DIGITAL EMS TENS - EMS and TENS devices SANITAS - Free user manual and instructions

USER MANUAL DIGITAL EMS TENS SANITAS

Please read these instructions for use carefully and keep them for later use, be sure to make them ­accessible to other users and observe the information they contain. English Table of Contents

1. Getting to know your machine

1.1 What is Digital EMS/TENS and what can it do?

Digital EMS/TENS belongs to the group of electrical stimulation systems. It has three basic functions, which can be used in combination:

1. Electrical stimulation of nerve tracts (TENS).

2. Electrical stimulation of muscle tissue (EMS).

3. A massage effect generated by electrical signals.

For this, the device has two independent stimulation channels and four selfadhesive electrodes. It has various versatile functions in order to increase general wellbeing, alleviate pain, maintain physical fitness, relaxation, revitalise muscles and combat fatigue. You can either select these functions from preset programmes or determine them yourself according to your requirements. The operating principle of electrical stimulation equipment is based on simulating the body’s own pulses which are transmitted transcutaneously to nerve or muscle fibres by means of electrodes. The electrodes can thereby be attached to many parts of the body, whereby the electrical stimuli are safe and practically painless. You merely feel a gentle prickling or vibrating in some applications. The electrical pulses transmitted to the tissue affect the trans­mission of stimulation in nerve conductions as well as neural nodes and muscle groups in the field of application. The effect of electrical stimulation is generally only recognisable after regularly repeated application. Electrical stimulation does not replace regular exercising of the muscle, but is able to reasonably supplement the effect thereof. TENS, transcutaneous electrical nerve stimulation, means electrical stimu­ lation of nerves through the skin. TENS is recognised as a clinically proven, effective, non-medication method of treating pain from certain causes. It is free from side-effects when used properly, and can also thereby be used as a simple means of self-treatment. The pain-alleviating or suppressing effect

Through integrated massage technology, Digital EMS/TENS also offers the possibility of reducing muscular tension and combating fatigue symptoms ­using a programme based on real massage in terms of sensation and effect. Using the positioning suggestions and programme charts in this manual, you can determine the machine setting fast and easily for the respective application (depending on the region of the body affected) in order to ensure the desired effect. Through the two separately adjustable channels, the Digital EMS/TENS has the advantage of adapting the intensity of the pulses independently of each other to two parts of the body to be treated, for example in order to cover both sides of the body or ensure even stimulation of larger areas of tissue. The individual intensity setting of each channel also allows you to treat two different parts of the body at the same time, whereby it is possible to save time compared with individual sequential treatment. is also achieved by preventing pain from being passed on into nerve fibres (above all through high-frequency pulses) and increasing the secretion of the body’s own endorphines which reduce awareness of pain through their effect on the central nervous system. The method is scientifically underpinned and medically approved. Any symptoms indicating TENS application must be clarified with the doctor in charge of your treatment. The latter will also give you information on the respective benefits of TENS self-treatment. TENS is clinically tested and approved with the following applications:

• Back pain, particularly also lumbar and cervical spine problems
• Joint pain (e.g. knee joint, hip joint, shoulder)
• Women's period pains
• Pain after injuries to musculoskeletal system
• Pain with circulatory problems
• Chronic pain through various causes

1.2 Scope of supply

– 1x Digital EMS/TENS machine (incl. belt clip) – 1x connecting cable – 4x adhesive electrodes (45 x 45 mm) – 3x AAA batteries – these instructions for use Subsequent purchase articles 8x adhesive electrodes (45 x 45 mm), Art. no. 661.22 4x adhesive electrodes (50 x 100 mm), Art. no. 661.21 Electrical muscle stimulation (EMS) is a widespread and generally recognised method and has been used for years in sports and rehabilitation medicine. In the sports and fitness field, one of the uses of EMS is as a supplement to conventional muscle training, in order to increase the efficiency of muscle groups and adapt physical proportions to the desired aesthetic results. EMS application goes in two directions. On the one hand, a targeted strengthening of musculature can be produced (activating application) and on the other hand a relaxing, resting effect can also be achieved (relaxing application). Active application includes the following:

• Muscle training to improve endurance performance and/or
• Muscle training to support the strengthening of certain muscles or muscle groups in order to achieve desired changes to body proportions. Relaxing application includes the following:
• Muscle relaxation in order to loosen up muscular tension
• Improving muscular fatigue symptoms
• Accelerating muscle regeneration after high muscular performance (e.g. after a marathon).

