INSTRUCTIONS FOR USEREAD CAREFULLY BEFORE USE

1 Introduction 12 HowTENSWorks 13 How EMS Works 24 SideEffects 75 Contents 86 InstallationofBatteries 87 BeltClip 108 TheProgrammes 119 ProgrammeSettings 1210 ControlsandDisplay 1911 Using the Manual Programme ‘M’ 2612 ConnectingLeadWires 2813 PositioningofElectrodePads 2914 GeneralAdvice 3915 Troubleshooting 4016 Cleaning 4117 Contraindications,Cautions&Warnings 4218 AccessoriesandSpares 4719 Guarantee 4720 WEEE 4821 TechnicalSpecification 4922 EMCPrecautions 51

CONTENTS

Section Page No.

1

1.INTRODUCTION

Device Description & Principles of Design

ThePerfectEMSisadualchannelTENS&EMSunitwithdigitalcontrolsforeasyuse.Achoiceofsixpre-setprogrammesandfourmanuallyadjustableprogrammesareavailable.TheoperationofthecontrolsisdescribedindetailinSections8to11.

TheTensCarePerfectEMSisadualchannelTENS&EMSunit. It has: •Twoindependentstrengthcontrolsforusewith 2padsor4 •90mAoutputover1KOhmload •Pre-setmodesincludingWarmUp,Endurance, PowerandBulk •ManualTENSprogramsgivingrangeof1-120Hz instepsof1;50-250uSinstepsof50 •ManualEMSprogramsgivingrangeof1-80Hz instepsof1;50-350uSinstepsof10 •Programtimerofupto90minutes •ProgramRetentionandUsageMemory

2

2.HOW“TENS”WORKS

TENSstandsforTranscutaneousElectricalNerveStimulation.TENSblocksnervesignalsandstimulatesthereleaseofendorphins-yourbody’sownnaturaldefencesagainstpain.TENSissafe,drug-freeandhasbeenusedsuccessfullybythousandsofpainsufferers.

TENS sends gentle stimulation through the skin which works in TWO ways:

Pain Gate

TENS stimulates the sensory nerves, which carry touchand temperature signals.These nerves go to the same connections in the spine asthe nerves carrying pain. Astrong sensory signal willblockthepainsignaltravellingup the spine to the brain.This is known as closing the “Pain Gate” and takes effectquite quickly after the unitis switched on. You can useTENS several times a day,for as long as you need to.

3

Endorphin Release

At low frequency settings, andslightly stronger outputs, TENSdrives the motor nerves to produce a small, repetitivemusclecontraction.Thisisseenbythebrainasexerciseandthispromotesthereleaseofendorphins–yourbody’sownnaturalpainkiller.Thereliefbuildsupandnormallytakesabout40minutestoreachamaximumlevelwhichcanlastforhoursafterthemachineisswitchedoff.

ByusingTENSyoucanexpecttoachieveasignificantreductioninpain,ifnotcompleterelieffrompain. •TENSiseffectiveforpainfromaverywiderange ofcauses. •Itdoesn’tappeartoproviderelieffrominternal painotherthanperiodpain. •Youcanuselowfrequency(<10Hz)programmes onacupuncturepoints,toachievesimilareffects toacupuncture. •Withneurogenicpain(causedbyinflamed nerves)suchasshinglesandneuralgia,TENS mayinitiallyincreasethepain.Werecommend thatyouonlyuseTENSfortheseconditions undermedicalsupervision.

4

• YoucansafelyuseTENSaslongasitgivesyoupainrelief.Theeffectmaywearoffafterafewhours(thisiscalled“accommodation”).Ifthishappens,takeabreakofanhourorsobeforetryingagain.TheEndorphinReleasesettingsshouldnotbeusedformorethanabout40minutes.Likeanyexercise,settingsthatcausemusclemovementmaycauseachingmusclesifusedtoolong.

3. HOW‘EMS’WORKSEMSstandsforElectricalMuscleStimulationandhassuccessfullybeenusedinmedicalrehabilitationandtrainingincompetitivesports.EMSproducesintensiveandeffectivemuscularcontraction,generatingextraordinarytrainingeffectsandrapidlyenhancingperformance.Inrehabilitation,EMSisawell-establishedmethodfortreatmentofabroadfieldofmusculoskeletaldiagnoses.Electricalstimulationofanintactperipheralnervoussystemmaycreatemotorresponsesinpatientswithimpairedorlostabilityforvoluntarymuscleactivity.

EMS is commonly used for:NeuromuscularFacilitation,MuscleRe-education,MuscleTraining,Prevention/SlowingofAtrophy/Hypotrophy,PreventingPostoperativeMuscleWeakness,ReductionofSpasticity,MaintainingorIncreasingRangeofMotion,

5

TrainingofPartialPeripheralNerveDamagewithSignsofReinnervation,TreatmentofScoliosis,IncontinenceTreatment.

EMSisacomplementtootherphysicaltherapyandshouldalwaysbecombinedwithactivemobility,strength,coordinationandfunctionaltraining.

Intraining,thetechnologyforelectrotherapyisusedforallkindsofmuscularexercise-warm-up,strength,speed,power,resistance,endurance,recoveryandalsoforrehabilitation.EMSiswellknownandworksasanexcellentcomplementtoregulartraining.

Advantages of EMS

UseofEMSmayleadtofasterprogressinthepatient’streatmentprogram.Themethodissimpleandappropriatefortreatmentintheclinicalsettingaswellasforself-treatmentathome.

Successfulathletesallovertheworldhavediscoveredtheadvantagesofelectricalmusclestimulation,suchasanincreaseofthelocalcirculationandthesizeofthemusclefibres.EMSalsohelpstoraisetheintakeofoxygenaswellasimprovingthemetabolicexchangeandtheconsumptionofenergyoftheuser.

