Intelect Advanced EPR

Transcription

1 Intelect Advanced EPR 2776 Intelect Mobile Ultra sound 2778 Intelect Mobile Stim DJO Incorporated 2762CC Intelect Advanced Color Combo + EMG 2752CC Intelect advanced color Combo 2772MC Intelect Advanced Monochromatic Combo 2778 Intelect Mobile Combo 2778 Intelect Mobile Laser (without probe)

2 Objectives Chattanooga PMM Overview Business objectives. Markets Product positioning. Value proposition. Chattanooga EPR review Features & Benefits. Clinical Indications / Contraindications

3 Chattanooga PMM Overview Level 1 Level 2 Hot & Cold Physical medicine modalities TENS Clinical * Shockwave Diathermy Iontophoresis/DD NMES Vital stimulation Combo* Ultrasound * Laser* Biofeedback Recovery sciences Tables and traction Electrodes Tables Traction Acute care therapy Continuous passive motion DJO Incorporated Mobility and active training PT equipment PT consumables OT consumables

4 Chattanooga PMM Overview cont- Clinical electrotherapy is a medium sized market with a total size of $200M globally. Estimated growth at 3-5% annually. DJO participates in several markets within this including clinical devices, iontophoresis, diathermy, shockwave, and electrodes. Chattanooga has a strong 40% share of the $50M market, primarily from the legacy and intelect advanced Chattanooga brands.

5 Chattanooga EPR positioning Functionality Hospitals,Out-patient Clinics, Institutions Private practices,on-field sport mobile usages DJO Incorporated Convenience

6 EPR Review Intelect advanced platform 25 + waveforms! 2 independent electrotherapy channels. Over 200 clinical protocols. Ability to program over 100 user defined protocols. Over 10 quick link indications for quicker access. Clinical & Pathological library designed by Physiotherapists for every clinician. Patient data storage cards. 1 & 3 MHz ultrasound frequencies. Continuous & Pulsed 10,20,50 delivery modes. Ergonomically designed U.S. applicators- 1,2,5 & 10cm. Audio & visual coupling systems. Head-warming option for patient comfort. DJO Incorporated 2762CC Intelect Advanced Color Combo + EMG 2752CC Intelect advanced color Combo 2772MC Intelect Advanced Monochromatic Combo

7 Intelect advanced Standard accessories tandard accessories included: Patient data card (1) 5 cm applicator Nylatex wrap, Flexible electrodes and sponges 6x8cm (4) Ultrasound gel, CD user manual, EMG and semg+stim module (2762CC only), Intravaginal probe (2762CC only) 3 cm electrodes (2762CC only) Only with combo +EMG

8 Intelect Advanced Optional Accessories DJO Incorporated

9 Overview of Clinical Modules EMG Three broad purposes : To increase muscle activity. To decrease muscle activity. DJO Incorporated To re-educate muscle activities.

10 EMG indications- INCONTINENCE :Retraining of pelvic floor muscles using intra vaginal or anal probes but also surface electrodes SOFT TISSUES INJURIES : Mostly due to hyper tonus Biofeedback goal is to modify postural behavior decreasing and/or balancing muscle activity. the information is more qualitative as long as Signal variability is a major issue with Surface EMG. GENERAL REHAB: Improving the outcomes of problems affecting voluntary muscle contraction ( post surgery, Nerve transplant, Muscle and Tendon trauma PAIN : Chronic pain produce reductions in joint movements and associated muscle tightness. EMG Biofeedback is used to promote relaxation SPASTICITY: Use to reduce and control spasticity DJO Incorporated STROKE retraining the voluntary activation of the wrist extensors, Shoulder abductors, and ankle dorsiflexors

11 EMG contraindications- There are no contraindications to EMG Biofeedback but limits to the actual method. Applicable to superficial muscles only. Practitioner expertise important. Patient must actively be able to participate..

12 Stimulation module Galvanic current- Direct current that flows 1 second or more continuously. Allows adding another 2 channels Clinical usage- Iontophoresis use of current flow between two electrodes to push ions through the skin barrier.

13 Waveforms continued- Russian current (KOTZ current) Russian Current name derives from muscle stimulation works conducted by Russian scientist KOTZ in the late 1970 s It is a 2,5kHz sinusoidal wave form deliver in bursts ( series of pulse) with a 50% duty cycle. Clinical usage- Innervated muscle stimulation Strengthening

14 Waveforms continued- TENS Trancutaneous nerve stimulation. TENS is the popularized name for electrical stimulations to treat pain. It is rectangular biphasic ( symmetrical or asymmetrical wave form at frequencies in a range 1 to 120Hz and pulse duration from 50 to 200µs Physiological effects- Nerve excitability: Selective excitability of A Beta and A Delta fibers (sensory nerves) for Gate control and Alpha Moto neurons ( producing muscles twitches at low frequency) for Endorphin release. Short duration and rectangular pulse shape provide very comfortable stimulation. DJO Incorporated Clinical usages- Acute and Chronic Pain Nocioceptive or neurogenic pain Dysmenorhea Angina pectoris Labor pain but not during actual partum.

