MU 4080 English Version 1.0.0

NEUROMED 4080

MU_4080_English_Version: 1.0.0 (032012) 1

Table of Contents

2 Presentation 2 Accessories that come with the product 3 Symbols 4 Warnings / Attention 7 Installation / Connection to the power network 8 General information 8 Interferential Current 11 Russian Current 12 FES 12 TENS 13 Bernard's Diadynamic Currents 15 Monophase Currents 17 Microcurrents 18 Display Language 19 Controls & Control Functions 20 Operation 21 Operation Mode : Interferential 28 Operation Mode : Russian Current 34 Operation Mode : TENS 43 Operation Mode : FES 48 Operation Mode : Diadynamic Current 54 Operation Mode : Monophase Current 59 Operation Mode : Microcurrent 61 Protocols 63 Indications & Contraindications 67 Electrode Application 68 Preventive maintenance, preservation and cleaning 69 Corrective maintenance 70 Technical Characteristics 75 Manufacturer declaration and orientation 79 Considerations 80 European Representative 81 Bibliographical reference

NEUROMED 4080


Presentation

Carci has the honor of congratulating you in your purchase of a high-tech equipment of intrinsic safety, which we are certain will meet the most demanding quality standards.

NEUROMED 4080 is an equipment for functional muscular stimulation of medium and low frequency, intended for all areas of electrotherapy, which was developed observing the safety standards NBR IEC 60601-1:1994 + amendment 1:1997, NBR IEC 60601-1-2:2006, and NBR IEC 60601-2-10:2002, which make it a safe and highly reliable equipment.

Accessories that come with the device

2 polarized cables 4 Conductive rubber (Silicone) electrodes 4 Sponges pad 1 Gel Tube 200 ml 4 Cables for electrode 1 Three-pole cable 1 User manual

To purchase optional accessories, consult the codes on page 74, 'Accessories' item.

In case of doubts, please contact: Technical Assistance Department Rua lvares Fagundes, 359 So Paulo SP Brazil -CEP [zip code] 04338-000 Phone: (0XX11) 5621 7024 / 5622 8205 email: [email protected]

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Symbols

Symbols on the equipment

Means equipment off

Means equipment on

This symbol shows that the equipment causes physiological effects and that the user must check the instruction manual

before using it.

Applied part type BF

Class II Equipment

Manufacturer Identification

Product Manufacturing Date

Product Serial Number

European Representative

CE Mark and identification of the notifying body

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Symbols on the packaging

Fragile. Handle with care

Keep in a dry place

This side up. This symbol shows the correct transport position

Maximum piling. Shows the maximum number of boxes that can be piled. The quantity is marked in the intermediary

square.

Minimum and maximum temperature limits for transport and storage.

ATTENTION / WARNINGS

1. Read, understand and practice the operation and precaution instructions. Know the limitations and dangers associated with use of any electrical stimulation device.

2. Do not expose the device to direct sunlight radiated from a heat radiator, excessive quantities of dust, humidity, vibrations and mechanical shocks.

3. In the case of liquid infiltration, disconnect the device from the power network and contact the Authorized Technical Assistance.

4. Before administering any treatment on a patient, you must become acquainted with the operational procedures for each

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treatment modality available, as well as the indications, contraindications, warnings and precautions. Consult other resources to obtain further information on the application of electrotherapy.

5. Operating sequence

Connect equipment to the power network

Turn on equipment through the

ON/OFF switch

Set the therapy parameters

Connect the electrode cables

to the patient

Set the current intensity desired

After the end of the time selected,

remove the electrodes from

the patient

Turn on the equipment through the

ON/OFF switch

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WARNINGS:

1. Never turn on the ON/OFF key of Neuromed while one or more cables of the electrodes are connected to the patient and to Neuromed.

2. This equipment is intended for use by health professionals only. 3. This equipment can cause radiofrequency or interrupt operation

of nearby equipment. 4. The use of accessories not specified by the manufacturer can

result in increase in EMISSIONS or decrease in IMMUNITY of the equipment.

5. The use of replacement parts not specified by the manufacturer, in technical assistance, can result in increase in EMISSIONS or decrease in IMMUNITY of the equipment.

6. We recommend not using this equipment piled or very close to other equipment.

7. Short-distance operation (e.g. 1 m) from a shortwave or microwave therapy EQUIPMENT can produce instability in the STIMULATOR output;

8. Application of electrodes near the thorax can increase the risk of cardiac fibrillation;

9. Simultaneous connections of a PATIENT to a high-frequency surgical EQUIPMENT can result in burning where the STIMULATOR electrodes are applied and possible damage to the stimulator;

10. We recommend that the current densities for any electrode exceeding 2 effective mA/cm2 may require special attention from the user;

11. Do not place the equipment on soft base that can cover the lower vents.

12. Keep this device out of reach of children. 13. This equipment is not suitable for use in the presence of mixture

of anesthetics inflammable with air, oxygen or nitrous oxide.

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Installation/Connection to the power network

For a perfect functioning of your equipment, we suggest that the electrical installations be according to the following standards:

Brazil : NBR 5410/1990 Low-voltage electrical installations; NBR13534/1995 Electrical installations in health establishments

- Safety requirements.

Other Countries : IEC 60364-7-7 (10/2002) Electrical Installations medical

locations; Or another related standard applied in the country of use.

Connect the power cable to the three-pole connector located in the posterior panel and connect it to the power socket.

Your equipment uses switched power sully and operates in any voltage between 100V~ and 240V~ 50 or 60Hz.

In case the protective fuse burns, replace it only be the value indicated: the fuses must be of 1.0A 250V~ 20AG

Remove the cover of the fuse box using a screw driver (insert the screw driver in the groove of the fuse box, apply a little pressure and turn it counterclockwise).