2. Important Information

Use of the machine does not replace medical consultation and treatment. In the event of any type of pain or illness, you must therefore always first ask your doctor. WARNING! In order to prevent any damage to health, we would urgently advise against using the Digital EMS/TENS in the following cases:

• With any implanted electrical devices (such as pacemakers)
• If there are any metal implants
• When using an insulin pump
• In case of high fever (e.g. > 39 °C)

• In case of known or acute cardiac arrhythmias and other disorders in ­stimulus formation and conduction of the heart
• If suffering from attacks (e.g. epilepsy)
• After operations where increased muscle contractions might impair the healing process
• Never use near the heart. Stimulation electrodes should never be placed anywhere on the front of the thorax (marked by ribs and breastbone), but above all not on the two large pectoral muscles. Here it can increase the risk of ventricular fibrillation and lead to cardiac arrest
• On the bony part of the cranium, near the mouth, throat or larynx
• Near the throat / carotid artery
• On acutely or chronically diseased (injured or inflamed) skin (e.g. in the event of painful and painless inflammation, reddening, skin rashes (e.g. allergies), burns, bruises, swellings, open wounds and wounds in the ­process of healing, on operation scars in the process of healing)
• In environments with high humidity such as in the bathroom or when ­having a bath or shower
• Do not use after consuming alcohol
• When a high frequency surgical device is connected at the same time Before using the machine, you should consult with the doctor in charge of your treatment in the event of the following:
• Acute diseases, especially if hypertension is suspected or actually exists, or blood-clotting disorders, tendency to thromboembolic diseases or in case of malignant new masses
• Chronic pain disorders which have not been clarified, regardless of the region of the body
• All sensitivity disorders with reduced pain awareness (such as metabolic disturbances)
• Medical treatments carried out simultaneously

• Complaints arising as a result of the stimulation treatment
• Constant skin irritation as a result of prolonged stimulation at the same electrode point. IMPORTANT! Use the Digital EMS/TENS solely:
• For the purpose for which it was developed and in the manner specified in these instructions for use. Any improper use can be hazardous.
• For external application.
• With the original accessory parts which are supplied and can be re-ordered, otherwise the warranty becomes null and void. PRECAUTIONARY MEASURES:
• Always remove the electrodes from the skin with a moderate pull in order to avoid injury in the event of highly sensitive skin.
• Keep the machine away from heat sources and never use it near (~1 m) short-wave or microwave equipment (e.g. mobile phones), as this may lead to unpleasant current spikes.
• Do not expose the machine to direct sunlight or high temperatures.
• Protect the machine from dust, dirt and humidity. Never submerge the device in water or other liquids.
• The machine is suitable for private use.
• For reasons of hygiene, the electrodes should only be used on one ­person.
• If the machine is not functioning properly, or if you start feeling unwell or there is any pain, stop the application immediately.
• To remove or move the electrodes, first switch off the machine or the appropriate channel in order to avoid unwanted irritation.
• Never modify any electrodes (e.g. by cutting). This leads to a higher ­current density and can be dangerous (max. recommended output value for ­electrodes: 9 mA/cm2, an effective current density over 2 mA/cm² requires greater attention).
• Do not use when asleep, when driving a vehicle or at the same time as operating machinery.
• Never use with any activities where an unforeseen reaction (e.g. increased muscle contraction despite low intensity) may be dangerous.

