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    COMPEX 3 USER MANUALOMPEX USER MANUAL

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    ©   Compex Médical SA - 01/07 - All rights reserved - Art. 841402 / V.1

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    FOREWARD

    Please read this manually carefully prior to using your Compex

    3 stimulator.

    We strongly recommend that you familiarize yourself with the

    content of chapter 1 (warnings) and the specific instructions

    chapter in the accompanying Practical Guide.

    The Compex 3 stimulator is designed to be used by

    health professionals.

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    ESPAÑAMediCompex Ibérica, S.L.

    Rambla Catalunya 2,1° DerechaE - 08007 BarcelonaHotline: 0900 801 280(número gratuito)

    Fax: +34 93 342 42 33E-mail: [email protected]

    EXPORT DEPARTMENTCompex

    19, avenue du Pré de ChallesF - 74940 Annecy-le-vieuxTél.: +33 (0) 4 50 10 24 80Fax: +33 (0) 4 50 09 25 70Email: [email protected]

    SUISSE/SCHWEIZ/SVIZZERA & ÖSTERREICHCompex Medical SA

    Z.I. “ Larges Pièces A ”Chemin du DéventCH - 1024 EcublensFax: +41 (0) 21 695 23 61E-mail: [email protected]

    Suisse/Schweiz/SvizzeraHotline/FR: 0848 11 13 12(tarif interurbain)

    Hotline/DE: 0848 11 13 13(Fernbereich)

    E-mail: [email protected]

    ÖsterreichHotline: 0810 102515 19(Orstarif)

    E-mail: [email protected]

    FRANCECompex

    19, avenue du Pré de ChallesF - 74940 Annecy-le-vieuxHotline: 0811 02 02 74(prix appel local à partir d’un poste fixe)

    Fax: +33 (0) 4 50 09 25 70Email: [email protected]

    ITALIACompex Italia Srl Via Algardi, 4I - 20148 Milano

    Tel.: +39 02 30412057Fax: +39 02 30412058E-mail: [email protected]

    BENELUXCompex19, avenue du Pré de ChallesF - 74940 Annecy-le-vieuxFax: +33 (0) 4 50 09 25 70

    Belgique/Belgïe

    Hotline: 0800 99 104(numéro gratuit/gratis nummer)E-mail: [email protected]

    NederlandHotline 0800 022 2593(Gratis nummer)

    E-mail: [email protected]

    Luxembourg/LuxemburgHotline: +33 450 10 24 63E-mail: [email protected]

    DEUTSCHLANDCompex Medical GmbHHotline: 0185 266 739(€ 0.12 pro Minute)

    Fax: + 49 (0) 611 690 7474E-mail: [email protected]

    Customer support…

    Compex Médical SA - Switzerland - compex-professional.com

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    CONTENTS

    I WARNINGS

    1 - Counter-indications ..................................................................................... 8

    2 - Safety measures .......................................................................................... 8

    II PRESENTATION

    1 - Reception of equipment and accessories .......................................10

    2 - Warranty .........................................................................................................10

    3 - Maintenance ..................................................................................................11

    4 - Storage and transportation conditions ............................................11

    5 - Usage conditions .........................................................................................11

    6 - Elimination .......................................................................................................12

    7 - Standards .......................................................................................................12

    8 - Patents .............................................................................................................12

    9 - Standardized symbols ................................................................................1210 - Technical specifications ........................................................................13

    III USAGE GUIDELINES

    1 - Placement of electrodes ........................................................14

    2 - Body position .................................................................................................153 - Adjusting stimulation energies ..............................................................15

    4 - Level progression active ....................................................................................15

    5 - Alternation of stimulation/active reeducation sessions .................. 16

    IV m  TECHNOLOGY 

    1 - Practical guidelines for using the m  system ...............................16

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     V USING THE STIMULATOR

    1 - Description of stimulator ........................................................................... 19

    2 - Connections

    A) Connecting the cables ..................................................................... 20

    B) Connecting the motor point pen ................................................. 20C) Connecting the charger ................................................................. 21

    3 - Preliminary settings

    A) Date and time ..................................................................................... 21

    B) Language, contrast, volume ......................................................... 22

    4 - Neurostimulation programmes

    A) Choosing a type of treatment ...................................................... 22

    B) Choosing a programme category ............................................. 23

    C) Choosing a programme ................................................................. 23

    D) Personalising a programme ........................................................ 23

    E) During the stimulation session ................................................... 24

    F) Using the Intelligent TENS function ............................................. 27

    5 - Direct currents

    A) Iontophoresis ....................................................................................... 28

    B) Hyperhidrosis ...................................................................................... 29

    C) Oedema ................................................................................................. 296 - Denervated programmes

    A) Automatic mode ................................................................................ 31

    B) Manual mode ....................................................................................... 31

    7 - Electricity consumption and recharging

    A) Battery life ............................................................................................. 33

    B) Recharging ........................................................................................... 33

    8 - TroubleshootingA) Electrode error ................................................................................... 34

    B) Memory full .......................................................................................... 34

     VI LIST OF PROGRAMMES 35

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     VII COMPEX 3 SOFTWARE

    1 - Scope

    A) Creating a patient list .................................................................. 38

    B) Creating a patient history .......................................................... 38

    C) Creating a personalised programme .................................. 382 - Mode of operation

    A) Creating a patient file .................................................................. 39

    B) Preparing data to transfer to Compex 3 ........................... 42

    C) Synchronising the stimulator ................................................... 44

    D) Tools .................................................................................................... 45

    3 - Using the Compex 3 stimulator with a patient list

    A) Using the Compex 3 stimulator with a patient list............... 48

    B) Creating a new patient in the Compex 3 stimulator ............. 48

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    I WARNINGS

    1 - Counter-indications

    2 - Safety measures

    • Cardiac stimulator (pacemaker).• Pregnancy (do not use in abdominal

    region).• Troubles Serious arterial circulation

    disorders in lower limbs.• Abdominal or inguinal hernia.

    Important!

    • Never use Compex 3 on patients whohave sensitivity problems or who areunable to let you know if they feel anydiscomfort, however slight.

    • Read this manual and theaccompanying Practical Guide carefully.

    Important points to take intoaccount when using Compex 3 andthe m system

    • Do not use the Compex 3 stimulator or the m-4 system in water or humidenvironments (saunas, hydrotherapypools, etc.).

