intelect advanced epr - djoglobalstorage.djoglobal.eu/.../intelect_adv_emea_dealer.pdf ·...
TRANSCRIPT
©D
JO Incorporated
2762CC Intelect Advanced Color Combo + EMG
2752CC Intelect advanced color Combo
2772MC Intelect Advanced Monochromatic Combo 2778 Intelect Mobile Combo
2776 Intelect Mobile Ultra sound
2778 Intelect Mobile Laser (without probe)
2778 Intelect Mobile Stim
Intelect Advanced EPR
©D
JO Incorporated
Objectives Chattanooga PMM Overview Business objectives. Markets Product positioning. Value proposition. Chattanooga EPR review Features & Benefits. Clinical Indications / Contraindications
©D
JO Incorporated
Chattanooga PMM Overview
Recovery sciences
Level 2
Combo*
Ultrasound *
Laser*
BiofeedbackPhysical medicine modalities
Tables and traction
Mobility and active training
Hot & Cold
Tables
Traction
NMES
PT equipment
PT consumables
OT consumables
Level 1
Electrodes
Iontophoresis/DD
TENS
Clinical *
Shockwave
Diathermy
Continuous passive motion
Acute care therapy
Vital stimulation
©D
JO Incorporated
Chattanooga PMM Overview cont-
Clinical electrotherapy is a medium sized market with a total size of $200M globally.
Estimated growth at 3-5% annually. DJO participates in several markets within this including clinical devices, iontophoresis, diathermy, shockwave, and electrodes.
Chattanooga has a strong 40% share of the $50M market,primarily from the legacy and intelect advanced Chattanooga brands.
©D
JO Incorporated
Chattanooga EPR positioning
Convenience
Functionality
Hospitals,Out-patient Clinics, Institutions
Private practices ,on-field sport mobile usages
©D
JO Incorporated
EPR Review Intelect advanced platform
2762CC Intelect Advanced Color Combo + EMG
2752CC Intelect advanced color Combo
2772MC Intelect Advanced Monochromatic Combo
•25 + waveforms!•2 independent electrotherapy channels.•Over 200 clinical protocols.•Ability to program over 100 user defined protocols.•Over 10 quick link indications for quicker access.•Clinical & Pathological library designed by Physiotherapists for every clinician.•Patient data storage cards.•1 & 3 MHz ultrasound frequencies.•Continuous & Pulsed 10,20,50 delivery modes.•Ergonomically designed U.S. applicators- 1,2,5 & 10cm .•Audio & visual coupling systems.•Head-warming option for patient comfort.
©D
JO Incorporated
Only with combo +EMG
Intelect advanced Standard accessories
Standard accessories included:
•Patient data card (1)•5 cm applicator•Nylatex wrap, •Flexible electrodes and sponges 6x8cm (4) •Ultrasound gel, •CD user manual, •EMG and sEMG+Stim module (2762CC only), •Intravaginal probe (2762CC only)• 3 cm electrodes (2762CC only)
©D
JO Incorporated
Overview of Clinical Modules EMG Three broad purposes :• To increase muscle activity.
• To decrease muscle activity.
• To re-educate muscle activities.
©D
JO Incorporated
EMG indications- INCONTINENCE :Retraining of pelvic floor muscles using intra vaginal or anal probes
but also surface electrodes
SOFT TISSUES INJURIES : Mostly due to hyper tonus Biofeedback goal is to modify postural behavior decreasing and/or balancing muscle activity. the information is more qualitative as long as Signal variability is a major issue with Surface EMG.
GENERAL REHAB: Improving the outcomes of problems affecting voluntary muscle contraction ( post surgery, Nerve transplant, Muscle and Tendon trauma
PAIN : Chronic pain produce reductions in joint movements and associated muscle tightness. EMG Biofeedback is used to promote relaxation
SPASTICITY: Use to reduce and control spasticity
STROKE retraining the voluntary activation of the wrist extensors, Shoulder abductors, and ankle dorsiflexors
©D
JO Incorporated
EMG contraindications-
•There are no contraindications to EMG Biofeedback but limits to the actual method.