Information on ESD (Electrostatic Discharge) Please note that jacks marked with the ESD warning label must not be touched. ESD protective measures: – Do not touch plugs/jacks marked with the ESD warning label with fingers! – Do not touch plugs/jacks marked with the ESD warning label with handheld tools! Further explanations on the ESD warning label, as well as possible training courses and their contents, are available on request from the customer service department.

• Make sure that no metallic objects such as belt buckles or necklaces can come in contact with the electrodes during stimulation. If you wear any jewellery or piercings (e.g. belly piercing) near the application site, you must remove these before using the machine as burning may otherwise occur at some points.
• Keep the device away from children to prevent any hazards.
• Do not confuse the electrode cables and contacts with your headphones or other devices, and do not connect the electrodes to other devices.
• Do not use this machine at the same time as other equipment which sends electrical pulses to your body.
• Do not use it near any highly flammable substances, gases or explosives.
• Never use accumulators, always use the same types of battery.
• In the initial minutes, carry out the application sitting or lying down in order to avoid any unnecessary risk of injury in the rare event of a vagal reaction (feeling of weakness). If you start feeling weak, switch the machine off ­immediately and put your legs up (approx. 5–10 minutes).
• It is not advisable to apply any enriching creams or ointments to the skin beforehand, as this greatly increases electrode wear or else unpleasant current spikes may occur here. Damage:
• If the machine is damaged, do not use it if you are in any doubt but rather contact your dealer or the customer service address indicated.
• Check the device at regular intervals for signs of wear or damage. If you find any such signs or if the device was used improperly, you must bring it to the manufacturer or dealer before it is used again.
• Switch off the device immediately if it is defective or if is not working properly.
• Do not, under any circumstances, attempt to open or repair the machine yourself! Only have repairs carried out by the customer service department or an authorized dealer. If these instructions are not heeded, the warranty becomes null and void.
• The manufacturer assumes no liability for damage caused through improper or wrong use.

3. Current parameters

Electrical stimulation machines operate with the following current settings, which will alter the stimulation effect depending on the setting.

3.1 Pulse shape

monophase pulses pulse intensity This describes the time function of the excitation current whereby monophase pulse trains are differentiated from biphase. With monophase pulse trains, the current flows in one direction. With biphase pulses, the excitation current alternates its direction. In the Digital EMS/TENS unit, there are only biphase pulse trains, as they reduce the strain on the muscle, leading to less muscle fatigue as well as safer application. time biphase pulses

3.2 Pulse frequency

Frequency indicates the number of individual pulses per periodic time second, and is indicated in Hz (Hertz). It can be calculated by working out the inverse value of the periodic time. The respective frequency determines which types of muscle fibre preferably react. Slow-response fibres tend to react to lower pulse frequencies up to 15 Hz, while fast-response fibres only respond to frequencies over approx. 35 Hz. With pulses of approx. 45–70 Hz, there is permanent tension in the muscle combined with premature muscle fatigue. Higher pulse frequencies can therefore preferably be used for elasticity and maximum strength training.

4. Unit description

3.3 Pulse width

Pulse width is used to indicate the duration of an individual pulse in microseconds. Pulse width also determines the pene­tration depth of the current whereby in general, the following applies: a greater muscle mass requires a greater pulse width.

4.1 Description of components

Display (main menu): A Pulse intensity B Programme/cycle numbers C Frequency (Hz)

D Low battery E TENS/EMS/MASSAGE submenus F Timer function (residual time indicator) G Operating status display Keys:

a UP and DOWN selection keys

b ENTER key c ON/OFF key d MENU key e CH1+, CH1-, CH2+, CH2- keys Accessories:

• 1x connection cable (with 2 separately controllable channels, recognisable by their difference in colour)
• 4x adhesive electrodes (45 x 45 mm)

3.4 Pulse intensity

Setting the degree of intensity is individually dependent on the subjective feeling of each individual user and is determined by a number of parameters such as application site, skin circulation, skin thickness as well as quality of electrode contact. The actual setting should be effective but should never produce any unpleasant sensations such as pain at the site of application. While a slight tingling sensation indicates sufficient stimulation energy, any setting which leads to pain must be avoided. With prolonged application, readjustment may be necessary due to time adjustment processes at the site of application.