On/Off Switch

Fuse box

Power cable connector

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General Information

The NEUROMED 4080 is a functional neuromuscular electrostimulator, Microcontrolled with the functions :

o Interferential Current Two-pole, Manual Vector, Automatic and Isoplanar.

o Russian Current o TENS

Normal, VIF, VLP, VF, Burst and Modulated Burst o FES o Diadynamic Currents

DF, MF, LP, SP, iD SP o Monophase

Square, Exponential, Ultra Exciting, Direct and Interrupted

o Microcurrents

Interferential Current

Interferential Current is a form of medium-frequency wave, distributed through two channels (four electrodes), where the currents cross themselves in the body, in the area that needs treatment. The two currents have interference between them at the crossing point, causing intensity modulation (the current intensity increases and reduces at a regular frequency). In the interferential current, a carrier frequency of the medium frequency is used to pass the low frequency stimulation (beat) through the skin. The relatively low resistance of the skin to the carrier frequency contributes toward the patient's comfort and is oftentimes associated with this type of stimulation. Interferential Currents are all AC currents without any DC residual component.

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Vector Interferential

In this method of therapy, four electrodes are used, and two modulated currents are generated for each electrode pair (two channels). The frequency of a channel is set in the carrier frequency, while the other channel has a variable frequency, based on the beat frequency and frequency modulation configurations. The Interference occurs when the two currents cross in the tissue. The depth of modulation (which determines the amplitude of the stimulation current) depends on the direction of the currents, and can vary from 0 to 100%. The 100% modulation occurs only in the diagonal (and therefore, in the intersection) of both currents. It is obviously a theoretical situation, based on the presupposition that the tissue is homogeneous. In reality, the tissue is heterogeneous, such that the balance between both channels must be used to obtain the 100-% modulation depth (Fig. 1).

1 beat frequency cycle

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Figure 1 Isoplanar

The isoplanar vector technique is intended to increase the area where effective stimulation occurs. Amplitude modulation occurs in the equipment and a special phase relation between both channels guarantees a 100% modulation depth between the four electrodes in all the positions. Modulation depth is 100% over the complete treatment area. The advantage of this method is that positioning of the four electrodes to effectively treat the affected tissue is less critical. The sensation of the isoplanar vector mode is mild and equally divided over the treatment area.

Isoplanar Vector Model

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Two-pole Interferential.

With the dipole vector technique, the currents of the two electrode pairs are summed vectorially in the tissue. The effect is that stimulation occurs only in direction of the resulting vector, which can be adjusted at an interval of 360. Amplitude modulation occurs in the equipment and the modulation depth is 100%. Stimulation with 100% modulation occurs only in direction of the vector. The advantage of this method is that the direction of stimulation can be adjusted electronically after positioning the electrodes. Automatic vector dipole

With the automatic vector dipole technique described above, it is turned at an adjustable speed. If the increase in the current amplitude is greater than the motor threshold, the tissue will contract and relax rhythmically. The current automatic dipole vector is ideal for areas where the mechanical pressure of massage is not desirable.

Russian Current

Alternating current with a carrier frequency of about 2500 Hz. Russian stimulation was used by the first time by Kots, professor of sports medicine in the Moscow State Academy. Kots used it for muscular strengthening in the training of Russian cosmonauts. With this technique, electrostimulation is applied in the individual muscles as well as in muscle groups (whether directly or through the nerve). In direct stimulation, it was found that the frequency of 2500 Hz produced the highest contraction, while the ideal frequency of indirect stimulation was 1000 Hz.) A specific characteristic of this type of muscular stimulation is that the alternating current is interrupted 50 times per second. This results in a train of pulses, comparable to the TENS explosion. The total duration of the train of pulses is 20 ms, giving a phase duration / interval phase

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ratio of 1:1. Kots uses a Burst frequency of 50 Hz, approximately in the middle of the frequency spectrum used to produce tetanic contraction (40-80 Hz). In addition to the ratio of 1:1, Kots also describes a phase duration / interval phase ratio of 1:5. The amplitude must be increased until a strong concentration is produced (from the level of motor stimulation up to the tolerance limit). Such as occurs with all muscular stimulation applications, a program may be used, allowing the muscles to rest between exercise cycles.

FES Functional electrical stimulation is a form of electrotherapy able to produce muscular contractions with functional objectives. The movements produced by the FES technique are fully controllable and allow the patient to have a positive psychological attitude due to the use of his own muscles, which contributes toward his physical and emotional rehabilitation.

Regular application of neuromuscular electrostimulation (NMES) using FES proved to be efficient in the treatment of patients with motor deficiencies caused by different neurological pathologies. Some results that can be obtained with use of this technique are: reduction of muscular spasticity, strengthening of the muscles and improvement in the gait standard.

The equipment allows, for example, stimulation of the quadriceps, dorsiflexion movement of the foot, gait monitoring, among other facilities.

TENS Chronic pain - continuous, debilitating pain like pains associated with rheumatism, arthritis, sciatic nerve, among others, does not have the purpose of indicating any eminent damage but rather that we have a damage resulting from the pathology itself. Treatment of chronic pains by narcotics and other drugs always brings the inconveniencies of side effects, almost always causing as many problems as the pain itself. Transcutaneous Electric Nerve Stimulation (TENS) promotes a simple, safe and effective solution for chronic pain problems.

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Diadynamic Currents

Diadynamic currents were introduced by Bernard (1) and won an important position in the history of physiotherapy. They are currently unfairly deemed as outdated compared to TENS or Interferential currents. Diadynamic Currents are used mainly to reduce pain and improve blood circulation. Bernard uses the term Diadynamic currents, which refer to a monophase (MF - Monophas fixe) or double phase (DF - Diphas fixe) rectified alternating current. The frequency was derived directly from the power source, resulting in sinusoidal pulses with a duration of 10 ms. This time, 10-ms phase will mainly depolarize thick fibers. Stimulation of the thin fibers can only be obtained with greater current amplitude.

