Tens Twin Stim Plus Instruction Manual page 10

Despite above recommendations, these individual patients may
require slight variations of the above settings, according to the nature
of their condition.
TREATMENT MODE
Normal or Conventional TENS offers the practitioners complete control
over all the various treatment parameters of the instrument.
Burst Mode is analogous to the Low Rate TENS technique except the
low frequency individual pulses are replaced by individual "bursts"
of 7-10 individual pulses. It is thus a combination of Conventional
TENS and Low Rate TENS. In Burst Mode, the treatment frequency
is adjustable at the range between 0.5Hz – 5Hz.
Modulated Mode attempts to prevent nerve accommodation by
continuously cycling the treatment intensity. When using Modulated
Mode increase the intensity only when the unit is at the maximum
intensity of the modulation cycle. If the intensity is increased during
a low intensity period of the cycle, the patient may turn up the control
very slowly, so that they may feel the intensity any higher.
INTENSITY
Each patient responds differently to different levels of intensity, due
to varying degrees of tissue resistance, enervation, skin thickness,
etc. Intensity instructions are therefore limited to the following settings:
Perception – The intensity is increased so that the patient can feel
the stimulation, but there is not any muscular contraction.
Slight Contraction – Intensity is increased to a barely visible muscular
contraction that is not strong enough to move a joint. When using
low pulse rate settings, this will show as individual twitches. At
higher pulse rates there will simply be increased muscle tension.
Strong muscular contraction is typically not used in TENS therapy.
However, muscular contraction may be useful if the pain involves a
cramped or spastic muscle.The TENS can be used as a traditional
muscle stimulator in the circumstances to quickly break the spasm.
Use a quick pulse rate, wide pulse duration and set the intensity to
visible contraction (still within patient tolerance). Twenty or thirty
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minutes of such a tetanized muscular contraction will generally break
the spasm. In all cases, if the patient complains that the stimulation is
uncomfortable, reduce intensity and/or cease stimulation.
TIME DURATION
The onset of pain relief should occur shortly after the intensity setting
has been determined. However, in some cases, pain relief may take
as long as 30 minutes to achieve, especially when using point
electrode placements and slow pulse rates.
TENS units are typically operated for long periods of time, with a
minimum of 20 – 30 minutes and in some post-operation protocols, as
long as 36 hours.
In general, pain relief will diminish within 30 minutes of the cessation
of stimulation. Pain relief obtained through point electrode placements
may last longer (perhaps because of the presence of endorphins).
CONTRACTION / RELAXATION
The contraction time and relaxation time of EMS is adjustable.
Stimulation will continue at the setting contraction time and cease
also at the setting relaxation time. Then the cycle starts over again –
Stimulation, Contraction and Relaxation.
RAMP
In order to achieve a comfortable exercise and avoid startle because
of electrical shock, each contraction course may be ramped so that
the signal comes on gradually and smoothly. The intensity of electrical
current will reach the setting level within the Ramp time, however, it
can not reach the expected level if the contraction time is less than
the ramp time.
OUTPUT MODE
The output of both channels are adjustable. It can be in the pattern
of synchronous or alternate. Stimulation of both channels will occur
at the same time when simultaneous pattern is selected. At alternating
mode, the stimulation of the CH2 will occur after the 1st contraction
of CH1 is finished.
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