3.5 Cycle-controlled pulse parameter variation

In many cases it is necessary to cover the entirety of tissue structures at the site of application by using several pulse parameters. With the Digital EMS/ TENS unit, this is done by the existing programmes automatically making a cyclical pulse parameter change. This also prevents individual muscle groups at the site of application from getting tired. With the Digital EMS/TENS unit there are useful presettings for current para­meters. During the application, however, you do have the possibility of changing pulse intensity at any time and, with individual programmes, you can also alter pulse frequency beforehand in order implement the application which is the most comfortable or promises the most success for you.

4.2 Key functions

Every time a key is pressed, this is acknowledged by a signal tone in order to ensure that any unintentional pressing of a key is detected. This signal tone cannot be switched off. ON/OFF (1) Hit briefly to switch on the machine. If the key is held down for 10 ­seconds when switching on, the unit automatically switches off again. (2) Press once to interrupt stimulation treatment = pause mode. (3) Hold ON/OFF key down (approx. 3 seconds) to switch off the machine. and (1) Select between (A) treatment programme, (B) frequency and (C) treatment time.

(2) The DOWN key is used to reduce pulse intensity for both channels during stimulation. MENU (1) Navigation between the submenus TENS, EMS and MASSAGE. (2) Return to (A) programme selection window or (B) main menu. ENTER (1) Menu selection. (2) To confirm a selection made with UP/ DOWN, apart from channel intensity. CH1+, CH1-, CH2+, CH2Setting pulse intensity.

6.1 Basic information

The Digital EMS/TENS unit has a total 50 programmes:

• 10 MASSAGE programmes With all programmes, you can set the length of application and (for each of the two channels) pulse intensity separately. Besides this, with TENS and EMS programmes 11–   20, you can also change the pulse frequency of the individual cycles in order to adapt the stimulation effect to the structure of the site of application. Cycles are the different sequences making up the programmes. They automatically run one after the other and increase the efficacy of stimulation on different types of muscle fibre and combat premature muscle fatigue. You will find the standard stimulation parameter settings and information on placing the electrodes in the following programme charts for TENS, EMS and MASSAGE.

5. Start-up

1. Remove the belt clip from the machine, if attached.

2. Press on the battery cover at the back of the machine and

push it to the side.

3. Insert three AAA 1.5 V alkaline batteries. Make absolutely

sure that you insert the batteries with the correct polarity as marked.

4. Replace the battery cover carefully (Fig. 1).

5. Attach the connecting cable to the electrodes (Fig. 2).

i Note: The electrodes have a clip fastener to ensure easy ­connection.

6. Insert the connecting cable connector into the socket at the

back of the machine (Fig. 3).

7. Do not pull, twist or make any sharp kinks in the cables

(Fig. 4). Fig. 1 Fig. 2 Fig. 3 Fig. 4

6.2 TENS programmes

Prog. No. Reasonable areas of application Indications 03, 04, 05, 06, 15, 23 07, 14 Cycle 1 Cycle 5 Width Fre- On (µs) quen- Time cy (Hz) (sec.)

Cycle 2 Cycle 6 Off Width Fre- On Time (µs) quen- Time (sec.) cy (Hz) (sec.)

Cycle 3 Cycle 7 Off Width Fre- On Time (µs) quen- Time (sec.) cy (Hz) (sec.)

Cycle 4 Cycle 8 Off Width Fre- On Time (µs) quen- Time (sec.) cy (Hz) (sec.)

4 + 14 Pain as a result of ­rheumatoid arthritis 5 + 15 Lumbar pain See note

7 + 17 Pain programme I See note

8 + 18 Knee pain Ankle joint pain, ­capsular injuries 9 + 19 Pain programme II (Burst) 10   +   20 Pain programme III (Burst)

0,25 0,25 1 + 11 Neck pain, tension headache 2 + 12 Back pain 3 + 13 Shoulder pain Possible ­electrode position 01, 02, 13 Off Time (sec.)

