Pathway TR-20 Operators Manual and Quick Start Guide

Pathway TR-20 Operator’s Guide

TR-20 Quick-Start Reference Guide Copyright (c) 1999 The Prometheus Group One Washington Street, Suite 303 Dover, NH 03820

FOR ASSISTANCE, CALL YOUR LOCAL SALES REPRESENTATIVE, DISTRIBUTOR, OR THE PROMETHEUS GROUP AT 800-442-2325 IN THE US AND CANADA OR AT 603-749-0733. FOR TECHNICAL ASSISTANCE, CALL THE PROMETHEUS GROUP TECH SUPPORT LINE AT 800272-8492 IN THE US AND CANADA OR 603-742-6053. MANUAL VERSION 100699

Web site: www.theprogrp.com E-mail: [email protected]

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Pathway TR-20 Operator’s Guide Indications for Use: Surface electromyography is a safe and effective technique for relaxation training and muscle re-education. Using internal perineometer electrodes such as the PerryVaginal: EMG biofeedback is a safe and effective technique for the assessment and treatment of pelvic floor dysfunction, monitoring the performance of Kegel exercises. The pelvic floor muscles include the Levator Ani group as well as the pubococcygeus (PC), ileococcygeus, and coccygeus. These are skeletal muscles which respond to reeducation, strengthening, endurance building, and relaxation. Conditions that can be assessed or treated using this technique include: stress incontinence, mixed incontinence, and urge incontinence. Contraindications: Do not use this device for treatment of incontinence in the presence of any bladder infection, vaginal infection, or during pregnancy. Caution: Federal law (USA) restricts this device for sale by or on the order of a licensed medical practitioner, licensed by law in the state in which they practice. Caution: Federal law (USA) restricts this device to sale by or on the order of a physician when used for the treatment of incontinence. Caution: Use only electrodes from The Prometheus Group with your Pathway surface EMG device. Any other electrode may not be compatible with the Pathway device. Warnings: • Be sure to read this operator's guide before using this device. • Do not use this device while the BATTERY indicator is blinking. The battery is low and the device may stop operating. • Do not put this device underwater or get device wet. It could damage the device. • Use only batteries with this device; do not use any type of line-powered adapter. • Do not connect any preamp, lead wire, electrode, or any other component to a wall outlet. • Do not leave electrodes attached when device is not in use. • For the treatment of incontinence do not attempt to use this device concurrently with stimulation being supplied from an electrical muscle stimulator.

TR-20 OPERATION

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Pathway TR-20 Operator’s Guide POWER-UP/STATUS Turn TR-20 on. 1ST SCREEN: Battery light will illuminate and a light will indicate battery level. LOW ON SCALE=LOW BATTERY; HIGH ON SCALE =GOOD BATTERY. 2ND SCREEN: 4 lights will then appear. TOP LEFT LIGHT INDICATES SCALE; SCALE = 1-800 (DEFAULTS TO 800). BOTTOM LEFT LIGHT INDICATES A CHANNEL GOAL (DEFAULTS TO NONE). TOP RIGHT LIGHT INDICATES MODE (DEFAULTS TO CONTINUOUS). BOTTOM RIGHT LIGHT INDICATES B CHANNEL GOAL (DEFAULTS TO NONE). 3RD SCREEN: TR-20 then defaults to EMG Measurement Mode. The TR-20 always powers-up in Continuous mode and is ready to measure at this time.

CHANGE SCALE To change scale press A key. TWO LIGHTS FLASH PROMPTING YOU TO MAKE CHANGES. TOP LIGHT INDICATES SCALE. TWO SCALES ARE AVAILABLE: 1-800 AND 1-30. A LIGHT BY 800=1-800 SCALE; A LIGHT BY 30 =1-30 SCALE. While lights are blinking, press down arrow to select 1-30 scale. Press up arrow to select 1-800 scale. NOTE THAT TR-20 ONLY GIVES YOU ABOUT 4 SECONDS TO MAKE A SELECTION BEFORE AUTOMATICALLY SELECTING THE SCALE INDICATED BY THE BLINKING LIGHT.

