place electrodes directly over the uterus or connect pairs of electrodes across the abdomen if you are pregnant. The reason is that, theoretically, the current could affect the foetus’s heart (although there are no reports of it being harmful). •...

  • Page 9: Nmes

    • The long-term effects of chronic electrical stimulation are unknown. • Pregnant women should not be treated with the TensMed S84 during the first trimester (12 weeks). • Stimulation should not be applied over swollen, infected, or inflamed areas of skin eruptions e.g., phlebitis, thrombophlebitis, varicose veins, etc.

  • Page 10: Indication/Contraindications For Nmes

    5.3.1 Indication/Contraindications for NMES Indications: • Relaxation of muscle spasms. • Prevention or retardation of disuse atrophy. • Increasing local blood circulation. • Muscle re-education. • Immediate post-surgical stimulation of calf muscles to prevent venous thrombosis. • Maintaining or increasing range of motion. Contraindications: •...

  • Page 11: Operation

    OPERATION Overview Control Buttons ON/OFF Turns the stimulator on and off. Can be used for terminating the stimulation at all times. 2. RETURN BUTTON To return to the previous menu 3. INCREASE/DECREASE Increases and decrease the amplitude in channel 1 (intensity of stimulation). Press and hold the button to increase or decrease the amplitude continuously.

  • Page 12: Display Symbols

    Warning: • Use only the rechargeable battery pack supplied by Enraf-Nonius. • Never recharge the TensMed S84 without first disconnecting all stimulation cables. • Do not recharge the battery with a charger other than that supplied by Enraf-Nonius. Display Symbols BROKEN CIRCUIT Broken circuit.

  • Page 13: Step-By-Step-Use

    Step-by-Step-Use The TensMed S84 can be used for TENS and NMES treatment. Use only those treatment programs that your health care provider has determined are the most effective for your needs. The stimulator has four simultaneous channels, which means that four channels stimulate with the same program.
  • Page 14 1. Switch the stimulator ON MAIN MENU Press the ON/OFF [1]. This button can be used NMES for terminating the stimulation at all times. TENS CUSTOM PROGRAMS PROGRAMMING 2. Select a function in the MAIN MENU MAIN MENU Press the button to select a function.
  • Page 15 4. Select Indication REHAB Press the button to select an indication ATROPHY Push confirmation button to select. FORCE MOBILIZATION 1 MOBILIZATION 2 FACILITATION  5. Select BODY PART Press the button to select a Body Part BODY PART Push START button. SHOULDER ...

  • Page 16: Single Programming

    Single programming Step 1 MAIN MENU Press the button to select programming NMES Push confirmation button to select TENS CUSTOM PROGRAMS PROGRAMMING  STEP 2 PROGRAMMING Press the button to select a function. NMES Push confirmation button to select. TENS ...

  • Page 17: Sequential Programming

    STEP 4 P_CONVENTIONAL Press the button to select a parameter Modify the parameter with the buttons µs under symbols + / - Push SAVE button to store. 30:00  + / - SAVE STEP 5 ENTER NAME Overwrite the name and push the SAVE button to store the program.
  • Page 18 STEP 2 PROGRAMMING Press the button to select a function. NMES Push confirmation button to select. TENS Note! Sequential programming is only possible with NMES  STEP 3 NMES Press the button to select SEQUENTIAL CONVENTIONAL CONVENT. or SEQ. MOD. FREQUENCY MOD.
  • Page 19 STEP 5 P_SEQUENTIAL CONVE Press the button to select the phase duration. Modify the with the buttons 30:00 µs Press the button to select the time in sequence 1. Modify the with the buttons 04:00 26:00 02:00 Push the + button under Modify the frequency with the buttons ...

  • Page 20: Programs

    The program is stored under de selected name and can be retrieved via Custom Programs in the main menu. PROGRAMS Preset Programs – TENS The TensMed S84 has 32 preset TENS programs for pain relief. These programs are created under 3 groups: • GENERAL •...

  • Page 21: Custom Programs

    Custom Programs With the TensMed S84 it is possible to create and store 15 custom programs for patient-specific treatment. To create a custom program, follow the programming procedure below. To use a custom program, follow the instructions in the CHAPTER 5.4 and 5.5 ACCESSORIES The TensMed electrodes will eventually wear out and have to be replaced.