On-Time (sec.) = Cycle switch-on time in seconds (contraction) – Off-Time (sec.) = Cycle switch-off time in seconds (relaxation) Note: Electrode position is supposed to surround the painful area. With painful muscle groups, the electrodes are grouped round the muscle affected. In case of joint pain, the joint on the front/rear side of the joint and, if electrode distances permit, on the right and left sides of the joint, should be surrounded with electrodes. Minimal electrode distance should not be less than 5 cm and not exceed 15 cm. See figure no. 9 an 10 for knee and ankle joint. Burst programmes are suitable for all sites which should be treated with an alternating signal pattern (to ensure minimum habituation).

6.3 EMS programmes

Prog. No. Reasonable areas of application Indications Possible ­electrode position Cycle 1 Cycle 5 Width Fre- On (µs) quen- Time cy      (Hz) (sec.)

Cycle 2 Cycle 6 Off Width Fre- On Time (µs) quen- Time (sec.) cy      (Hz) (sec.)

Cycle 3 Cycle 7 Off Width Fre- On Time (µs) quen- Time (sec.) cy      (Hz) (sec.)

Cycle 4 Cycle 8 Off Width Fre- On Off Time (µs) quen- Time Time (sec.) cy      (Hz) (sec.) (sec.)

1 + 11 Shoulder muscles 07, 14 2 + 12 Middle and lower trapezius muscle, lattisimus dorsi ­muscle, neck muscles 3 + 13 Back musculature near spinal column, Prog. I 4 + 14 Front and back upper arm ­musculature (including ­biceps), front and back lower arm musculature 5 + 15 Straight and transverse ­abdominal musculature 6 + 16 Back musculature near spinal column, Prog. II 7 + 17 Back musculature near spinal column, Prog. III 8 + 18 Posterior musculature 11, 20, 21

03, 06, 22, 03, 06, 22,

9 + 19 Front and back upper thigh 25, 26 musculature 10    +    20 Front and back lower thigh 27, 28 musculature

On-Time (sec.) = Cycle switch-on time in seconds (contraction) – Off-Time (sec.) = Cycle switch-off time in seconds (relaxation)

6.4 MASSAGE programmes

The following guideline holds when selecting electrode distances:

• most reasonable distance: approx. 5   –15 cm
• below 5 cm, it is mainly surface structures which are strongly stimulated
• over 15 cm, large-area and deep structures are stimulated very weakly Electrode relationship to muscle fibre orientation Choice of current flow direction must be adapted to the muscle fibre orientation according to the desired muscle layer. If surface muscles are to be reached, the electrodes must be placed parallel to the fibre orientation (p. 2, fig. 16; 1A-1B/2A-2B). If deep tissue layers are to be reached, the electrodes must be placed crosswise to the fibre orientation (p. 2, fig. 16; 1A-2A/1B-2B). The latter arrangement can, for example, be achieved via the cross electrode arrangement, e.g. p. 2, fig. 16; 1A-2B/2A-1B. Note the colour-codes of the cables and the channels. The white cable belongs to channel CH1 and the grey cable to channel CH2. i In the treatment of pain (TENS) using the Digital EMS/TENS machine with its 2 separately controllable channels and in each case 2 adhesive electrodes, it is advisable to either position the electrodes of one channel so that the pain spot lies between the electrodes or else you position one electrode directly on the pain spot and the other at least 2  –   3 cm away. The electrodes of the second channel can be used to treat other pain spots simultaneously or else, however, together with the electrodes of the first channel, to surround the pain area (opposite). A cross arrangement is again advisable here. i Massage function tip: always use all 4 electrodes to ensure optimal ­treatment. i In order to extend the durability of the electrodes, use them on clean skin which is as free as possible from hair and grease. If necessary, clean the skin with water before application and remove the hair. i If an electrode becomes detached during the application, the pulse intensity of both channels goes to the lowest setting. Press the ON/OFF key to enter pause mode, reposition the electrode and continue application by pressing the ON/OFF key again and setting the required pulse intensity. Massage form Tap and grasp massage Knead and grasp massage Tap massage Side of hand/pressing massage Side of hand/pressing massage Vibratory massage Tap massage (switch between electrodes) Massage jet (switch between electrodes) Pressure massage jet (switch between electrodes) Combination programme (switch between electrodes) Electrodes must be placed so that they surround the muscle segments in question. For optimal effect, electrode distance must not be greater than approx. 15 cm. The electrodes should not be applied to the anterior wall of the thorax, i.e. never massage the left or right large pectoral muscle.

