294man

294man
Sys*Stim 294
®
Instruction Manual
®
1333 South Claudina Street • Anaheim, CA 92805, U. S. A.
Toll Free: (800) 854–9305 • Telephone: (714) 533–2221 • FAX: (714) 635–7539
Web Site: http://www.mettlerelectronics.com • Email: mail@mettlerelectronics.com
IR7–98
Copyright © 1999, 2010 by Mettler Electronics Corp.—Anaheim, CA
Rev.E_07/02/12
Mettler Electronics Corp.— Rev.E_07/02/12
2
Sys*Stim 294 Instruction Manual— Rev.E_07/02/12
Table of Contents
Section
Title
1
Introduction
Introduction to the Sys*Stim 294
Introduction to this Manual
Safety Precautions
Caution
Shipping Damage
Package Contents
Limited Warranty
Symbol Glossary and List of Abbreviations
Symbol Glossary
Treatment Status Indicator Icons
List of Abbreviations
Installation
Installation Instructions
EMC Guidance
Operating Instructions
A Note About Electrodes
General Operating Instructions
Stimulation Set-up Procedure
Electrode Positioning
Indications, Contraindications, Precautions and Adverse
Reactions
Indications for Neuromuscular Electrical Stimulation
Contraindications for Neuromuscular Electrical Stimulation
Warnings for Neuromuscular Electrical Stimulation
Precautions for Neuromuscular Electrical Stimulation
Side Effects/Adverse Reactions for Neuromuscular Electrical
Stimulation
Maintenance and Troubleshooting
Cleaning the Sys*Stim 294
Routine Maintenance
Troubleshooting the Sys*Stim 294
References
Specifications
General Specifications
Waveform Specifications
Amplitude Modulation Specifications
Accessories
Ordering Information
Sys*Stim 294 Accessories
1.1
1.2
1.3
1.4
1.5
1.6
1.7
2
2.1
2.2
2.3
3
3.1
3.2
4
4.1
4.2
4.3
4.4
5
5.1
5.2
5.3
5.4
5.5
6
6.1
6.2
6.3
7
8
8.1
8.2
8.3
9
9.1
9.2
Page
5
5
6
6
7
7
7
7
9
9
11
12
13
13
14
19
19
20
21
25
29
29
29
30
30
31
33
33
33
33
35
37
37
37
41
43
43
43
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Mettler Electronics Corp.— Rev.E_07/02/12
List of Figures
No. Title
1.1
3.1
3.2
4.1
4.2
4.3
4.4
4.5
4.6
8.1
8.2
8.3
8.4
8.5
8.6
4
Sys*Stim 294
Sys*Stim 294, Back view—Mains Power Switch and Line Cord connection
Sys*Stim 294, Front View—Electrode Cable Connections
Front membrane panel and LED indicators
Electrode Sizes and Current Density
Quadpolar Electrode Placement Technique
Bipolar Electrode Placement Technique
Monopolar Electrode Placement Technique
Using the Pencil Electrode
Interferential Waveform
Premodulated Waveform
Medium Frequency (Russian) Waveform
Biphasic Waveform
High Volt Waveform
Microcurrent Waveform
Page
5
13
14
19
20
25
26
26
27
37
38
39
39
40
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Sys*Stim 294 Instruction Manual— Rev.E_07/02/12
Section 1:
Introduction
1.1 Introduction to the Sys*Stim 294
Thank you for purchasing the Sys*Stim 294 four-channel neuromuscular stimulator. The
microprocessor controlled Sys*Stim 294 provides interferential, premodulated, medium
frequency, symmetrical biphasic, high volt and microcurrent waveforms with enhanced
reliability and ease of use.
The four–channel Sys*Stim 294 allows you to utilize up to four different waveforms using
four channels simultaneously. You can choose between several different amplitude
modulation options such as the surge, reciprocation and vector rotation. The interferential
and premodulated modes offer frequency modulation as well as a static frequency option.
Figure 1.1— Sys*Stim 294
The membrane panel provides both tactile and audio feedback when buttons are pressed.
Blinking LED’s guide you through the easy setup routine. The new Treatment Status
Indicator shows you which stimulation waveform has been chosen for treatment. The
status display moves when treatment output is active.
Large, soft-touch control knobs make adjusting stimulation intensity easy to accomplish
with no guesswork involved. Two LED output displays allow you to monitor two
channels simultaneously. These also allow you to adjust both channels of an interferential
protocol simultaneously while monitoring the current.
The Sys*Stim 294 can provide electrical stimulation from four channels. Add the optional
treatment cart to create a mobile treatment center for your office.
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Mettler Electronics Corp.— Rev.E_07/02/12
The Sys*Stim 294 has been certified by Intertek Testing Services to meet the requirements
for ETL Listing per the following standards:
 UL 2601-1-UL Standard for Safety–Medical Electrical Equipment, Part 1:
General Requirements for Safety Second Edition.
 CAN/CSA C22.2 NO 601.1 – Medical Electrical Equipment – Part 1:
General Requirements for Safety
 IEC60601-2-10 – Safety of Nerve and Muscle Stimulators
In addition, the Sys*Stim 294 meets the following standards for radio frequency emissions:
 EN 60601-1-2
 EN–55011 (CISPR–11)
Mettler Electronics Corp. has been certified by VTT Expert Services LTD to be compliant
with EN ISO 13485:2003 and MDD 93/42/EEC Annex II requirements. In addition, Mettler
is certified by DQS Medizinprodukte GMBH to be compliant with ISO 13485:2003
(CMDCAS) Canadian Medical Device requirements.
1.2 Introduction to This Manual
Read the contents of this manual before treating patients with the Sys*Stim 294.
This manual has been written to assist you with the safe operation of the Sys*Stim 294. It is
intended for use by the owners and operators of the Sys*Stim 294. The goal of this manual
is to direct the correct operation and maintenance of this unit.
The specifications and instructions presented in this manual are in effect at the time of its
publication. These instructions may be updated at any time at the discretion of the
manufacturer. Please fill in the warranty card to assure that you will be updated on
changes should that become necessary. You may also go to our website at,
http://www.mettlerelectronics.com/product-registration/ , to register your product.
1.3 Safety Precautions
The Sys*Stim 294 operates with high voltages. Qualified biomedical technicians with
training in neuromuscular stimulator service should perform servicing of the Sys*Stim 294
or it should be returned directly to the factory. To maximize safety during use, the unit
should be plugged into a grounded wall outlet. General safety guidelines for medical
electronic equipment should be followed.
Service may be obtained from the manufacturer by sending the Sys*Stim 294 in its original
shipping container to Mettler Electronics Corp., 1333 South Claudina Street, Anaheim, CA
92805, ATTN: Service Department. (Telephone toll free: (800) 854–9305, Email:
service@mettlerelectronics.com, Alternate telephone number: 1 (714) 533–2221)
NOTE: All warranty repairs must be performed by Mettler Electronics Corp. or by a
service facility authorized by Mettler Electronics to perform warranty repair work.
A service manual for the Sys*Stim 294 is available from Mettler Electronics Corp. for a
nominal charge.
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Sys*Stim 294 Instruction Manual— Rev.E_07/02/12
1.4 Caution
Federal law restricts the sale of this device to, or on the order of, a physician, dentist,
veterinarian or any other practitioner licensed by law of the state in which he practices.
Use of controls or adjustments or performance of procedures other than those specified
herein may result in hazardous exposure to electrical energy. The electric energy delivered
by this device may possibly be lethal. Treatment should be administered only under the
direct supervision of a health care professional.
1.5 Shipping Damage
Your new Sys*Stim 294 is shipped complete in one carton. Upon receipt, please inspect the
carton and the unit for visible and hidden damage. If you discover any damage, hold all
shipping materials, including the carton, and call the shipping agent who delivered the
unit. They are responsible for all damage in transit; therefore, all claims should be filed
directly with them. The factory will not be responsible for any damage in shipment, nor
allow any adjustments unless proper formal claim has been filed by the receiver against
the carrier.