  • Page 22: 11 Frequently Asked Questions

    THE STIMULATION FEELS WEAK OR NOT AT ALL • Check if the battery pack needs to be recharged. • Electrodes are too old and need replacement. THE BROKEN CIRCUIT SYMBOL IS SHOWN ON THE DISPLAY SYMBOL The broken circuit symbol indicates that the resistance is too high, or that a cable is broken or unplugged.

  • Page 23: 12 Technical Data

    Remember that the patient may develop sore muscles after NMES treatment. 12 TECHNICAL DATA The TensMed S84 is a four channel stimulator for both muscle rehabilitation (NMES) and pain relief (TENS) and features 107 preset programs and 15 custom programs.

  • Page 24: Used Symbols

    The TensMed S84 is designed to be used in typical domestic or clinical environments and is approved according to the EMC safety standard of EN 60601-1-2. The TensMed S84 emits very low levels in the radio frequency (RF) interval. Therefore it is not likely to cause any interference in nearby electronic equipment (radios, computers, telephones etc.).The TensMed S84 is designed to withstand foreseeable disturbances originating from...
  • Page 25 Guidance and manufacturer’s declaration – electromagnetic immunity The TensMed S84 is intended for use in the electromagnetic environment specified below. The customer or the user of the TensMed S84 should assure that it is used in such an environment. Immunity test...
  • Page 26 Guidance and manufacturer’s declaration – electromagnetic immunity The TensMed S84 is intended for use in the electromagnetic environment specified below. The customer or the user of the TensMed S84 should assure that it is used in such an environment. Immunity test...
  • Page 27 RF transmitters, an electromagnetic site survey should be considered. If the measured field strength in the location in which the TensMed S84 is used exceeds the applicable RF compliance level above, the TensMed S84 should be observed to verify normal operation.

  • Page 28: 13 Ordering Details

    13 ORDERING DETAILS 1427.980 TensMed S84 Standard accessories 3444.220 Set Patient cables 4 pc. Self adhesive electrodes 2 sets of 4 pc. 1427.781 Operating manual TensMed S84 3444.344 Carrier case 3444.345 Belt clip 3444.325 Charger 3444.330 Battery pack Optional accessories 3444.056 Self adhesive electrodes, size 32mm Ø, 1 pack = 10 sheets of 4 pc...

  • Page 29: Indications

    14.1.2 Indications • Neuromuscular facilitation • Maintaining and increasing range of motion • Circulation increase • Prevent atrophy/hypotrophy • Reduction of spasticity • Peroneal nerve stimulation • Incontinence treatment • Pain relief 14.1.3 Placement of electrodes The placement of the electrodes is significant for the best results. Select the electrode size according to the muscle group to be treated.

  • Page 30: 15 Nmes Programs

    15 NMES PROGRAMS 15.1 REHAB 15.1.1 ATROPHY The training focuses on aerobic metabolism, training mainly type I fibres to improve stamina in the muscle. Each program consists of two sequences. The first is a warm-up sequence that prepares the patient for the second – the training sequence. During the training sequence, the amplitude must be set so that visible muscle contractions occur.
  • Page 31 Body Zone BACK – TRUNK Muscle latissimus dorsi, pectorals, abdominals, spinal erectors Placement of Use 4 small or 2 large electrodes. Vary the placement the electrodes to find the optimum location Feel free to combine training with active movements Body Zone Muscle gluteus medius, gluteus maximus, tensor fascia latae Placement of...
  • Page 32 Body Zone FOOT Muscle abductor hallucis Placement of Use 2 extra small electrodes. Vary the placement to the electrodes find the optimum location Intensity Visible muscle contractions without pain Treatment Time 24:50 minutes ATROPY Sequence 1 Sequence 2 Sequence 3 Time (min) 5:00 19:50...

  • Page 33: Force

    15.1.2 FORCE The training focuses on aerobic metabolism, training mainly type II fibres to improve stamina in the muscle. Each program consists of three sequences. To ensure balanced training, the program always starts with a warm-up and ends with a recovery sequence. The middle sequence is the actual strength training sequence, and it is crucial that the amplitude is set on a strong level, but not a painful one.
  • Page 34 Body Zone LOWER ARM Muscle carpal flexors, carpal extensors, brachioradial muscle Placement of Use 4 small or 2 large electrodes. Vary the placement the electrodes to find the optimum location Feel free to combine training with active movements Body Zone BACK –...

  • Page 35: Mobilisation 1 + 2

    Body Zone LOWERLEG Muscle anterior tibial, posterior tibial, peroneal, gastrocnemial Placement of Use 4 small or 2 large electrodes. Vary the placement the electrodes to find the optimum location Feel free to combine training with active movements Body Zone FOOT Muscle abductor hallucis Placement of...