6.5 Information on placing the electrodes

For the desired success of any stimulation application, it is important that electrodes are placed sensibly. We advise you to coordinate with your doctor regarding the best electrode positions for your intended field of application. The electrode positions suggested inside the cover (Figs. 1–  28) serve as a guide. The following applies when choosing electrode positions: Electrode distance The greater the electrode distance which is selected, the greater will be the volume of tissue that is stimulated. This applies to the area and the depth of the tissue volume. At the same time, however, the strength of tissue stimulation decreases as the electrode distance becomes greater, which means that, if a greater electrode distance is chosen, a greater volume is stimulated, but stimulation is weaker. To increase stimulation, pulse intensity must then be increased.

7. Application

7.3 Procedure for TENS/EMS programmes 11 to 20

(individual programmes)

7.1 Advice on application

Programmes 11 to 20 are preset programmes which you can also individualise. Here you can set pulse frequency.

• From the programme charts, select a programme that is suitable for your purpose.
• Place the electrodes in the area selected and connect these to the machine. The corresponding positioning suggestions may help you here.
• Press the ON/OFF key in order to switch on the machine.
• Press MENU and navigate through the sub-menus (TENS/ EMS/MASSAGE) and confirm your selection with ENTER (Fig. 1, example of TENS display).
• Using the UP/DOWN keys, select the programme you want Fig. 1 and confirm with ENTER (Fig. 2, example of display for No. 11 TENS programme).
• Using the UP/DOWN keys, select the frequency you want for Cycle 1 (Hz) and confirm with ENTER (Fig. 3). Repeat this Fig. 2 process for all subsequent cycles.
• To terminate frequency setting, set the frequency (Hz) after the cycle last required “--0” and press ENTER. All frequency settings of subsequent cycles are then automatically set at Fig. 3 “0” and thus not taken into account. i Tip: Hold down the ENTER key for 2 seconds in order to skip frequency settings and access ‘treatment time setting’. In the event that you need all 8 cycles, you can also press Fig. 4 ENTER for 2 seconds to terminate selection of frequency settings.
• Using the UP/DOWN keys, select the desired treatment time and confirm with ENTER (Fig. 4, example of 30-minute treat- Fig. 5 ment duration).
• The machine is in wait status (Fig. 5).
• Press ON/OFF to start the stimulation treatment. The operation status display starts to flash (Fig. 6). Fig. 6

• If the machine is not used within 3 minutes, it switches off automatically (automatic switch-off function). When it is switched on again, the LCD main menu screen appears, with the last used submenu flashing.
• If an admissible key is pressed, there is one short beep. If an inadmissible key is pressed, there are two short beeps.

