STABILIZER Operating Instructions 2002

TABLE OF CONTENTS

ENGLISH... 3 DEUTSCH... 17 FRANÇAIS... 31 ESPAÑOL... 45 ITALIANO... 59 PORTUGUÊS... 73 NEDERLANDS... 87 DANSK... 101 SVENSKA... 115

© 2002 Encore Medical Corporation or its affiliates, Austin, Texas, USA. Any use of editorial, pictorial or layout composition of this publication without express written consent from the Chattanooga Group of Encore Medical, L.P. is strictly prohibited. This publication was written, illustrated and prepared for print by the Chattanooga Group of Encore Medical, L.P.

2

The STABILIZER™, designed by physical therapists, is a simple device which registers changing pressure in an air filled pressure cell. This allows body movement, especially spinal movement, to be detected during exercise. The unit consists of a combined gauge/inflation bulb connected to a pressure cell. Core Stabilization training involves the re-learning of co-activation of co-contraction patterns of the transverse abdominis and the lumbar multifidus to provide local spinal segmental support. Published research has shown that when functioning normally, the transverse abdominis and the lumbar multifidus act in concert, increasing tension on the thoracolumbar fascia acting like a corset, providing stability to the lumbar spine. Research has shown these types of exercise are especially important for the prevention and treatment of low back and neck pain (of various pathologies). The exercise techniques discussed in this instruction manual involve slow and controlled body movement. The STABILIZER is used to monitor and provide feedback on body movement during exercise. This promotes effective exercise to improve back and neck pain. The concepts put forth in this literature were in effect at the time of publication. However, due to Chattanooga Group's policy of continuous improvement, changes may be made at any time without obligation on the part of the designing physical therapists or the Chattanooga Group.

WARNING CAUTION: This product contains natural rubber latex which may cause allergic reactions.

3

STABILIZER™ Pressure Bio-Feedback A simple device that provides feedback to ensure quality and precision in exercise performance and testing. The STABILIZER is useful in an infinite number of exercises for all parts of the body. This instruction manual contains information on its use for exercises aimed at enhancing the stability of the lumbo-pelvic and cervical region. Considerable research has been completed on the specific stabilization exercises related to these areas.

GENERAL INSTRUCTIONS • The three-chamber pressure cell of the STABILIZER is placed between the part of the body requiring monitoring and a firm surface (e.g., floor, back of chair, plinth, bed, wall). • Tighten the screw (gently) at the base of the pressure gauge. Pump to inflate the three chambers of pressure cell until it molds between the body part and the supporting surface. A pressure of 40 mmHg (orange band) is suitable for the resting pressure of the inflated cell. • The initial baseline pressure may decrease initially as the air backflows into the tube. Reinflate before commencing exercise. • Changes in body weight on the cell on any of the three compartments will register a pressure change on the gauge. • Pressure on the cell can be increased, decreased or maintained depending on the exercise/movement required. • After exercise, air is released by loosening the screw.

4

PRECISION IN SPECIFIC MUSCLE TESTING The deep muscle system in the lumbar spine and pelvic region is directly responsible for stabilizing the vertebral segments and sacro-iliac joints. The larger, more superficial muscles are involved in moving the trunk. The deep muscles are underactive in low back pain and the more superficial muscles are often overactive. In order to retrain the deep muscles, specific exercise and testing with the STABILIZER is required.

1. The Prone Test for Transversus Abdominis and Internal Oblique. • Place the three-chamber pressure cell under the abdomen and inflate to baseline of 70 mmHg. (brown band) • Draw abdominal wall up and in without moving the spine or pelvis. • Pressure should decrease 6-10 mmHg. • Hold 10-15 seconds, breathe normally. • Perform 10 repetitions.

Lying on abdomen

5

2. Training the Corset Action of Transversus Abdominis in Supine • Place the three-chamber pressure cell under the lumbar spine and inflate to a baseline of 40 mmHg (orange band). • Draw in the abdominal wall without moving the spine or pelvis. • Pressure should remain at 40 mmHg (i.e. no movement of the spine). • Hold for 10-15 seconds; breathe normally. • Perform 10 repetitions. Lying on back

3. Training the Corset Action of Transversus Abdominis with Leg Loading • Place the three-chamber pressure cell behind the lumbar spine and inflate to baseline of 40 mmHg (orange band). • Draw in the abdominal wall without moving the spine or pelvis. • Pressure should remain at 40 mmHg (i.e. no movement of the spine) while leg lifts. • Hold for 10-15 seconds; breathe normally. • Repeat 10 times with each leg. Standing

Lying (controlled leg movement)

6

4. Lumbar Stabilization During Stretching Techniques The STABILIZER helps to stabilize the spine while adjacent body segments are moved in order to stretch the appropriate muscles.