    • Do not use the stimulator or m-4system in oxygen-rich environments.

    • Never carry out the first 5 minutes ofany stimulation session on a patient whois standing. Make sure they are seatedor lying down. In rare instances, people of

    a nervous disposition may experience a vasovagal reaction. This is apsychological response triggered by fearof the procedure and the shock of seeingone of their muscles contractinvoluntarily. A vasovagal reactioncauses a patient’s heart to slow downand blood pressure to drop, which canmake them feel weak and faint. Should this happen, simply interrupt the sessionand help the patient to lie down with theirlegs raised until the feeling disappears(5 to 10 minutes).

    • Contractions should always be isometric.Never allow active muscle contractionsduring a stimulation session.

    • Do not use the stimulator or   m-4

    system on a patient who is connected toa high-frequency surgical instrument as this could cause skin irritation or burnsunder the electrodes.

    • Do not use the stimulator or m-4system within 1 metre of short wave ormicrowave devices as this could alter thecurrents generated by the stimulator.

    • Do not use the stimulator or m-4system in areas where unprotecteddevices are used to emit

    electromagnetic radiation. Portablecommunications equipment caninterfere with electrical medicalequipment.

    • Only use stimulation cables supplied byCompex.

    • Always switch off the stimulator beforedisconnecting any stimulation cablesduring a session.

    • Never connect the stimulation cables to

    an external power source due to risk ofelectric shock.• Only use rechargeable battery units

    supplied by Compex.

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    • Never recharge the stimulator withoutfirst disconnecting all stimulation cables.

    • Do not recharge the battery with acharger other than that supplied byCompex.

    • Do use the Compex 3 stimulator, dockingstation, or charger if any of the elements

    are damaged (case, cables, etc.) or if thebattery compartment is open. There is arisk of electric shock.

    • Unplug the charger immediately if yourCompex 3 emits a continuous beepingsound or if you notice any abnormal heat,smells, or smoke from either thecharger or the stimulator.

    • Never recharge the battery in a confinedspace (carrying case, etc.) as this couldcause a fire or electric shock.

    • Keep Compex 3 and its accessories outof the reach of children.

    • Keep the stimulator, batterycompartment, docking station, andcharger free of foreign matter (soil,water, metal, etc.)

    • Sudden temperature changes can causecondensation to build up inside thestimulator. To prevent this, allow it toreach ambient temperature before use.

    • Do not use your Compex 3 while drivingor operating machinery.

    • Do not use the stimulator at altitudes ofover 3,000 metres.

    Never use the electrodes orthe motor point pen:

    • In the vicinity of the head.

    • Counter-laterally, i.e. do not use twopoles connected to the same channel onopposite sides of the body.

    • On or near skin lesions of any kind(wounds, swelling, burns, irritation,eczema, etc.).

    Precautions when using them-4 system

    • To access Compex 3’s m functions, makesure that the stimulation cable fitted with the m-4 is connected before you turn on the stimulator.

    • Do not connect the m-4 cable while

     the Compex 3 is connected.

    • Do not disconnect the m-4 cablewhile the sensor is being used.

    • The m-4   system may not work correctly if restrained or subject topressure in any way.

    Precautions when using theelectrodes and the motor point pen

    • Only use electrodes and pens supplied byCompex. Other electrodes and pens mayhave electrical properties that areincompatible with the Compex 3stimulator.

    • Always turn off the stimulator beforemoving or removing any electrodes duringa session.

    • Do not place the electrodes or the pen inwater.

    • Do not apply solvents of any kind to theelectrodes or pen.

    • For optimal results, wash and clean theskin of any oil and dry it before attaching the electrodes.

    • Attach the electrodes in a such a way that their entire surface is in contact with theskin.

    • For hygiene reasons, each patient musthave his own set of electrodes. Never use the same electrodes on different patients.

    • Never use a set of adhesive electrodes formore than 15 sessions as their stickingpower deteriorates with time and optimalcontact is very important for both usercomfort and treatment efficacy.

    • Some people with very sensitive skin mayexperience redness under the electrodesafter a session. This redness is generallyharmless and normally disappears within10 to 20 minutes. Never start another

    stimulation session in the same area,however, if the redness is still visible.

    • Clean and disinfect the tip of the motorpoint pen that comes in contact with theskin before each use.

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    II PRESENTATION

    1 - Reception of equipment

    and accessories Your kit contains:

    513000 1 stimulator683028 1 docking station683010 1 battery charger601131 1 set of black snap connectors forelectrodes, colour-coded (blue, green, yellow, red)601132 1 set of grey 2.1 mm pin connec- tors for electrodes, colour-coded (blue,green, yellow, and red)

    601161 1 adapter cable for probe601160 4 black electrodes cables fittedwith the m-4 system601162 1 USB cable602076   3 bags of small electrodes(5x5 cm)602077 3 bags of large electrodes(5x10 cm)

    602110  1 set of denervated electrodes642110   1 set of iontophoresis electrodes842302   1 directions for use manualincluding:

    820002 1 folder841402 1 user manual841302 1 practical guide880042 1 electrode placement booklet880307 1 software/docking station

    installation leaflet880308 1 EMC Compex 3 leaflet

    880041 1 Compex 3 Software CD980020 1 motor point pen602047  1 bottle of gel (260 g)690001  1 protective cover949000 1 belt clip680031  1 carrying case

    2 - Warranty

     Your Compex 3 stimulator is guaranteedfor a period of 2 years from the date ofpurchase. The warranty covers thestimulator and the stimulation cables fittedwith the m-4 system (material andworkmanship) but not the battery unit,other cables, or battery unit. All defects

    arising from substandard material orworkmanship are covered. The warrantydoes not cover damage resulting fromimpact, accident, improper use, insufficientprotection against damp, immersion inwater, or repair work conducted byunauthorized personnel.

    This warranty is valid only if accompaniedby proof of purchase.

     Your legal rights are not affected by thiswarranty.

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    3 - Maintenance

    4 - Storage and transportation conditions

    Do not sterilize the stimulator.Clean with a soft cloth and an alcohol-based, solvent-free cleaning product.