7.2 Procedure for TENS, EMS and MASSAGE programmes 01–10

• From the programme charts, select a programme that is suitable for your purpose.
• Place the electrodes in the area selected and connect these to the machine. The corresponding positioning suggestions may help you here.
• Press the ON/OFF key in order to switch on the machine. Fig. 1
• Press MENU and navigate through the sub-menus (TENS/ EMS/MASSAGE) and confirm your selection with ENTER (Fig. 1, example of TENS display).
• Using the UP/DOWN keys, select the programme you want Fig. 2 and confirm with ENTER (Fig. 2, example of display for No. 1 TENS programme).
• Using the UP/DOWN keys, select the total treatment time and confirm with ENTER (Fig. 3, example of 30-minute treat- Fig. 3 ment duration). The machine is in wait status (Fig. 4).
• Press ON/OFF to start the stimulation treatment. The operation status display starts to change (Fig. 5). Fig. 4
• Select the pulse intensity which is the most comfortable for you by pressing the key CH 1+/CH 2+. The pulse intensity display adapts accordingly. Fig. 5

• Select the pulse intensity which is the most comfortable for you by pressing the key CH 1+/CH 2+. The pulse intensity display adapts accordingly. i Note: Your individualised programme settings are stored and automatically retrieved when you select it next.

• Before you activate the programme by pressing the ON/OFF key, hold ON/OFF and CH 2+ keys down simultaneously for approximately 5 seconds. Storage in Doctor's Function is confirmed by a long signal tone. Cancelling Doctor’s Function: To clear the device again and access other programmes, hold down the two keys ON/OFF and CH 2+ once again for approximately 5 seconds (not possible during stimulation). Cancelling of the Doctor’s Function is confirmed by a long signal tone.

7.4 Changes to the settings

Changing intensity (during application)

• CH1+/- and CH2+/-: Changing the intensity for each channel.
• DOWN key : the intensity of both channels is reduced. Interrupting stimulation Press the ON/OFF button. If you press it again, the application is resumed. Switching off a complete channel Press the CH- key until the channel reaches the lowest intensity, then hold the key depressed until the channel no longer appears in the display. Hold down the corresponding key CH+ to reactivate the channel. Changing application (completely or single parameters)
• ON/OFF: to interrupt stimulation
• MENU: back to program selection window or main menu
• Set required parameters. Confirm with ENTER. Press ON/OFF to continue application.

8. Cleaning and storage

Adhesive electrodes:

• In order to ensure that the electrodes adhere for as long as possible, they should be cleaned carefully with a damp, lint-free cloth.
• After use, stick the electrodes onto the backing film. Cleaning the unit:
• Remove the batteries from the device every time you clean.
• Clean the unit after use with a soft, slightly moistened cloth. In case of more extreme soiling you can also moisten the cloth with mild soapy water.
• Ensure that no water penetrates into the machine. If this should ever happen, only use the machine again once it is completely dry.
• Do not use any chemical cleaners or abrasive agents for cleaning. Storage:
• Remove the batteries from the unit if you are not going to use it for a longer period. Leaking batteries can damage the unit.
• Do not make any sharp kinks in the connecting leads or electrodes.
• Detach the connecting cable from the electrodes.
• After use, stick the electrodes onto the backing film.
• Store the machine in a cool, well-ventilated place.
• Never place any heavy objects on the machine.

7.5 Doctor’s Function

Doctor’s Function is a specific setting to allow you to call up your specific personal programme even more easily. Your individual programme setting is immediately retrieved in wait status when you switch on and is activated by simply pressing the ON/OFF key. Settings for this individual programme may, for example, be on the advice of your doctor. With the Doctor’s Function, only pulse intensity can be changed during stimulation treatment. All other parameters and programmes of the Digital EMS/TENS are blocked in this case and cannot be modified or called up. Setting the Doctor’s Function:

• Select your programme and appropriate settings as described under 7.2 or 7.3.

9. Disposal

Used, fully discharged batteries must be disposed of in a specially labeled collection container, at toxic waste collection points or through an electrical retailer. You are under legal obligation to dispose of batteries correctly.

Note: You will find these markings on batteries containing harmful substances: Pb = battery containing lead, Cd = battery containing cadmium, Hg = battery containing mercury.