6

How EMS Works

Muscularactivityisproducedbythecentralandperipheralnervoussystemstransmittingelectricalstimulitothemusclesofourbody.EMSusesexternalelectricalimpulsesthatworkthroughtheskintostimulatethenervessupplyingaspecificmusclegroup.

Themusclereactsindifferentwaysdependingonthestrengthofcurrent,durationandfrequencyoftheelectricalimpulse.

Musclesaremadeupoftwodifferenttypesoffibre:

1.Redfibreisslowercontractingandaerobicworking.

2.Whitefibreisfasteractingandcapableofanaerobicworking.

Theproportionsofredandwhitefibresdependonthewaythemuscleisused.

Fibrecanbeconvertedfromonetypetotheother,dependingonthesignalsitreceives.ThisisknownastheTrophiceffect.

Differentfrequencieshavedifferenteffects;lowfrequencies(1-10Hz)coupledwithlongimpulsetimes,forexample,haveapurifyingandrelaxingeffectthroughindividualcontractions,wherebythecirculationinthetreatedmuscleissimultaneouslyimprovedandremovalofmetabolicendproductsissupported(lymphaticdrainage).Theoxygensupplytothemuscleisimproved.

7

Incontrast,bymeansofarapidsuccessionofcontractions(fibrillation),mediumfrequencies(20-50Hz)canputahighlevelofstrainonthemuscle,thuspromotingthemuscularstructure.

Thepadsarenormallyplacednearthemusclemotornerveandtheunittransmitsastimulusthroughtheskin,withachoiceofspecifictherapeuticpatterns.Thecorrectpositioningofthepadsisimportant(pleaseseepages33-38).

4. SIDEEFFECTSTherearenoknownsideeffectstoTENSuseandlong-termTENSuseisnotharmful.IfyouareusingTENSforlongperiodsoftime,ensureyouallowtheskinunderneaththepadstobreathebymovingthepadseverysooften.

IfyouareusingEMSforlongperiodsoftime,allowadequateresttimebetweensessionstoallowyourmusclestimetorelax.Ifyouexperiencemuscleaching,simplyreducethestrengthofthemachineorallowyourmusclestorestuntiltheachingdisappears.

8

5. CONTENTSThispackcontains:

• PerfectEMSPainReliefUnit• Packof4,50x50mm,Self-AdhesiveElectrodePads(E-CM5050)

• BeltClip• 2xAA1.5V(TypeLR6)AlkalineBatteries• 2xLeadWire(L-CPT)• InstructionManual• Storage Pouch

6. INSTALLATIONOFBATTERIES

i) Removebeltclipbysliding down

9

ii) Removebatterycoverbypullingontag

iii) InsertbatteriesEnsurethatthebatteriesareinsertedtherightwayasshowninbatterycompartmentandthattheribbon is behind them

iv) Replacebatterycoverandbeltclip.

LOW BATTERYWhenthebatteriesarerunninglow,alowbatteryindicatorwillshowonthescreenanditisimportanttochangethebatteriesassoonaspossible.

RECHARGEABLE BATTERIES Theunitwillworkwithrechargeablebatteries,butthedisplaymayappeardimandoutputmaybereduced.

10

STORAGE RemovebatteriesfromyourPerfectEMSiftheunitisunlikelytobeusedforalongperiod.Some types of battery may leak corrosive fluid.

Alwaysdisposeofbatteriessafely.

7. BELTCLIPAbeltclipisprovidedtoallowyoutoattachthePerfectEMStoyourclothing.Slidetheclipalongthebackoftheunituntilitlocksinposition.

Youcanalsohangtheunitfromyourneckusingtheholesoneachshoulderoftheunit.Forsafety,usethreadorwoolthatwillsnapeasilyiftheunitsnagsonsomething.

Battery Warnings:

Keep batteries out of reach of small children.

If battery leakage occurs and comes in contact with skin or eyes, wash thoroughly with water and consult your GP.

Do not attempt to recharge alkaline batteries.

Do not pierce, expose to temperature of >600C, or leave near sources of heat

Do not connect the device unless the battery cover is in place

11

8. THEPROGRAMMESThePerfectEMShassixdifferent,speciallydevelopedEMSprogrammes(A-F),twomanualEMSprogrammes (G-H)andtwomanualTENSprogrammes(S-T).

ThereisnooneTENSsettingforaparticularconditionandthebestchoicevariesfromonepersontoanother,eveniftheyhavethesametypeofpain. Eachuserneedstoselectboththeprogrammeandthepositioningofthepadsthatisbestforthem.Youmayneedtotryafewpositions/programmesbeforefindingtheonethatsuitsyou.

Thefollowinggridsummarisestheprogrammesavailable:

USAGETENScanbeusedforaslongasisnecessary.Continuoustreatmentisfinebutelectrodepadsshouldberepositionedregularly(atleastevery12hours)toallow

12

theskintobeexposedtotheair.EndorphinReleaseworksbetterwhenthestrengthishighenoughtocausesmallmusclecontractions.Bestresultsareachievedatbetween20and40minutes.Longerusemaycausemuscleache.

IfyouareusingEMSforlongperiodsoftime,allowadequateresttimebetweensessionstoallowyourmusclestimetorelax.Ifyouexperiencemuscleaching,simplyreducethestrengthofthemachineorallowyourmusclestorestuntiltheachingdisappears.

9. PROGRAMMESETTINGS

TheeffectofElectricalStimulationonthebodydependsonthefollowingcurrentsettings:

Pulse Waveform

Thisdescribesthetimefunctionoftheexcitationcurrentwhichmaybeeithermonophasicorbiphasic.Withmonophasicpulsetrains,thecurrentflowsinonedirection.Withbiphasicpulses,theexcitationcurrentalternatesitsdirection(thecurrentflowsbackandforth).