    Use only a minimum amount of liquid whencleaning the unit. unit should not beexposed to excessive f luids duringcleaning).Do not attempt to repair the stimulator orany of its accessories. Do not disassemble the stimulator, docking station, or chargeras these all contain hi gh-voltagecomponents that could cause electricshock.Compex Médical SA declines allresponsibil ity for any damages orconsequences resulting from unauthorized

    attempts to open, modify, or repair thestimulator. This may only be done bypersons or repair services authorized byCompex Médical SA. Your stimulator does not requirecalibration. All Compex 3 units aresystematically tested and validated prior todistribution. Their characteristics do not vary under normal conditions.

    Nonetheless, as Compex 3 is a high-qualityelectrical instrument, its life span dependson the use that is made of it and the care

    and maintenance it receives during itslifetime. If your stimulator contains parts that seem worn or defective, pleasecontact your nearest Compex Médical SAcustomer service centre (see page 4 in this manual) regarding an upgrade.Medical and health professionals areobliged to service the unit in compliancewith relevant national laws and regulation.This involves testing performance andsafety parameters at regular intervals.

    The Compex 3 contains rechargeablebatteries and so the storage and transportation conditions must not exceed the following figures:

    • Storage and transportation temperature:-20°C to 45°C

    • Maximum relative humidity: 75%• Atmospheric pressure: 700 hPa

     to 1060 hPa

    5 - Usage conditions

    Temperature: 0°C to 40°CRelative humidity: 30% to 75%Atmospheric pressure: 700 hPa to1060 hPa.

    Do not use in an explosion risk area.

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    6 - Elimination

    The main purpose of the Directive2002/96/EEC is to prevent the creationof waste electrical and electronic

    equipment (WEEE) and to reduce theamount of waste to be disposed of byencouraging reuse, recycling, and otherforms of recovery. Any products bearing the WEEE marking (a crossed-out wheeledbin) must be separated from ordinaryhousehold waste and sent to specialcollection facilities for recycling and

    recovery. By doi ng so, you will becontributing to the safeguarding of naturalresources and health.

    Batteries must be disposed of incompliance with relevant nationalregulatory requirements.

    7 - Standards

    8 - Patents

    9 - Standardized symbols

    Compex 3 is designed for use by healthprofessionals and as such complies withrelevant medical standards and regulatoryrequirements.

    To guarantee your safety, Compex 3 hasbeen designed, manufactured, anddistributed in compliance with therequirements of the European Directive93/42/EEC on medical devices.

    Compex 3 also complies with the IEC60601-1 standard on general safetyrequirements for medical electricaldevices, the IEC 60601-1-2 standard onelectromagnetic compatibility, and the IEC

    60601-2-10 standard on particular safetyrequirements for nerve and musclestimulators. International standards (IEC60601-2-10-am1 2001) require that awarni ng be gi ven concerni ng theapplication of electrodes to the thorax(increased risk of cardiac fibrillation).Compex 3 also complies with Directive2002/96/EEC on waste electrical andelectronic equipment (WEEE).

    The Compex 3 incorporates severalinnovations with patents pending.

    Caution: read User Manual oroperating instructions

    (symbol no. 0432 IEC60878).

    Compex 3 is a class II devicewith internal electric power

    and type BF applied parts(symbol no. 5333 IEC60878).

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    Waste electrical andelectronic equipment (WEEE)marking according to EN50419 standard.

    The On/Off switch is a multi-function key (symbol no. 5009IEC 60878)Functions• On/Off (2 positions, stable)• Waiting or preparation for

    part of the unit• Off (turns system off)

    10 - Technical specifications

     A) General information

    941210   Power: Nickel metal hydride(NiMH) rechargeable battery (4.8   ≈ V 1200mA/h).

    Battery chargers: Only battery chargersbearing the following information can beused to recharge the batteries supplied withCompex 3 stimulators.

    Europe

    683010Type TR1509-06-E-133A03Input 90-264 VAC /47-64 Hz/0.5 A max.Output 9 V/1.4 A/15 W

    USA

    683016Type TR1509-06-A-133A03Input 90-264 VAC /47-64 Hz / 0.5 A max.Output 9 V/1.4 A/15 W

    UK 

    683012Type TR1509-06-U-133A03Input 90-264 VAC /47-64 Hz / 0.5 A max.Output 9 V/1.4 A /15 W

    B) NeurostimulationAll electrical specifications are given for animpedance of 500-1000 Ohm per channel.

    Channels: Four independent and individuallyadjustable channels that are electrically iso-lated from each other and earthed.

    Impulse shape: Constant rectangular currentwith pulse compensation to eliminate anydirect current component to prevent residualpolarization at skin level.

    Maximum pulse intensity: 120 mA

    Pulse intensity increments: Manual adjust-ment of stimulation intensity:0-999 (energy units) – Minimum increment:0.5 mA

    Pulse width: 30 to 400 microsecondsMaximum electrical charge per pulse: 96microcoulombs (2 x 48 µC, compensated)

    Standard pulse ramp-up time:3 microseconds (20%-80% of maximumcurrent)

    Pulse frequency: 1-150 Hz.

    C) Denervated currents

    Impulse shape: Compensated, rectangular,or triangularMaximum pulse intensity: 30 mAMinimum intensity increment: 0.25 mA

    Pulse width: 10 ms – 1000 msPulse frequency: 1/30 Hz – 10 Hz

    D) Direct currents

    Iontophoresis and  Hyperhidrosis:Continuous currentMaximum intensity: 20 mAMinimum intensity increment: 0.125 mAOedema:Rectangular, non-compensated currentPulse width: 150 µS

    Maximum intensity: 120 mAMinimum intensity increment: 1 mAPulse frequency: 100 Hz

    E) General technicalspecifications

    601131   Snap-connector stimulationcablesMachine connector: 6 polesElectrode connector: Female snapconnectorLength: 1500 mm

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    601132 Pin-connector stimulation cablesMachine connector: 6 polesElectrode connector: 2.1 mm pinsLength: 1500 mm

    601161 Adapter cable for probeMachine connector: 6 polesProbe connector: DIN 41524 female, 3 polesLength: 750 mm

    601160 stimulation cables fitted withm-4 system.Machine connector: 6 polesElectrode connector: Female snap connectorLength: 1500 mm

    601162 USB cableMachine connector: 4 polesPC connector: USBLength: 1500 mm

    IPX0 protection rating (IEC 60529)

    III USAGE GUIDELINES

    The usage guidelines described in this

    section are valid only for Compex 3’sneurostimulation programmes. Pleaseconsult separate guidelines for theDenervated, Iontophoresis, and Oedema

    programmes. In all cases, read the

    information and recommendations in thePractical Guide carefully.