To Test/Stretch: • Hip Flexors (Thomas Test) • Rectus Femoris • Latissimus Dorsi and Pectoralis Major. Follow stabilization procedure and maintain pressure during the stretch.

Test/stretch for tight hip flexors (Thomas Test)

Test/stretch for tight Rectus Femoris Test/stretch for tight Latissimus Dorsi and Pectoralis Major

To Test/Stretch: Tensor Fascia lata • Have patient lying on their side. • Place pressure cell between lateral trunk (lumbar spine level) and supporting surface. • Inflate pressure cell to 40 mmHg.(orange band) • Maintain lumbo-pelvic stability by maintaining pressure at 40 mmHg during the stretching maneuvers. Test/stretch for tight tensor fascia lata

7

5. Lower Trapezius • Place the three-chamber pressure cell under abdomen and inflate to baseline of 70 mmHg. (brown band) • Draw abdominal wall up and in as described in exercise 1. (Prone test for Transverse Abdominis and Internal Obliques.) • Lift one arm and draw the scapula down and in, towards the spine. The pressure must remain constant. • Hold for 5 seconds. • Perform 10 repetitions.

Lying on abdomen (arm exercise)

8

The STABILIZER is used to monitor proximal trunk stability to detect substitution for the tested muscle’s action.

6. Iliopsoas • Place the three-chamber pressure cell behind the lumbar spine and inflate to baseline of 40 mmHg (orange band). • Draw in abdominal wall without thoracic or pelvic movement. • Pressure should increase 8-10 mmHg. • Lift one leg slowly to test position with the other leg unsupported (i.e., no stool). Pressure should remain constant at 48-50 mmHg. • Hold for 5 seconds. Sitting Upright • Perform 10 repetitions.

7. Gluteus Maximus • Place the three-chamber pressure cell under the abdomen and inflate to baseline of 70 mmHg. (brown band) • Draw abdominal wall up and in as described in Exercise 1. (Prone test for Transverse Abdominis and Internal Obliques.) • Extend hip by lifting knee up 5 cm (2 in) off supporting surface. The pressure must remain constant. • Hold for 5 seconds. • Perform 10 repetitions. Lying on abdomen

9

8. Training of the Deep Cervical Flexors • Position the folded cell (secure with pressure studs) under the neck so that it abuts against the occiput. Do not let it slide down to the lower cervical area. • Inflate to a baseline of 20 mmHg. (red band) Note: Do not inflate the Stabilizer before insertion behind the neck. Because the air has to completely enter all of the bag’s pressure cells , it is helpful to squeeze the pressure bag to speed up the air distribution. Reinflate and repeat the gentle squeeze. This may take two to three repetitions to complete the process. • The movement the patient is to perform is a gentle nodding of the head as if they were saying “yes”. • Instruct the patient to place the tongue on the roof of the mouth, lips together but teeth just separated. This will discourage substitution with the platysma or hyoids. • Instruct the patient to gently nod to target 22 mmHg, just one mark on the pressure dial. (green band) See if the patient can hold the position steadily. If successful, relax and repeat at each target position of 24 mmHg through 30 mmHg. (yellow, blue and gray bands) • The pressure that the patient can hold steady, with minimal superficial muscle activity, is the one on which you will measure endurance capacity. (i.e. 10 repetitions held for 10 seconds each) Lying on back (neck exercise)

10

MONITORING OF LUMBAR SPINE STABILIZATION FOR SAFETY AND PRECISION OF EXERCISE AND PROTECTION OF LUMBAR SPINE Limb Loading • STABILIZER is used to monitor the appropriate use of the muscles required in the stabilization and protection of the lumbar spine during lower and upper limb testing and exercise.

Stabilization Procedure • Place the three-chamber pressure cell longitudinally under the back of the side on the spine opposite the limb being lifted in exercise and inflate to baseline of 40 mmHg (orange band). • Control the back position during limb loading activities and keep the pressure constant. • In addition, a presetting action of the abdominals may be performed prior to limb loading.

11

Either Presetting as for Exercise 2. The pressure will increase 8-10 mmHg. Keep pressure constant.

OR Presetting with a pelvic tilt position. The pressure will increase 20-50 mmHg. Keep pressure constant.

Lying (controlled leg movement)

Standing

12

SPECIFICATIONS MEASURING RANGE

Analog 0-200 mmHg

pressure

ACCURACY

±3 mmHg pressure

INFLATE

Squeeze bulbs (after tightening screw valve)

DEFLATE

Loosen screw valve

Complete unit comes with instruction booklet. BOXED: Dimensions: 10 x 10 x 19 cm (4 x 4 x 8 in)

WEIGHT: Approx. 600 g (21 oz)

RECOMMENDATIONS 1. The connector tube should be disconnected from the dial gauge/inflation bulb before storage. 2. The three-chamber pressure cell must be stored flat or folded along the seams when not in use. 3. Cleaning the STABILIZER should be done only with a damp cloth.