(1) Bernard, Pierre D. La diadynamique thrapie, Paris, Editions Physio ', dated 1962.

ATTENTION: Diadynamic Currents are monophase currents that produce electrolysis subproducts. These subproducts can result in burning beneath the electrodes. Always use a correctly wet sponge / electrode combinations to absorb these products during the treatment.

The available variations are as follows:

MF (Monophas fixe) It is a single sinusoidal phase rectified current with a frequency of 50 Hz. MF is a vibration waveform that easily induces the contractions.

DF (Diphas Fixe)

It is a dual sinusoidal phase rectified current with a frequency of 100 Hz.

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DF is usually experienced with a fast vibration. It is a pleasant waveform that is often used as an introduction to SP or LP.

LP (Long Periods)

It is a slow alternance between six seconds of MF and six seconds of DF. In the DF phase, the intervals between the MF pulses are filled with additional pulses gradually with the increase and decrease in amplitude. LP is suaver than SP.

SP (Short Periods)

It is a fast alternance between a second MF course and a second of the current DF. CP has as strong re-absorption effect.

iD SP ( Isodynamic Short Periods )

Is identical to SP, except that the amplitude of the current in the MF phase is 12.5% smaller than during the DF phase. Usually, a lower frequency is experienced to be more aggressive than a higher frequency. IDSP prevents this difference in the sensation.

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Monophase ( Faradic )

Monophase / Faradic currents are often used for muscular stimulation applications that are based on previous diagnosis. The diagnostic objective is the obtainment of information on the sensitivity of the neuromuscular device for electrical stimulation. This g ives an indicat ion of the level of muscular t issue enervation. With this technique, the ratio between amplitude and the duration of the current phase of a rectangular and triangular pulse is plotted in a power / duration curve. The power / duration curve is recorded by observing the amplitude of the current required in phase of various values of duration (varying from 0.01 to 1000ms) that produce contraction of a muscle or muscular group that is just perceptible (that is only visible or palpable). In case of reduced sensitivity or absence in electrical stimulation, the power / duration curve gives an indication of the current waveform, phase duration and amplitude of the electrical stimulation current to be used in any therapy that can be applied.

Square Monophase Current.

Exponential Monophase Current.

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Galvanic current

Direct Galvanic Current

Direct galvanic current, applied constantly without rest interval.

Interrupted Galvanic Current

Interrupted galvanic current, and modulation of direct galvanic current, at the frequency of 8 KHz, with working cycle of 90%.

Trabert Ultra-Exciting.

The 2-5 or "Ultra-exciting current was introduced by Trbert.(2) . The 2-5 faradic current is a rectangular pulsated current with a phase duration of 2 ms and a phase interval of 5 ms. These configurations are the standard configurations for the faradic current rectangular waveform and result in a pulse frequency of approximately 143 Hz. Trabert did not provide any explanation for the choice of these parameters. However, many workers have adopted the treatment and it is still applied with success. A notable effect is the absence of pain that can arise from just the first treatment and that can last for several hours.

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Tp = 2 mS / Tr = 5 mS

(2) Trabert, H. Ultra-Reizstrom, neues ein therapeutisches Phnomen, Elektromedizin 2, 1957 (7).

ATTENTION: Monophase currents are currents that produce electrolysis subproducts. These subproducts can result in burning beneath the electrodes. Always use a correctly wet sponge / electrode combinations to absorb these products during the treatment.

Microcurrents

Microcurrent is a rectangular monophase waveform selected manually or with alternate polarity.

Many therapists prefer Microcurrent therapy because of the low current amplitudes used. Alternate polarity can be used for the average of the DC component, reducing electrolysis formation.

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Display language

NEUROMED 4080 allows accessing three display languages: Portuguese English Spanish

If you wish to change the current language, follow the steps below:

1. Connect the power cable of the NEUROMED 4080 to the power network.

2. Turn on the device - the equipment will conduct a test of the display, presenting the Main screen.

3. Next, press the key and keep it pressed

4. After the equipment issues a double beep, release the Menu key

5. The display will show the accessible languages: ENGLISH PORTUGUESE SPANISH

6. Select the language desired through the keys

7. Press the key

8. The equipment will exit the language selection mode, displaying the Main menu.

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Controls

Control functions

Control of intensity of channels 1, 2, 3 and 4.

Decrease

Moves to next field

Increase

Moves to previous

field

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Figure : 1 Figure : 2

Enables the funct ion chosen

Enables the main menu screen

Enables the NEUROMED outputs

Disables the NEUROMED outputs

Operation

Operation of the device:

Press the ON/OFF at the back of the device. (Figure 1 page 7).

ATTENTION: Never turn on the ON/OFF key of Neuromed while one or more cables of the electrodes are connected to the patient and to Neuromed.

The display will show the Initial Screen:

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Use the keys to select the current types.

1. Interferential : Use the and keys to enable selection of the interferential modes : Two-pole, Manual Vector, Automatic Vector or Isoplanar Vector

1.1. Two-pole Interferential

o Select the Two-pole Interferential mode.