13

ThePerfectEMSusesonlybiphasicpulsetrainsastheyreducestrainonthemuscle,leadingtolessmusclefatigueaswellassaferapplicationandalsoreducetheriskofskinirritationundertheelectrodepads. Pulse Frequency

FrequencyindicatesthenumberofindividualpulsespersecondandisindicatedinHz(Hertz=pulsespersecond).Itcanbecalculatedbyworkingouttheinversevalueoftheperiodictime.Differenttypesofmusclefibresreactpreferentiallytodifferentfrequencies. Slow-responsefibrestendtoreacttolowerpulsefrequenciesupto15Hz,whilefast-responsefibresonlyrespondtofrequenciesoverapproximately35Hz.Withpulsesofapproximately45~70Hz,thereispermanenttensioninthemuscle(tetany)combinedwithprematuremusclefatigue.Higherpulsefrequenciescanthereforepreferablybeusedforelasticityandmaximumstrengthtraining.

Thinkofweightlifting:ahigherpulsefrequencycorrespondstohigherweights.

14

For TENS:Afrequencyof110Hzisgoodatblockingpainsignals.Alowfrequencyof4or10Hzallowsforthereleaseofendorphins,thebody’snaturalpainreliefmechanism. Pulse Width

Pulsewidthisusedtoindicatethedurationofanindividualpulseinmicroseconds(millionthsofasecond).Pulsewidthalsodeterminesthepenetrationdepthofthecurrent.Ingeneral,agreatermusclemassrequiresagreaterpulsewidth.AhigherPulseWidthisalsomorelikelytoactivatepainnerves,sothereisafinebalancebetweenmaximummusclestimulationandtolerablesensation.

EMS:50μSforsmallmusclesliketheface,upto350μSforlargemuscles.TENS:50to250μS.ThepainreliefeffectdoesnotseemtobeverydependentonPulseWidth,sothechoicedependsmainlyoncomfort.Generallyasettingof200μSiseffective.

15

Pulse Strength

Settingthestrengthisdependentoneachindividualuserandisdeterminedbyanumberofparameterssuchasapplicationsite,skincirculation,skinthicknessaswellasqualityofelectrodecontact.Theactualsettingshouldbeeffectivebutshouldneverproduceanyunpleasantsensationsuchaspainatthesiteofapplication.InTENSprogrammes,youshouldalwaysbeawareofastrongtinglingsensation,butanysettingwhichleadstopainmustbeavoided. Withprolongedapplication,youmayneedtoincreasestrengthasnervesgetusedtothestimulationandbecomelesssensitive(knownasaccommodation). InEMSprogrammes,theobjectistoproducepowerfulmusclecontractions.Thestrengthofthecurrentshouldbeincreasedtoaboutthreetimesthelevelatwhichyoucanfirstfeelthetingling,ortoashighasyoucanstandwithoutcausingpain.

Youwillprobablyfeelthatelectricalcontractionismorepowerfulthanavoluntarycontraction,becausethecurrentalsostimulatesyoursensorynerves.Thesignalshaveapain-relievingeffect.Youmayfindthesensationuncomfortabletostartwith,sothatyoumaynotgetuptotherapeuticstrengthatthestartoftreatment.

16

Thestrengthcanbeincreasedduringthecourseofthetreatment,asyoubecomeaccustomedtothesensation.Voluntarymuscularactivityismoreeffectivethanstimulationanditmayimproveprogressifyoucombinevoluntarycontractionwithstimulation.Thepowerfulmusclecontractionscausedbyelectricalstimulationgiverisetotrainingaches,whichusuallydisappearwithinaweek.Aftertreatmenttinglingsensationsmaycontinueoryourskinmayfeelnumb,thisisnormal. WORKisthetimeinsecondsthatmuscleisstimulated(notincludingRamptime).ThePerfectEMSoffersarangeofworkperiodsfrom1-40seconds.

RESTisthetimeinsecondsatzerostrengthinbetweenstimulation(i.e.whenthemuscleisatrest).ThePerfectEMSoffersarangeofrestperiodsfrom1-40seconds.TheEMSprogrammesuseanActiveRest–lowfrequencypulseshelptoclearmetabolitesinbetweenWorkperiods.

Work/Rest Ratio. Ifyouareworkingmusclesyouneedtoallowarestperiodtoallowmetabolitestoclear.Atsettingsabove20Hz,youshouldallowatleasttwiceaslongaRestastheWorktime.Thinkingofweightliftingagain:withhigherpulsefrequency(largeweight)useahighStrength,shortWorktime,andlongResttimetosimulateasmallnumberofrepetitions.

17

RAMP isthetimeinsecondstakentomoveupanddownbetweenzeroandthesetstimulationstrength(i.e.thetimetakentomovebetweentheWorkstimulationandtheRestperiod).ThePerfectEMSoffersRampperiodsfrom0–5seconds.

Constant and Burst Modes TheTENSprogrammesofferachoiceofmodes.Constant modeiswhenthesensationiscontinuousversus Burstmodewhenthesensationcomesinbursts(onandoff).BurstgivesacombinationofPainGateandEndorphinReleasebutthesqueezingfeelingmaynotbeascomfortable.

9.2MANUALTENSPROGRAMMES(S-T)InTENSManualprogrammes(S-T)youcanselectandchangethefollowingparametersusingthe‘T’timerbutton:

Parameter to Change Display Symbol FlashesFREQUENCY HzPULSEWIDTH μSCONSTANT/BURST C/BTreatmentTimer(minutes) min

18

AfterusingprogrammesS-T,whenyouturnthedeviceoffandturnitonagain,allparameterswillberemembered.Strengthwillresumeat50%ofthatlastused.