13

REORDERING INFORMATION ITEM NUMBER

DESCRIPTION

9296

Stabilizer Unit

92100

Spygmomanometer

92965

Instruction Manual

92961

Pressure Cuff

9301

Instruction Video PAL (16 mins.)

92966

Instruction Video NTSC (16 mins.)

31223

Stabilizer Poster

14

WARRANTY Chattanooga Group ("Company") warrants that the Stabilizer™ ("Product") is free of defects in material and workmanship. This warranty shall remain in effect for ninety (90) days from the date of original consumer purchase. If this Product fails to function during the 90 day warranty period due to a defect in material or workmanship, Company or the selling dealer will repair or replace this Product without charge within a period of thirty (30) days from the date on which the Product is returned to the Company or the dealer. All repairs to the Product must be performed by a service center authorized by the Company. Any modifications or repairs performed by unauthorized centers or groups will void this warranty. To participate in warranty coverage, this Product's warranty registration card (included with Product) must be filled out and returned to the Company by the original owner within ten (10) business days of purchase.

This Warranty Does Not Cover: Replacement parts or labor furnished by anyone other than the Company, the selling dealer or a certified Company service technician. Defects or damage caused by labor furnished by someone other than Company, the selling dealer or a certified Company service technician. Any malfunction or failure in the Product caused by product misuse, including, but not limited to, the failure to provide reasonable and required maintenance or any use that is inconsistent with the Product User's Manual. The STABILIZER is not designed to be used at pressures above 200mmHg. Damage or deficit caused to the STABILIZER during application resulting in pressures above 200mmHg on the dial gauge is not covered by the warranty statement.

COMPANY SHALL NOT BE LIABLE IN ANY EVENT FOR INCIDENTAL OR CONSEQUENTIAL DAMAGES. Some states do not allow the exclusion or limitation of incidental or consequential damages, so the above limitation or exclusion may not apply to you. To Obtain Service From Company or the selling dealer under this warranty: 1. A written claim must be made within the warranty period to the Company or the selling dealer. Written claims made to the Company should be sent to: 4717 Adams Road P.O. Box 489 Hixson, TN 37343 USA Telephone: (423) 870-2281 Outside USA: (423) 870-7200 Facsimile: (423) 875-5497 and 2. The Product must be returned to the Company or the selling dealer by the owner. This warranty gives you specific legal rights and you may also have other rights which vary from state to state. The Company does not authorize any person or representative to create for it any other obligation or liability in connection with the sale of the Product. Any representation or agreement not contained in the warranty shall be void and of no effect.

THE FOREGOING WARRANTY IS IN LIEU OF ALL OTHER WARRANTIES, EXPRESSED OR IMPLIED, INCLUDING ANY WARRANTY OR MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE.

15

NACHBESTELLINFORMATION ITEM NUMBER

DESCRIPTION

9296

Stabilizer-Gerät

92100

Spygmomanometer

92965

Instruction Manual

92961

Pressure Cuff

9301

Instruction Video PAL (16 mins)

92966

Instruction Video NTSC (16 mins)

31223

Stabilizer Poster

28

INFORMATION DE COMMANDE DE PIÈCES DE RECHANGE ITEM NUMBER

DESCRIPTION

9296

STABILIZER

92100

Spygmomanometer

92965

Instruction Manual

92961

Pressure Cuff

9301

Instruction Video PAL (16 mins)

92966

Instruction Video NTSC (16 mins)

31223

Stabilizer Poster

42

DETALLES NECESARIOS PARA NUEVOS PEDIDOS ITEM NUMBER

DESCRIPTION

9296

Aparato STABILIZER

92100

Spygmomanometer

92965

Instruction Manual

92961

Pressure Cuff

9301

Instruction Video PAL (16 mins)

92966

Instruction Video NTSC (16 mins)

31223

Stabilizer Poster

56

INFORMAZIONI PER NUOVI ORDINI ITEM NUMBER

DESCRIPTION

9296

Stabilizer

92100

Spygmomanometer

92965

Instruction Manual

92961

Pressure Cuff

9301

Instruction Video PAL (16 mins)

92966

Instruction Video NTSC (16 mins)

31223

Stabilizer Poster

70

DADOS NECESSÁRIOS PARA NOVOS PEDIDOS ITEM NUMBER

DESCRIPTION

9296

Equipamento Estabilizador

92100

Spygmomanometer

92965

Instruction Manual

92961

Pressure Cuff

9301

Instruction Video PAL (16 mins)

92966

Instruction Video NTSC (16 mins)

31223

Stabilizer Poster

84