    1 - Placement of electrodes(neurostimulation programmes)

    For optimal results, use the electrodepositions recommended by Compex. For the placement of electrodes, refer to theelectrode placement booklet.

    Each stimulation cable has two poles:

    • positive pole (+) = red connection• negative pole (-) = black connection

    A different electrode must be connected toeach pole.

    NOTE: When working with largeelectrodes, there are cases where just 1of the 2 connections are used. This isperfectly normal.

    Depending on the characteristics of thecurrent, efficacy can be optimized incertain programmes by placing theelectrodes connected to the positive pole(red connection) “strategically”.

    When working with a muscle stimulationprogramme (programme involving muscle

    contractions), it is important to place thepositive electrode on the motor point of themuscle.

    It is crucial to choose the right sizeelectrodes (large or small) and correctlyposition these on the muscle group youwant to stimulate to ensure the efficacy of the treatment. To do this, always use thesi zes and posi tions shown in thepictograms unless otherwise required bymedical needs. Where necessary, look for the best possible position by slowly moving the positive electrode over the muscle until you find the point that will produce the bestcontraction or the most comfort for thepatient.

    These recommended positions are also the optimal positions for the m-4system, and as such should be followedclosely.

    Compex disclaims all responsibilityfor consequences arising from electrodesplaced in other positions.

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    2 - Body position

    4 - Level progression

    3 - Adjusting stimulation energies(neurostimulation programmes)

    Refer to the pictograms and pictures in theelectrode placement booklet to determine

     the stimulation position for your patient

    d epe nd in g o n th e p lace me nt o f t heelectrodes and the chosen program..

    This position will vary depending on theposition of the electrodes, the muscle group

     you wish to stimulate, and the programme you are using.When working with programmes involvingmuscle contractions (prolonged, or tetanic,contractions), always make the muscle work 

    isometrically as this will prevent cramps andserious muscle soreness after the session.F or e xamp le , whe n s tim ulati ng t he

    quadriceps, place the patient in a seatedposition with his ankles strapped in place toprevent him from extending his knees. Forprogrammes that do not involve musclecontractions (Analgesic programmes, forexample), make sure that the patient is ascomfortable as possible.

    T he n um be r o f f ib re s re cruite d in as tim ul at ed m uscle d ep en ds o n t hestimulation energies used. It is thereforeextremely important to use maximumstimulation energies where possible in order

     to recruit the maximum number of fibres. If

     the stimulation energy is too low, too fewfibres wil l be obl iged to work and theimprovement in muscle quality wil l benegligible.

    The more fibres that are recruited, thegreater the improvement that will be seen.For example, if only 10% of the fibres in amuscle are stimulated, only this 10% willimprove. The improvement will obviously bemuch greater if 60%, 70%, or even 80% of

     the fib res are stimulated . It is crucial therefore to work with maximum stimulation

    energy levels, i.e. the maximum levels that a

    pat ient can tolerate. I t takes at least3 sessions to reach this maximum energylevel . The f irst few sessions serve tointroduce progressive increments instimulation energy (and muscle contraction)levels and to help the patient to become used

     to the method.After an initial warm-up period, which shouldproduce very clear muscle twitches, increase

     the stimulatio n ene rgi es gra dually,contraction by contraction, for the durationof the session. Also seek to progressivelyincrease energy levels from session tosession.

    Generally speaking, it is not advisable to tryand reach maximum stimulation levels tooq ui ck ly . The d if ferent l evel s i n eac hstimulation programme are designed to

    reeducate the muscle gradually.W e recom mend you prioritize thestimulation energies at each level to recruitas many fibres as possible before movingon to the next level.

    Ideally, therefore, you should start at level 1,maintain this level for an entire stimulationcycle, and only move up to the next levelwhen you start a new cycle.

    For maintenance purposes, it is a good idea to hold one session per week with theenergy level you used in the previous cycle.

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    5 - Alternation of stimulation/active reeducation sessions

    1 - Practical guidelines for using

    the m system

    Stimulation sessions are mostly used aspart of a reeducation programme.

    If you wish to combine a reeducationsession involving voluntary muscle trainingwith a muscle stimulation session, wegenerally recommend you schedule the

    reeducation session first. This ensures that the patient does not have to work on

     tired muscle fibres.

    Compex’s   m   technology providespractitioners with specific information ondifferent muscles and allows them toadapt each stimulation session to theneeds of their patients.

    The corresponding data is transferredautomatically from the sensor to thestimulator!

    IV m TECHNOLOGY

    To access the m functions, makesure that the stimulation cable fitted with the   m-4   is connected to thestimulator before this is turned on.

    Do not connect the m-4 cable if thestimulator is already on.The   m-4   system may not work properly if restrained or subject topressure in any way.

    The m-4 must be connected to anadhesive electrode at all times during astimulation session.

    m-4 ____________________

    This is a small sensor that l inks thestimulator to the electrodes. It performs akey function in that it measures certainphysiological characteristics of the muscle to be stimulated and transfers this data to

     the stimulator, which, in turn, analyses thedata and adapts its parametersaccordingly. This tai loring of eachprogramme to the changing condition of the muscle clearly enhances both patientcomfort and therapeutic efficacy.

    m-3 ______________________

    Just before beginning a stimulation session, the m-3 analyses the excitability of themuscle to be stimulated. The   m-3determines the chronaxy of the muscle inapproximately 12 seconds and sends thisdata to the stimulator so that it can adapt

     the pulse width (durat ion) ac cordingly.Adapting the pulse width to the chronaxy of

     the muscle to be stimulated allows the

    same muscle response to be achieved withless energy.

    NOTE: The m-3 function is enabled onlywhen a cable fitted with the m-4system is connected to the stimulator.

    As many as 4 different chronaxymeasurements – corresponding to4 different muscle groups – can be takenper session. The number ofmeasurements depends on how manysensors are connected to the stimulator.

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    Each channel that is connected to astandard cable receives the same data asa channel connected to a m-4 cable(see below).

    Before a programme is executed, thesensor scans the muscle briefly. During this time, a horizontal bar will move up anddown the figure on the left of the screen.