SET GOALS To select A Channel Goal Press A key. TWO LIGHTS FLASH PROMPTING YOU TO MAKE CHANGES. NOTE THAT TR-20 ONLY GIVES YOU ABOUT 4 SECONDS TO MAKE A SELECTION BEFORE AUTOMATICALLY SELECTING THE MODE INDICATED BY THE BLINKING LIGHT. BOTTOM LIGHT INDICATES GOAL READ THE WORDS TO THE LEFT: None

(No Work/Rest goals set; No Goals set)

Above (Goal)

(When EMG level is ABOVE the Goal light, success tone sounds) (Goal light appears at 10; it may be adjusted by using the left up and down arrows).

Below (Goal)

(When EMG level is BELOW the Goal light, success tone sounds) (A Goal light appears at 10; it may be adjusted by using the left up and down arrows).

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Pathway TR-20 Operator’s Guide Ratio A/B

(Displays the A channel divided by the B channel Use the .1 to 10 scale (If A=B the reading is 1. If A is greater than B the reading is greater than 1. If A is less than B the reading is something less than 1). (A Goal light appears at 1; it may be adjusted by using the left Up and Down arrows). Press the A key repeatedly to select desired A Channel Goal. TR-20 then defaults to EMG Measurement Mode. The A goal may be adjusted at this time by using the Up/Down arrows on the left side of the TR-20. Goal can be adjusted anytime during Measurement Mode. To set B Channel Goal press the B key. Note: If a goal is set on both A and B channels, both conditions have to be met for success tone to be generated. TWO LIGHTS FLASH PROMPTING YOU TO MAKE CHANGES. BOTTOM RIGHT LIGHT INDICATES B CHANNEL GOAL.(NONE, ABOVE, BELOW, B OFF) Press the B key repeatedly to select desired B Channel Goal. TR-20 then defaults to EMG Measurement Mode. The B goal may be adjusted at this time by pressing the Up/Down arrows on the right side of the TR-20. Goal can be adjusted anytime during Measurement Mode.

SELECT MODE Press the B key to Select Mode. TWO LIGHTS FLASH PROMPTING YOU TO MAKE CHANGES. USE THE UP AND DOWN ARROWS ON THE RIGHT SIDE OF THE TR-20 TO MAKE SELECTION. NOTE THAT TR-20 ONLY GIVES YOU ABOUT 4 SECONDS TO MAKE A SELECTION BEFORE AUTOMATICALLY SELECTING THE MODE INDICATED BY THE BLINKING LIGHT. TOP RIGHT LIGHT INDICATES MODE. CONTINUOUS (No Work/Rest Mode) W/R: 5/10 (TR-20 prompts user to work for 5 seconds, rest for 10 seconds) W/R: 10/10 (TR-20 prompts user to work for 10 seconds and rest for 10 seconds) THE TR-20 IS NOW IN EMG MEASUREMENT MODE AND THE SESSION HAS BEGUN. USE THE NUMBERS IN THE MIDDLE (1-800) TO READ EMG LEVEL IN MICROVOLTS WHEN IN THE EMG MEASUREMENT MODE.

CABLE CONNECTIONS •

Use illustrations to connect cables, electrodes and accessories.

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Pathway TR-20 Operator’s Guide Choose from the following configurations: 1. Orthopedic 2. Continence: Internal Sensor 3. Continence: External Pelvic Floor Monitoring •

Illustrations also helpful for part identification and re-order numbers

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Pathway TR-20 Operator’s Guide

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Pathway TR-20 Operator’s Guide

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Pathway TR-20 Operator’s Guide

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Pathway TR-20 Operator’s Guide

PATHWAY TR-20 SURFACE EMG TRAINER OPERATOR'S GUIDE

Copyright (c) 1999 The Prometheus Group 1 Washington Street, Suite 303 Dover, NH 03820

FOR ASSISTANCE, CALL YOUR LOCAL SALES REPRESENTATIVE, DISTRIBUTOR, OR THE PROMETHEUS GROUP AT 800-442-2325 IN THE US AND CANADA OR AT 603-749-0733. FOR TECHNICAL ASSISTANCE, CALL THE PROMETHEUS GROUP TECH SUPPORT LINE AT 800-272-8492 IN THE US AND CANADA OR AT 603-749-0733. MANUAL VERSION 052099.

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Pathway TR-20 Operator’s Guide

CONTENTS

The Pathway TR-20 kit contains the following items: • The Pathway TR-20 module • Two Pathway preamplifiers for EMG A and EMG B • One 9 volt alkaline battery • One carrying case • Operator's guide.