THERAPY Interferential Two-pole Russian Current Manual Vector TENS Autom. Vector FES Isoplanar Diadynamic Monophase Microcurrent Protocols

Interferential Two-pole Russian Current Manual Vector TENS Autom. Vector FES Isoplanar Diadynamic Monophase Microcurrent Protocols

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o Press the key to enable the Two-pole Interferential mode. The Two-pole mode set screen will be displayed.

o Through the and keys, set the parameters:

o Set : 1 minute to 60 minutes, in steps of 1 minute.

o

Settings : 2 KHz, 4 KHz, 6 KHz, 8 KHz & 10 KHz.

o

Settings : 10 Hz to 150 Hz ( steps of 10 Hz ) o


Settings : Rise/fall : 0 s to 9 s (steps of 1 s) Sustaining/Rest : 1 s to 30 s (steps of 1 s)

o After setting the parameters, connect the electrode cables in channels 1 and 2 to the electrodes in the patient. Press the

Interferential Two-pole

Timer 05:00 s

Carrier Frequency : 2 KHz Frequency Modulation : 100 Hz Frequency Variation

: 100 Hz

0 s: 1 s : 0 s : 2 s Slope Channel 1 Channel 2

Carrier Frequency

Frequency Modulation

Frequency Variation

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key , the output settings of channels 1 and 2 will be enabled.

o Use the keys of the channels to set the intensity.

1.2. Manual Vector Interferential

o Select the Manual Vector Interferential mode

o Press the key to enable the Manual Vector Interferential mode. The Manual Vector mode set screen will be displayed.


o

Set : 1 minute to 60 minutes, in steps of 1 minute.

Channel 1 Channel 2


Timer 05:00 s


: 100 Hz Slope 0 s: 1 s : 0 s : 2 s Channel 1 Channel 2

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o Settings : 2 KHz, 4 KHz, 6 KHz, 8 KHz & 10 KHz.

o Settings : 10 Hz to 150 Hz ( steps of 10 Hz )


o Settings : Rise/fall : 0 s to 9 s (steps of 1 s) Sustaining/Rest : 1 s to 30 s (steps of 1 s)


key , the output settings of channels 1 and 2 will be enabled.


o Use the keys to move the to the desired position.

1.3. Automatic Vector Interferential

o Select the Automatic Vector Interferential mode

Carrier Frequency


Frequency Variation

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o Press the key to enable the Automatic Vector Interferential mode. The Automatic Vector mode set screen will be displayed.


o

Set : 1 minute to 60 minutes, in steps of 1 minute.




o Set : 1 s to 15 s (steps of 1 s) o

Settings : Rise/fall : 0 s to 9 s (steps of 1 s)

Carrier Frequency


Frequency Variation

Speed


Timer 05:00 s



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Sustaining/Rest : 1 s to 30 s (steps of 1 s)


key , the output settings of channels 1 and 2 will be enabled. The time selected will decrease.


o The will move according to the speed selected.

1.4. Isoplanar Interferential

o Select the Isoplanar Interferential mode

o Press the key to enable the Isoplanar Interferential mode. The Isoplanar mode set screen will be displayed.


Timer 05:00 s



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o Set : 1 minute to 60 minutes, in steps of 1 minute.




o Set : 1 s to 15 s (steps of 1 s)


o After setting the parameters, connect the electrode cables in channels 1 and 2 to the electrodes in the patient. Press the key

, the output settings of channels 1 and 2 will be enabled.


o The will move according to the speed selected.

Speed

Carrier Frequency


Frequency Variation

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2. Russian Current:

o In the initial screen, select the keys to select Russian Current.

o Use the and keys to enable selection of the Russian Current modes (Synchronous, Sequential, Alternate and Reciprocal )

2.1. Synchronous Russian Current:

o Select the Synchronous Russian Current mode

o Press the key to enable the Synchronous Russian mode. The Synchronous Russian parameter set screen will be displayed.

THERAPY Interferential Synchronous Russian Current Sequential TENS Alternate FES Reciprocal Diadynamic Monophase Microcurrent Protocols

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o Settings : 1 minute to 60 minutes, in steps of 1 minute.

o

Frequency is fixed.

o


Settings : 10 % to 50 % ( steps of 10 % ) o


o After setting the parameters, connect the electrode cables in the outputs of 1 to 4 to the electrodes in the patient. Press the key

, the output settings of channels 1 to 4 will be enabled.

Car r i er F requency

Frequency Modula t ion

Work Cycle


Timer 05:00 s


: 100 Hz

Slope 0 s: 1 s : 0 s : 2 s Channel 1 Channel 2 Channel 3 Channel 4

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o Use the keys of the channels to set the intensity. ( Figure : 1 page 20 )

2.2. Sequential Russian Current:

o Select the Sequential Russian Current mode.

o Press the key to enable the Sequential Russian mode. The Sequential Russian parameter set screen will be displayed.



o Settings : Frequency is fixed.




Russian Current Sequential

Timer 05:00 s

Carrier Frequency : 2500 Hz Frequency Modulation : 100 Hz Frequency Variation

: 10%


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o Settings : 10 % to 50 % ( steps of 10 % )





2.3. Alternate Russian Current:

o Select the Alternate Russian Current mode.

o Press the key to enable the Alternate Russian mode. The Alternate Russian parameter set screen will be displayed.

Work Cycle

Russian Current Alternate

Timer 05:00 s


: 10%


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2.4. Reciprocal Russian Current:

o Select the Reciprocal Russian Current mode.



Work Cycle

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o Press the key to enable the Reciprocal Russian mode. The Reciprocal Russian parameter set screen will be displayed.








Work Cycle

Russian Current Reciprocal

Timer 05:00 s


: 10%


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3. TENS

o Use the and keys to enable selection of the TENS modes ( Normal, Burst, VIF, VLP, VF or Modulated Burst).

3.1 Normal TENS

o Select the Normal TENS mode.