    It is essential that the patient remainscompletely still and relaxed while thesemeasurements are being taken. Them-4 system is very sensitive and the

    slightest contraction or movement couldinterfere with its results.

    Note that certain people might feel anunpleasant tingling sensation during the

     test.

    Once the test is complete, a symbol will

    appear on the screen indicating that

     the programme can be started.

    m-1 _____________________m-1   is a work mode in which thepatient triggers an electrically inducedstimulation by voluntarily contracting oneof his muscles. The stimulation contractionis therefore controlled by the patient.

    For a patient to fully benefitfrom the   m-1   training mode, hismuscl es must be well developed.

    Insufficiently developed muscles may, insomecase, prevent the triggering of theelectrically induced contraction.

    Programmes run in m-1 mode offer anumber of distinct benefits:

    • They require the active participation ofpatients and encourage them to becomefully involved in their treatment.

    • They allow patients to control theircontractions, allowing them to feel moreat ease with the system.

    • They optimize performance by combining voluntary and electri cal stimulationexercises, which results in a moreintensive recruitment of muscle fibres.

    • They help to retone the body andfacilitate motor reeducation in patientswith neuromuscular disorders.

    • They integrate the stimulation ofstabilising muscles into a broaderfunctional exercise plan.

    The m-1 mode is only available forcertain programmes.

    Programmes run in m-1 mode arealways preceded by a m-3  test.

    The   m-1   mode is enabled only duringwork sequences (not during warm-up andrelaxation sequences).The first muscle contraction in the work sequence is triggered automatically.This is followed by an active rest phase

    consisting of a series of muscle twitches.Le déclenchement volontaire d’une nouvellecontraction n’est possible qu’après un tempsde repos minimum, qui var ie selon leprogramme. A new contraction can only be

     triggered after a minimum rest time, which varies from programme to programme. Thestimulator emits a signal to notify the patientwhen he can trigger another contraction.

    This signal can take different forms:

    • A series of increasingly fast short beeps:

     voluntary contraction possible.

    • A continuous beep: ideal moment for voluntary contraction.

    • A series of increasingly slow beeps: voluntary contraction stil l possible andwork rate still satisfactory.

    • If no voluntary contractions are detectedwithin a certain time (this varies fromprogramme to programme), the stimulatorwill automatically enter Standby mode.

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    NOTE: The m-4  system needs to record the muscle twitches in the active rest phasein order to offer optimal results.If the twitches are not sufficiently intenseduring this phase, the stimulator will emit aseries of beeps and a sign will appearon the screen.Note that these muscle twitches will onlyoccur if the muscles are sufficiently

    relaxed. Patients should therefore beencouraged to adopt a position in which they will be as relaxed as possible at theend of each contraction phase.

    In contrast to CommonTreatment programmes in which thestimulator adjusts the stimulation energiesduring the rest phase, these energiesoften need to be increased manually whenin m-1 mode.

    m-5 ______________________

    The   m-5   function can be used toconsiderably reduce the number ofunwanted muscular contractions,enhancing both user comfort and treatment efficacy.

    It is available only for the TENS, ModulatedTENS,   Epicondylitis   and   Arthralgiaprogrammes.

    When enabled, the  m-5

      functioncontrols stimulation energies by keeping them at an effective level and reducing thenumber of unwanted contractions.

    It works by performing a series of shortmeasurement tests (lasting 2 to 3seconds) at regular intervals throughout the entire programme.

    A test is automatically launched whenever the stimulation energies are increased.The subject must remain perfectly stillduring the test to ensure optimal results.

    Depending on the results, the stimulatormay automatically reduce the stimulationenergies slightly.

    NOTE: It is important to ensure thatpatients adopt the most comfortableposition possible during stimulation,remain still, and do not contract any of themuscles in the stimulation area.

    m-6_____________________

    The   m-6   function is used inprogrammes which depend on the triggering of vigorous muscle twitches toindicate the optimal stimulation energyrange.

    It is therefore only available in

    programmes that use low stimulationfrequencies (less than 10 Hz).

    When the m-6 function is enabled, thestimulator will check whether you areworking in the optimal energy range. If thelevel is too low, it will prompt you toincrease the level by displaying a series of

    signs on the screen.

    Once the stimulator has detected the idealenergy range, a square bracket will appear to the right of the bar graph corresponding

     to the stimulation channel the  m-4   isconnected to. The figures enclosed by thisbracket indicate the range you must work in in order to achieve optimal results.

    If you set the energy level below this range, the stimulator will prompt you to increaseit by flashing a series of signs on thescreen.

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     V USING THE STIMULATOR

     You are strongly advised tocarefully read the counter-indications andsafety measures described at the

    beginning of this manual (chapter 1“Warnings”) prior to using your stimulator

    1 - DESCRIPTION OF STIMULATOR

    A - On/Off button

    B - i button. This is used to:• Increase stimulation energies in several

    channels simultaneously.• Access the Top 5 menu (showing 5 most

    recently used programs• Access the contraction info menu

    (showing number of contractions and total contraction time).

    • Access parameter info menu forpersonalised programmes.

    • Access electrode placement info (forHyperhidrosis menu only).

    C  - Sockets for 4 stimulation cables

    D -  Stimulation cablesChannel 1 = blue Channel 2 = greenChannel 3 = yellow Channel 4 = red

    E  - Stimulation cables fitted with m-4system

    F -  +/- buttons for 4 stimulation channels

    G -  Rechargeable battery compartment

    H -  Belt clip socket

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    2 - Connections

    A) Connecting the cablesThe stimulator cables plug into the 4

    sockets on the base of the device.All 4 cables can be connected simultaneously.Both the sockets and the cables arecolour-coded to simplify use and facilitateidentification of the different channels:

    blue=channel 1 green = channel 2 yellow = channel 3 red = channel 4

    The kit includes four snap-connectorcables and four 2,1 mm pin-connectorcables.

    NOTE: The pin-connector cables aredesigned for use only with   Denervated,Iontophoresis   and   Hyperhidrosisprogrammes.

    To connect a snap-connector cable to anelectrode, simply insert the snap end of thecable into the electrode eyelet and twist ita quarter turn.

    In addition to these standard cables,Compex 3 comes with 2 special cablesfitted with the m-4 system.These cables can be connected to any of the 4 sockets for the stimulation channels,on the base of the stimulator. Just like thestandard cables, they must also beconnected to 2 electrodes.