Pathway is a trademark of The Prometheus Group. The TR-20 and this manual are Copyright (c) 1999, The Prometheus Group.

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Pathway TR-20 Operator’s Guide Indications for Use: Surface electromyography is a safe and effective technique for relaxation training and muscle re-education. Using internal perineometer electrodes such as the PerryVaginal: EMG biofeedback is a safe and effective technique for the assessment and treatment of pelvic floor dysfunction, monitoring the performance of Kegel exercises. The pelvic floor muscles include the Levator Ani group as well as the pubococcygeus (PC), ileococcygeus, and coccygeus. These are skeletal muscles which respond to reeducation, strengthening, endurance building, and relaxation. Conditions that can be assessed or treated using this technique include: stress incontinence, mixed incontinence, and urge incontinence. Contraindications: Do not use this device for treatment of incontinence in the presence of any bladder infection, vaginal infection, or during pregnancy. Caution: Federal law (USA) restricts this device for sale by or on the order of a licensed medical practitioner, licensed by law in the state in which they practice. Caution: Federal law (USA) restricts this device to sale by or on the order of a physician when used for the treatment of incontinence. Caution: Use only electrodes from The Prometheus Group with your Pathway surface EMG device. Any other electrode may not be compatible with the Pathway device. Warnings: • Be sure to read this operator's guide before using this device. • Do not use this device while the BATTERY indicator is blinking. The battery is low and the device may stop operating. • Do not put this device underwater or get device wet. It could damage the device. • Use only batteries with this device; do not use any type of line-powered adapter. • Do not connect any preamp, lead wire, electrode, or any other component to a wall outlet. • Do not leave electrodes attached when device is not in use. • For the treatment of incontinence do not attempt to use this device concurrently with stimulation being supplied from an electrical muscle stimulator.

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Pathway TR-20 Operator’s Guide

TABLE OF CONTENTS

PHYSICAL

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TR-20 FRONT PANEL

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MECHANICAL

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Installing or Changing the Battery

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ELECTRODE CONNECTIONS

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Electrode Types

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Attaching the Electrodes

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Lead Wires

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Preamp Adapter

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DISPLAY

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Front Panel LED Indicators

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Status Indicators

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Bar Graph Display

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OPERATION

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Start-up Sequence

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Battery Level Indication During Start-up

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Goals, Display Range, and Timing Mode Indication During Start-up

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The Training Displays

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Displaying EMG

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Pathway TR-20 Operator’s Guide Expanded EMG Display Range

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Expanded Display Range Scale

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Setting the Display Range

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Setting the Feedback Modes

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Feedback Modes

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Ratio A/B Display Mode

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Goal Display

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Setting the Goal Value

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Work/Rest Intervals

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Setting the Timing Mode

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Pathway TR-20 Operator’s Guide

PHYSICAL The Back Panel: • The 9 volt battery compartment. The serial number label is inside the compartment.

The Bottom Panel: • The preamp cables connect to the module here. Use care with the preamp cable. Pulling on it or bending it sharply will cause it to eventually break.

The Front Panel: • An OFF VOLUME rotary thumbwheel which turns the Pathway TR-20 on and off and controls audio volume • Two LED bar graphs to display microvolt level, goal type, and goal level • Four individual LED indicators to provide status information • Up and down arrow keys to change the goal • A and B goal keys to define EMG A and EMG B goal type and direction.

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Pathway TR-20 Operator’s Guide

TR-20 FRONT PANEL STATUS INDICATOR LEDS

RATIO A/B DISPLAY SCALE EMG DISPLAY SCALE

MOVE EMG A GOAL UP SET DISPLAY RANGE HIGH

MOVE EMG B GOAL UP CHANGE TIMING MODE

MOVE EMG A GOAL DOWN SET DISPLAY RANGE LOW

MOVE EMG B GOAL DOWN CHANGE TIMING MODE

CURRENT TIMING MODE

CURRENT EMG A GOAL TYPE

CURRENT EMG B GOAL TYPE

CHANGE SETTINGS SET EMG A GOAL TYPE

CHANGE SETTINGS SET EMG B GOAL TYPE

BOLD = NORMAL REAL-TIME EMG DISPLAY MODE ITALICS = CHANGE SETTINGS MODE

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Pathway TR-20 Operator’s Guide

MECHANICAL Installing or Changing the Battery On the back panel is a 9 volt battery compartment. To install or change the battery simply press down on the designated area and slide the cover in the direction indicated. Clip on the new battery, place the battery in the compartment and replace the cover, snapping firmly into place. Either a disposable or rechargeable battery may be used. If using a disposable, an alkaline battery is recommended for longer life. A fresh alkaline battery will have 15-20 hours of useful life. Use only a battery, do not use a linepowered adapter.