15 Waveforms continued- NMES Description The current use for Neuro Muscular Electrical stimulation is basically a TENS current as rectangular biphasic (symmetrical wave form at frequencies in a range of 1 to 120Hz and pulse duration from 150 to 500µs Physiological effects Nerve excitability: Excitability of Alpha motor neurons producing normally innervated muscles contractions. Short duration and rectangular pulse shape can provide very strong contractions but very comfortable stimulation. DJO Incorporated Clinical usages- Normally innervated muscle stimulation Prevention of Atrophy Mobilization Muscle reinforcement Functional Electrical Stimulation

16 Waveforms continued- INTERFERENTIAL (IFC) time Description Interferential currents IFC are two Alternating currents applied in a continuous mode Frequencies are in the range of 1-10kHz. The currents have a slightly different frequency. The total current amplitude is the sum of the two currents at any point in the tissue where they interfere. Physiological effects Deep efficiency of stimulation ( maximum stimulus is produced at depth ) High frequency currents are more comfortable in case of High impedance ( resistive skin and fat tissues) Nerve excitability Gate control Endorphins & encephalin release. Clinical usages- Pain ( same as TENS )

17 Waveforms continued- INTERFERENTIAL 4 pole Vector Vector rotation This is achieved by rhythmically increase or decrease the amount of current applied on each pair of electrode over a period of several seconds ( when one current goes up the other goes down and vice versa). Vector rotation will change the pattern of stimulation in the tissue volume. Increasing the current in one direction between one pair of electrode will stimulate more fibers lying parallel to the current path. I2 I1 I2 I1 Clinical usage- Greater stimulation is produced at deeper depth. Mainly use for pain ( gate control). Whirlpool effect. Itotal DJO Incorporated I1 I2

18 Waveforms continued- PREMODULATED INTERFERENTIAL 2 poles Description The 2 frequencies are combined within the stimulator producing one current claimed as having similar parameters to the expected outcome of current mixing in tissues producing better comfort. I1 Clinical usage- Easier to apply Maybe be more effective and comfortable in muscle stimulation Greater stimulation remains superficially to treatment. I1

19 Waveforms continued- High Voltage pulsed currents- Description The High Voltage Pulsed Current (HVPC) has a very brief pulse duration ( 7µs) characterized by two distinct peaks delivered at high ( V) voltage. The waveform is monophasic (current flows in one direction only). Clinical use Pain Wound healing Better tissue penetration in impedance issue patients. Volt 7µs time

20 Waveforms continued- BIPHASICS PULSED CURRENTS -Balanced Asymmetrical : can result in different sensations under each electrode ex. Slow twitch or fast twitch muscle re-innervation or re-education. BIphasic pulsed currents can t be be apply on: Electrically sensitive support systems Pacemakers -Balanced Symmetrical : current flow equally in both directions during alternate phase of the pulse. Generates same feeling under each electrode. -Can be applied for hours without risk of burn or skin irritations. -Can be apply over metallic implants -Can be apply over fragile skins

21 Waveforms continued- Microcurrents Description Microcurrent is a current delivered at very low intensity ( less than 1mA. Can be monophasic or biphasic. Volt or Amp 1 to 1000 µa time Physiological effects Microcurrent is delivered well below the threshold for nerve stimulation. At similar magnitude to the endogenous currents identified as being part of normal tissue healing. It can supplement or enhance the naturally direct current potentials associated with repair, and thereby stimulate the healing process. Microcurrent is the only current that patients does not feel due to its very low intensity DJO Incorporated Clinical use Wound healing Facial paralysis

22 Vacuum Module 2774 Vacuum Electrode Module with Cart 2785 Vacuum Electrode Module without Cart

23 Ultrasound Module Standard accessories cm applicator 4248 Ultrasound gel

24 2767 Battery Module

25 Therapy cart / remote options

26 hattanooga Intelect Mobile Ultrasound & 3 MHZ frequencies Pulsed & Continuous delivery modes- 10,20, 50 & 100%. Clinical indication screen provides most complete patient application parameters. Ergonomically designed heads of 1,2,5, & 10cm Head-warming option Lightweight design along with battery option. Mobile tote bag to allow safe transferring.

27 Chattanooga Intelect Mobile Combo & 3 MHZ frequencies Pulsed & Continuous delivery modes- 10,20, 50 & 100%. Multiple waveforms (2 & 4 pole IFC,Galv,HV pulsed current, Russian, Mono & Biphasic and TENS. Clinical indication screen provides most complete patient application parameters. 15 user designed protocols. Ergonomically designed heads of 1,2,5, & 10cm Head-warming option Lightweight design along with battery option. Mobile tote bag to allow safe transporting.

28 Chattanooga Intelect Mobile Stim 2778 Multiple waveforms (2 & 4 pole IFC,Galv,HV pulsed current, Russian, Mono & Biphasic and TENS. Clinical indication screen provides most complete patient application parameters. 2 channels of stimulation output independently controlling intensity parameters. Lightweight design along with battery option. Mobile tote bag to allow safe transporting.

29 Chattanooga Intelect Mobile Laser 2779 Class 3 B LLLT Independent control over all parameters. Continuous & Pulsed operation available. Various pulsed frequencies. Energy display in Joules/ Joules cm². Clinical indications specific to applicator. 15 user protocols. 17 different laser applicators to choose from.

30 Clinical Indications for Electrotherapy Acute conditions- Sprains / Strains Tendonitis Bursitis Wound healing Muscle re-education Nerve re-innervations Inflammatory conditions Chronic pain Drug delivery

31 Electrotherapy Contraindications Low back during pregnancy. Eyes, carotid sinus or nerve plexus. Potential cancer or malignancy. Dementia or lack of cognitive skills. Diabetes Suspect DVT in lower extremities. Over any space occupying lesion.

32 Please address questions to : Farley Brown PM Farley.Brown@djoglobal.com