    B) Connecting the motorpoint pen

    Never use the motor point pen for anypurposes other than locating the motorpoint of the muscle. Follow the instructionsin this manual. Clean and disinfect the tip of the motor point pen that comes in contactwith the skin before each use.

    Apply a small amount of Compex gel to the

    skin when looking for the motor point toenhance patient comfort.

    All Compex 3 stimulators are supplied witha motor point pen designed to help you tofind the exact location of the motor point of the muscle group(s) you wish to stimulate.Refer to the picture below to see how toconnect the pen.

    Connect the tip of the motor point pen to the positive connector (red). The othersnap connector (black) must be connected to a negative electrode already on themuscle to be stimulated.

    For details on how to use the motor pointpen, refer to the chapter “Specificindications” in the Practical Guide.

    COMPEX 3

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    C) Connecting the charger

    The Compex 3 is a portable musclestimulator powered by a rechargeablebattery unit. To recharge the stimulator,simply connect the charger to the base of the stimulator or the docking stationsupplied with the unit.

    Connect the charger to the mains.

    Remove any stimulation cables connected to the stimulator before recharging it.We strongly recommend you fully charge the battery before using it for the first timeas this will improve its autonomy and lifespan.

    3 - Preliminary settings

     A) Date and time

     Your Compex 3 has an internal clock forrecording the dates and times of differentp ro gr amme a ct iv it ies (see c ha pter"Compex 3 software"). The clock needs tobe set to the current date and time when

     the stimulator is started up for the first time.

    1b: Use the channel 1 +/- button to select the parameter you wish to set: year, month,day, hour, and minutes (in this order).1c: Use the channel 2 +/- button to define

     the value of each parameter.1e : U se the c ha nnel 4 +/- b utto n toconfirm your choice and bring up thelanguage settings screen.

    NOTE: The clock wil l be automaticallyupdated with the date and time of your PCd ur in g co mp ute r sy nch ro nis ationo pera ti ons (see c ha pter " Co mp ex 3

    software").The clock will need to be updated if thebattery is changed.

    fig. 1

    1b 1c 1e

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    B) Language, contrast, volume

    When you start up the stimulator for thefirst time, you wil l need to choose theinterface language you wish to use from theoptions screen. See below for instructionson how to proceed. There are a range ofsettings that you can adjust to suit yourneeds (interface language, display contrast,

    backlighting, volume). To change any of these sett ings, bring up the options screenby holding the On/Off button on the front of

     the stimulator for a few seconds.2b: Use the channel 1 +/- button to choose

     the language you wish to use.2c: Use the channel 2 +/- button to adjust

     the contrast of the screen.2d: Use the channel 3 +/- button to adjust

     the volume.2e: Use the channel 4 +/- button to adjust

     the backlighting.On: Backlighting always onOff: Backlighting always offAuto: Backlighting activated whenever abutton is pressed.

    2a: Use the On/Off button to confirm andsave your choices. The settings will beapplied immediately.

    fig. 2

    4 - Neurostimulation programmes

    The presence of osteosynthesisequipment (metallic equipment in contactwith the bone: pins, screws, plates,prostheses, etc.) is not a counter-indicationfor the use of Compex programmes. Theelectrical current of the Compex isspecially designed to have no harmfuleffect with regard to osteosynthesisequipment.

    To start the stimulator, press the On/Offbutton. To choose a programme, you mustfirst choose a type of treatment and a

    programme category.

    NOTE: There is a table summarizing thedifferent programmes and their functionsat the end of this manual.

    A) Choosing a type of treatment

    Common treatment

    Specific treatment

    Conditioning

    The default type of treatment isCOMMON.

    3a: Press the On/Off button to turn off theunit.3b - 3d: Use the channel 1 and 3 +/-buttons to choose another type of treatment menu (Specific Treatment orConditioning).3e: Press the channel 4 +/- button toconfirm your choice and access theprogramme category selection screen.Press the i button to access the Top 5menu.

    fig. 3

    2a 2b 2c 2d 2e

    3a 3b 3d 3e

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    B) Choosing a programmecategory

    4a: Press the On/Off button to return to the previous screen.4b: Use the channel 1 +/- button tochoose a category.4e: Press the channel 4 +/- button toconfirm your choice and access theprogramme selection screen.

    Press the i button to access the Top 5menu.

    C) Choosing a programme

    NOTE: Consult our Practical Guide for helpin choosing a programme.Once you choose a category, the screenwill display a list of available programmes.

    5a: Press the On/Off button to return to the previous screen.5b: Use the channel 1 +/- button tochoose the programme you want.5e: Press the channel 4 +/- button toconfirm your choice. Certain programmesstart right away while others allow you tospecify additional options.

    TOP 5

    The TOP 5 menu is designed to make yourCompex 3 easier to use and more efficientby providing quick access to the last 5programmes run.

    To access the menu, press the i buttonbefore selecting a programme.The menu can be accessed from the typeof treatment screen (Figure 3), theprogramme category screen (Figure 4), or the programme list screen (Figure 5).

    6a: Press the On/Off button to return to the previous screen.6b: Use the channel 1 +/- button tochoose the programme you want.

    6d: Use the channel 3 +/- button topersonalize the programme.6e: Press the channel 4 +/- button toexecute the programme.

    D) Personalising a programme

    Not all programmes have an optionsscreen.

    m-4 not connected

    In certain programmes, you will need to

    choose the muscle group you want tostimulate when there are no m-4cables connected to the stimulator. The target area is shown in black on the figureabove channel 1.

    7b: Use the channel 1 +/- button tochoose the desired treatment area. Youcan choose from among 7 areas.

    Current international standardsrequire that a warning be given concerning the application of electrodes to the thorax(increased risk of cardiac fibrillation).

    fig. 4

    fig. 6

    fig. 5

    fig. 7

    4a 4b 4e

    6a 6b 6d 6e

    5a 5b 5e

    7a 7b 7c 7d 7e

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    m-4 connected

    The stimulator will automatically select themuscle group to be stimulated when am-4 cable is connected to the unit.

    Reminder: The m-3 function will activate

    automatical ly in programmes thataccommodate this function when at least1 m-4 cable is connected to thestimulator.