(3) Check that the electrodes are positioned properly and make sure that the adhesive electrodes are not overlapping. (4) Increase pulse intensity in stages. (5) The batteries are almost empty. Replace these. You are aware that the electrodes feel uncomfortable. What should I do? (1) The electrodes are badly positioned. Check positioning and if necessary reposition the electrodes. (2) The electrodes are worn. Due to the fact that current distribution can no longer be guaranteed evenly over the entire surface, these may lead to skin irritation. You must therefore replace these. The skin in the treatment area becomes red. What should I do? Stop treatment immediately and wait until the skin has returned to normal. If any redness beneath the electrode soon disappears, this is not dangerous and is due to the increased circulation which has been stimulated locally. If, however, the skin irritation remains and there is possibly itching or inflammation, please consult your doctor before further use. It may possibly be caused by an allergy to the adhesive surface. The belt clip is not secure. What should I do? If the clip is fastened to the belt and only then connected to the machine, there is not optimal hold. You should therefore take the machine in your hand. Position the belt clip on the back of the machine. You will notice the correct position of the clip when you hear it click into position. Now secure the ­machine with belt clip on the belt again.

Please dispose of the device in accordance with the directive 2002/96/ EC – WEEE (Waste Electrical and Electronic Equipment). If you have any queries, please refer to the local authorities responsible for waste disposal.

10. Problems and solutions

The machine does not switch on when the ON/OFF button is pressed. What should I do? (1) Make sure that the batteries have been inserted correctly and have contact. (2) Change the batteries if necessary. (3) Contact customer service. The electrodes are detaching themselves from the body. What should I do? (1) Clean the adhesive surface of the electrodes with a damp, lint-free cloth. Then let them dry in the air and attach them again. Should the electrodes still not adhere firmly, they must be replaced. (2) Before each application, clean the skin, avoiding using any skin cream or oils before treatment. Shaving can increase adhesion of the electrodes. The machine is giving out abnormal signal tones during treatment. What should I do? (1) Look at the display. Is any channel flashing? ‡ Interrupt the programme by pressing the ON/OFF button. Make sure that the connecting leads are properly connected to the electrodes. Make sure that there is a firm contact between the electrodes and the treatment area. (2) Make sure that the plug of the connecting lead is firmly connected to the machine. (3) If the signal tones do not stop and the channel is flashing, change the connecting cable. (4) The display shows a flashing battery signal. Renew the batteries. There is no noticeable stimulation. What should I do? (1) If a warning signal sounds, go through the steps described above. (2) Press the ON/OFF key to start the programme again.

11. Technical details

Name and model: Initial curve shape: Pulse duration: Pulse frequency: Output voltage: Output current: Power supply: Treatment time: Intensity:

SEM 40 biphase square-wave pulse 40–  250 µs 1–120 Hz max. 90 Vpp (at 500 Ohm) max. 180 mApp (at 500 Ohm) 3x AAA batteries adjustable from 5 to 90 minutes adjustable from 0 to 15 Operating conditions: 10 °C   –     40 °C (50 °F   –   104 °F) with a relative humidity of 30   –   85% Storage conditions: -10 °C   –    50 °C (14 °F   –   122 °F) with a relative humidity of 10   –   95% Dimensions: 130 x 68 x 29 mm (incl. belt clip) Weight: 105 g (without batteries) , 140 g (incl. belt clip and batteries) Explanation of symbols: Application part type BF Caution! Read the instructions for Use. Note: If the machine is not used according to these specifications, perfect functioning is not guaranteed. We reserve the right to make any technical alterations that are necessary in order to improve and develop the product further. This unit is in line with European Standards EN60601-1, EN60601-1-2 and EN60601-2-10 and is subject to particular precautions with regard to electromagnetic compatibility (EMC). Please note that portable and mobile HF communication systems may interfere with this unit. For more details, please contact customer service at the address indicated. The machine meets the requirements of the European Medical Products ­Directive 93/42/EC and the German Medical Products Act. In accordance with the Operators’ Ordinance on Medical Products, regular measurement precision controls must be carried out if the machine is used for commercial or economic purposes. Even in the case of private use, we recommend checking measurement precision at two-yearly intervals at the manufacturers.

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