9.3MANUALEMSPROGRAMMES(G-H)InEMSManualprogrammes(G-H)youcanselectandchangethefollowingparametersusingthe‘T’timerbutton:

Parameter to Change Display Symbol FlashesFREQUENCY HzPULSEWIDTH μSRAMPTIME(seconds)WORKTIME(seconds) WRESTTIME(seconds) RTreatmentTimer(minutes) min

Simplyclickthe‘T’timerbuttonuntilyourrequiredparametersymbolflashesonthedisplay.ThenusetheCH1▲orCH1▼toincreaseordecreasethevalues.AfterusingprogrammesG-H,whenyouturnthedeviceoffandturnitonagain,allparameterswillberemembered.Strengthwillresumeat50%ofthatlastused.

19

ON/OFF

Channel 2 Strength

DOWN

Programme Selected

Timer&ManualSetting

Selector

Time Selected (minutes)

KeypadLock

ProgrammeSelector Channel 2

Strength UP

Channel 2 StrengthChannel1

Strength

Timer Clock

Channel1Strength UP

Channel1Strength DOWN

10.CONTROLSANDDISPLAY

SCREEN DISPLAY W =“WorkMode”R=“RestMode”

=“LowBatteryWarning”

20

To turn the unit ON, pressthe ON/OFFbuttononthetopoftheunitandholdforat least 3 seconds untilthedisplayshows. To turn the unit OFF,pressthe ON/OFFbuttononthetopoftheunit and hold for at least 3 seconds untilthedisplayturnsoff.

The unit will turn OFF automatically:•Whenthetimerreacheszero.•Ifitisleftatzerostrengthformorethan5minutes.

Theunitwillstartwiththeprogramyouusedlastandat50%ofthestrengthyouwerelastusing.

Atfirstuse,orafterchangingbatteries,thedisplayshowsthattheunitisautomaticallysetinProgrammeAatzerostrength.

21

STRENGTH CONTROLSThe buttonsmarkedCH1▲,CH1▼,CH2▲,CH2▼ are strengthcontrols.

Thelefthandbuttonschangestrengthinthelefthand lead (CH1) and the righthandbuttonschangethe right hand lead (CH2).

Toincreasestrengthinstepsof1,pressandreleasethetoppartofthetwochannelbuttons,marked▲.ThestrengthlevelsareshownontheLCD.

Thestrengthcontrolbuttonswillnotoperateuntiltheunitisproperlyconnectedtoyou.IfthePerfectEMSdetectsadisconnectionineitherchannelitwillautomaticallyreturnthestrengthinthatchanneltozeroandflash‘CH00’.

ThePerfectEMShas90 levels of strength.Ratherthanmakingmultiplepresses,ifyouholddowneitherofthe▲ buttonsfor>2secondsthestrengthwillchangecontinuouslyuntilyoureleasethebutton.Youmaynotfeelanysensationoverthefirstfewpresses.Continuepressinguntilthesensationisstrongbutcomfortable.Furtherincreasesduringusemaybenecessaryifyourbodybecomesaccustomedtothe

▲ CH1

▼

▲ CH2

▼

22

sensation.Todecreasethestrength,pressandreleasethelowerpartofthebuttonsmarkedCH1▼or CH2▼.PressingastrengthbuttonautomaticallystartsaWORKperiod.

PROGRAMME CONTROL

Thebuttonmarked‘P’istheprogrammecontrol.ThePerfectEMShassixdifferent,speciallydevelopedEMSprogrammes(A-F),twomanualEMSprogrammes(G-H)andtwomanualTENSprogrammes(S-T).

WhentheunitisfirstswitchedonitautomaticallyentersProgrammeA.

Eachtimeyoupressandreleasethe‘P’button,theprogrammechangesandtheprogrammeletterisshownontheLCD.

Eachtimeyouchangetheprogramme,thestrengthlevelrevertsbacktozero.Thisisasafetyfeaturetoalleviateanysuddenfeelingofasurge,aseachprogrammegivesadifferentsensation.

23

TREATMENT TIMER

The ‘T’buttoncanbeusedtosetthesessiondurationandtoselectmanualparametersforadjustment.Whenyouswitchtheuniton,itisautomaticallysetatContinuous,(displayedas‘C’)inallprogrammesexceptB,C&H,whichmeansthattheunitwillcontinuefunctioninguntilyouswitchitoff.

Whenyoupressthe‘T’button,the‘min’symbolwillflash.Youcansetsessiontimesof10,20,30,45or90minuteswiththeCH1▲ andCH1▼ buttons.Press ‘T’againtosaveyourselection.

Thedisplayshowsthesessiondurationnexttotheclocksymbol.Theunitautomaticallycountsdowntheminutessetandswitchesoffwhenthisreacheszero.

LOW BATTERYAnemptybatterysymbolwillshowwhenyouneedtochangethebatteries.Theunitwillshutdownapproximately2minutesafterthis.

24

KEYPAD LOCKIfyoudonotpressanykeysfor30seconds,thekeypadwilllocksothatonlythekeysmarked▼willwork.Thisistoavoidaccidentalchangesinsettings.Tounlock,holddowneithertheCH1▼ or CH2▼ buttonforafewsecondsuntilthelocksymboldisappearsfromthedisplay.

OPEN CIRCUIT CUTOUTIfthePerfectEMSisnotcorrectlyconnectedtoyourbody,thestrengthinthechannelwhichisnotproperlyconnectedwillautomaticallyresettozero.Thisistopreventsuddenchangesifabrokenconnectionisre-made.Ifthisoccurs,checktheleadwireconnectionsandensureallpadsareincompletecontactwiththeskin.

25

MEMORYThePerfectEMShasamemorywiththreefunctions:

1) Programme Retention Whenyouswitchtheuniton,itwillautomaticallystartintheprogrammewhichwasbeingusedwhenitwasswitchedoffandat50%ofthestrengththatwaslastused.

