BIODEX ADVANTAGE Software Operation Manual V4.X Rev A March 2014

TABLE OF CONTENTS This manual covers operation procedures for the following Biodex Advantage Software, V.4X, products: 840-101 840-102 840-103 840-104 840-105 840-106 840-107 840-108 840-109 850-101 850-102 850-103 850-104 850-105 850-106 850-107 850-108 850-109

SOFTWARE, SYS 4 Q/S, RUS SOFTWARE, SYS 4 Q/S, POL SOFTWARE, SYS 4 Q/S, KOR SOFTWARE, SYS 4 Q/S, JPN SOFTWARE, SYS 4 Q/S, GER SOFTWARE, SYS 4 Q/S, FR SOFTWARE, SYS 4 Q/S, ITA SOFTWARE, SYS 4 Q/S, SPN SOFTWARE, SYS 4 Q/S, ENG SOFTWARE, SYS 4 PRO, RUS SOFTWARE, SYS 4 PRO, POL SOFTWARE, SYS 4 PRO, KOR SOFTWARE, SYS 4 PRO, JPN SOFTWARE, SYS 4 PRO, GER SOFTWARE, SYS 4 PRO, FR SOFTWARE, SYS 4 PRO, ITA SOFTWARE, SYS 4 PRO, SPN SOFTWARE, SYS 4 PRO, ENG

IMPORTANT NOTE While this manual is an important source of information on using Biodex Advantage Software, it is by no means the only resource necessary to begin testing and rehabilitation programs for your clients. Just as important as an understanding of your computer is a thorough knowledge of the mechanical, physical and clinical aspects involved. To that end, the user is referred to the Biodex System 4 Pro Operation Manual, which offers detailed instructions and general guidelines for patient setups and various joint-testing and rehabilitation patterns, plus an explanation of system controls, modes and operation. For a detailed explanation of report parameters, refer to the Biodex System Multi-Joint and Rehabilitation System Clinical Reference Guide. Should you have any questions about Biodex Advantage Software, please contact the Biodex Customer Service Department at the following address: Biodex Medical Systems, Inc. 20 Ramsey Road Shirley, New York 11967-4704 (631) 924-9000 (800) 224-6339 FAX: (631) 924-8355

REMARQUES IMPORTANTES Bien que cette notice d’utilisation contienne beaucoup d’informations sur le logiciel BIODEX SYSTEM, elle ne peut être la seule source de renseignement nécessaires pour évaluer et rééduquer des patients. En plus d’une bonne compréhension de votre système informatique, il faut bien connaître les aspects mécaniques, anatomiques et cliniques applicables. A cette fin, nous vous référons à la notice du système multi-articulaire, laquelle fournit des consignes détaillés et des principes généraux pour les montages patient et les différents mouvements utilisés pour l’évaluation et la rééducation en plus d’explications sur les contrôles, les modes et le fonctionnement du matériel. Pour de plus amples renseignements sur le logiciel BIODEX ADVANTAGE, nous vous demandons de bien vouloir contracter notre responsable local. Authorized European Community Representative: Emergo Europe Molenstraat 15 EC REP 2513 BH, The Hague The Netherlands -I-

TABLE OF CONTENTS 1.

INTRODUCTION ...1-1 The Biodex Advantage ...1-1

2.

GETTING STARTED ...2-1 Hardware Requirements ...2-1 Start-Up Procedure ...2-1 Exiting the Program ...2-2 The Dynamometer Operation Screen...2-3 System Setup ...2-6 Calibration Verification ...2-9

3.

PATIENT SELECTION...3-1 The Patient Selection Screen ...3-1 Patient Selection Options ...3-1

4.

PROTOCOL DEFINITION...4-1 The Protocol Definition Screen ...4-1 Linking Protocols...4-5 Protocol Definition Screen Parameter Fields Defined ...4-7

5.

SETTING RANGE OF MOTION (ROM) ...5-1 The Set Range Of Motion Screen ...5-1 Clinical Applications For Setting ROM ...5-3

6.

GENERATING REPORTS ...6-1 Report Formats ...6-1 Generating Reports ...6-2 Print All Reports ...6-3 Report Options...6-4 Notes About Windowing, Cushion Filtering and Curve Filtering ...6-4 Graphical Evaluation Reports ...6-5 General Evaluation Reports...6-6 Comprehensive Evaluation Reports...6-7 Narrative Cover Letter ...6-9 Rehab Session Summary ...6-11 Progress Reports ...6-12 Proprioception Report ...6-15

7.