The carton in which your new Sys*Stim 294 was received is specially designed to protect
the unit during shipping. Please retain all shipping materials in the event that you will
need to return your unit for servicing. NOTE: All warranty repairs are to be performed by
Mettler Electronics Corp. or an authorized Mettler Electronics warranty repair center.
1.6 Package Contents
Your new Sys*Stim 294 comes complete with all the necessary components to perform
neuromuscular electrical stimulation. Below is a list of items that are included in the
shipping carton.
1. Sys*Stim 294
2. Four electrode cable sets, (ME 2260)
3. Two gray pin to banana adapters, (ME 2027)
4. One package each EZ Trodes, 2" diameter (ME 2221) and 2.75" diameter (ME 2222)
5. Detachable U.L. listed, hospital–grade line cord, (ME 7293)
6. Instruction Manual, Electrical Stimulation & Ultrasound Pocket Guide and Warranty Card
1.7 Limited Warranty
The Sys*Stim 294 neuromuscular electrical stimulator is warranted against defects in
materials and workmanship for a period of two years from date of purchase. During the
applicable warranty period Mettler Electronics Corp. will, at its discretion, either repair or
replace the Product without charge for these types of defects.
For service under this warranty, the Product must be returned by the buyer within the
applicable warranty period to Mettler Electronics Corp. Shipping charges to Mettler
Electronics Corp. under this warranty must be paid by the buyer. The buyer must also
include a copy of the sales receipt or other proof of the date of purchase. If the Product
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Mettler Electronics Corp.— Rev.E_07/02/12
is returned without proof of the date of purchase, it will be serviced as an out–of–
warranty product at Mettler Electronics Corp.'s prevailing service rates.
Alteration, misuse, or neglect of the Product voids this warranty. Except as specifically
set forth above, Mettler Electronics Corp. makes no warranties, express or implied,
including without limitation any implied warranty of merchantability or fitness for a
particular purpose, with respect to the Product. If any implied warranties apply as a
matter of law, they are limited in duration to one year.
Mettler Electronics Corp. shall not be liable for any indirect, special, consequential or
incidental damages resulting from any defect in or use of the Product.
Any legal action brought by the buyer relating to this warranty must be commenced
within one year from the date any claim arises and must be brought only in the state or
federal courts located in Orange County, California.
Some states do not allow limitations on how long an implied warranty lasts, or the
exclusion or limitation of incidental or consequential damages, so the above limitations or
exclusions may not apply to the buyer. This warranty gives the buyer specific legal rights,
and the buyer may also have other rights which vary from state to state.
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Sys*Stim 294 Instruction Manual— Rev.E_07/02/12
Section 2—Symbol Glossary
and List of Abbreviations
2.1 Symbol Glossary

Electrical Stimulation Selector
Time display

1 5. 0 0 
min
s
s
Hz
Time display LED’s. Displays treatment time and numeric values for
frequency, phase duration, on/off times and alphanumeric error codes.
s
These LED’s will illuminate to prompt the clinician to input either time
in seconds (s), microseconds (μs), or frequency (Hz). The time or the
frequency will be displayed in the numeric time display.


1
Treatment Status Indicator
2
Channel display indicator and selector
3
1
4








Numeric keypad for time, frequency or phase duration entry.
Starts treatment and stimulation output.
Stops treatment for the treatment displayed in timer window or acts as
an “Enter” button during treatment setup.
Stops all stimulation output.
Interferential waveform selector—LED is illuminated when this function
is activated.
Premodulated waveform selector—LED is illuminated when this
function is activated.
Medium frequency waveform selector—LED is illuminated when this
function is activated.
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Mettler Electronics Corp.— Rev.E_07/02/12



s
Hz
+
–
Symmetrical biphasic waveform selector—LED is illuminated when this
function is activated.
High volt waveform selector—LED is illuminated when this function is
activated.
Microcurrent waveform selector—LED is illuminated when this function
is activated.
Phase duration control selector—Press this button during a biphasic
treatment to display phase duration.

Frequency control selector—Press this button during a stimulation
treatment to display frequency.

Polarity selector for high volt and microcurrent waveforms.

Amplitude modulation (Vector rotation), used for interferential
waveform only.
Continuous stimulation selector
Surge selector to set on and off times
Reciprocation selector, use for channel pairs 1 & 2 or 3 & 4.

Stimulation output displays
LED’s that display the output intensity during a treatment. When the
unit is in the “Hold” mode for electrical stimulation, “--- ---“ will be
displayed.
00 0
1
mA
3
V
2
4
mA
A
LED indicators are lit to define which output intensity is being
displayed in the two windows.
LED indicators are lit to show the measurement units of the output
intensity being displayed in the window.
Output intensity control knob, rotate knob clockwise to increase output
and counterclockwise to decrease output.
I
10
Mains On.
Sys*Stim 294 Instruction Manual— Rev.E_07/02/12
O
Mains Off.
Attention, consult instruction manual.
Type BF Equipment—Class I
IPX0
Not suitable for use in the presence of a flammable anaesthetic mixture
with air or with oxygen or nitrous oxide.
ETL and C–ETL Listed (new ETL logo phase in)
2.2 Treatment Status Indicator Icons
Stimulation selected, waiting for waveform type to be selected.
Interferential waveform selected. Display will move to the right when
the outputs are active.
Interferential vector rotation control selected. Display appears to rotate.
Premodulated waveform selected. Display will move to the right when
the outputs are active.
Medium frequency (Russian) waveform selected. Display will move to
the right when the outputs are active.
Biphasic waveform selected. Display will move to the right when the
outputs are active.
High volt waveform selected. Display will move to the right when the
outputs are active.
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Mettler Electronics Corp.— Rev.E_07/02/12
Microcurrent waveform selected. Display will move to the right when
the outputs are active.
2.3 List of Abbreviations
Hz
LED
—
—
Hertz (pulses per second)
Light Emitting Diode
A
—
Microampere (1 x 10-6 ampere)
s
mA
ms
min
s
S/N
—
—
—
—
—
—
Microsecond (1 x 10-6 second)
Milliampere (1 x 10-3 ampere)
Millisecond (1 x 10-3 second)
Minutes
Seconds
Serial Number
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Sys*Stim 294 Instruction Manual— Rev.E_07/02/12
Section 3—Installation
3.1 Installation Instructions
1. Connect the line cord to the back of the Sys*Stim 294. (See Figure 3.1)
2. Plug the line cord (ME 7293) into a grounded wall outlet that is rated between 90–240
VAC, 50–60 Hz. Your power supply must match the voltage requirements listed on the
serial number label of your device. Do not connect the Sys*Stim 294 to a power
supply rated differently than that described above.
3. The line cord comes equipped with a standard 3–prong plug. This plug provides
grounding for the Sys*Stim 294. Do not defeat its purpose by using 3–to–2 prong
adapters or any other means of attaching to a wall outlet.
4. Plug the electrode cables (ME 2260) into the electrode cable connections as seen in
Figure 3.2.
5. The Sys*Stim 294 may be susceptible to interference originating from shortwave
diathermy units operating in close proximity to it. Avoid operating the Sys*Stim 294
adjacent to and simultaneously with operating shortwave devices.
6. Do not use sharp objects to operate the membrane panel switches. If the tough outer
layer of the membrane is broken, moisture may leak into the switches resulting in
switch failure.
7. Once you have verified proper functioning of your Sys*Stim 294, using the instructions
in Section 4, please fill in the enclosed self–addressed Warranty Registration Card and
mail it to Mettler Electronics.
