Programs List Incontinence; Rheobase Calculation; Chronaxie Calculation; Slope Calculation - Globus Genesy 500 User Manual

Electrostimulators
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PROGRAMS LIST
Bladder Instability
Mixed incontinence 1
Mixed incontinence 2
INFORMATION ON UROLOGY PROGRAMS
The urology programs require the use of specific endovaginal and endorectal electrode probes,
certified according to the Directive for Medical Devices 93/42/EEC. These are bipolar probes with
a 2-mm female adapter which attaches to 2-mm male cables.
Warning: urological electrostimulation is a medical application, which must be carried out under
supervision of a physician.
To correctly use the probe electrode, follow the instructions provided by the manufacturer and
given by the physician.
For cleaning and disinfection, refer to the manufacturer's instructions.
In case of deterioration of the probe electrode, replace it immediately.
DIAGNOSTIC Denervated muscle
The Globus Electrostimulator offers an electrodiagnostic program to calculate rheobase, chro-
naxie and slope. Parameters for this program are easily defined and stored.

Rheobase calculation

The impulse is rectangular and of long duration; the amplitude of the impulse is 300 ms. The use
of small electrodes (32-50 mm ) is recommended. As the current increases, record the intensity
value when the first motor response is seen. This value is the rheobase, i.e. the minimum intensity
to excite a muscle with a long impulse. The rheobase value is necessary to calculate the chro-
naxie.
NOTE: The absolute value of the rheobase depends on the position and the dimension of the
electrodes; it relates to the contractile value of the muscle and to its trophism.

Chronaxie calculation

The instrument automatically selects a value of intensity twice that of the rheobase. The ampli-
tude of the impulse is set automatically to a minimal value, and the operator gradually increases
it. Chronaxie is determined as the amplitude that causes the first motor response (at a current
intensity twice that of rheobase); confirm the value of chronaxie by pressing OK.
Chronaxie values are interpreted as follows:
-Chronaxie <1 ms. Normally innervated muscle.
-Chronaxie between 1 and 10 ms. Weak denervation or denervation to a limited number of
muscle fibers. Treatment is not generally necessarily.
-Chronaxie between 10 and 20 ms. Partially denervated muscle; inhibition of some motor units
while others are normal. Presence of spontaneous activity. Treatment consists in selectively sti-
mulating denervated fibers without stimulating healthy ones, achieved by the progressive slope
of trapezoidal or triangular currents.
-Chronaxie >20 ms. Complete denervation, total interruption of nerve conduction, and absen-
ce of voluntary muscle activity. Treatment uses rectangular currents of long duration (100 or 300
ms).

Slope calculation

After having saved the chronaxie value, the display prompts you to set a value of impulse slope:
this modifies the wave form from rectangular to triangular or trapezoidal. Use the UP and DOWN
keys to select the slope; confirm with OK. Then, proceed by increasing the current intensity until
a stimulus is generated. It is possible to further modify the slope and intensity.
NOTE:
Programs for which parameters are set in the Diagnostics menu are saved in the
Programming menu, where they can be recalled and executed later.
MEDICAL CURRENT - INCONTINENCE
Stress incontinence 1
Stress incontinence 2
REV. 03.09.04
25

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