  • Page 36: Mobilisation 1 + 2

    MOBILISATION Indication Post-operative, muscles that have been immobilized for some time or are weakened. Body Zone SHOULDER Muscle deltoid, infraspinal, supraspinal, teres minor Placement of Use 4 small or 2 large electrodes. Vary the placement the electrodes to find the optimum location Feel free to combine training with active movements Body Zone UPPERARM...
  • Page 37 Body Zone Muscle gluteus medius, gluteus maximus, tensor fascia latae Placement of Use 4 small or 2 large electrodes. Vary the placement the electrodes to find the optimum location Feel free to combine training with active movements Body Zone THIGH – KNEE Muscle Quadriceps (rectus femoris) Placement of...

  • Page 38: Facilitation

    Intensity Visible muscle contractions resulting in movement, without pain. Treatment Time 15 minutes MOBILISATION 1 Sequence 1 Sequence 2 Sequence 3 Time (min) Pulse duration (μs) Frequency (Hz) Ramp up time (sec) Hold time (sec) Ramp down time (sec) Rest (sec) MOBILISATION 2 Sequence 1 Sequence 2...

  • Page 39: Maximum Force

    15.2.1 MAXIMUM FORCE MAXIMUM FORCE Indication Increases the capacity for maximum strength development, and increases muscle mass. Recommended for people whose sports require maximum strength. Body Zone SHOULDER Muscle deltoid Body Zone UPPERARM Muscle brachial, brachial biceps, brachial triceps Body Zone LOWER ARM Muscle carpal flexors, carpal extensors, brachioradial muscle...
  • Page 40 Body Zone BACK – TRUNK Muscle latissimus dorsi, pectorals, abdominals, spinal erectors Current International standards require that a warning be given concerning the application of electrodes to the thorax (increased risk of cardiac fibrillation). Body Zone Muscle gluteus medius, gluteus maximus, tensor fascia latae Body Zone THIGH –...

  • Page 41: Resistance Force

    Intensity Maximum muscle contractions without pain. Active rest should generate muscle vibrations. Treatment Time 30:45 minutes MAXIMUM FORCE Sequence 1 Sequence 2 Sequence 3 Time (min) 15:45 Pulse duration (μs) Frequency (Hz) 3 – 10 50 – 70 2 – 8 Modulation time (sec) Rest Frequency (Hz) Ramp up time (sec)
  • Page 42 Body Zone LOWER ARM Muscle carpal flexors, carpal extensors, brachioradial muscle Body Zone BACK – TRUNK Muscle latissimus dorsi, pectorals, abdominals Current International standards require that a warning be given concerning the application of electrodes to the thorax (increased risk of cardiac fibrillation).

  • Page 43: Recovery

    Body Zone LOWERLEG Muscle anterior tibial, posterior tibial, peroneal, gastrocnemial Intensity Medium to strong muscle contractions. Active rest should generate muscle vibrations. Treatment Time 33 minutes RESISTANCE Sequence 1 Sequence 2 Sequence 3 Time (min) Pulse duration (μs) Frequency (Hz) 3 –...
  • Page 44 Body Zone UPPERARM Muscle brachial, brachial biceps, brachial triceps Body Zone LOWER ARM Muscle carpal flexors, carpal extensors, brachioradial muscle Body Zone BACK – TRUNK Muscle latissimus dorsi, pectorals, abdominals Current International standards require that a warning be given concerning the application of electrodes to the thorax (increased risk of cardiac fibrillation).

  • Page 45: Toning

    Body Zone THIGH – KNEE Muscle femoral biceps, quadriceps Body Zone LOWERLEG Muscle anterior tibial, posterior tibial, peroneal, gastrocnemial Intensity Visible muscle vibrations. Treatment Time 10 minutes RESISTANCE Sequence 1 Sequence 2 Sequence 3 Time (min) Pulse duration (μs) Frequency (Hz) 15.2.4 TONING TONING...
  • Page 46 Body Zone UPPERARM Muscle brachial, brachial biceps, brachial triceps Body Zone LOWER ARM Muscle carpal flexors, carpal extensors, brachioradial muscle Body Zone BACK – TRUNK Muscle latissimus dorsi, pectorals, abdominals Current International standards require that a warning be given concerning the application of electrodes to the thorax (increased risk of cardiac fibrillation).
  • Page 47 Body Zone THIGH – KNEE Muscle femoral biceps, quadriceps Body Zone LOWERLEG Muscle anterior tibial, posterior tibial, peroneal, gastrocnemial Intensity Medium-intensity muscle vibrations. Treatment Time 25 minutes TONING Sequence 1 Sequence 2 Sequence 3 Time (min) Pulse duration (μs) Frequency (Hz) 25 –...