THERAPY Interferential Normal Russian Current Burst TENS VIF FES VLP Diadynamic VF Monophase Modulated Burst Microcurrent Protocols

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o Press the key to enable the Normal TENS mode. The Synchronous Russian parameter set screen will be displayed.


o Settings : 1 minute to 60 minutes, with steps of 1 minute.

o

Settings : 1 Hz to 200 Hz ( steps of 1 Hz )

o

Settings : 50 uS to 400 uS ( steps of 10 uS )




Frequency

Pulse Width

TENS Normal

Timer 05:00 s Frequency : 100 Hz Pulse Width : 100 S


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3.2 Burst TENS

o Select the Burst TENS mode.

o Press the key to enable the Burst TENS mode. The Burst TENS parameter set screen will be displayed.


o Settings : 1 minute to 60 minutes, with steps of 1 minute.

o Set at 100 Hz.

o Settings : 50 uS to 400 uS ( steps of 10 uS )

Frequency

Pulse Width

TENS Burst



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3.3 VIF TENS

o Select the VIF TENS mode.

o Press the key to enable the VIF TENS mode. The VIF TENS parameter set screen will be displayed.



o

Settings : 1 Hz to 200 Hz ( steps of 1 Hz )

Frequency

TENS VIF

Timer 05:00 s Frequency : 100 Hz Pulse Width : 100 S Frequency Modulation : 10% Pulse Modulation : 10% Speed : 1 s

Channel 1 Channel 2 Channel 3 Channel 4

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o

Settings : 50 uS to 400 uS ( steps of 10 uS )

o

Settings : 10 % to 50 % ( steps of 10 % )

o


o

Settings : 1 s to 15 s (steps of 1 s)




3.4 VLP TENS

o Select the VLP TENS mode.

o Press the key to enable the VLP TENS mode. The VLP TENS parameter set screen will be displayed.

Pulse Width


Pulse Modulation

Speed

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o Settings : 1 s to 15 s (steps of 1 s)



Frequency

Pulse Width

Pulse Modulation

Speed

TENS VLP


Pulse Modulation : 10% Speed : 1 s


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3.5 VF TENS

o Select the VF TENS mode.

o Press the key to enable the VF TENS mode. The VF TENS parameter set screen will be displayed.





o

Frequency

Pulse Width


TENS V F

Timer 05:00 s Frequency : 100 Hz Pulse Width : 100 S Frequency Modulation : 10%

Speed : 1 s


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Settings : 1 s to 15 s (steps of 1 s)



o Use the keys of the channels to set the intensity. o ( Figure : 1 page 20 )

3.6 Modulated Burst TENS

o Select the Modulated Burst TENS mode.

o Press the key to enable the Modulated Burst TENS mode. The Modulated Burst TENS parameter set screen will be displayed.

Speed

TENS Burst Modulada

Timer 05:00 s Frequency : 100 Hz Pulse Width : 100 S Frequency Modulation : 10%

Speed : 1 s


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o Set at 100 Hz.



o Settings : 1 s to 15 s (steps of 1 s)


, the output settings of channels 1 to 4 will be enabled. The time selected will start the count (decreasing).


Frequency

Pulse Width


Speed

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4. FES

o Use the and keys to enable selection of the FES modes (Synchronous, Sequential, Alternate or Reciprocal ).

4.1 Synchronous FES

o Select the Synchronous FES mode.

o Press the key to enable the Synchronous FES mode. The Synchronous FES parameter set screen will be displayed.

THERAPY Interferential Synchronous Russian Current Sequential TENS Alternate FES Reciprocal Diadynamic Monophase Microcurrent Protocols

FES Synchronous



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o Set at 100 Hz.






4.2 Sequential FES

o Select the Sequential FES mode.

o Press the key to enable the Sequential FES mode. The Sequential FES parameter set screen will be displayed.

Pulse Width

Frequency

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o Set at 100 Hz.

o Settings : 50 uS to 400 uS ( steps of 10 uS ) o





Frequency

Pulse Width

FES Synchronous



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4.3 Alternate FES

o Select the Alternate FES mode.

o Press the key to enable the Alternate FES mode. The Alternate FES parameter set screen will be displayed.



o Set at 100 Hz.



Frequency

Pulse Width

FES Alternate



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4.4 Reciprocal FES

o Select the Reciprocal FES mode.

o Press the key to enable the Synchronous Russian mode. The Synchronous Russian parameter set screen will be displayed.



o Set at 100 Hz.

Frequency

FES Reciprocal



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o Settings : 50 uS to 400 uS ( steps of 10 uS ) o



, for output settings of channels 1 to 4.


5. Diadynamic

o Use the and keys to enable selection of the DIADYNAMIC modes (DF, MF, LP, SP or CP Id ).

Pulse Width

THERAPY Interferential DF Russian Current MF TENS LP FES SP Diadynamic CP Id Monophase Microcurrent Protocols

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5.1 DF

o Select the Diadynamic DF mode.

o Press the key to enable the Diadynamic DF mode. The Diadynamic DF parameter set screen will be displayed.



o

Settings : + V , + P or Automatic ( AUTO )

o After setting the parameters, connect the electrode cable in output

4 to the electrodes in the patient. Press the key , the output settings of channel 4 will be enabled.

o Use the key of the channel to set the intensity.

Polarity

Interferential DF Timer 05:00 s :

:

Polarity : +V

Channel 4

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5.2 MF

o Select the Diadynamic MF mode.

o Press the key to enable the Diadynamic MF mode. The parameter set screen will be displayed.



o Settings : + V , + P or Automatic ( AUTO )

o After setting the parameters, connect the electrode cable in output



Polarity

Diadinamicas MF Timer 05:00 s :

:

Polarity : +V

Channel 4

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5.3 LP

o Select the Diadynamic LP mode.

o Press the key to enable the Diadynamic LP mode. The parameter set screen will be displayed.



o Settings : + V , + P or Automatic ( AUTO ) o After setting the parameters, connect the electrode cable in output



Polarity

Diadinamicas LP Timer 05:00 s :

:

Polarity : +V

Channel 4

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5.4 CP

o Select the Diadynamic SP mode.

o Press the key to enable the Diadynamic SP mode. The parameter set screen will be displayed.






Polarity

Diadinamicas CPID Timer 05:00 s :

:

Polarity : +V

Channel 4

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5.5 CP iD

o Select the Diadynamic CP iD mode.

o Press the key to enable the Diadynamic CP iD mode. The parameter set screen will be displayed.