Mains Power Switch
Line Cord Connection
Figure 3.1— Sys*Stim 294, Back View—
Mains Power Switch and Line Cord Connection
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Mettler Electronics Corp.— Rev.E_07/02/12
Electrode Cable Connections
Figure 3.2— Sys*Stim 294, Front View—
Electrode Cable Connections
3.2 EMC Guidance
CAUTION:
Medical Electrical Equipment needs special precautions regarding Electromagnetic
Compatibility (EMC) and needs to be installed and put into service according to the EMC
information provided in the following tables.
Portable and mobile Radio Frequency (RF) communications equipment can affect Medical
Electrical Equipment.
Accessories:
Hospital Medical grade power cord of a maximum length of 120 inches
WARNING:
The use of accessories, other than those specified, except those supplied or sold by Mettler
Electronics Corp., as replacement parts for internal or external components, may result in
increased EMISSIONS or decreased IMMUNITY of the Sys*Stim 294.
Guidance and manufacturer’s declaration – electromagnetic emissions
The Sys*Stim 294 is intended for use in the electromagnetic environment specified below. The customer or
the user of the Sys*Stim 294 should assure it is used in such an environment.
Emissions Test
RF emissions
Compliance
Group 1
The Sys*Stim 294 must emit electromagnetic energy in order to
perform its intended function. Nearby electronic equipment
may be effected.
Class B
The Sys*Stim 294 is suitable for use in all establishments other
than domestic and those directly connected to the public lowvoltage power supply network that supplies buildings used for
domestic purposes.
CISPR 11
RF emissions
CISPR 11
Harmonic emissions
Applicable
IEC 61000-3-2
Voltage
fluctuations/flicker
emissions
IEC 61000-3-3
14
Electromagnetic environment-guidance
Applicable
Sys*Stim 294 Instruction Manual— Rev.E_07/02/12
Guidance and manufacturer’s declaration – electromagnetic immunity
The Sys*Stim 294 is intended for use in the electromagnetic environment specified below. The customer or
the user of the Sys*Stim 294 should assure that it is used in such an environment.
Immunity test
Electrostatic
discharge (ESD)
IEC 60601
test level
Compliance level
±6 kV contact
±6 kV contact
±8 kV air
±8 kV air
Electrical fast
transient/burst
±2 kV for power
supply lines
±2 kV for power
supply lines
IEC 61000-4-4
±1 kV for
input/output lines
±1 kV for
input/output lines
Surge
±1 kV differential
mode
±1 kV differential
mode
±2 kV common mode
±2 kV common mode
<5% UT
(>95% dip in UT)
for 0.5 cycle
<5% UT
(>95% dip in UT)
for 0.5 cycle
40% UT
(60% dip in UT)
for 5 cycles
40% UT
(60% dip in UT)
for 5 cycles
70% UT
(30% dip in UT)
for 25 cycles
70% UT
(30% dip in UT)
for 25 cycles
<5% UT
(>95% dip in UT)
for 5 seconds
<5% UT
(>95% dip in UT)
for 5 seconds
3 A/m
3 A/m
IEC 61000-4-2
IEC 61000-4-5
Voltage dips, short
interruptions and
voltage variations
on power supply
input lines
IEC 61000-4-11
Power frequency
(50/60 Hz)
magnetic field
IEC 61000-4-8
Electromagnetic environment —
guidance
Floors should be wood, concrete or
ceramic tile. If floors are covered
with synthetic material, relative
humidity should be at least 30%.
Mains power quality should be that
of a typical commercial or hospital
environment.
Mains power quality should be that
of a typical commercial or hospital
environment.
Mains power quality should be that
of a typical commercial or hospital
environment. If the user of the
Sys*Stim 294 requires continued
operation during power mains
interruptions, it is needed that the
Sys*Stim 294 be powered from an
uninterruptible power supply.
Power frequency magnetic fields
should be at levels characteristic of a
typical location in a typical
commercial or hospital environment.
NOTE UT is the A.C. mains voltage prior to application of the test level.
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Mettler Electronics Corp.— Rev.E_07/02/12
Guidance and manufacturer’s declaration – electromagnetic immunity
The Sys*Stim 294 is intended for use in the electromagnetic environment specified below. The customer or
the user of the Sys*Stim 294 should assure that it is used in such an environment.
Immunity test
IEC 60601 test level
Compliance
level
Electromagnetic environment – guidance
Portable and mobile RF communications
equipment should be used no closer to any part
of the Sys*Stim 294, including cables, than the
recommended separation distance calculated
from the equation applicable to the frequency of
the transmitter.
Recommended separation distance
Conducted RF
IEC 61000-4-6
3 Vrms
150 kHz to 80 GHz
3V
d = 1,2√P
Radiated RF
IEC 61000-4-3
3 V/m
80 MHz to 2,5 GHz
3 V/m
d = 1,2√P 80MHz to 800 MHz
d = 2,3√P 800MHz to 2,5 GHz
where P is the maximum output power rating of
the transmitter in watts (W) according to the
transmitter manufacturer and d is the
recommended separation distance in meters (m).
Field strengths from fixed RF transmitters, as
determined by an electromagnetic site survey, a
should be less than the compliance level in each
frequency range.b
Interference may occur in the vicinity of
equipment marked with the following symbol:
NOTE 1
At 80 MHz and 800 MHz, the higher frequency range applies.
NOTE 2
These guidelines may not apply in all situations. Electromagnetic propagation is affected by
absorption and reflection from structures, objects and people.
a
Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless) telephones and
land mobile radios, amateur radio, AM and FM radio broadcast and TV broadcast cannot be predicted
theoretically with accuracy. To assess the electromagnetic environment due to fixed RF transmitters, an
electromagnetic site survey should be considered. If the measured field strength in the location in which
the Sys*Stim 294 is used exceeds the applicable RF compliance level above, the Sys*Stim 294 should be
observed to verify normal operation. If abnormal performance is observed, additional measures may be
necessary, such as reorienting or relocating the Sys*Stim 294.
b
Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 3 V/m.
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Sys*Stim 294 Instruction Manual— Rev.E_07/02/12
Recommended separation distances between
portable and mobile RF communications equipment and the
Sys*Stim 294
The Sys*Stim 294 is intended for use in an electromagnetic environment in which radiated RF disturbances
are controlled. The customer or the user of the Sys*Stim 294 can help prevent electromagnetic interference
by maintaining a minimum distance between portable and mobile RF communications equipment
(transmitters) and the Sys*Stim 294 as recommended below, according to the maximum output power of the
communications equipment.
Rated maximum output
power of transmitter
W
0,01
0,1
1
10
100
Separation distance according to frequency of transmitter
m
150 kHz to 80 MHz
d = 1,2√P
80 MHz to 800 MHz
d = 1,2√P
800 MHz to 2,5 GHz
d = 2,3√P
0,12
0,38
1,2
3,8
12
0,12
0,38
1,2
3,8
12
0,23
0,73
2,3
7,3
23
For transmitters rated at a maximum output power not listed above, the recommended separation distance
d in meters (m) can be estimated using the equation applicable to the frequency of the transmitter, where P
is the maximum output power rating of the transmitter in watts (W) according to the transmitter
manufacturer.
NOTE 1 At 80 MHz and 800 MHz, the separation distance for the higher frequency range applies.
NOTE 2 These guidelines may not apply in all situations. Electromagnetic propagation is affected by
absorption and reflection from structures, objects and people.
Guidance and manufacturer’s declaration
No.