2) UsagePress ‘T’ and ‘CH2▼’togetherandholddownfor3seconds.Thedisplaywillshowthenumberoftimestheunithasbeenusedandthedurationofuseinhours.

Pressthesamebuttonsagaintoreturntonormalcontrolsanddisplay.

3) Memory Reset Toresetthememorytozero,holddownthe‘T’ and ‘CH1 ▼’buttonstogetherfor3seconds.Thescreenwillflashwithbothoftheabovevaluesshownas‘0’.

Numberofuses

Time used in hours

26

11.USINGTHEMANUALPROGRAMMES(G,H,S,T)

In Programmes G & Hyoucanindependentlyadjust:• Frequency inHz• Pulse Width in µS• Ramp in seconds• Work Rest in seconds • Timerinseconds.

In Programmes S&Tyoucanindependentlyadjust:• FrequencyinHz• Pulse Width in µS• Mode Continuous or Burst • Timerinseconds.

Toadjusttheseparameters,simply:a)Press‘T’tochangetheparameters:The ‘Hz’symbolwillflashnexttothenumberatthelowercentreofthescreen.

RampTime

Work Time

RestTime

FrequencyHz

Pulse Width µS

Treatment Time

TENS Mode

27

b)PressCH1▲andCH1▼ toadjustthefrequency:

Youcanselect:-1-80HzinprogrammesG and H and 1-120HzinprogrammesS and T

c)Press‘T’againtosaveyourchangeandadvancetothenextsettingµS(pulse width):

Youcanselect:-50-350µsinprogrammesG and H and50-250µsinprogrammesS and T

d)Press‘T’ again to select Ramp:(ModeinSandT) Youcanselect0-5 secondse)Press‘T’ again to select Work Time: Youcanselect1-40 secondsf)Press‘T’ again to select Rest Time: Youcanselect1-40 secondsg)Finally,youcanselecttheTreatment Timer(clocksymbol): Continuous, 10, 20, 30, 45, 60 or 90 minutesh)Press‘T’ once more to return to the main screen to beginusingyourPerfectEMS.

WhenNOsymbolsareflashing,youcanpressCH1▲ or CH2▲toincreasethestrength.

See Section 8 and 9 for more information on the choice of settings available.

28

12.CONNECTINGLEADWIRES

Inserttheleadwireplugsintothebaseoftheunit.

Attaching the electrode pads to lead wiresPushthepinendsfirmlyintothepigtailendsoftheelectrodepads.

Theleadwiresmaybedamagedbyroughhandlingandshouldbetreatedwithcare.

Lead wire colour codingTheendsoftheleadwireareblack(-ve)orred(+ve).Thiscodingisprovidedforsomeprofessionaluses.FormostTENSapplications,youcanignorethecolourcoding.

29

13.POSITIONINGOFELECTRODEPADS13.1.TENSELECTRODEPADPLACEMENT

•TENSworksonevertebraatatime.Youneedtostimulatethesensorynervesthatenterthespineatthesamelevelasthenervecarryingyourpain.Sinceyoudon’tknowexactlywhereyournervesare,thesimplestthingistoapplythepadsaroundorneartothesourceofthepain.•TENSbestactivatesthenervesifittravelsalongthenerveratherthanacrossit.Soplaceonepadfartherfromthespinethanthesourceofthepainandplaceonepadcloser.•Thenerveswraparoundthelimbsandtorso,soyoumayhavetotryafewpositionsbeforeyougetthebesteffect.•Ifthepainisin,orcloseto,yourspineyoucanplaceonepadeithersideofthespine. •Youmayfeelmoresensationinonepadthantheother.Thisisnormal–itdependsonwherethepadsareplacedinrelationtoyournerves.Thefollowingpicturesshowsometypicalpadpositionsforarangeofcommoncomplaints.

30

NOTES:• Forsymptomsnotillustrated,seekadvicefromyour

doctororphysiotherapist.• Theelectrodepadsmustalwaysbeusedinpairs(two

padsoneachchannel),sothatthesignalcanflowinacircuit.

• AlwayscheckunitisswitchedOFFbeforeattachingorremovingpads.

• ThePerfectEMSresetsthestrengthtozeroifthepadorleadisdisconnectedfromyourbody.Thisistopreventsuddenchangesinsensationwhenthepadisre-connected.

• Forareasthataredifficulttoreach,whynotaskafriendtohelpyouattachthepads?

31

ELECTRODEPADPOSITIONS

Neck & Shoulder Low Back Pain Tension Sciatica

See section 17 for information on where you should not place electrode pads.

Shoulder Pain Knee Pain Elbow Pain

Ankle Pain Headache/Nausea Leg Pain

32

13.2.EMSElectrodePadPlacement

ElectrodeplacementforEMSisveryimportantforobtainingthebestresults.Placetwoelectrodesoverthebulkofthemuscle,withoneelectrodeoverthemuscle’smotorpoint.Themotorpointistheareaontheskinthatislocatedclosesttothemotornerve’sentryintothemuscle–about1/3ofthewaydownthemusclefromthespine.Here,itiseasiesttotriggeracontractionbyelectricalstimulation(seeimagesonpages37-38).

Experimentbymovingtheelectrodeacrosstheskinuntilyoulocatethepointoverthemusclethatgivesthecleanestcontraction.Intheexamplesonthefollowingpages,thepadsaremarked +ve (red) and -ve (black) tomatchtheredandblackleads.Thepositive(redconnector)electrodeshouldbeclosesttothespine.

Largemusclegroupsmayrequirestimulationwithtwochannels,thatis,fourelectrodessimultaneously.Theelectrodepadsmustalwaysbeusedinpairs,sothatthesignalcanflowinacircuit.

NOTE:AlwayscheckthattheunitisswitchedOFF beforeattachingorremovingpads.