Polarity

Diadinamicas CPID Timer 05:00 s :

:

Polarity : +V

Channel 4

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6. Monophase

o Use the and keys to enable selection of the MONOPHASE modes (Square, Exponential, UE, Direct and Interrupted ).

6.1. Square

o Select the Square Monophase mode.

o Press the key to enable the Square Monophase mode. The parameter set screen will be displayed.


o

Monofasica Square Timer 05:00 s

Pulse Widht : 200S Rest : 5 mS Polarity : +V

Channel 4

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Settings : 1 minute to 60 minutes, in steps of 1 minute.

o Settings : 20 uS to 2000 uS ( steps of 10 uS ) o Settings : 1 mS to 100 mS (in steps of 1 mS) o Settings : + V , + P or Automatic ( AUTO ) o After setting the parameters, connect the electrode cable in output



6.2. Exponential

o Select the Exponential Monophase mode.

o Press the key to enable the Exponential Monophase mode. The parameter set screen will be displayed.

Pulse Width

Rest

Polarity

Monofasica Exponential Timer 05:00 s

Pulse Widht : 2000 Rest : Polarity : +V

Channel 4

NEUROMED 4080





o Settings : 1 mS to 100 mS (in steps of 1 mS)




6.3. Ultra Exciting (UE)

o Select the Ultra Exciting Monophase mode

o Press the key to enable the Ultra Exciting Monophase mode. The parameter set screen will be displayed.

Pulse Width

Rest

Polarity

NEUROMED 4080







6.4. Direct

o Select the Direct Monophase mode.

o Press the key to enable the Direct Monophase mode. The parameter set screen will be displayed.

Polarity

Monofasica

UE Timer 05:00 s : Polarity : +V :

Channel 4

NEUROMED 4080







6.5. Interrupted

o Select the Interrupted Monophase mode.

o Press the key to enable the Interrupted Monophase mode. The parameter set screen will be displayed.

Polarity

Monofasica

Interrupted Timer 05:00 s : Polarity : +V :

Monofasica

Direct Timer 05:00 s : Polarity : +V :

Channel 4

NEUROMED 4080







7. Microcurrents

o Select the Microcurrents mode.

o Press the key to enable the Microcurrents mode. The parameter set screen will be displayed.

Polarity

NEUROMED 4080




o Settings : 1 Hz to 200 Hz ( in steps of 1 Hz )




Polarity

Frequency

Channel

NEUROMED 4080


8. Protocols

Attention

Before applying the treatment protocols, the operator must be informed of the content of this manual as well as operation of this equipment and all aspects related to the patient's treatment.

Liability Limitations

Under no circumstance will Carci Ind. e Com., or its suppliers and/or dealers, be held liable for any indirect, special, incidental damage caused by use or inability to use the product, including, without being limited to damages due to loss, or every and any other damage or commercial loss, and regardless of the legal or equal theory (contract, complaint or other mode) on which the claim is based.

Carci shall not be held liable for any consequence resulting from inaccurate information provided by its personnel, or errors included in this manual and/or other adjunct documentation (including commercial documentation).

o In the main screen,

NEUROMED 4080


o select the option PROTOCOLS, through the keys ,

position the cursor in the option SELECT, press the key o The display will show the screen:

o Use the keys to select the desired protocol.

o Use the keys to change the cursor to the right; and

to select or delete the protocol.

o Press the key to confirm.

Selec t De le t e Dele t e A l l

NEUROMED 4080


Indications & Contraindications

FES

Indications

Muscular strengthening through resistance and force programs; Maintenance or increase in the range of movements (extension and

contraction), including correction of contracture; Facilitation and reeducation of voluntary motor functions; Orthostatic training, including replacement of traditional orthesis; Control of chronic or acute edemas; Control of temporary inhibition of muscular spasms.

Contraindications

Patients with heart problems; Pregnancy, especially in the first three months;

TENS

Acute or chronic painful processes (suppressing the picture of pain until its cause is safely identified) :

Cervical dorsal lumbar pains Lumbar sciatic pains, neuralgias of the trigeminal brachialgias pains from the surgical wound headaches and joint pains Patients subjected to surgery and who need to mobilize body

segments traumatized during the surgical act. Pulmonary re-expansion after chest or abdominal surgery limb mobilization in cases of segment amputations bursitis

NEUROMED 4080


traumatized limbs and hundreds of other acute or chronic painful states

Contraindications

To date, there are no known express contraindications in the use of TENS. However, applications in the following must be avoided:

patients with Cardiac or Cerebral pacemaker; cardiac patients; epileptic patients lumbar and abdominal regions in patients during the first three

months of pregnancy; region on the carotid sinuses.

Note: The TENS must be applied only in diagnosed pains otherwise we may be masking a pathological symptom of the organism.

Interferential Current

Indications :

Joint Sprain Ligament lesion Muscular contusion Muscular distension Traumatic Synovitis Tendinitis Myalgias Radiculopathies ( lumbosciatalgias and cervicobrachialgias ) Post-operatory of Meniscectomy.

Contraindications:

Muscular injuries, tendinitis; Dysfunctions in acute joints (arthritis, bursitis combined with heat)

and functional lesion;

NEUROMED 4080


Unconsolidated fibers; Forms of spasticity;

Russian Current Stimulation

Indications

Increase the muscular force for improvement of stability (active) and joint;

Recover muscular force;

Contraindications

Muscular injuries, tendinitis; Dysfunctions of acute joints (arthritis, bursitis combined with heat)

and functional lesion; Unconsolidated fibers; Forms of spasticity;

Polarized currents

Indications: Traumatisms, arthropathies, myalgias Muscular Paresis Edemas (due to vasomotor effect) Arthritis Hydrate and soften sites with progression of fibrosis. Cutaneous diseases Neuralgias

Contraindications: Absence of sensitivity; Presence of metal plates in the patient; Pacemaker; Spastic excitation in cerebral spastic paresis;

NEUROMED 4080


Electroporation.