1
Mode of Operation
Unit tested to 230
VAC for CE
Essential Performance
Degradation Allowed
Unit designed to be failure safe in
abnormal condition
Unit tested to 120
VAC for US/Canada
2
Unit has four
stimulation channels
Reset allowed as long as failure safe
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Mettler Electronics Corp.— Rev.E_07/02/12
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Sys*Stim 294 Instruction Manual— Rev.E_07/02/12
Section 4—Operating
Instructions
Stim
Output
Stim Setup
®
SYS*STIM 294
1
3
00 0
mA
Timer Functions
1 5. 0 0
min
s
V
2
4
00 0
mA
A
s
s
Hz
Sweep Frequency
Stim Channels
1
3
2
1
2
3
4
5
6
7
8
9
4
Premodulated
1 - 15 Hz
80 - 150 Hz
1 - 150 Hz
Hz1 - Hz2
Hz
Amplitude
Modulation
Continuous
Medium
Frequency
0
Start
Interferential
Hold /
Enter
Stop All Output
Biphasic
High Volt
Phase
Duration
Frequency
s
Hz
Polarity
Frequency
+
–
MicroCurrent
Polarity
+
–
Hz
Surge
Reciprocation
Frequency
Hz
!
WARNING: Hazardous electrical output. This
equipment is for use by qualified personnel.
Use electrode cable set ME 2260.
Figure 4.1—Front membrane panel and LED indicators
4.1 A Note About Electrodes
To ensure safe operation of the Sys*Stim 294, follow the recommendations listed below:
1. We strongly encourage careful maintenance of the electrode system. This includes the
lead wires as well as the pads themselves. Worn cables and/or poor pads (or the
wrong sized pads) can have a significant impact upon treatment results.
2. For best performance, use Mettler Electronics’ brand electrodes.
3. Do not exceed the number of recommended uses listed on the instructions for EZ
Trodes or other reusable self–adhesive electrodes.
4. Make sure that the entire surface of the electrode is contacting the patient.
5. Do not use moist hot packs to secure electrodes.
6. To avoid skin irritation due to high current density, do not use electrodes smaller in
surface area than the 2" diameter EZ Trode® self-adhesive electrode (ME 2221).
7. Do not use conductive carbon electrodes with this product.
8. Whenever clinically possible, utilize the largest possible pads to reduce local increases
in current density. In situations where small pads are required, use the lowest
stimulation intensity necessary to achieve the desired clinical results.
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Mettler Electronics Corp.— Rev.E_07/02/12
The table below illustrates the relationship between electrode diameter and current
density. As you can see the current density increases rapidly when diameter decreases.
Diameter
Surface Area
Current Density
inches
Square inches
mA/sq in (for 10mA)
1.25
1.2
8.2
2.00
3.1
3.2
3.00
7.1
1.4
1.25 inch
diameter
2.00 inch
diameter
3.00 inch
diameter
Figure 4.2—Electrode Sizes and Current Density
4.2 General Operating Instructions:
Before you start.
a) Review precautions, contraindications and side effects/adverse reactions
listed in Section 5.
b) Use Mettler Electronics electrodes to ensure safe and effective operation.
c) Verify connection of the line cord to a grounded wall receptacle and the
Sys*Stim 294.
d) For electrical stimulation connect electrode cables (ME 2260) into the electrode
connections for the channels that are going to be used.
e) Note: Descriptions of the symbols used on controls are in Section 2.
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Sys*Stim 294 Instruction Manual— Rev.E_07/02/12
4.3 Stimulation Set-up Procedure
1. Press the stimulation treatment selector. The Treatment
Status Indicator will show you the stimulation icon and all
the waveform LED’s will begin to blink. Press this key to begin
programming additional treatment sessions. The active channel
indicators will blink and new channels will be lit when the
treatment type is selected. You can go back to check on active
channels any time, by pressing the channel keys that are blinking.
2. Select the stimulation waveform that you would like to use.
Interferential—Channels 1 & 2 or Channels 3 & 4
Premodulated—Channels 1, 2, 3 or 4
Medium Frequency, Russian waveform—Channels 1, 2, 3, or 4.
Biphasic— Channels 1, 2, 3, or 4.
High Volt—Channel 1 only
Microcurrent—Channel 2 only
1
2
3
4
Please Note: For two-channel operations, the Sys*Stim 294
works in channel pairs only—Channels 1 & 2 or 3 & 4. Up to
four different stimulation protocols may be run simultaneously.
The Treatment Status Indicator will show you the icon for the
selected waveform.
3. For the interferential waveform, the Sys*Stim 294 will
automatically pick channel pairs 1 & 2 or 3 & 4. For the
premodulated, medium frequency and biphasic waveforms, the
next available channel will be selected. If a two-channel
treatment is desired pick the second member of the channel
pair by pressing its button. Channel 1 is automatically
selected for the high volt waveform and Channel 2 is
automatically selected for the microcurrent waveform. If a
channel is already in use, you will need to free it up before
using these two waveforms. Cancel a treatment setup by
pressing the channel selector.
4. Set treatment pulse frequency (Hz), phase duration (s) and
polarity (+ or -) for each waveform.
1 - 15 Hz
80 - 150 Hz
1 - 150 Hz
Hz1 - Hz2
Hz
Interferential—
Choose from preset frequency modulation programs: 1-15,
80-150 or 1-150 Hz or…
Pick Hz1-Hz2 to set your own static frequency or frequency
sweep range. Enter values for each frequency using the
numeric keypad followed by the
key. The frequency is
displayed in the timer window and the Hz LED is lit.
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1 - 15 Hz
80 - 150 Hz
1 - 150 Hz
Hz1 - Hz2
Hz
Premodulated—
Choose from preset frequency modulation programs: 1-15,
80-150 or 1-150 Hz or…
Pick Hz1-Hz2 to set your own static frequency or frequency
sweep range. Enter values for each frequency using the
key. The frequency is
numeric keypad followed by the
displayed in the timer window and the Hz LED is lit.
Medium Frequency—
No optional selections
s
Hz
+
–
Hz
+
–
Hz
Biphasic—
The Sys*Stim 294 stores the value for the phase duration and
the frequency for the last Biphasic session. If the value
displayed in the timer window is acceptable press the key.
Set s for the phase duration, 50-300 s. Enter a numeric
key.
value followed by the
Set Hz for the frequency, 1-120 Hz. Enter a numeric value
followed by the
key.
High Volt—
Set the treatment polarity. The LED that is lit indicates the red
lead wire’s polarity.
Set Hz for the frequency, 1-120 Hz. Enter a numeric value
key.
followed by the
Microcurrent—
Set the treatment polarity. The LED that is lit indicates the red
lead wire’s polarity. Pressing the button twice will allow the
polarity to alternate in a biphasic manner. Both LED
indicators will be illuminated.
Set Hz for the frequency, 0.5-500 Hz. Enter a numeric value
key, (05 = 0.5 Hz).
followed by the
5. Set options for amplitude modulation—continuous, surge
and reciprocation.
Continuous—no amplitude modulation, no On/Off times,
default setting
Surge—Set an On and Off time, 3 seconds Up ramp, 2
seconds Down ramp
Reciprocation—Stimulation alternates equally between
Channels 1 & 2 or Channels 3 & 4, 1 second Up and Down
ramps. May be combined with the Surge option for longer
rest times.
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Sys*Stim 294 Instruction Manual— Rev.E_07/02/12
Interferential—Continuous
Premodulated—Continuous, Surge and Reciprocation
Medium Frequency, Russian—Continuous, Surge and
Reciprocation
Biphasic—Continuous, Surge and Reciprocation
High Volt—Continuous and Surge
Microcurrent—Continuous
s
s
Hz
10 10
min
min
s
s
s
Hz
10
s
1 5. 0 0
min
s
s
s
Hz
1
2
3
4
5
6
7
8
9
Surge Mode—
Press Surge selector until you see the On/Off duty cycle that
you would like to use. Press the key to accept the values.
Preset On/Off choices are 10 10, 10 20, 10 30, 10 40,
10 50 and 10 60.
If you press the Surge selector one more time after “10 60” is
displayed, a single number is displayed. This represents the
last On time that was programmed. To change the number,
use the numeric keypad to enter a new value followed by the
key. The Off time is then displayed, enter a new value
key.
followed by the
Reciprocation Mode—
To setup a Reciprocation program you must have stimulation
setup for two-channel operation. If Channel 1 is lit, press
Channel 2. If Channel 3 is lit, press Channel 4.