  • Page 48: Drainage

    15.2.5 DRAINAGE DRAINAGE Indication Activates the circulation through a pumping effect of the muscles. Gives effective elimination of waste products. The drainage programs are serial contraction programs, which means that the muscles are stimulated one after each other in a series. Body Zone SHOULDER Muscle...
  • Page 49 Body Zone Muscle gluteus medius, gluteus maximus, tensor fascia latae Body Zone THIGH – KNEE Muscle femoral biceps, quadriceps Body Zone LOWERLEG Muscle anterior tibial, posterior tibial, peroneal, gastrocnemial Intensity Visible muscle vibrations. Note: There are 42 loops. Sequence 1 is on channel 1+2 only, Sequence 2 is on channel 1+2+3+4 Treatment Time 20:39 minutes...

  • Page 50: Urology

    15.2.6 UROLOGY Urinary incontinence is a major problem for many people. We can define two main types of urinary incontinence. 15.2.6.1 Urge incontinence Urge incontinence means a sudden, intense, uncontrollable urge. Sometimes major urine leakage cannot be prevented due to an involuntary contraction of the bladder. Both men and women can be affected, particularly older adults.
  • Page 51 MIXED INCONTINENCE 2 In cases of mixed incontinence, the stimulation treats both urge and stress incontinence. Treatment Time: 14:56 minutes Sequence 1 Sequence 2 Sequence 3 Time (min) 14:56 Pulse duration (μs) Frequency (Hz) Stimulation time (sec) Rest time (sec) 15.2.6.3 Stress incontinence Stress incontinence means that the urine leak is caused by increased abdominal pressure during physical activity.

  • Page 52: Hemiplegia

    PELVIC FLOOR PAIN Treatment Time: 15 minutes Sequence 1 Sequence 2 Sequence 3 Time (min) Pulse duration (μs) Frequency (Hz) 15.2.7 HEMIPLEGIA NMES is an excellent complement to traditional physiotherapy after a stroke. It can be used to aid facilitation and relearning of motor skills, and also to reduce spasticity. When used to treat spasticity, the electrodes can be placed on the agonist or the antagonist.
  • Page 53 HEMIPLEGIA - ARM Intensity: Visible muscle contractions without pain, ideally resulting in movement. Treatment Time: 20:18 minutes Placement of electrodes 2 large electrodes. Vary the placement to find the optimum location Muscles: brachial triceps, carpal extensors Sequence 1 Sequence 2 Sequence 3 Time (min) 20:18...
  • Page 54 HEMIPLEGIA - HIP and THIGH Intensity: Visible muscle contractions without pain, ideally resulting in movement. Treatment Time: 19:49 minutes Placement of electrodes Combine 2 small and 2 large electrodes. Vary the placement to find the optimum location Muscles: gluteus medius, gluteus maximus, tensor fascia latae, quadriceps Sequence 1 Sequence 2...
  • Page 55 HEMIPLEGIA - LOWER LEG Intensity: Visible muscle contractions without pain, ideally resulting in movement. Treatment Time: 19:49 minutes Placement of electrodes 2 or 4 medium electrodes. Vary the placement to find the optimum location Muscles: antererior tibial Nerve: peroneal Sequence 1 Sequence 2 Sequence 3 Time (min)
  • Page 56 HEMIPLEGIA - SPASTICITY Intensity: Visible muscle contractions without pain. Treatment Time: 30 minutes Placement of electrodes Place the electrodes on the muscle, agonist or antagonist. Sequence 1 Sequence 2 Sequence 3 Time (min) 29:58 Pulse duration (μs) Frequency (Hz) Ramp up time (sec) Stimulation time (sec) Ramp down time (sec) Rest time (sec)

  • Page 57: Introduction To Tens

    INTRODUCTION TO TENS TENS is used for both acute and long-term pain conditions, particularly when the pain originates in joints, skeleton, muscles, skin, viscera or the nervous system – both nociceptive and neuro- genic pain. TENS may be sufficient as the only treatment form, but it is also a valuable complement to other pharmacological and/or physical treatments.