Micro Currents

Indications: Acute and chronic pain Inflammation edema Synovitis Musculoskeletal dysfunctions Premenstrual syndrome Sports lesions luxations, stretches and contusions Arthritic conditions - Osteoarthritis (OA) Lumbosciatalgia Temporo-mandibular dysfunctions (TMDs) Fibromyalgia (FMS) Plantar fascitis Tennis elbow Carpal tunnel syndrome (CTS) Fractures Bone calcification Cicatrization of wounds ischemic ulcers

Contraindications: In painful syndromes where the etiology is not established: Pregnancy Pacemaker users Directly on infected wounds On malignant or benign tumors On the ocular globe On the carotid Osteomyelitis On the laryngeal musculature In the presence of topical substances containing metallic ions

NEUROMED 4080


Electrode Application

Attention:

The connection of accessories not specified by the manufacturer can affect the patient and correct operation of the equipment, which is not allowed.

Before the Treatment:

Check if the patient fits any other contraindication. Heat sensitivity test of the area to be treated. Clean the area to be treated with aqueous solution with neutral

soap.

Conductive Rubber (Silicone) Electrode

The use of conductive rubber (silicone) electrode is recommended, in combination with conductor gel or wet sponge. The use of gel or duly wet sponges assures low impedance between the skin and the NEUROMED stimulator. The electrodes and sponges can easily be cleaned after treatment. To fix the electrodes with gel, or wet sponges, with the patient's skin, sticky tape of medical use or rubber band can be used.

Self-Adhesive Electrode

The use of self-adhesive electrodes is characterized by the ease of contact with the skin, due to their malleability. The thin layer of adherent gel allows low impedance between the skin and the Fesmed stimulator. If peradventure during the application the patient informs that the stimulus is too weak, it is a sign that the electrodes must be changed. They must be changed if the display shows the letter M on the right side of the intensity indicator, and the intensity marks zero.

Electrolytic Effect

Electrolysis occurs under the electrodes, when the types of currents with DC component are applied.

NEUROMED 4080


NEUROMED has null DC component for alternating currents. In the electrolytic effect, due to the high concentration of electrolytes caused by the migration of ions occurring under the electrodes, we recommend that the silicone electrodes have sufficient gel, the sponges be duly wet or that the self-adherent electrodes be new in order to have minimal electrolytic effect.

Current Density

According to Brazilian Standard NBR IEC 60601-2-10, the maximum current density allowed is 2 mA RMS per cm2 . The NEUROMED output is limited to 50 mA RMS, with charge of 500 Ohms. To check if the current density did not exceed the maximum allowed, divide the output current in mA by the effective area of the electrode in cm2

Electrode connection and disconnection reactions

NEUROMED has Constant Current in the current output, which can cause unpleasant reactions if the electrodes are not correctly coupled to the skin, or if there is loss of contact with the skin. Ensure that the output is marking 0 (zero) mA when placing or removing the electrodes.

Preventive maintenance, preservation and cleaning

We recommend that the NEUROMED be inspected and calibrated once a year Always ensure that the device is disconnected from the power supply before cleaning. Avoid wetting the electric contacts of the wires and connectors Use a cloth wet with water and soap to clean the cabinet of your device Regularly control the power supply and power cable, assuring that there are no defects.

NEUROMED 4080


On disconnecting the power cable from the device, always remove it from the plug, thus preventing the wire from breaking Always remove the electrodes from the patient with care so as not to damage them. Regularly inspect the cables of the electrodes, checking if there is no breakage of the cable with the plugs.

Special cares for adherent or silicone electrodes

Cares for longer lasting electrodes:

When using silicone electrodes, always clean the contacts of the plugs, preventing residues that render electric contact difficult.

After using the silicone electrodes, wash them with running water and dry them, keeping in a fresh and dry place.

After using the adherent electrodes, carefully remove them from the electrode cable, wet them with water and keep in their envelope, in a fresh and dry place.

Corrective maintenance

Problems Solutions

Equipment does not come on Check if the power cable is connected to the power network Check if the fuse(s) is(are) not burnt

Patient reports that the sensation of the stimulus is greater in one electrode than in the other

Change the electrodes (silicone or adherent) because they have become worn out

The intensity is increased to the maximum and the patient reports little stimulation

Check the patient's sensitivity Change the electrodes (silicone or adherent)

NEUROMED 4080


On increasing the intensity, after 10 mA, the intensity is zeroed, and the letter m is displayed on the right side of the intensity

Press the Start key and start the treatment again. Check continuity of the electrode cable Check conductivity of the electrodes

On increasing the intensity, it is zeroed, and the letter M is displayed on the right side of the intensity. This means that there was excess current

Press the Start key and start the treatment again. Check conductivity of the electrodes. Check if there is short circuit in the electrode cable plug Contact technical assistance,

Device comes on normally but the patient reports non-stimulation

Check the coupling and continuity of the electrode cables with the patient Check conductivity of the electrodes

Important notes:

Corrective maintenance of this equipment, in addition to the prescriptions above, must be conducted by the CARCI authorized technical assistance only. Electric diagrams, circuits and parts lists are not supplied to end consumers. If needed, contact the Carci Authorized Technical Assistance.