Press the Reciprocation key. Enter a value from 2 to 240 and
press the
key.
Surge + Reciprocation—
Press Reciprocation key. Press the
key. Press the Surge
key until you see the On/Off time you want to use. Press the
key.
6. Enter the treatment time using the numeric keypad. The
maximum treatment time is 60 minutes. If you do not enter a
time, the time will count up during a treatment session, but
will not exceed 60 minutes.
0
7. Apply the electrodes to the patient. Attach the electrode
cables to the electrodes.
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8. Press the start key to begin treatment. The waveform will
start to move in the treatment status box and the output
display will show 0’s.
Please Note: If you are using the pencil electrode with the microcurrent waveform,
you must press the button on top of the pencil electrode to establish
contact prior to starting a treatment or a contact error will occur.
Once the treatment begins, hold the button down while increasing
output intensity.
1
3
2
00 0
mA
4
00 0
V
mA
A
9. Adjust the output intensity by turning the knobs clockwise.
The numeric display shows the output in the units indicated
by the lit LED below the display for that channel. Please note:
Adjust the intensity at the peak when the current is on with
an amplitude modulation function. Adjust intensity down
any time during the On time.
NOTE 1: For the surge mode, adjust the output intensity for
the active channels and then press to start the Surge cycle.
The timer will then begin counting.
NOTE 2: For the reciprocation mode adjust the intensity for
Channel 1 or 3 and then press . Then adjust the intensity for
Channel 2 or 4 and press .
10. In the interferential mode, press the amplitude modulation
(vector rotation) key after the output intensity is adjusted.
Adjust intensity Up only at the peak and Down at any time.
11. Press the “Hold” key to temporarily suspend treatment. All
treatment parameters except output intensity will be
retained. Press to resume treatment and then readjust the
output intensity.
12. Use this button to stop all active treatments. Treatment
parameters will still be active so you would be able to resume
treatment at any time. For stimulation, you will be required
to readjust the output intensity starting at zero if you resume
treatment.
24
1
2
3
4
13. After the treatment ends, you can press the channel selector
to free up the channel(s) for the next treatment selection..
Remove the electrodes from the patient and return them to
their package for storage. To setup additional stimulation
treatments, start back at the beginning at step 1.
Sys*Stim 294 Instruction Manual— Rev.E_07/02/12
4.4 Electrode Positioning
1. General information
Placement of electrodes may be by the quadpolar,
bipolar or monopolar techniques. Proper positioning
and contact will insure treatment comfort and
efficiency. Electrodes should never be placed in such
a manner as to produce current flow through the
cardiac area. For safe operation of the Sys*Stim 294,
review contraindications, warnings, precautions and
Side Effects/Adverse Reactions in sections 5.2, 5.3, 5.4
and 5.5 before positioning electrodes.
2. Preparation of the skin prior to electrode application
To insure the efficient current conduction necessary
for proper treatment, certain preparations must be
made. Cleaning or wetting should eliminate any
impairment to current conduction on the patient’s
skin such as an oily or dry surface, or excessive hair
coverage. Shaving may be necessary depending upon
the density of hair coverage. Failure to provide for
maximum current conduction efficiency could result
in skin irritation relating to an increase in current
density at the electrode site.
Using reusable electrodes for longer periods of time
than those recommended by the package insert could
result in ineffective treatments or cause skin irritation.
Care should be taken to ensure application of the total
electrode surface area to the patient's skin prior to
commencing treatment.
3. Quadpolar electrode application technique
Quadpolar techniques should be used with the
“Interferential” waveform. The electrodes from
Channel 1 are placed diagonally from each other.
While the electrodes from Channel 2 are placed
diagonally across from each other to form an “X” over
the treatment area. The zone of maximum
interference between the two channels occurs roughly
in the center of the “X”.
Figure 4.3—Quadpolar Electrode
Placement Technique
Constantly changing the intensity levels of the two
channels will change the interference pattern felt by
the patient. Pressing the amplitude modulation key
will constantly change the intensity of the outputs of
the two channels during treatment, increasing the
area covered by the interference pattern.
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4. Bipolar electrode placement techniques
Figure 4.4—Bipolar Electrode
Placement Technique
Bipolar electrode placement techniques should be
used to provide stimulation to larger muscle groups,
such as the quadriceps or the hamstrings. The
symmetrical waveforms of the “Premodulated”,
“Medium Frequency” and “Biphasic” waveforms are
usually applied to the body using the bipolar
technique.
Equal size electrodes are placed at each end of the
muscle or muscle group. Current concentration is
over the entire length of that muscle or muscle group
and especially effective on weak musculature.
Electrode placement should be at opposite ends of the
limb or muscle group. Care should be taken to insure
that electrodes are not placed too close together which
could produce current concentration along the edges
of the pads. This is the so-called “edging effect”
which can cause patient discomfort. The figure on the
left shows a pad set up for stimulation of the quadriceps.
5. Monopolar electrode application techniques
Figure 4.5—Monopolar
Electrode Placement
Technique
Monopolar techniques may be used with the “High
Volt”, “Microcurrent”, “Premodulated”, “Medium
Frequency” and “Biphasic” waveforms. The smaller,
active, electrode (black and negative) is placed over
the muscle motor point. In treatments designed to
relieve pain, the active electrode is placed over the
painful area. The larger, dispersive, electrode (red and
positive) is placed on the same side of the body at
some point distal to the active electrode. The
dispersive pad is generally three to four times larger
than the active electrode so that current density is too
low to cause muscle contractions under the dispersive
electrode. Never place the dispersive electrode over
the antagonist muscle.
The monopolar electrode placement technique has
been found to be especially useful for muscle
stimulation of the upper extremities and small muscle
groups. This technique helps concentrate the
stimulation effect on the muscle under the smaller
electrode. The figure on the left illustrates one
possible electrode placement for muscle stimulation
of the forearm.
6. Using the pencil electrode
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Sys*Stim 294 Instruction Manual— Rev.E_07/02/12
The pencil electrode is used for the stimulation of
small muscles or painful areas. It is also useful to help
identify the exact motor point of a muscle or muscle
group. The pencil electrode may be used with the
“High Volt”, “Microcurrent”, “Premodulated”,
“Medium Frequency” or “Biphasic” waveforms.
Attach the pencil electrode to the black electrode cable
using a pin to banana adapter. Attach the red
electrode cable to a dispersive pad. Apply dispersive
electrode in such a manner to prevent transthoracic
stimulation
Pressing the switch located on the pencil electrode
will allow treatment currents to be delivered to the
patient. Four tips o
f different sizes are included with the pencil electrode.
The figure on the left shows an application of the
pencil electrode.
Figure 4.6—Using the Pencil
Electrode
Please Note: If you are using the pencil electrode with the microcurrent
waveform, you must press the button on top of the pencil
electrode to establish contact prior to starting a treatment
or a contact error will occur. Once the treatment begins,
hold the button down while increasing output intensity.
7. Additional information about electrode placement:
Motor point charts are available as guides from
Mettler Electronics Corp. These points may vary from
patient to patient, and at time of injury, may vary in
the same patient. The Electrical Stimulation &
Ultrasound Pocket Guide by Michelle Cameron is
provided at no charge with the Sys*Stim 294.
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Sys*Stim 294 Instruction Manual— Rev.E_07/02/12
Section 5—Indications,
Contraindications, Precautions
and Adverse Reactions
5.1 Indications for Neuromuscular Electrical Stimulation
The application of pulsating electric currents to the body via electrodes elicits responses
from nerves, which conduct pain sensation and muscle contraction information.
Stimulation of sensory fibers will help block pain while the stimulation of motor fibers will
generate pulsatile contractions of the muscle groups innervated by the nerves being
stimulated.
