APPLICATION MANUAL. Electrotherapy device for: Pain relief Soft tissue damage Ulcers Wounds Joint pain Muscle spasms

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1 Electrotherapy device for: Pain relief Soft tissue damage Ulcers Wounds Joint pain Muscle spasms APPLICATION MANUAL No part of this document may be reproduced by any means whatsoever without the prior permission of Globe Skincare

2 CERMET, Notified Body n.0476 Certificate MED 24010

3 Page 1 of 14 Naturepulse: The manufacturer Naturepulse is an electrotherapy instrument produced by Globe Ltd. Therapeutic effects The therapy in many cases allows an improvement in symptoms over a period of treatment of some 3 to 4 weeks. It needs to be added that therapeutic results are always obtained in a non-invasive manner. Characteristics of the electrodes The electrodes should be small in order to permit their application even in restricted areas. Electrodes for neonatal or paediatric cardiac monitoring are suitable. If the area for application is large enough, the dimensions of the electrodes are not important. The electrodes should have a sponge centre and be of liquid gel type. Solid gel electrodes with a rubber centre are less suitable, but their performance may be improved by placing a small drop of gel at the centre of the electrode. A small drop of gel should also be used with liquid gel electrodes when their gel has dried up (for example when the bag containing them has not been properly closed). It often happens that the patient scarcely feels the signal at all because of the scant conductivity of deteriorated electrodes. Operation Use of the instrument is clearly described in the Instructions Manual, and its principal functions are reconsidered in condensed form in the Handbook. The program of the instrument, which may be visualised on the display, is characterised by two levels allowing identification of the pathology it is intended to treat. After the electrodes have been applied, it is only necessary is to select the pathology to be treated and start the treatment. The therapist does not need to intervene during treatment, as the patient manages the intensity of the impulses according to his or her sensitivity, using the controls for this purpose. The impulses should be kept as high as possible without causing suffering. The treatment is composed of one or more phases, separated by 20 seconds pauses. The active phases of the treatment are indicated on the display by a rotating circular symbol. Pauses are indicated by two flashing lights. At the end of each pause, the intensity of the impulses returns automatically to the value at the close of the preceding phase. The patient may at any time intervene to regulate the intensity of the impulses by use of the manual control. The layout of the electrodes The layout of the electrodes is obviously a function of the pathology being treated. In the following tables, suggested layouts are given for each pathology indicated. The doctor in charge may always prescribe other positions for the electrodes after having taken into consideration the specific nature of each individual case. Graphic correspondences The following conventions are used in the graphics showing the suggested layout for the electrodes. Checking: Cristina Scavi Approval: Cristina Scavi 1 /14 Document property of Globe No reproduction or distribution without prior authorisation forbidden

4 Page 2 of 14 Channel 1 (CH1) electrode with red connector Channel 1 (CH1) electrode with black connector Channel 2 (CH2) electrode with red connector Channel 2 (CH2) electrode with black connector Battery charging Connect the transformer cable to a mains socket. Connect the other end of the cable to the Nesyal- PBK instrument. A fully recharged battery requires around twelve hours connected to the mains. This operation is generally carried out during the night. Starting up the instrument To start the instrument press the ON-OFF button Therapeutic treatments The layout of the electrodes for each individual pathology is suggested in the graphic table. This position may vary according to the position of the lesion and the indications given by the doctor. TRAUMATOLOGY The expected therapeutic effects in traumatology are a reduction in the VAS pain rating and reduced recovery times. Post traumatic cervicalgia Post traumatic dorsalgia Checking: Cristina Scavi Approval: Cristina Scavi 2 /14 Document property of Globe No reproduction or distribution without prior authorisation forbidden

5 Page 3 of 14 Post traumatic lumbalgia Lumbo-sciatica Shoulder tendonitis Coxalgy Knee distorsion Achilles tendonitis Ankle distorsion Checking: Cristina Scavi Approval: Cristina Scavi 3 /14 Document property of Globe No reproduction or distribution without prior authorisation forbidden