    8b: Use the channel 1 +/- button to enable the m-1 function. When the function isenabled, the screen will display the wordON rather than OFF. When in ON mode, itis the patient who triggers the stimulation.Reminder: Not all motor nerve stimulationprogrammes use the m-1 function. If the m-1 function is not available, therewill be no symbol above channel 1.7- 8c: Press the channel 2 +/- button toenable the   TENS   function. When enabled,channels 1 and 2 are used for theprogramme chosen, and channels 3 and 4for the TENS treatment.

    NOTE: When the  TENS   function is enabled, the m-1 cannot be activated and thecorresponding symbol will disappearautomatically from the screen.

    Use the channel 2 - button to delete thedefault warm-up period.

    7 - 8d: Use the channel 3 +/- button tochoose the programme difficulty level.7 - 8a: Press the On/Off button to return to the previous screen.7 - 8e: Use the channel 4 +/- button toconfirm your choices and launch theprogramme.

    E) During the stimulation session

    Preliminary m-3  test

    This test is launched only if a cable fittedwith the   m-4   system is alreadyconnected to the stimulator when this is turned on!

    It is essential that the patientremains completely still and relaxed during the entire test.

    If the m-4 cable is connected, the testwill begin as soon as you choose andpersonalise your programme.

    NOTE: The test is not launched if youchoose a programme that does not

    require the preselection of a muscle group.

    9e: The m logo above channel 4 indicates that the m-4 cable is connected to thestimulator. The figures in channel 4 willautomatically change during the test as the sensor records differentmeasurements.

    NOTE: When several sensors areconnected simultaneously, the m-3  testis performed progressively, one m-4connected channel after the other. Thechannel being scanned is easily identifiedby its changing numbers and the mi logo

    above the channel.The 4 +/- buttons will be disabled for theduration of the test.

    9a: Press the On/Off button to interrupt the test at any moment. To relaunch the test from the start, press any of the 4 +/-buttons.Press the On/Off button a second time toreturn to the list of programmes.

    Once the test is complete, you wil lautomatically be taken to the default

    programme start screen and prompted toincrease the stimulation energies.

    Session duration

    (in min.)

    TENS programme enabled Combination without TENS programme

    fig. 8

    fig. 9

    no warm-up sequence   warm-up sequence

    8a 8b 8c 8d 8e

    9a 9e

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    Adjusting stimulation energies

    When you start a programme, you will beprompted to increase the stimulationenergies. This is key to the success of any treatment.

    10a: Press the On/Off button to return to the previous screen.10 b c d e: The unit will beep and thesymbols for the 4 channels will alternatebetween + and 000.The energy level for the 4 channels is at 0.To start the programme, you will need toincrease the energy levels in the channels you are going to use.To do this, use the corresponding +buttons.

    NOTE: If you want to increase the energylevels in all 4 channels simultaneously,press the i button. Press it twice toincrease the levels in the first 3 channels,and 3 times to increase the levels in thefirst 2 channels.

    Interdependent channels will be highlightedin white against a black background.

    Programme progression

    11 b c d e: The different energies reachedduring the contraction phase are shown by aseries of black bar graphs. Active rest phaseenergies are shown by hatched bar graphs.

    NOTE: Active rest phase stimulationenergies are automatically set at 50% ofcontraction intensities but can be modifiedduring the rest phase. Once modified, theywi ll be total ly independent of thecontraction intensities.

    11a: Press the On/Off button to interrupt the programme momentarily To restart it,

    simply press the channel 4 +/– button(11e). The session will resume at 80% of the energy levels that were being usedprior to the interruption.

    NOTE: If your Compex 3 emits a beepingsound and the + symbols under the activechannels begin to flash, the stimulator issuggesting you increase the level of thestimulation energies. If you are working at the patient’s maximum tolerance level,simply ignore this message.

    Contraction information

    When working with a muscle contractionprogramme, you can access thecontraction info screen at any time toconsult the number of contractions and total contraction time.

    To access the screen, simply hold down the i button.

    SKIP function

    In certain programmes, the SKIP functionallows you to end the current programmephase and move on to the next one. ForSKIP function to work, the unit must be inPause mode.

    Session duration

    (in min.)

    Heat waves depicting

    the warm-up sequencefig. 10

    Session sequences

    Warm-up Work period Relaxation

     Time bar showingcontraction

    time and active rest time.

    Shown only during work sequence.

    fig. 11

    Contraction time

    Number of contractions

    fig. 12

    10a 10b 10c 10d 10e

    11a 11b 11c 11d 11e

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    13a: Press the On/Off button to return to the list of programmes in the category youare working with.13d: Use the channel 3 +/- button to skipa particular sequence of a programme.When you do this, the unit will beep and thecursor under the progress bar will move to the beginning of the next sequence.13e: Use the channel 4 +/- button toresume the programme at the chosensequence.

    NOTE: The SKIP function is not available forall programmes. It should also be noted that this function can reduce theeffectiveness of a programme if used toshorten the work sequence excessively.

    Statistics

    The Compex 3 stimulator includes astatistics menu containing importantprogramme information that can beconsulted in real time. To access thestatistics screen, you must place thestimulator in pause mode or wait for theprogramme to end.

    Fig. 15: Neuromuscular electrostimulationprogrammesMAX indicates the maximum stimulationenergy level reached per channel during the contraction phase. AVG indicates theaverage stimulation energy level used by the different channels during thecontraction phase.

    Fig. 16:  In low frequency programmes, them-6   function figure enclosed by asingle square bracket shows whatpercentage of stimulation time was spentin the optimal energy range.15-16e: Press the channel 4 +/- button toresume the programme at the point whereit was interrupted.

    NOTE: The i button allows you to consultsettings for personalised programmeswhen the unit is in pause mode. Example:

    Duration of programme

    Contractionfrequency

    and rest frequency

    Duration of contraction Duration of rest

    Number of loops

    fig. 15

    fig. 16

    fig. 17

    fig. 13

    End of programme

    Different statistics are displayed dependingon the programmes and options used (seeFigures 15 and 16). It should be noted,

    however, that statistics are not available forall programmes.

    fig. 18

    13a 13d 13e

    15e

    16e

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    F) Using the Intelligent TENSfunction

    When you choose a   TENS   programmefrom the  Analgesic   programme category, you will automatically be shown an optionsscreen where you can specify yourpatient’s sensitivity level.

    There are 3 sensitivity levels. To tailor thelevel to your patient, choose one of theselevels manually or activate the  IntelligentTENS function. This measures the patient’ssensitivity threshold automatically andensures that each programme is perfectlyadapted to the patient’s needs.