Use50x50mmsquareelectrodepadsforallareasexcepttheface,wheresmaller25x25mmdiameterelectrodes

33

maybenecessary(thesecanbepurchasedasaseparateaccessory-seeSection18).

Whenexercisingsmallermuscles,takecaretoadjustthestrengthslowlyasthemotornervesmaybemoresensitiveandusingsmallerelectrodesincreasesthecurrentdensity.

Example EMS Electrode Pad Positions

Eye careYoucanuseProgrammeFtostimulatethemusclesaroundtheeyestoreducewrinklesandpuffinessassociatedwiththesignsofaging.Youwillnoticethemusclesworkingstraightawayfromtheslighttwitching.Theactivationofthemusclesstimulatesthecirculation.Thisrelaxingskincarealsocontributestoanincreaseinwell-being,makingyouappearmoreawakeandcontent.

Usesmall25x25mmroundelectrodes(thesecanbepurchasedasaseparateaccessory-seeSection18).Inordertopreventtriggeringunpleasantsensations,youshouldincreasethecurrentstrengthverycarefully.

34

Stomach / HipsWeightreductioniseffectivelyaidedbytrainingthestomachmuscles.WiththePerfectEMS,youcanselectsingularmusclesfordirectstimulation.Thestomachcontainsseveraldifferentindividualmusclesandthecentralstomachmuscleisresponsibleforgivingyouaslimstomachandagoodupperbodyposture.

ButtocksThebottomisequippedwitha very strong set of muscles.Unfortunately, unwanted fat and cellulite zones are oftento be found in this area andare very difficult to combat.Musculartrainingisonewayofimproving shape. The pictureshows the possible electrodepositionsforbuildingmuscles.

35

Upper ArmsOurupperarmsoftenhavelittleshape,usuallycausedbyalackofmovementandmuscularwork.ThePerfectEMScanbeusedtocarryoutmuscletraining.Inthiscase,itisallaboutstimulationofthecirculationofblood.Youhavetheoptionoftreatingthefrontsideorthereversesideofbothupperarmsdependingonwheretheneedisgreatest.

Chest and ShouldersBuildingchestandshouldermuscleimprovespostureandmovementintheupperbodyasawhole.

36

Legs - Thighs and CalvesItisusuallyalackoftrainedmusclesinthelegswhichdisturbsusmost,particularlyinconjunctionwithareasofcelluliteinthethigharea.Targetedmuscletrainingforthefrontandbackofthethighandcalvesisverysimpletoperform.

37

EMSELECTRODEPLACEMENTCHART-FRONT

38

EMSELECTRODEPLACEMENTCHART-BACK

39

14.GENERALPADADVICE

•Theelectrodepadssuppliedarereusablebutareforsinglepatientuse.•Inordertoobtainthebestconductivitythroughthepads,alwaysensurethattheyareingoodconditionandtacky.•Beforeuse,makesureyourskiniscleananddry.•Peeltheelectrodepadsfromtheirprotectiveplasticshieldbyholdingandliftingonecornerofthepadandpulling.DoNOTpullonthepigtailleadwireofthepad.•Afterusealwaysreplacethepadsontheplasticsheetprovidedandplaceinthere-sealableplasticbag.•Ifthepadsdryoutthenitisbesttobuyareplacementpackofelectrodes.Inanemergencyitmaybepossibletorestoresomeofthetackinessofthepadbyaddingatinydropofwateroneachpadandspreading around.Iftoomuchwaterisaddedthepadswillbecometoosoft.Ifthisoccurs,simplyplacethepadsstickysideupinarefrigeratorforafewhours.•Inveryhotweatherthegelonthepadsmaybecomesoft.Insuchcasesplacethepads,stillontheirplasticlinersandintheirbag,intoafridgeuntiltheyreturntotheirnormalcondition.•Thepadsprovidedarelatex–free.•Replacepadswhentheylosetheirstickiness. Poor connection may cause discomfort and skin irritation.

40

•Storagelifeofanunopenedpackofelectrodesis2years.Thismaybeaffectedbyveryhightemperaturesorverylowhumidity.

15.TROUBLESHOOTINGIfyourmachineisnotworkingproperlypleasecheckthefollowing:Problem Possible Causes SolutionNo display FlatBatteries Replacebatteries

Batteriesinsertedincorrectly

Check

Damagedspringsinbatterycompartment

Contactsupplier

Low battery display Lowbatteries ReplacebatteriesNo sensation Incorrect

connectionHaveyouappliedbothelectrodepads(perleadwire)toensureacompletecircuit?Aretheleadsproperlyconnectedto the machine and theelectrodepads?

Not strong enough Steadilyincreasestrength.Mostuserswillfeelsomethingatasettingbelow20

41

Problem Possible Causes SolutionOutput will not increase above zero

Opencircuitcut-outoperating.Either: Electrodes not connectedtobodyorfaulty/damaged OR Leadwiresfaulty/damaged.

Ensure the electrodes areattachedtoyourbodycorrectly.Tryusing the second lead.Purchasereplacementelectrodesorleadsifnecessary.

(Leadwirescanbreakatthebendwheretheyleavethemachinegivingnoorintermittentoutput)

Sudden change in sensation

Ifyoudisconnectandre-connectafewminuteslater,thesignalwillfeelquite a lot stronger

Alwaysreturnstrengthtozeroafterdisconnectingthelead or electrode pads.

Iftheabovereviewhasfailedtoresolveyourproblem,ortoreportunexpectedoperationorevents,callTensCareon01372723434oryourlocaldealer(addressonbackcover)foradvice.

16.CLEANINGCleanthecaseandleadwiresatleastonceaweekbywipingwithadampclothandasolutionofmildsoapandwater.Wipedry.

Do NOTimmerseyourTENSmachineinwater.Do NOTuseanyothercleaningsolutionthansoapandwater.