THE CURVE ANALYSIS SCREEN Curve Analysis...7-1 Curve Analysis Options ...7-2

8.

TESTING AND EXERCISE PROCEDURES ...8-1 New Test or Exercise with New Patient ...8-2 New Test or Exercise With Existing Patient ...8-8 Repeat Test or Exercise with Existing Patient...8-11 Proprioceptive Testing and Exercise Procedure...8-13

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TABLE OF CONTENTS

TABLE OF CONTENTS 9.

BIOFEEDBACK OPERATION ...9-1 Setting Up for Biofeedback Exercise...9-1 Modifying the Biofeedback Graph ...9-3 Graph Options ...9-5

10.

THE DATABASE MANAGER ...10-1 Accessing the Database Manager ...10-1 Navigating the Database Manager Main Screen ...10-2 The Patient Data Screen ...10-4 The Protocols Screen ...10-6 The Normative Goals Screen ...10-7 Database Back-Up ...10-9

APPENDICES A. Biodex Multi-Joint System Structures, Formulas and Calculations ...A-1 B. Range of Motion Cushion Implementation ...B-1 C. Patient Progress Chart ...C-1 D. Current Recorded Normative Goals ...D-1 E. License Agreement ...E-1

TABLE OF CONTENTS

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1. INTRODUCTIONOF CONTENTS THE BIODEX ADVANTAGE Biodex Advantage Software is a user-friendly software package developed specifically for isolated muscle testing and rehabilitation. Windows-based, it is comprehensive, fast and flexible. Whether you’re a computer novice, computer genius or somewhere in-between, you’ll find its many features, functions and applications – including a Biofeedback Graphical User Interface (GUI) screen - can greatly enhance your ability to quickly and easily test, motivate and rehabilitate patients. Biodex Advantage Software features seamless architecture, pull-down menus and pop-up windows in a touch-screen Windows environment to provide for quick, intuitive operation. Need help? Simply follow the Wizard as it guides you through the standard procedures. Not sure how to set up for a particular pattern? Select an action video for a real demonstration of the desired exercise or testing setup. Want a report? Choose from a variety of formats with easy-toread, easy to interpret normative data. Just setting up for a quick and easy exercise ? One touch of the screen or click of the mouse is all that’s needed to activate the Biofeedback screen and begin. Biodex Advantage Software makes it easy for clinicians to gather, organize and report on patient testing and rehabilitation. During testing and rehab sessions, the software gathers pertinent patient data for isometric, isokinetic, isotonic, passive and reactive eccentric modes. Curve analysis functions allow for comparison of results from different tests. Torque curves and bar graphs enhance biofeedback capabilities while a patient pain scale entry allows the clinician to track patient pain levels throughout the rehabilitation process. Test data can be generated in standard report format or in easy-to-read, narrative letters that are addressed and ready for mailing to referring physicians or third-party payers. Data legends and on screen editing simplify the task of communicating test results to doctors, payors and employers. Easy to use, intuitively organized, versatile and complete, Biodex Advantage Software will help speed your patients on the road to functional outcomes, help you to increase your referral base, and make the day more manageable for you and your staff. That’s the Biodex Advantage.

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INTRODUCTION

2. GETTING STARTED HARDWARE REQUIREMENTS Biodex Advantage Software, Version 4.X, can be used on any Biodex Multi-Joint System 4, or Biodex Multi-Joint System 3, Rev 2 or higher, with the proper hardware. Firmware must be Rev. 2K or higher. Minimum hardware requirements are as follows: • Windows XP • Processor: P4 • Ram 512 meg • CDRW • 2 COM ports • 2 USB ports • Printer: HP 5550, HP 5650 or HP 6940

START-UP PROCEDURE (See Figures 2.1 and 2.2.) 1.

Ensure that no attachments are connected to the dynamometer to insure proper dynamometer initialization.

2.

Turn the main power switch (black) on the back of the CDS Cart to the ON (I) position.

3.

Ensure the dynamometer and computer power switches (green) on the back of the CDS Cart are set to the ON (I) position.