Based on this information, some of the indications for use are as follow:
1.
Symptomatic relief of chronic intractable pain, acute post traumatic pain or acute post
surgical pain (Interferential, Premodulated and Microcurrent waveforms).
2.
Temporary relaxation of muscle spasm, all waveforms except Microcurrent.
3.
Prevention of post–surgical phlebo–thrombosis through immediate stimulation of calf
muscles, all waveforms except Microcurrent.
4.
Increase of blood flow in the treatment area, all waveforms except Microcurrent.
5.
Prevention or retardation of disuse atrophy in post–injury type conditions, all
waveforms except Microcurrent
6.
Muscle re–education, all waveforms except Microcurrent.
7.
Maintaining or increasing range of motion, all waveforms except Microcurrent.
5.2 Contraindications for Neuromuscular Electrical
Stimulation
1.
Electrical neuromuscular stimulation should not be administered to individuals who
are or may be pregnant.
2.
Do not stimulate a patient who has a cardiac demand pacemaker.
3.
Patients with implanted electronic devices should not be subjected to stimulation.
4.
Placement of electrodes across the chest laterally or anterior/posterior creates a
possible hazard with cardiac patients and is therefore not recommended. Do not use
transthoracically in any mode. Great care should be exercised in applying the electrical
stimulus current to any region of the thorax because the stimulus current may produce
cardiac arrhythmia. In patients with known heart disease, electrical stimulation should
be used only after careful physician evaluation and patient instruction.
5.
Place electrodes in such a way to avoid stimulation of the carotid sinus (neck) region.
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Mettler Electronics Corp.— Rev.E_07/02/12
6.
Patients with arterial or venous thrombosis, or thrombophlebitis are at risk of
developing embolisms when electrical stimulation is applied over or adjacent to the
vessels containing the thrombus. If a patient has a history of deep vein thrombosis,
even many years past, the affected area should not be stimulated.
7.
Do not use over swollen, infected, or inflamed areas. Do not place electrodes over skin
eruptions.
8.
Fresh fractures should not be stimulated in order to avoid unwanted motion.
9.
Do not apply stimulation transcerebrally (through the head).
10. Do not use on cancer patients.
11. Stimulation should not be applied immediately following trauma or to tissues
susceptible to hemorrhage.
12. Positioning electrodes over the neck or mouth may cause severe spasm of the
laryngeal or pharyngeal muscles. These contractions may be strong enough to close
the airway or cause difficulty in breathing.
13. Do not apply stimulation for undiagnosed pain syndromes, until etiology is
established.
14. Do not apply electrodes directly over the eyes or inside body cavities.
15. Do not use electrical stimulation in conjunction with high frequency surgical
equipment or microwave or shortwave therapy systems.
5.3 Warnings for Neuromuscular Electrical Stimulation
1.
Electrical stimulation is ineffective for pain of central origin.
2.
Electrical stimulation must be applied by a physician or other qualified practitioner
and should be used for only the prescribed purposes.
3.
Electrical stimulation is of no curative value.
4.
Electrical stimulation is a symptomatic treatment and as such suppresses the sensation
of pain, which could serve as a protective mechanism.
5.
The safety of electrical stimulators for use on children has not been determined. Keep
out of reach of children.
6.
Electronic monitoring equipment (such as ECG monitors and ECG alarms) may not
operate properly when electrical stimulation is in use.
5.4 Precautions for Neuromuscular Electrical Stimulation
1.
30
Care should be taken in the treatment of patients receiving another type of
electrotherapeutic treatment (such as conventional TENS) or having indwelling
electrodes, lead wires, or transmitters (for electrophrenic pacing or cerebellar or
urinary bladder stimulation). Stimulation currents should not cross the lead wires or
electrodes.
Sys*Stim 294 Instruction Manual— Rev.E_07/02/12
2.
It is advisable to insulate patients, preferably by use of a wooden treatment table or
one that is completely padded by non–conductive material. Added safety is provided
if the patient cannot touch any grounded metal parts.
3.
Limit treatment intensity to 50 mA (50 V) or less, when using small electrodes (2" X 2",
pencil or smaller), to reduce the chance of thermal burns due to high current density.
Avoid current densities exceeding 2 mA/cm² when using this device.
4.
Isolated cases of skin irritation may occur at the site of electrode placement following
long–term application.
5.
Avoid placing electrodes directly over open wounds since current density tends to
concentrate in these areas.
6.
Use extreme caution when treating desensitized areas or on patients who may not be
able to report discomfort or pain.
7.
Use caution in applying electrical stimulation over areas where there is a loss of
normal skin sensation.
8.
Adequate precautions should be taken in the case of persons with suspected or
diagnosed epilepsy.
9.
Patients should not be left unattended during any treatment.
10. Care should be taken following recent surgical procedures when muscle contraction
may disrupt the healing process.
11. Do not apply electrical stimulation over the menstruating uterus.
12. The long–term effects of chronic electrical stimulation are unknown.
13. Effectiveness for pain management is highly dependent upon patient selection by a
person qualified in the management of pain patients.
14. Turn on the Sys*Stim 294 before applying electrodes to the patient.
5.5 Side Effects/Adverse Reactions for Neuromuscular
Electrical Stimulation
1.
Skin irritation and burns beneath the electrodes have been reported with the use of
electrical muscle stimulators.
2.
Possible allergic reactions to tape, gel or electrodes may occur.
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Sys*Stim 294 Instruction Manual— Rev.E_07/02/12
Section 6—Maintenance and
Troubleshooting
6.1 Cleaning the Sys*Stim 294
1.
The Sys*Stim 294 can be wiped off with a damp cloth. The power cord should be
disconnected from the unit before this is done. In the case of stubborn dirt a gentle
household cleaner can be sprayed on the cloth and then wiped on the unit. If this
method is used, remove any cleaner residue with a damp cloth. Do not spray cleaner
into the vents of the unit.
2.
Follow the EZ Trode package insert for the use and care of the electrodes supplied
with the Sys*Stim 294.
3.
For routine cleaning of the electrode cables use soap and water. Thoroughly dry after
cleaning.
6.2 Routine Maintenance
1.
Standard medical electrical safety checks should be performed annually by qualified
biomedical engineers or technicians trained to perform these procedures.
2.
Inspect electrode cables and associated connectors for damage.
6.3 Troubleshooting the Sys*Stim 294
Symptom
1. Nothing lights when main
power switch is turned on.
Action
Is line cord connected to outlet?
Does the outlet have power?
Unit may require servicing if none of the above
resolve the problem.
2. “E60_” displayed in Time
window.
There is an output voltage error for electrical
stimulation. If powering unit OFF and restarting
does not remove error, the unit requires servicing.
3. “E70_” displayed in Time
window.
If E7 occurs during the treatment the patient
connection impedance may be increasing because
the electrodes are drying out or lifting from the
patient.
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Mettler Electronics Corp.— Rev.E_07/02/12
If E7 occurs when the output is first being
adjusted, it may mean the electrodes or cables are
not making a good circuit. Check cable and
electrode connections and make sure electrodes
are making good contact with the patient.
In the continuous treatment modes the output
voltage is reduced while the unit monitors the
impedance of the patient connection. If the unit is
in amplitude modulated modes, such as recip or
surge, this patient connection error causes the unit
to go into the HOLD mode.
All patient connection errors should be
investigated to determine their cause.
4. “E80_” displayed in Time
window.
An output overcurrent has been detected. Current
exceeded 70 mA RMS for interferential, 55 mA for
premodulated, and medium frequency or 105 mA
peak for biphasic.
Reposition electrodes farther apart. Remove any
moisture or gel from between the electrodes and
try again. If error persists even without a patient
connection or load, unit requires servicing.
5. “E90_” displayed in Time
window.
Output error for electrical stimulation has been
detected. Remove electrode cables from unit and
restart. Replace electrode cables onto unit.