15.TROUBLESHOOTING(CONT.)

42

17.CONTRAINDICATIONS,WARNINGS&CAUTIONSCONTRAINDICATIONS• Do not useifyouhaveaheartpacemakerorhavea

heartrhythmproblem.TENS or electrical stimulation in the direct vicinity of a pacemaker may affect some models. If TENS or electrical stimulation is applied on the front of the neck this can affect your heart rate. Very strong TENS or stimulation across the chest may cause an extra heartbeat.

• Do not use ifyouhaveepilepsy.TENSmayaffectseizurethreshold.

• Do not use ifyouarepregnantorattemptingtobecomepregnant.It is not known whether TENS or electrical stimulation may affect foetal development.

• Do not useontheabdomeninthelaterstagesofpregnancy.Stop use immediately if you experience unexpected contractions.

• Do not usewhendriving,operatingmachinery,orsimilaractionsneedingfinecontrol.Loose pads, damaged leads, or sudden changes in contact may cause brief involuntary muscle movements.

• Do not usetomaskorrelieveundiagnosedpain.This may delay diagnosis of progressive condition.

• Do not useifyouhavecognitivedisabilities,i.e.;Alzheimer’sdiseaseordementia.

43

In this manual:

A Warningisusedwhenfailuretofollowtheinstructionsmayresultinseriousinjuryordeath. A Cautionisusedwhenfailuretofollowinstructionsmayresultinaminorormoderateinjury,ordamagetothedeviceorotherproperty.

Notesareusedtoprovideclarificationorrecommendation.

WARNINGS:Warning: The device should not be used while walking,driving,operatingmachinery,oranyotheractivityinwhichinvoluntarymusclecontractionmayputyouatriskofinjury.Warning:Ifyouhaveactivecancer,consultwithyourclinicianbeforeuseduetoconcernsforstimulationpotentiallyspreadingcancerouscells.Warning: Cautionshouldbeusedifyouhavesuspectedordiagnosedepilepsyaselectricalstimulationmayaffectseizurethreshold.Warning: Cautionshouldbeusedifyouhaveableedingdisorderasstimulationmayincreasebloodflowtothestimulatedregion.

44

CAUTIONS:Caution: ObservecautionwhenusingthePerfectEMSatthesametimeasbeingconnectedtomonitoringequipmentwithbodywornelectrodepads.It may interfere with the signals being monitored.Caution:Strongelectromagneticfields(electrosurgery/microwavecookers/mobilephones)mayaffectthecorrectoperationofthisunit—seeSection22.Ifitappearstobehaveunusually,moveitawayfromthesedevices.Caution:Usecautionfollowingrecentsurgicalprocedures.Stimulation may disrupt the healing process.Caution: ObservecautionwhenusingthePerfectEMSathighstrengthsettings.Prolonged use at high settings may cause muscle injury or tissue inflammation. The Perfect EMS is capable of delivering outputs in excess of 10 mA (RMS) or 10 V averaged over any period of 1 s”.Caution: Notsuitableforchildrenunder5yearsofage.Longcord-riskofstrangulationininfants.

45

Do NOT place electrode pads:On broken skin

The pads could encourage infection.On skin which does not have normal sensation

If the skin is numb, too great a strength may be used, which could result in skin inflammation.

On the front of the neckCould cause the airway to close, giving breathing problems. May cause sudden drop in blood pressure (vasovagal response).

Over the eyesMay affect eyesight or cause headaches.

Across the front of the headEffect on patients who have had strokes or seizures is not known.May affect sense of balance.The effects of stimulation of the brain are unknown.

Near malignant tumoursIn vitro experiments have shown that electricity can promote cell growth.

Do not:Ignoreanyallergicreactiontotheelectrodepads:

If a skin irritation develops stop using TENS, and try a different type of electrode. Alternative pads specially made for sensitive skin are available, see Section 18.

46

TO KEEP YOUR DEVICE IN GOOD WORKING ORDER, OBSERVE THE FOLLOWING ADDITIONAL CAUTIONS

DonotimmersethePerfectEMSunitinwaterorplaceitclosetoexcessiveheat.It may cease to operate correctly.DonotattempttoopenupthePerfectEMSunit. This will invalidate the guarantee.Donotusethisdevicewithleads,electrodesandaccessoriesotherthanthoserecommendedbythemanufacturer.Performance may vary from specification and will invalidate the warranty. KeeptheunitawayfromsourcesofhighmagneticfieldssuchasTV’s,microwaveovensandhi-fispeakersasthesemayaffecttheLCDscreen.Keepthedeviceawayfromafireplaceorradiantheaterastheheatmayaffectthedevice.Keepthedeviceawayfromnebulizerorsteamkettleasthemoisturemayaffectthedevice.Keepthedeviceawayfromsunlightaslong-termexposuretosunlightmayaffecttherubbercausingittobecomelesselasticandcrack.Keepthedeviceawayfromlintanddustas long-termexposuretolintanddustmayaffectthesocketsorcausethebatteryconnectortodevelopabadcontact.Donotmixold,newordifferenttypesofbatteries.

47

18.ACCESSORIESANDSPARESExpected Service Life•Themachinewilloftenlastformorethan5years,butisguaranteedfor2years.•Leadlifedependsgreatlyonuse.Alwayshandletheleadswithcare.•Padsshouldlast12-20applications,dependingonskinconditionandhumidity.•AAalkalinebatteriesshouldlastatleast15hours.

ThefollowingreplacementpartsmaybeorderedfromtheTensCarewebsiteatwww.tenscare.co.ukorbycalling+44(0)1372723434.