4.

Press the ON switch on the Central Processing Unit (CPU) located on the left side of the CDS Cart. Following the system boot-up process, the software will display a note that it is initializing the dynamometer. Once dynamometer initialization is completed, the Advantage Software program will open to the Dynamometer Operation screen. NOTE: Should an error message display on the screen as you try to access the Advantage Software program, check that all attachments have been removed from the dynamometer and that all connecting cables are secure. Turn OFF the main power switch, dynamometer and computer switches and the CPU ON switch. Wait at least 30 seconds, and then repeat steps 1 – 4 above. If the error message still appears, contact Biodex Customer Service for instructions on how to proceed.

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GETTING STARTED

CONTENTS

4

2 1 3

Figures 2.1 and 2.2: The main power(1), dynamometer power (2), computer power (3) and CPU (4) switches must all be turned ON to run the Advantage Software program.

EXITING THE PROGRAM Because Biodex Advantage Software operates within the Windows environment, it is vital that you use the Windows shutdown procedure after exiting Biodex Advantage Software. Always shut down the Windows program before turning OFF your computer. CAUTION: Turning your computer OFF without properly shutting down both the Biodex Advantage and Windows software programs may result in lost or damaged files or database corruption. ATTENTION: Arrêter l’ordinateur sans suivre les procédures de sortie et de sauvegarde du logiciel BIODEX et de WINDOWS peut compromette l’intégrité des fichiers. To Quit Windows and Shut Down the Computer 1. To close the Biodex Advantage Software application, select the <X> in the top right corner of the screen. 2, Select <Start> at the lower left side of the screen to access the Start menu. 3. Select <Turn Off Computer>. 4. Select <Turn Off> to shut down the computer. NOTE: Be sure to back-up all database files at least once per month. See Chapter 10 for more information.

GETTING STARTED

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CONTROLS AND ADJUSTMENTS THE DYNAMOMETER OPERATION SCREEN (See Figure 2.3.) The Dynamometer Operation screen serves as the main screen for most operations and is automatically selected whenever you access the Biodex Advantage Software program. It is, in effect, the Main Screen for the Advantage Software program, serving as the launching point for all operations and procedures. You can navigate this screen, or any Advantage Software screen, using either the touch-screen feature or the mouse. The Dynamometer Operation screen allows clinicians to easily jump back and forth between testing, exercise and biofeedback applications via the Configuration and Operating Mode Tool Bars. When the system is first accessed, the last mode of operation in use is automatically selected. Thus, the Dynamometer Operation screen may have the test/exercise scoring window or biofeedback graph displayed. Note that the presence of some tool bars, and appearance of others, will change based on the procedure or mode selected. Except where otherwise noted, Biodex Advantage Software follows the same logic as the Windows operating system. 1 2 3

Figure 2.3. The Dynamometer Operation screen in Test Mode with scoring window displayed. The System Menu Tool Bar (1), Operating Mode Tool Bar (2) and Configuration Tool Bar (3), allow for quick and intuitive operation. Users can navigate all Advantage Software screens using touch-screen operation or the mouse.

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GETTING STARTED

SYSTEM SPECIFICATIONS The System Menu Tool Bar Located at the top of the screen directly beneath the system header, the System Menu Tool Bar allows access to the File, View, Window and Help menus. <File>: Allows access to Set Up, Database Manager, Compact Database, Verify Calibration, Diagnostics and Exit functions, each of which are described in detail later in this manual. <View>: Allows the System Menu Tool Bar and Status Bar to be hidden or displayed. <Window>: Allows selection of cascade or tile window formats and displays the currently active window. <Wizard>: When accessed from the System Menu Tool Bar, allows system-wide topics to be selected from a list and then guides the user through selected functions and procedures. <Help>: Displays basic Biodex Advantage Software information including release date and software version, and offers a video introduction to Biodex Medical Systems, Inc. The Operating Mode Tool Bar Located directly beneath the System Menu Tool Bar, the Operating Mode Tool Bar allows users to easily move between test, exercise and biofeedback applications and provides access to other important functions. <Test>: Select this option for testing applications. <Exercise>: Select this option for exercise applications. <Biofeedback>: Select this option biofeedback applications. Current Mode: The current mode of operation is always displayed in bold between the <Biofeedback> option and System Status. There are six operating modes of operation from which to choose: Setup, Isokinetic, Passive, Isometric, Isotonic and Reactive Eccentric. Setup mode is automatically selected when the system is first turned ON. System Status: Displays the current dynamometer status and simple prompts or instructions (i.e., press <Start>). Also displays system status codes in the case of malfunction. <Anatomical>: Select this option to display a short AVI movie or still image detailing subject setup and ROM for the currently selected pattern. <Options>: Use this icon to change the way the dynamometer operation window displays data. This option is also used to enable/disable graph settings. <Wizard>: Select this option to open the Biodex Wizard.