Reprogram treatment and try starting treatment
session again.
If powering unit OFF and restarting does not
remove error, the unit requires servicing.
6. “F1__” displayed in Time
window.
There has been a communication error between
the microprocessors. If powering unit OFF and
restarting does not remove error, unit requires
servicing.
7. “F2__” displayed in Time
window.
There has been a self-test error— If powering unit
OFF and restarting with all the electrode cables
removed does not remove error, the unit requires
servicing.
8. “F3 _” displayed in Time
window.
There has been a power supply error— If
powering unit OFF and restarting does not
remove error, the unit requires servicing.
If problem is not addressed above, or if additional troubleshooting guidance is desired,
call (800) 854-9305 or email service directly at service@mettlerelectronics.com.
The distributor who sold the Sys*Stim 294 should be able to assist you with a loaner unit
during warranty service.
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Sys*Stim 294 Instruction Manual— Rev.E_07/02/12
Section 7—References
1. Baker, L.L., Bowman, B.R., and McNeal, D.R.: “Effects of Waveform on Comfort
During Neuromuscular Electrical Stimulation”, Clinical Orthopedics and Related Research,
No. 233, pp. 75–85, August, 1988.
2. Belcher, J.: "Interferential Therapy", N.Z. Journal of Physiotherapy, 6:29-34, 1974.
3. Benton, L., et al.: Functional Electrical Stimulation – A Practical Guide, Rancho Los
Amigos Hospital, 1981.
4. Bowman, B.R. and Baker, L.L.: “Effects of Waveform Parameters on Comfort During
Transcutaneous Neuromuscular Electrical Stimulation”, Annals of Biomedical
Engineering, Vol. 13, pp. 59–74, 1985.
5. Brooks, M.E., Smith, E.M., and Currier, D.P.: “Effect of Longitudinal Versus Transverse
Electrode Placement on Torque Production by the Quadriceps Femoris Muscle during
Neuromuscular Electrical Stimulation”, JOSPT, 11:11, pp. 530–534.
6. De Dominico, G.: New Dimensions in Interferential Therapy, A Theoretical and Clinical
Guide, Reid Medical Books, Sydney, 1987.
7. De Dominico, G.: "Motor Stimulation with Interferential Currents", Australian Journal of
Physiotherapy, 31:225-230, 1985.
8. De Dominico, G.: "Pain Relief with Interferential Therapy", Australian Journal of
Physiotherapy, 28:14-18, 1982.
9. DeLitto, A. and Snyder–Mackler, L.: “Two Theories of Muscle Strength Augmentation
Using Percutaneous Electrical Stimulation”, Physical Therapy, (70:158–164), 1990
10. Electrotherapy Standards Committee of the Section on Clinical Electrophysiology of the
American Physical Therapy Association. Electrotherapeutic Terminology in Physical
Therapy, APTA, 1990.
11. Ganne, J. M. "Interferential Therapy", Australian Journal of Physiotherapy, 22:101-110,
1976.
12. Hayes, K.W.: A Manual for Physical Agents, Appleton & Lange, 1993.
13. Hecox, B., Mehreteab, T.A. and Weisberg, J.: Physical Agents—A Comprehensive Text for
Physical Therapists, Appleton & Lange, 1994.
14. Kahn, J.: Principles and Practice of Electrotherapy, Churchill Livingstone, 1987.
15. Killian, C.B.: “Electrical Stimulation Overview, Introduction to High Frequency
Stimulation”, Stimulus, 1986.
16. Kottke, F.J., Stillwell, G.K. and Lehman, J.F., eds.: Krusen's Handbook of Physical
Medicine and Rehabilitation, W.B. Saunders Company, 1982.
17. Low, J. and Reed, A.: Electrotherapy Explained—Principles and practice, Butterworth–
Heinemann, 1994.
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Mettler Electronics Corp.— Rev.E_07/02/12
18. Jaskoviak, P.A. and Schafer, R.C.: Applied Physiotherapy – Practical Clinical Applications
with Emphasis on the Management of Pain and Related Syndromes, Associated Chiropractic
Academic Press (A.C.A.), 1986.
19. Jorgenson, S. P. "Interferential Therapy", ACA Journal of Chiropractic, 23:12, 28-30, 1986.
20. Kahn, Joseph.: Principles and Practice of Electrotherapy, Churchill Livingstone, New York,
1987.
21. Kottke, F.J.; Stillwell, G.K.; and Lehman, J.F. ed. Krusen’s Handbook of Physical Medicine
and Rehabilitation. W.B. Saunders Co., Philadelphia, 1982.
22. Mannheimer, J.S. and Lampe, G.N: Clinical Transcutaneous Electrical Nerve Stimulation,
F. A. Davis Company, 1984.
23. Nelson, R.M. and Currier D.P.: Clinical Electrotherapy, Appleton and Lange, 1991.
24. Nikolova, L.: Treatment with Interferential Current, Churchill Livingstone, 1987.
25. Prentice, W.E.: Therapeutic Modalities in Sports Medicine, Times Mirror/Mosby College
Publishing, 1990.
26. Savage, B. Interferential Therapy, Faber and Faber, Boston, 1984.
27. Selkowitz, D.M.: “Improvement in Isometric Strength of the Quadriceps Femoris
Muscle After Training with Electrical Stimulation”, Physical Therapy, (65:186–196), 1985.
28. Snyder–Mackler, L. and Robinson, A. J., eds.: Clinical Electrophysiology, Electrotherapy
and Electrophysiologic Testing, Williams and Wilkins, 1989.
29. Starkey, C.: Therapeutic Modalities for Athletic Trainers, F. A. Davis Company, 1993.
30. Wadsworth, H. and Chanmugam, A.P.P.: Electrophysical Agents in Physiotherapy –
Therapeutic and Diagnostic Use, Science Press, Marrickville NSW 2204 Australia, 1983.
31. Wilkie, C. D. "Interferential Therapy", Physiotherapy, 55: 503-506, 1969.
32. Wolf, S.L., ed.: Electrotherapy, Churchill Livingstone, New York, 1981.
This manual has been written as a guideline for the correct use of the Sys*Stim 294
Sys*Stim 294. Reading the above references will provide a more complete understanding
of the correct use of neuromuscular stimulation.
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Sys*Stim 294 Instruction Manual— Rev.E_07/02/12
Section 8—Specifications
8.1 General Specifications:
Input:
90–240 VAC, 50–60 Hz, 2.3 Amp Nom.
ETL and C-ETL Listed:
Model ME 294 (9801427)
Year 2000 Compliant
Yes
Weight:
9.4 pounds
Dimensions:
5 in (H) x 14.5 in (W) x 10 in (D)
Operating Temperature:
+50°F to +104°F
Humidity:
Operating, 30% to 75% Relative Humidity at 104F
Nonoperating, 5 to 95% Relative Humidity, noncondensing
Storage Temperature:
-40°F to 167°F
Timer Accuracy:
±30 seconds
Maximum Treatment Time:
60 minutes–electrical stimulation
Treatment Timer:
Treatment time counts down to zero when a time is set,
or up to 60 minutes when no time is set. The digital
timer indicates time in minutes and seconds. The timer
also indicates the remaining or elapsed treatment time
during the “Hold” period.
8.2 Waveform Specifications:
Interferential Mode
Figure 8.1—Interferential
Waveform
Waveform Type:
Polarity:
Volts:
Current:
Average current at
maximum intensity
and frequency:
Maximum current
density under 2"
diameter electrode.