E-CM5050Packof4,50x50mmelectrodepadsE-696SS-4Packof4,50x50mmhypoallergenicelectrodepadsE-CM25Packof10,25x25mmcircularelectrodepadsL-CPT CPTLeadwireB-AA 1.5VAAbatteriesX-BC-PTReplacementbeltclipX-BL-PTTReplacementbatterycover

19.GUARANTEE

YourTensCaredeviceisguaranteedfortwoyearsfromthedateofpurchase.Ifafaultdevelops,returntheunittoTensCareattheaddressonthebackcoverofthismanual,togetherwithacopyofyourinvoiceanddetails

48

oftheproblem.Theguaranteedoesnotcoveraccessories(thebatteries,electrodepadsorleadwires).

Pleasenotethattheguaranteeisinvalidatedifincorrectbatterieshavebeenfitted,ortheunithasbeenimmersedinwater,maltreatedorotherwisetamperedwith.

20.DisposalofWasteElectricalAndElectronicProducts(WEEE)OneoftheprovisionsoftheEuropeanDirective2002/96/CEisthatanythingelectricalorelectronicshouldnotbetreatedasdomesticwasteandsimplythrownaway.Toremindyouofthisdirectiveallaffectedproductsarenowbeingmarkedwithacrossed-outwheeliebinsymbol,asdepictedbelow.

Tocomplywiththedirectiveyoucanreturnyouroldelectro-therapyunittousfordisposal.Simplyprintapostage-paidPACKETPOSTRETURNSlabelfromourwebsite www.tenscare.co.uk,attachthistoanenvelopeorpaddedbagwiththeunitenclosed,andpostitbacktous.Uponreceiptwewillhandleyourolddeviceforcomponentsrecoveryandrecyclingtohelpconservetheworld’sresourcesandminimiseadverseeffectsontheenvironment.

49

21.TECHNICALSPECIFICATIONAmplitude: 90mAzeropeakto+veinstepsofapprox.(over1KOhmload) 1mAChannels: Dual ChannelWaveform: SymmetricalsquarewaveBi-PhasicPower: 2xAAAlkalineLR6batteriesBatterylife: Atleast15hoursat50mA300uS50HzAdjustableTimer: 10,20,3045,60,90min Defaultsto20minOutputplug: Fullyshielded:TouchProofWeight: 80gmwithoutbatteriesDimensions: 115x53x27mmSafetyClassification: Internalpowersource.TypeBF: Designedforcontinuoususe.IP22. Nospecialmoistureprotection.

EnvironmentalSpecifications:Operating:

Storage:

AppliedPart: SelfadhesiveskinelectrodeContactduration: Atleast10minutesNB:Theelectricalspecificationsarenominalandsubjecttovariationfromthelistedvaluesduetonormalproductiontolerancesofatleast5%.

Temperaturerange:5to40C

Humidity:15to93%RH

Atmosphericpressure700hPato1060hPa

Temperaturerange:-25to+70C

Humidity:93%RHnon-condensing

Atmosphericpressure700hPato1060hPa

50

Symbols Used Attention!PleasefollowtheinstructionsintheUserManual.

TYPEBFEQUIPMENT:Equipmentprovidingadegreeofprotectionagainstelectricshock,withisolatedappliedpart.Indicatesthatthisdevicehasconductivecontactwiththeenduser.

Thissymbolontheunitmeans“RefertoInstructionManual”.

TemperatureLimitation:indicatesthetemperaturelimitstowhichthemedicaldevicecanbesafetyexposed. LotNumber:indicatesthemanufacturer’sbatchcodesothatthebatchorlotcanbeidentified.

HumidityLimitation:indicatesthehumiditylimitstowhichthemedicaldevicecanbesafelyexposed.

SerialNumber:indicatesthemanufacturer’sserialnumbersothataspecificmedicaldevicecanbeidentified.

Donotdisposeinhouseholdwaste.

CatalogNumber:indicatesthemanufacturer’scatalognumbersothatthedevicecanbeidentified.

This medical device is not water resistant and should beprotectedfromliquids.

LOT

S/N

REF

51

AtmosphericPressure:indicatestheatmosphericlimitstowhichthemedicaldevicecanbesafelyexposed.

DateofManufacture:indicatesthedatewhichthemedicaldevicewasmanufactured.Thisisincludedwithintheserialnumberfoundonthedevice(usuallyinthebatterycompartment),eitheras“E/Year/Number”(YY/123456)or“E/Month/Year/Number”(MM/YY/123456). Thismedicaldeviceisindicatedforhomeuse.

The first number 2: Protectedagainstaccesstohazardous partswithafinger,andthejointedtestfingerof12mmø,80mmlength,shallhaveadequateclearancefromhazardousparts,andprotectedagainstsolidforeignobjectsof12.5mmøandgreater.The second number 2:Protectedagainstverticallyfallingwaterdropswhenenclosureistiltedupto15˚.Verticallyfallingdropsshallhavenoharmfuleffectswhentheenclosureistiltedatanyangleupto15˚oneithersideofthevertical.

IP22

22.EMCPRECAUTIONSWirelesscommunicationsequipmentsuchaswirelesshomenetworkdevices,mobilephones,cordless telephonesandtheirbasestations,walkie-talkiescanaffectthisequipmentandshouldbekeptatleastadistanced=3,3mawayfromtheequipment. (Note.AsindicatedinTable6ofIEC60601-1-2:2007forMEEQUIPMENT,atypicalcellphonewithamaximumoutputpowerof2Wyieldsd=3,3matanIMMUNITYLEVELof3V/m).

Forhospitaluse,fullEMCtablesareavailableonrequest

52

NOTES:

Distributedby:

Manufacturedby:

TensCareLtd,9BlenheimRoad,

LongmeadBusinessPark,Epsom,Surrey,KT199BE,UKTel:+44(0)1372723434Fax:+44(0)1372745434Email:info@tenscare.co.ukWeb:www.tenscare.co.uk

Pub Ref: I-PEMS-UK Rev 1.2 04/17

0088