GETTING STARTED

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ASSEMBLY AND INSTALLATION The Configuration Mode Tool Bar Located along the left side of the screen during testing and exercise applications, the Configuration Tool Bar features icons for primary screens and functions used frequently throughout the program. Select on any icon to advance to the screen or function desired. From top to bottom the icons and their usage are defined as follows: <Patient>: Access the Patient Selection screen to choose a patient or enter a new patient. <Protocol>: Access the Protocol Definition screen to select a pre-defined or user-defined protocol, or to enter a new protocol. <Set ROM>: Use this icon to set a new range of motion or adjust a previously stored range of motion at any point throughout the program. <Report>: The Report Generation screen is used to select options and reports for preview and/or editing. Choose from Graphical Evaluation, General Evaluation, Comprehensive Evaluation, Narrative Cover Letter and Isomap Evaluation. <Curve>: The Curve Analysis function allows the user to view test data on screen in various formats including individual curves, windowed curves, filtered curves, and a curve log. The Status Bar Located at the bottom of the screen, the Status Bar displays <Start> and application name.

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GETTING STARTED

C SYSTEM SETUP (See Figure 2.4.) The Setup Options window allows the user to set default values for selected system prompts and preferences. It also provides access to the Orient Fixtures screen. To Access the Setup Options screen: 1.

Select <File> in the System Menu Tool Bar and select <Setup> from the pull-down menu. The Setup Options screen should now be displayed.

2.

Select or enter the appropriate value or preference for each of the fields provided.

3.

Once you are satisfied with all of the selections, select <Okay> to record the new settings and return to the Dynamometer Operation screen. When prompted, select <Yes> to restart the application and save the new settings.

Figure 2.4. The Setup Options window. This screen is accessed through <File> in the System Menu Tool Bar.

GETTING STARTED

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Setup Options The following options and fields are addressed from the Setup Options screen. Dynamometer Interface Values for this field are factory pre-set and should not be changed. AVI Folder Enter here the desired path for storage of the system AVIs (Action Video Inserts). The system default is to the CD-ROM drive. AVIs run faster off the hard disk, but they take up a lot of disk space. (Consult Biodex Customer Service before making changes to the AVIs.) Facility Name Select to the field to activate the cursor and enter your facility name here. Biofeedback Preferences Select the desired field to activate the cursor and use the keyboard to make changes to the following parameters: NOTE: These will be the default values for the patient when using the Biofeedback Mode of the software for exercises. • Rest Period: default value set for the length of rest period between sets. • Isometric Contraction: default value set for the length of time a patient must maintain an isometric contraction. • Isometric Relaxation: default value for length of time between repetitions. General Preferences • Side Change Reminder Notice: Toggles side change notice ON and OFF. If ON, a notice will appear after completion of all sets for first side. • Repetition Event Sounds: Toggles audible start and stop signals for exercise and test sessions ON and OFF. If ON, signals are provided at the beginning and end of each set, and during each repetition during data collection. • Video Clips (AVIs) for: Choose from Pro or Quick Set Formats at scroll bar. If ON, action AVIs can be selected from the Protocol Selection screen for any standard patient setup. NOTE: Do not change this factory preset value without calling Biodex Customer Service first. • Metric Units: When ON, all data is displayed in metric units. When OFF, all data is displayed in English measures. • Automatic Start Following Rest Periods: Activate this toggle if you would like the system to initiate the countdown for the next set following completion of each previous set, as opposed to having the system await user input to begin the countdown. • Set Focus To Limb Weight: When setting is checked, “Limb Weight” flashes in red on Set Dynamometer Range of Motion screen after anatomical position has been calibrated. When unchecked, “Limb Weight” does not flash in red but may still be set.