Technical characteristics

Origin : CARCI Brazil Models : NEUROMED 4080 Function and Application : Equipment for Electrotherapy Power supply : 100230 V~ automatic ( 10%)

: 50 / 60 Hz Maximum Consumption : 100 VA ANVISA [National Health Surveillance Agency] Registration : 10314290035

NEUROMED 4080


-------------------------------------------------------------------------------------------------

Classification according to the standards NBR IEC 60601.1 and NBR IEC 60601.2.10:

- Type of protection against electric shock:............................... class II - Level of protection against electric shock of the part applied: type BF - Level of protection against harmful water penetration: IPX0 - Disinfection methods : see preventive maintenance - Level of application safety in the presence of an anesthetic mixture inflammable with air, oxygen or nitrous oxide: not suitable - Mode of operation: continuous --------------------------------------------------------------------------------------------------

Fuse : 1,0 A 250 V 20 AG Dimensions : 31 x 6 x 18 (LxHxD) (cm) Weight : 2.6 kg Excess current protection Continuous component of current equal to Zero

Neuromed Output Parameters: Output channels : 4 channels Output characteristics : Constant Current Current Amplitude Range : Depends on the waveform Current Amplitude Resolution : 1 mA Maximum Amplitude ( Ipp) : 140 mA (charge of 500 Ohms) Timer : 0 - 60 minutes

Interferential

Automatic Vector Interferential Frequency : 2, 4, 6, 8 and 10 kHz Frequency Modulation (AMF) : 10 to 150 Hz (steps of 10 Hz) Frequency Spectrum : 10 to 100 Hz (steps of 10 Hz) Ramp rise/descent time: 0 to 9 (steps of 1s) Ramp sustaining time: 1 to 30 s (steps of 1s) Ramp rest time : 1 to 30 s (steps of 1s) Vector Speed : 1 to 9 S Amplitude: 0 - 140 mA

Isoplanar Interferential Frequency : 2, 4, 6, 8 and 10 kHz Frequency Modulation (AMF) : 10 to 150 Hz (steps of 10 Hz)

NEUROMED 4080


Frequency Spectrum : 10 to 100 Hz (steps of 10 Hz) Ramp rise/descent time : 0 to 9 (steps of 1s) Ramp sustaining time : 1 to 30 s (steps of 1s) Ramp rest time : 1 to 30 s (steps of 1s) Vector Speed : 1 to 9 S Amplitude : 0 - 140 mA

Two-pole Interferential Frequency : 2, 4, 6, 8 and 10 kHz Frequency Modulation (AMF) : 10 to 150 Hz (steps of 10 Hz) Frequency Spectrum : 10 to 100 Hz (steps of 10 Hz) Ramp rise/descent time : 0 to 9 (steps of 1s) Ramp sustaining time : 1 to 30 s (steps of 1s) Ramp rest time : 1 to 30 s (steps of 1s) Amplitude : 0 - 140 mA

Russian Stimulation Ramp rise/descent time : 0 to 9 (steps of 1s) Ramp sustaining time : 1 to 30 s (steps of 1s) Ramp rest time : 1 to 30 s (steps of 1s) Pulse frequency : 2500 Hz Frequency Modulation : 10 Hz to 150 Hz ( steps of 10 Hz ) Work Cycle : 10% to 50% ( steps of 10% ) Amplitude : 140 mA

FES Ramp rise/descent time : 0 to 9 (steps of 1s) Ramp sustaining time : 1 to 30 s (steps of 1s) Ramp rest time : 1 to 30 s (steps of 1s) Pulse duration : 50 to 600 uS (steps of 10 uS) Pulse frequency : 1 to 200 Hz (steps of 1 Hz) Amplitude : 140 mA

TENS Pulse duration: 50 to 600 uS (steps of 10 uS) Pulse frequency: 1 to 200 Hz (steps of 1 Hz) Amplitude : 100 mA Modes of operation :

Continuous : adjustable frequency and duration Burst : Ton : 1s - Toff : 1s with adjustable pulse duration

NEUROMED 4080


VIF : adjustable and variable frequency and duration VF : adjustable and variable frequency, adjustable

duration VLP : adjustable and variable duration, adjustable frequency

.

Diadynamic Currents

Modes : DF, MF, SP, LP and iDSP Amplitude : 0 to 70 mA Polarity : Positive, Negative or Automatic.

Monophase

Interrupted Galvanic : Frequency : 8000 Hz Work Cycle : 95% Polarity : Positive, Negative or Automatic. Amplitude : 0 to 40 mA

Direct Galvanic Polarity : Positive, Negative or Automatic. Amplitude : 0 to 40 mA

Square Monophase Phase Duration : 0.05 to 2000 uS ( steps of 10 uS ) Phase Interval : 1 100 ms ( steps of 1 mS ) Polarity : Positive, Negative or Automatic. Amplitude : 0 to 40 mA

Exponential Monophase Phase Duration : 0.05 to 2000 uS ( steps of 10 uS ) Phase Interval : 1 100 ms ( steps of 1 mS ) Polarity : Positive, Negative or Automatic. Amplitude : 0 to 40 mA

Trbert Ultra Exciting Phase Duration : 2 mS Phase Interval : 5 mS Polarity : Positive, Negative or Automatic.

NEUROMED 4080


Amplitude : 0 to 40 mA

Microcurrents Frequency : 1 Hz to 200 Hz ( steps of 1 Hz ) Polarity : Positive, Negative or Automatic. Amplitude : 0 to 40 mA

Equipment working conditions:

Room temperature : +10C to +40C Relative humidity : 0% to 80% Atmospheric pressure : 700 hPa to 1060hPa

Environmental conditions for transport and storage: Room temperature : -10C to 60oC Relative humidity : 20% to 90% Atmospheric pressure : 500hPa to 1060hPa

Optional Accessories:

Conductive rubber (Silicone) electrodes Code 04033 Self adhesive electrode Sponges pad Electrode cables

Yellow Code 21305G Green Code 21306G Blue Code 20307G Purple Code 21308G

Three-pole cable Code 14747G User manual Code 10395G

Note: In case of accesso

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MU 4080 English Version 1.0.0

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