ELECTRODE CONNECTIONS Electrode Types There are several electrode types which may be used with the TR-20. The size and location of the target muscle often determines which type of electrode to use. The standard electrode used with the TR-20 has three electrode contacts in one foam pad and snaps directly to the preamplifier.

Attaching the Electrodes Snap on a disposable electrode to EMG A. The preamplifier has 3 snaps; 2 labeled ACT for Active and 1 GND for Ground. The disposable electrode must be completely snapped into all 3. Important: Prepare the skin by wiping the area with an alcohol pad and then wiping it dry with a tissue or cloth, to avoid high impedance artifact by removing oils and dead skin. The most common reason for inaccurate readings is insufficient cleaning of the skin. Remove the backing on the disposable electrode to expose the adhesive surface and adhere fully to the skin. The two active electrodes must be placed parallel to the muscle fiber.

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Pathway TR-20 Operator’s Guide

Lead Wires Lead wires may be used to connect to three individual electrodes when necessary to aid small muscle placements. These lead wires connect to the preamps with the preamp adapter. Contact The Prometheus Group for any of these electrodes. The use of any other electrodes is not recommended. Warnings: • Discontinue use if any irritation occurs. • Long term air exposure will result in drying of gel. Keep unused electrodes sealed in bag. • Prepare skin by wiping area with alcohol pad. Allow to dry before applying electrode. • Use electrode only with Pathway EMG unit. • Use only on clean unbroken skin. • Do not connect preamps, electrodes, lead wires or any other component to wall outlets, line-powered adapters, or any other electrical connection! Do not leave electrodes attached to the preamp when the device is not in use.

Preamp Adapter The preamp adapter is used to interface the preamp to different styles of electrodes. It has an input jack to interface to lead wires or an incontinence sensor. Please contact The Prometheus Group for any adapter or electrode requirements.

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Pathway TR-20 Operator’s Guide

DISPLAY Front Panel LED Indicators The TR-20 uses LED indicators to display information. These LEDs are labeled with their meaning or values. Some indicators are used for more than one function such as displaying EMG level and goal level or goal type. The TR-20 uses 4 individual LED indicators and two Bar Graph Displays.

Status Indicators The TR-20 has 4 LED indicators labeled BATTERY, WORK, REST, and SUCCESS. These are used to show information about the current state. The BATTERY indicator lights during start-up while showing battery level on the bar and begins blinking during operation if the battery voltage drops too low. The WORK and REST indicators light when the unit is in the work/rest timing mode. The WORK LED will light when in a work period and the REST LED will light when in a rest period. The SUCCESS indicator lights when goal success is achieved.

Bar Graph Display The bar graph display is used to show the current levels of EMG A and EMG B by illuminated LEDs based on the scale from 1 to 800 microvolts for the normal range or on the scale from 1 to 30 microvolts for the expanded display range. When a goal is set the goal value is also shown on the bar graph by one illuminated LED. The bar graph display is also used to show the current settings for the TR-20 on start-up and when making selections. The display will indicate the current microvolt display range, the EMG A and EMG B goal types, and the current timing mode.

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Pathway TR-20 Operator’s Guide

OPERATION Start-up Sequence The thumbwheel switch turns the TR-20 on and adjusts the volume level. When first turned on, the TR-20 will sound a several second tone which may be used to adjust the speaker volume to a comfortable level.

Battery Level Indication During Start-up During this start-up tone, the current battery voltage is indicated on the Bar Graph display while the BATTERY LED indicator is illuminated. The top of the display indicates a new battery. As the battery voltage drops during its lifetime the level indicated on the display will drop as well. The bottom of the display indicates that the battery is at the end of useful life and should be replaced. Battery indication on start-up: BATT

BATTERY NEW

BATTERY OK

REPLACE BATTERY

IF THE TR-20 IS TURNED ON AND IT DOES NOT WORK PROPERLY, FIRST TRY REPLACING THE BATTERY WITH A NEW ONE. Call Technical Support for further assistance if necessary.

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