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GETTING STARTED

CONTENTS • Require Anatomical Calibration: When ON, requires anatomical calibration of the joint in the anatomical reference angle before testing can begin. It is recommended to perform anatomical calibration prior to the start of any test to correlate curve deficits to joint position. • Use Color-Coded Columns in Reports: Color is used in graphs and curves to indicate uninvolved (blue) and involved (red) sides. • Scoring Window: This is drawn on the Dynamometer Operation screen as a horizontal pair of violet-colored lines. The scoring window allows the clinician to set a biofeedback goal for the patient. The top line is 100%. The lower line is a percentage of (default = 70% of max peak torque). To change the lower line default value, simply enter a new value in the scoring window parameter box. This setting also determines the isokinetic window when printing reports containing windowed data. Linked Protocol Preferences NOTE: All Linked Protocol Preferences described below are default settings. • During acquisition, mark tests as complete: After completing a linked exercise protocol, an on screen prompt indicates completion of the protocol. On screen results are then automatically marked as completed to confirm for the clinician that the patient did complete the entire routine. Default =ON • During acquisition, save exercise data: Selecting this option allows collected exercise data to be saved. Storage of this information required additional disk space. If you choose to save exercise data, the system will “time out” after 10 minutes of data collection due to limited database size. Therefore, exercise sessions must be limited to less than 10 minutes if data collection is desired. Default =OFF • Restrict selections to unilateral protocols: When linking protocols, selecting this option allows only unilateral treatment protocols to be selected. Default =ON • Restrict selections to same joint/pattern: When linking protocols, restricts selections to protocols for same joint/pattern. Default =ON • Restrict selections to exercise only: When selected, this option restricts selection to exercise protocols only. Default =ON Orient Fixtures The <Orient Fixtures> icon at the bottom of the Setup Options screen is used during system installation to provide the system with information for correcting limb weight readings. You should not need to access this function unless you receive a new set of dynamometer attachments. If you do receive a new set of attachments, you may need to confirm that these settings are correct. NOTE: If you receive new, updated or attachments other than those originally supplied for you system by Biodex, contact Biodex Customer Service for information on the Orient Fixtures procedure.

GETTING STARTED

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C Database Manager NOTE: This section is explained fully in Chapter 10. Compact Database This utility is used to remove any empty spaces that may occur in your database. This utility will occur on its own as the computer detects wasted database space. CAlIBRATION VERIfICATION (See Figures 2.5 and 2.6.) Your Biodex System Isokinetic Dynamometer comes factory calibrated. The only maintenance required to assure that your Biodex System remains calibrated is to once a month perform a Calibration Verification Procedure, as described below. 1.

Select <File> from the System Menu Tool Bar and select <Verify Calibration> from the pull-down menu. The Calibration Verification screen should now be displayed.

2.

Enter your name in the red field. This is required to perform the verification.

3.

Attach the long shoulder attachment to the dynamometer (remove any handgrip).

5.

Select <ROM Set> to advance to the Set Dynamometer Range of Motion screen.

6.

Select <Clear Limits>.

7.

Allow the long shoulder attachment to hand vertically so that Total ROM is zero degrees. Select the <SET> for the TOWARD Limit.

8.

Move the long shoulder attachment away until Total ROM is 90 degrees and then select <SET> for the AWAY Limit.

9.

Move the long shoulder attachment to vertical and calibrate the position, then select <Continue> to return to the Verify Calibration screen.

10. Select <Mode> and then select <Isometric Mode>. 11. Move the long shoulder attachment to full horizontal (90 degrees). Select <Start>. 12. Insert the calibration weight until the detent pin engages (torque = 50.0 ftlbs, 67.8 NM). 13. Select <Verify Calibration> when ready. 14. When finished, remover the calibration weight and select <Exit> to return to the Dynamometer Operation screen. NOTE: If a message is displayed indicating an Invalid Calibration, repeat the calibration procedure. If you receive the message three times, please call Biodex Customer Service at 1-800-224-6339 or in the State of New York 631-924-9000 for assistance. 15. Select <Report> to generate a printed report, which can be filed for later reference. 16. If desired, select <History> to generate a listing of all Calibration Verifications performed on the machine. 17. Select <Exit> to advance to the Dynamometer Operation screen. NOTE: For research applications, you may want to perform Calibration Verification after a specific number of patients in case questions regarding the validity of your data arise at a later time. - 2-9 -

GETTING STARTED

CONTENTS

Figure 2.5. The Calibration Verification Screen.