•Applicable to superficial muscles only.
•Practitioner expertise important.
•Patient must actively be able to participate.
.
©D
JO Incorporated
Stimulation module
Galvanic current-Direct current that flows 1 second or more continuously.
Clinical usage-Iontophoresis use of current flow between two electrodes to push ions through the skin barrier.
Allows adding another 2 channels
©D
JO Incorporated
Waveforms continued-
Russian current (KOTZ current)
Russian Current name derives from muscle stimulation works conducted by Russian scientist KOTZ in the late 1970’s It is a 2,5kHz sinusoidal wave form deliver in bursts ( series of pulse) with a 50% duty cycle.
Clinical usage-• Innervated muscle stimulation •Strengthening
©D
JO Incorporated
Waveforms continued- TENS Trancutaneous nerve stimulation. TENS is the popularized name for electrical stimulations to treat pain. It is rectangular biphasic ( symmetrical or
asymmetrical wave form at frequencies in a range 1 to 120Hz and pulse duration from 50 to 200µs Physiological effects-• Nerve excitability: Selective excitability of A Beta and A Delta fibers (sensory nerves) for Gate control and Alpha Moto neurons ( producing muscles twitches at low
frequency) for Endorphin release. Short duration and rectangular pulse shape provide very comfortable stimulation.
• Clinical usages-• Acute and Chronic Pain • Nocioceptive or neurogenic pain• Dysmenorhea • Angina pectoris• Labor pain but not during actual partum.
©D
JO Incorporated
Waveforms continued- NMES Description The current use for Neuro Muscular Electrical stimulation is basically a TENS current as rectangular biphasic
(symmetrical wave form at frequencies in a range of 1 to 120Hz and pulse duration from 150 to 500µs Physiological effects• Nerve excitability: Excitability of Alpha motor neurons producing normally innervated muscles contractions.
Short duration and rectangular pulse shape can provide very strong contractions but very comfortable stimulation.
• Clinical usages-• Normally innervated muscle stimulation• Prevention of Atrophy• Mobilization• Muscle reinforcement • Functional Electrical Stimulation
©D
JO Incorporated
Waveforms continued- INTERFERENTIAL (IFC)
Description Interferential currents IFC are two Alternating currents applied in a continuous mode Frequencies are in the range of 1-10kHz. The currents have a slightly different frequency. The total current
amplitude is the sum of the two currents at any point in the tissue where they interfere.
Physiological effects• Deep efficiency of stimulation ( maximum stimulus is produced at depth ) • High frequency currents are more comfortable in case of High impedance ( resistive skin and fat tissues)• Nerve excitability• Gate control• Endorphins & encephalin release.
• Clinical usages-• Pain ( same as TENS )
time
©D
JO Incorporated
Waveforms continued-INTERFERENTIAL 4 pole Vector
Vector rotation•This is achieved by rhythmically increase or decrease the amount of current applied on each pair of electrode over a period of several seconds ( when one current goes up the other goes down and vice versa). Vector rotation will change the pattern of stimulation in the tissue volume. Increasing the current in one direction between one pair of electrode will stimulate more fibers lying parallel to the current path.
Clinical usage-
Greater stimulation is produced at deeper depth. Mainly use for pain ( gate control) . Whirlpool effect.
I2I1
Itotal
I1
I1
I2
I2
©D
JO Incorporated
Waveforms continued-
PREMODULATED INTERFERENTIAL 2 poles
DescriptionThe 2 frequencies are combined within the stimulator producing one current claimed as having similar parameters to the expected outcome of current mixing in tissues producing better comfort.
Clinical usage-Easier to apply Maybe be more effective and comfortable in muscle stimulationGreater stimulation remains superficially to treatment.