Frequency:
Frequency Modulation:
Sinewave
None
0–65 volts RMS, 1 Kohm load
0–65 mA RMS, 1 Kohm load
65 mA RMS
3.2 mA/cm²
Channel 1 = 4000 Hz
Channel 2 = 4000 to 4250
Hz variable frequency sine
wave
1–15 Hz
80–150 Hz
1–150 Hz
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Mettler Electronics Corp.— Rev.E_07/02/12
Phase Duration:
Available Amplitude
Modulation Options:
Available Channels:
xx–xx Hz,
xx=any value from
1 to 250 Hz
125 s
Vector rotation
Channel pairs 1 & 2 or 3 &4
Premodulated Mode
Waveform Type:
Polarity:
Volts:
Current:
Figure 8.2—Premodulated
Waveform
Average current at
maximum intensity
and frequency:
Maximum current
density under 2"
diameter electrode.
Frequency:
Frequency Modulation:
Phase Duration:
Available Amplitude
Modulation Options:
Available Channels:
38
Amplitude modulated
sine wave
None
0–50 volts RMS, 1 Kohm load
0–50 mA RMS,
1 Kohm load
50 mA RMS
2.5 mA/cm²
4,000 Hz
1–15 Hz
80–150 Hz
1–150 Hz
xx–xx Hx,
xx=any value from
1 to 250 Hz
125 s internal sine wave
4–1,000 ms beat envelope
Continuous
Surge
Reciprocation
All
Sys*Stim 294 Instruction Manual— Rev.E_07/02/12
Medium Frequency Mode
Waveform Type:
Polarity:
Volts:
Current:
Average current at
maximum intensity
and frequency:
Figure 8.3—Medium Frequency Maximum current
(Russian) Waveform
density under 2"
diameter electrode.
Frequency:
Frequency Modulation:
Phase Duration:
Available Amplitude
Modulation Options:
Available Channels:
Burst modulated sine wave
None
0–50 volts RMS, 1 Kohm load
0–50 mA RMS, 1 Kohm load
50 mA RMS
2.5 mA/cm²
2500 Hz, Burst at
10 ms on and 10 ms off
No
200 s
Continuous
Surge
Reciprocation
All
Biphasic Mode
Waveform Type:
Polarity:
Volts:
Current:
Average current at
maximum intensity
Figure 8.4—Biphasic Waveform
and frequency:
Maximum current
density under 2"
diameter electrode.
Frequency:
Frequency Modulation:
Phase Duration:
Available Amplitude
Modulation Options:
Available Channels:
Symmetrical biphasic square
wave
None
99 volts peak, 1 Kohm load
0 –99 mA peak,
1 Kohm load
7.2 mA
0.36 mA/cm²
1–120 Hz
No
50–300 s
Continuous
Surge
Reciprocation
All
39
Mettler Electronics Corp.— Rev.E_07/02/12
High Volt Mode
500 volts
8 us
50 %
0 volts
75 us
Figure 8.5—High Volt
Waveform
Waveform Type:
Polarity:
Volts:
Current:
Average current at
maximum intensity
and frequency:
Maximum current
density under 2"
diameter electrode.
Frequency:
Frequency Modulation:
Phase Duration:
Polarity:
Available Amplitude
Modulation Options:
Available Channels:
Monophasic twin peak
Positive or negative
500 volts peak, 1 Kohm load
0 –500 mA peak,
1 Kohm load
1.2 mA at 120 pps with
1 Kohm load
0.06 mA/cm²
1–120 Hz
No
8 s at 50% Vmax
Positive or negative
Continuous
Surge
Channel One only
Microcurrent Mode
Waveform Type:
+
Polarity:
-
or
+
-
Figure 8.6—Microcurrent
Waveform
40
Volts:
Current:
Average current at
maximum intensity
and frequency:
Maximum current
density under 2"
diameter electrode.
Frequency:
Duty Cycle:
Frequency Modulation:
Pulse Duration:
Available Amplitude
Modulation Options:
Available Channels:
Monophasic or biphasic
square wave
Positive or negative or
biphasic pulses
1 Volt peak, 1 Kohm load
10-990 A peak, 1 Kohm load
990 A
24.4 A/cm²
0.5-500 Hz
50%
No
1-1000 ms
Continuous
Channel Two only
Sys*Stim 294 Instruction Manual— Rev.E_07/02/12
8.3 Amplitude Modulation Specifications:
Vector rotation:
Interferential Mode Only,
-50% amplitude modulation in
anti phase with an eight second modulation period.
Surge Mode:
Premodulated, Medium Frequency, High Volt and Biphasic
Pulsed Modes
3 seconds
2 seconds
10 seconds on, 10 seconds off
10 seconds on, 20 seconds off
10 seconds on, 30 seconds off
10 seconds on, 40 seconds off
10 seconds on, 50 seconds off
10 seconds on, 60 seconds off
1–240 seconds
1–240 seconds
Up ramp:
Down ramp:
Preset on/off times:
Programmable On time:
Programmable Off time:
Reciprocation mode:
Up and down ramps:
Reciprocation time:
Combine with Surge:
Premodulated, Medium Frequency and Biphasic Pulsed
Modes
1 second, reciprocation only
2–240 seconds, (On time = off time)
Use up and down ramps of surge program
Use on/off times of surge program.
41
Mettler Electronics Corp.— Rev.E_07/02/12
42
Sys*Stim 294 Instruction Manual— Rev.E_07/02/12
Section 9—Accessories
9.1 Ordering Information:
Therapy products and accessories are available from Mettler Electronics authorized
Distributors. For information regarding either Mettler products or a distributor near you,
please call toll free, (800) 854–9305 or phone (714) 533–2221 in areas outside the continental
United States. Ask for Customer Service. Mettler Electronics is open from 7 AM until 5 PM
Pacific Time for your convenience. The email address for Customer Service is
mail@mettlerelectronics.com.
9.2 Sys*Stim 294 Accessories
Catalogue #
Item Description
2000
4 Sponge electrodes (2" x 2")
2001
24 Sponge inserts (2" x 2")
2002
4 Sponge electrodes (4" x 4")
2003
24 Sponge inserts (4" x 4")
2004
1 Sponge electrode (3.5" x 7")
2005
12 Sponge inserts (3.5" x 7")
2006
1 Sponge electrode (8" x 10")
2007
12 Sponge inserts (8" x 10")
2008
4 Electrode straps (24")
2009
4 Electrode straps (48")
2023
Pencil electrode set with push button stimulation control, (includes
handle, 4 different sizes of stainless steel spot electrode tips, and
carrying case)
2027
Pin to banana adapter plug set to be used with ME 2026, 2260 or 2201
electrode cables. Four each, gray.
2030
Bifurcated cord set, one red and one black, , pin termination
2221
EZ Trode – 2" diameter round self–adhering, reusable electrodes with
lead wires; case of ten packages (four electrodes/pkg.)
2222
EZ Trode – 2.75" diameter round self–adhering, reusable electrodes
with lead wires; case of ten packages (four electrodes/pkg.)
2223
EZ Trode – 2" x 5" self–adhering, reusable electrodes with lead wires,
case of 10 packages (2 electrodes/pkg.)
2224
EZ Trode – 2" square self–adhering, reusable electrodes with lead
wires; case of ten packages (four electrodes/pkg.)
2260
Electrode cable for the Sys*Stim 294 with pins
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Mettler Electronics Corp.— Rev.E_07/02/12
2702
V Trode –2" diameter round electrodes with lead wires, case of ten
packages (four electrodes/pkg.)
2703
V Trode –2.75" diameter round electrodes with lead wires, case of 10
packages (four electrodes/pkg.)
2704
V Trode –2" x 4" oval electrodes with lead wires, case of 10 packages
(four electrodes/pkg.)
2705
V Trode –2" square electrodes with lead wires, case of 10 packages
(four electrodes/pkg.)
7293
Detachable U.L. listed, hospital–grade line cord
73
9900
44
Three-shelf mobile cart for all Sonicator Plus products. Holds unit on
the top shelf with lower shelves for accessories.
Electrical Stimulation & Ultrasound Pocket Guide by Michelle H.
Cameron. Designed for use with the Sys*Stim 294.
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