Figure 2.6. The Calibration Verification Set Dynamometer Range of Motion Screen.

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3. PATIENT SELECTION THE PATIENT SElECTION SCREEN (See Figure 3.1.) The Patient Selection screen is used to: • Open and view existing Patient Records • Add a New Patient to the Patient List • Add a New Test or exercise to a Patient Record • Update or Edit Patient Records • Edit or Update the Pain Scale NOTE: The Pain Scale must be edited or updated following each test or exercise session. To access the Patient Selection screen select <Patient> from the Configuration Tool Bar in the top left corner of the Dynamometer Operation screen. The Patient Selection screen is now displayed. The last patient selected is the current patient.

Figure 3.1. The Patient Selection Screen.

PATIENT SElECTION OPTIONS Located at the top of the Patient Selection screen, the Patient Selection Operating Mode Tool Bar displays icons used to access the patient selection options. From left to right, the icons and their usage are defined as follows: Open (See Figure 3.2.) The Open option is used to select and open an existing patient record, allowing the clinician to view, edit, update, delete the patient record or a selected test/exercise, print reports, repeat a test/exercise, or add a new test/exercise to the patient record.

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PATIENT SELECTION

COMPUTER PRELIMINARIES To Open An Existing Patient Record: 1. Select <Open>. The Patient Name window should now be displayed with a listing of all previously entered patients. 2.

Select any patient to expand the patient list to show all tests and exercise sessions for that patient. Use the scroll feature to advance through the alphabetical listing as needed or enter the patient Last Name or ID and select search to quickly locate a specific patient.

3.

Select the desired test/exercise. The Patient Selection screen should now display the desired patient and the test/exercise selected. NOTE: If you know a patient’s last name or patient ID number, you can enter it in the search field below the patient list and select <Search> to advance quickly to that patient.

Selecting a patient activates the following options at the bottom of the Patient Name window: • <New>: Select this option to proceed directly to the Protocol Definition screen. • <Delete>: Select this option to delete from the patient record selected and all associated tests. Selecting a specific patient test/exercise activates the following options at the bottom of the Patient Name window: • <Repeat>: Select this option to advance directly to the Set Dynamometer Range Of Motion window and repeat the selected test/exercise. • <Report>: Select this option to advance directly to the Report Generation screen. • <Edit>: Select this option to edit Test/Exercise information on the Patient Selection screen.

Figure 3.2. The Patient Record list.

PATIENT SELECTION

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X Add Patient (See Figure 3.3.)

Figure 3.3. All mandatory fields (red), must be completed to save a new patient record. Clinicians should also consider updating the patient pain scale when repeating a test so that patient pain can be plotted on Exercise Summary Reports.

The Add Patient option is used to enter a new patient on the patient list, creating a patient record. When you select this option, a blank Patient Selection screen is displayed. The new screen, must be filled out to create the new patient record. The following fields on the screen appear in red. These are mandatory fields that must be completed to save this screen as a new patient record: • Last Name • Weight • ID # • Gender • Involved Side NOTE: If the first name of the patient is not filled out, you cannot edit this field later. It will remain blank. NOTE: Although not a mandatory field, it is suggested that clinicians always adjust the patient pain scale when entering a new patient, editing a patient, or repeating a test. Using the pain scale, patient pain can be plotted on the Exercise Summary Report. To adjust the pain scale, slide the pointer to the appropriate pain level reported by the patient. The zero setting (left end of scale) is equal to no pain and the 10 setting (right end of scale) is equal to excruciating pain. When repeating a test, update the patient pain scale by selecting <Edit> before selecting <Repeat> and make the appropriate changes to the Patient Selection screen.