I1
I1
©D
JO Incorporated
High Voltage pulsed currents-
DescriptionThe High Voltage Pulsed Current (HVPC) has a very brief pulse duration ( 7µs) characterized by two distinct peaks delivered at high (100-500V) voltage. The waveform is monophasic (current flows inone direction only).
Clinical use PainWound healingBetter tissue penetration in impedance issue patients.
Volt
time7µs
Waveforms continued-
©D
JO Incorporated
Waveforms continued-BIPHASICS PULSED CURRENTS
-Balanced Asymmetrical : can result in different sensations under each electrode ex. Slow twitch or fast twitch muscle re-innervation or re-education.
-Balanced Symmetrical : current flow equally in both directions during alternate phase of the pulse. Generates same feeling under each electrode.-Can be applied for hours without risk of burn or skin irritations.-Can be apply over metallic implants-Can be apply over fragile skins
BIphasic pulsed currents can’t be be apply on:
Electrically sensitive support systemsPacemakers
©D
JO Incorporated
Microcurrents
DescriptionMicrocurrent is a current delivered at very low intensity ( less than 1mA . Can be monophasic or biphasic.
Physiological effectsMicrocurrent is delivered well below the threshold for nerve stimulation. At similar magnitude to the endogenous currents identified as being part of normal tissue healing. It can supplement or enhance the naturally direct current potentials associated with repair, and thereby stimulate the healing process.
Clinical use Wound healingFacial paralysis
Microcurrent is the only current that patients does not feel due to its very low intensity
time
1 to 1000 µAVolt or Amp
Waveforms continued-
©D
JO Incorporated
2774 Vacuum Electrode Module with Cart2785 Vacuum Electrode Module without Cart
Vacuum Module
©D
JO Incorporated
Chattanooga Intelect Mobile Ultrasound 2776 •1 & 3 MHZ frequencies•Pulsed & Continuous delivery modes- 10,20,50 & 100%.• Clinical indication screen provides most complete
patient application parameters.•Ergonomically designed heads of 1,2,5, & 10cm•Head-warming option•Lightweight design along with battery option .•Mobile tote bag to allow safe transferring.
©D
JO Incorporated
Chattanooga Intelect Mobile Combo 2778 •1 & 3 MHZ frequencies•Pulsed & Continuous delivery modes- 10,20,50 & 100%.•Multiple waveforms (2 & 4 pole IFC,Galv,HV pulsed current, Russian, Mono & Biphasic and TENS.• Clinical indication screen provides most complete
patient application parameters.15 user designed protocols.•Ergonomically designed heads of 1,2,5, & 10cm•Head-warming option•Lightweight design along with battery option .•Mobile tote bag to allow safe transporting.
©D
JO Incorporated
Chattanooga Intelect Mobile Stim 2778
•Multiple waveforms (2 & 4 pole IFC,Galv,HV pulsed current, Russian, Mono & Biphasic and TENS.• Clinical indication screen provides most complete
patient application parameters.•2 channels of stimulation output independently controlling intensity parameters.•Lightweight design along with battery option .•Mobile tote bag to allow safe transporting.
©D
JO Incorporated
Chattanooga Intelect Mobile Laser 2779
•Class 3 B LLLT•Independent control over all parameters.•Continuous & Pulsed operation available.•Various pulsed frequencies.•Energy display in Joules/ Joules cm².•Clinical indications specific to applicator.•15 user protocols.•17 different laser applicators to choose from.
©D
JO Incorporated
Clinical Indications for Electrotherapy•Acute conditions-•Sprains / Strains•Tendonitis•Bursitis•Wound healing•Muscle re-education•Nerve re-innervations•Inflammatory conditions•Chronic pain•Drug delivery
©D
JO Incorporated
Electrotherapy Contraindications
Low back during pregnancy. Eyes, carotid sinus or nerve plexus. Potential cancer or malignancy. Dementia or lack of cognitive skills. Diabetes Suspect DVT in lower extremities. Over any space occupying lesion.