  • Page 58: Nociceptive And Neurogenic Pain

    16.1.2 Nociceptive and neurogenic pain The difference between nociceptive and neurogenic pain is that with nociceptive pain, the nervous system is intact, while neurogenic pain means that the nervous system is damaged in some way. Always remember to test sensitivity before treating with TENS, and be careful with the intensity in the beginning when treating neurogenic pain.

  • Page 59: Nociceptive Pain

    16.3 Nociceptive Pain RIB FRACTURE Intensity: Clear feeling of current without pain. Treatment Time: 30 minutes Time (min) Pulse duration (μs) Frequency (Hz) SPINE COMPRESSION Intensity: Clear feeling of current without pain. Treatment Time: 30 minutes Time (min) Pulse duration (μs) Frequency (Hz) FRACTURE PAIN Intensity:...
  • Page 60 NECK PAIN Intensity: Clear feeling of current without pain. Treatment Time: 30 minutes Current International standards require that a warning be given concerning the application of electrodes to the thorax (increased risk of cardiac fibrillation). Time (min) Pulse duration (μs) 70 –...
  • Page 61 CERVICAL SPASM Intensity: Clear feeling of current without pain. Treatment Time: 30 minutes Time (min) Pulse duration (μs) 60 – 160 Frequency (Hz) Modulation time (sec) EPICONDYLITIS Intensity: Clear feeling of current without pain. Treatment Time: 30 minutes Time (min) Pulse duration (μs) Frequency (Hz) THORACAL BACK PAIN...
  • Page 62 LOW BACK PAIN Intensity: Clear feeling of current without pain. Treatment Time: 30 minutes Time (min) Pulse duration (μs) Frequency (Hz) 40 – 100 Modulation time (sec) SHOULDER PAIN Intensity: Clear feeling of current without pain. Treatment Time: 30 minutes Time (min) Pulse duration (μs) 75 –...
  • Page 63 WRIST PAIN Intensity: Clear feeling of current without pain. Treatment Time: 30 minutes Time (min) Pulse duration (μs) 60 – 150 Frequency (Hz) Modulation time (sec) FINGER PAIN Intensity: Clear feeling of current without pain. Treatment Time: 30 minutes Time (min) Pulse duration (μs) Frequency (Hz) HIP PAIN...
  • Page 64 KNEE PAIN Intensity: Clear feeling of current without pain. Treatment Time: 30 minutes Time (min) Pulse duration (μs) 75 – 180 Frequency (Hz) Modulation time (sec) ANKLE PAIN Intensity: Clear feeling of current without pain. Treatment Time: 30 minutes Time (min) Pulse duration (μs) 75 –...

  • Page 65: Tens Neurogenic

    16.4 TENS NEUROGENIC Always remember to test sensitivity before treating with TENS, and be careful with the intensity in the beginning when treating neurogenic pain. Sometimes patients with neurogenic pain feel increased pain from the TENS treatment, in which case the treatment must be altered or stopped. One alternative is to treat the patient on the contralateral side.
  • Page 66 SCIATICA Intensity: Visible muscle contractions without pain. Treatment Time: 30 minutes Time (min) Pulse duration (μs) Burst Frequency (Hz) CARPAL TUNNEL Intensity: Clear feeling of current and visible muscle contractions without pain. Treatment Time: 30 minutes Time (min) Pulse duration (μs) 60 –...
  • Page 67 POST HERP NEURALGIA Intensity: Clear feeling of current and visible muscle contractions without pain. Treatment Time: 20 minutes Time (min) Pulse duration (μs) Frequency (Hz) HEMI SHOULDER PAIN Intensity: Clear feeling of current without pain. Note: If the patient has reduced sensitivity, test what amplitude the patient prefers on the undamaged side.
  • Page 68 POST STROKE PAIN 1 Intensity: Clear feeling of current without pain. Treatment Time: 25 minutes Time (min) Pulse duration (μs) Frequency (Hz) POST STROKE PAIN 2 Intensity: Visible muscle contractions without pain. Treatment Time: 25 minutes Time (min) Pulse duration (μs) Burst Frequency (Hz) MONONEUROPATHY Intensity:...

  • Page 69: Dermatome And Myotome Chart

    DERMATOME AND MYOTOME CHART Enraf-Nonius...
  • Page 70 Enraf-Nonius...
  • Page 71 Enraf-Nonius B.V. Vareseweg 127 3047 AT Rotterdam P.O. Box 12080 3004 GB Rotterdam The Netherlands +31 - (0)10 - 20 30 600 +31 - (0)10 - 20 30 699 info@enraf-nonius.nl www.enraf-nonius.com...

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