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PATIENT SELECTION

APPLICATIONS Data entry for the remaining fields is optional. Should you forget to fill in one of the mandatory fields and try to save the new patient, a prompt will appear to inform you that all mandatory fields must be completed before saving. NOTE: The patient ID number is a permanent number used to identify the patient in your files. Once entered and saved as part of the Patient Record, it cannot be changed To Add A New Patient to the Patient Record: 1. Select <Add Patient> A blank Patient Selection screen should now be displayed with mandatory fields in red. 2. Enter the appropriate information in each field, making sure that all mandatory fields are complete. 3. At the bottom of the screen, position the pain indicator along the pain scale to reflect the patient’s current pain status. The pain scale indicates pain from zero (no pain) to 10 (excruciating pain) and must be updated following exercise sessions for pain to be plotted on the Exercise Summary Report. 4. Select <Save> in the Patient Selection Operating Mode Tool Bar to save the new patient record. 5. Select <Open> to display the Patient List and ensure the new patient record has been saved, or select <Close> to simply return to the Dynamometer Operation screen. Edit The Edit option allows the clinician to edit an existing patient record. NOTE: Patient name and I. D. # cannot be edited. To Edit an Existing Patient Record: 1. Select <Open> from the Patient Selection Operating Mode Tool Bar. The Patient Name window should now be displayed with a listing of all previously entered patients. 2. Select any patient to expand the patient list to show all tests and exercise sessions for that patient. Use the scroll feature to advance through the alphabetical listing as needed or enter the patient Last Name or ID and select <Search> to quickly locate a specific patient. 3. Select the desired test/exercise to edit. The Patient Selection screen should now display the desired patient and the test/exercise selected. 4. Select <Edit>. Fields that will allow editing will turn from gray to white. 5. Make the desired edits and then select <Save> in the Patient Selection Tool Bar to save the changes. The edited patient record is saved and now displayed as the currently selected patient record. Save The Save option allows the clinician to save any changes made to the currently selected or edited patient record. To Save A New or Edited Patient Record: 1. Select <Save> from the Patient Selection Operating Mode Tool Bar. All changes will be saved to the patient record. After it has been saved, the patient record remains selected. Cancel The Cancel option allows the user to exit any operation on the Patient Selection screen without saving or making changes to the currently selected patient record. In some instances, you will need to cancel before closing a record if you do not wish to save. To Cancel Any Operation: 1. Select <Cancel> in the Patient Selection Operating Mode Tool Bar. Any changes made since the last time the currently selected patient record was saved will be erased and the previous values will be restored. The currently selected patient file is still open.

PATIENT SELECTION

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X Delete Test The Delete TestExercise option allows any study to be permanently deleted from the currently selected patient record. To Delete a Specific TestExercise from the Patient Record: 1. Select <Open> from the Patient Selection Operating Mode Tool Bar. The Patient Name window should now be displayed with a listing of all previously entered patients. 2. Select any patient to expand the patient list to show all tests and exercise sessions for that patient. Use the scroll feature to advance through the alphabetical listing as needed or enter the patient Last Name or ID and select <Search> to quickly locate a specific patient. 3. Select the desired test/exercise to delete. The Patient Selection screen should now display the desired patient and the test/exercise selected. 4. Select <Delete>. 5. Respond “YES” to the “Confirm Study Delete Operation?” prompt. The selected testexercise will be permanently deleted from the patient record.

Delete Patient The Delete Patient option allows for removal of a selected patient and associated records from the patient file. To Delete A Patient From The Patient File: 1. Select <Open> from the Patient Selection Operating Mode Tool Bar. The Patient Name window should now be displayed with a listing of all previously entered patients. 2. Select any patient. Use the scroll feature to advance through the alphabetical listing as needed or enter the patient Last Name or ID and select <Search> to quickly locate a specific patient. 3. Select <Delete>. 4. Respond “YES” to the “Confirm Patient Delete Operation?” prompt. The currently selected Patient and associated tests, exercises and files will be permanently deleted from the patient record. The Patient Name window is now displayed. NOTE: If you delete a patient, the entire patient record is permanently deleted from the patient file. This information cannot be restored unless it has been already been backed up. Close The Close option allows the clinician to close any screen or patient record currently displayed. The user is given an option to save or discard any changes made since the current patient record was last saved. NOTE: If you have performed any operation on the screen or patient record, you must first <Save> or <Cancel> before closing. To Close a Patient Record or Screen: 1. After saving the patient record, or canceling any function, select <Close> from the Patient Selection Operating Mode Tool Bar. The system will close the currently displayed screen display the logical next or previous screen.

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PATIENT SELECTION