6 Page 4 of 14 Muscle contractures Muscle strains Example of muscle contracture Example of muscle strain CHRONIC ORTHOPAEDIC PATHOLOGIES The expected therapeutic effects in orthopaedic pathologies are a reduction in the VAS pain rating and an objective improvement in the clinical case history, which may be measured by instrument evaluation. Cervicalgia Dorsalgia Lumbalgia Epicondylitis Checking: Cristina Scavi Approval: Cristina Scavi 4 /14 Document property of Globe No reproduction or distribution without prior authorisation forbidden

7 Shoulder arthrosis Hip arthrosis Page 5 of 14 Gonarthrosis Foot arthrosis Carpal tunnel Rizarthrosis Heel spur Plantar fasciitis Checking: Cristina Scavi Approval: Cristina Scavi 5 /14 Document property of Globe No reproduction or distribution without prior authorisation forbidden

8 Page 6 of 14 VASCULAR PATHOLOGIES In peripheric vascular pathologies the expected benefits are a reduction of the ulcered surface (where present), a reduction in the loss of peripheric sensitivity and/or a reduction in neuropathic pain of vascular origin. Peripheral vasculopathies Diabetic foot UROGENITAL PATHOLOGIES The expected benefit in treatment of urinary incontinence is a reduced number of episodes of uncontrolled urination. Inflammation is normally reduced when treating cystitis and prostatitis. Urinary incontinencia Prostatitis Checking: Cristina Scavi Approval: Cristina Scavi 6 /14 Document property of Globe No reproduction or distribution without prior authorisation forbidden

9 Cystitis Page 7 of 14 Checking: Cristina Scavi Approval: Cristina Scavi 7 /14 Document property of Globe No reproduction or distribution without prior authorisation forbidden

10 Page 8 of 14 COSMETIC MEDICINE The benefits expected in cosmetic applications are the regulation of localised microcycles and a toning up of tissue. Legs microcircle activation Checking: Cristina Scavi Approval: Cristina Scavi 8 /14 Document property of Globe No reproduction or distribution without prior authorisation forbidden

11 Page 9 of 14 Checking: Cristina Scavi Approval: Cristina Scavi 9 /14 Document property of Globe Skincare No reproduction or distribution without prior authorisation forbidden

12 Face microcircle activation Page 10 of 14 The electrodes should be placed at a distance of at least one centimetre from the eye socket Checking: Cristina Scavi Approval: Cristina Scavi 10 /14 Document property of Globe Skincare No reproduction or distribution without prior authorisation forbidden

13 Page 11 of 14 Checking: Cristina Scavi Approval: Cristina Scavi 11 /14 Document property of Globe Skincare No reproduction or distribution without prior authorisation forbidden

14 Page 12 of 14 Neck application Scalp microcircle activation Scalp application Checking: Cristina Scavi Approval: Cristina Scavi 12 /14 Document property of Globe Skincare No reproduction or distribution without prior authorisation forbidden

15 Page 13 of 14 SPECIAL PROGRAMMES The expected therapeutic effects in fibromyalgia are a reduction in the VAS pain rating The expected benefit in treating constipation is an objectively measurable reduction of the phenomenon. The expected benefit in treating irritation to the colon is a reduction in the frequency of episodes of pain. The expected benefit in treating trigeminal neuralgia is a reduction in the VAS pain rating. The expected benefits in treating cephalea are a reduction in the frequency of the episodes and a reduction in the VAS pain rating. Fibromyalgia Example of electrodes application The points indicated relate to one of the muscular-tendinous zones most commonly treated Checking: Cristina Scavi Approval: Cristina Scavi 13 /14 Document property of Globe Skincare No reproduction or distribution without prior authorisation forbidden

16 Page 14 of 14 Constipation Irritable bowel sindrome Hemorrhoids Trigeminal neuralgia Cephalea Neck application Forehead application Checking: Cristina Scavi Approval: Cristina Scavi 14 /14 Document property of Globe Skincare No reproduction or distribution without prior authorisation forbidden