    19a: Press the On/Off button to return to the previous screen.19b: Press the channel 1 +/- button toenable the   Intelligent TENS   function.When enabled, the term ON will replaceOFF above channel 1.19d: Use the channel 3 +/- button tochoose the Tens sensitivity level manually.1 =  TENS  for patients with a low sensitivity

     threshold.2 =   TENS   for patients with a normalsensitivity threshold3 = TENS for patients with a high sensitivity

     threshold.19e: Press the channel 4 +/- button toconfirm your choice:• The   TENS   Analgesic programme will be

    launched.• If you have chosen the sensitivity level

    manually, and the sensitivity threshold test if you have chosen the  IntelligentTENS function.

    Using the Intelligent TENS  function

    Once you have enabled the   IntelligentTENS function in the corresponding optionsscreen and confirmed your choice, thesensitivity test will start automatically. TheMEMO symbol wi ll appear over anychannels that are connected.

    NOTE: If no channels are connected, theelectrode error symbol will be displayed on the screen.

    When your patient feels the first signs of tingling, press any MEMO button. Theprogramme will start automatically.

    20a: Press the On/Off button to stop theprogramme.20 b d e: Press any of the active channel+/- buttons (any but number 2 in theexample above) to register your patient’ssensitivity threshold.

    The programme will begin automatically.

     You can use any of the active +/- buttons to adjust the stimulation energies in thedifferent channels during a   TENS treatment session.

    fig. 19

    fig. 20

    At the end of each session, a small flag willbe displayed on the screen and a shortmelody will be played.

    NOTE: Press the i button to access thecontraction info screen.

    To turn off the stimulator, press theON/OFF button.

    19a 19b 19d 19e

    20a 20b 20d 20e

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    5 - Direct currents

    Never use direct currents on

    patients with osteosynthesis devices orother metal implants.

    Direct currents are used by theIontophoresis,  Hyperdrosis and  Oedemaprogrammes.Although these currents are not used for therapeutic purposes in the chest region,international standards require theinclusion of a warning against attachingelectrodes to this region (increased risk of

    cardiac fibrillation).

    A) Iontophoresis

    Read the chapter “Iontophoresis”in the practical guide to become fullyfamiliar with this programme before usingit.

    NOTE: Use the coloured electrodes (red,

    green, yellow) supplied with the stimulatorwhenever you use an   Iontophoresisprogramme. Use the 2.1 mm pin-connector cables (grey) to connect theelectrodes.

    The  Iontophoresis   programme is in thedirect current category in the specific typeof treatment.

    21a: Press the On/Off button to return to the previous screen.21b: Use the channel 1 +/- button tochoose the category you want.21e: Press the channel 4 +/- button toconfirm your choice and access theprogramme selection screen.

    22a: Press the On/Off button to return to the previous screen.22b: Use the channel 1 +/- button tochoose a programme.22e: Press the channel 4 +/- button to

    confirm your choice.

    When working with an   Iontophoresisprogramme, you can choose the numberof channels and size of electrodes youwant to use. There are 3 electrode sizes(red, green, and yellow).

     You can also edit the default parameters –Duration, Electrical density – recommendedby Compex.

    23a: Press the On/Off button to return to the previous screen.23b: Use the channel 1 +/- button toselect the parameters you wish to edit:channel to use, density, and duration ofsession. In the above example, only channel1 (red electrodes) is active. The electricaldensity is 0.05 mA and the sessionduration is 6 minutes.23c: Use the channel 2 +/- button tochoose the electrode size (colour) you wish to use for each channel and/or to modify the default values (density, duration).23e: Press the channel 4 +/- button toconfirm your choices and access aconfirmation screen.

    fig. 21

    fig. 22

    fig. 23

    21a 21b 21e

    23a 23b 23c 23e

    22a 22b 22e

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    24a: Press the On/Off button to return to the previous screen24e: Use the channel 4 +/- button to confirm your choices and launch theprogramme.

    NOTE: Current intensity is automaticallycalculated in line with the size of electrodeused. Electrode size is determined bycolour. Make sure you choose the correctcolour before running the programme.

    Press the i button from the stimulationscreen or the end of programme screen toaccess the programme parameters.

    B) Hyperhidrosis

    Read the chapter “Hyperhidrosis”in the Practical Guide to become fullyfamiliar with this programme before usingit.

    NOTE: The   Hyperhidrosis   programmeshould always be run in channel 1 with thelarge (red) iontophoresis electrodessupplied with the stimulator.Use the 2.1 mm pin-connector cables(grey) to connect the electrodes

    The   Hyperhidrosis   programme is in theDirect Current category of the SpecificTreatment type.

    25a: Press the On/Off button to return to the previous screen.25b: Use the channel 1 +/- button tochoose a programme.25e: Press the channel 4 +/- button toconfirm your choice and execute theprogramme.

    26a: Press the On/Off button to return to the previous screen.26c: Use the channel 2 +/- button tochange the default electrical density value.26e: Press the channel 4 +/- button toconfirm your choices and access aconfirmation screen.

    Use the i button to access the electrodeplacement pictogram.

    The   Hyperhidrosis   programme lasts for12 minutes and can only be run on channel1. Only use the red electrodes with thisprogramme. Other electrodes will causecurrent intensity calculation errors.

    27a: Press the On/Off button to return to the previous screen.27e: Press the channel 4 +/- button toconfirm your choices and launch theprogramme.Use the i button to access the electrodeplacement pictogram.

    NOTE: Press the i button from thesti mulation screen or the end ofprogramme screen to access theprogramme parameters.

    C) Oedema

    Read the chapter “Oedema” in the Practical Guide to become fully familiarwith this programme before using it.

    The  Oedema  programme is in the Direct

    Current category of the SpecificTreatment type.

    fig. 24

    fig. 25

    fig. 26

    fig. 27

    24a 24e

    25a 25b 25e

    26a 26c 26e

    27a 27e

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    28a: Press the On/Off button to return to the previous screen.28b: Use the channel 1 +/- button tochoose a programme.28e: Press the channel 4 +/- button toconfirm your choice and execute theprogramme.

    The Oedema programme begins by lookingfor the motor evoked potential (MEP)

     threshold in order to calculate the currentintensity that will offer optimal therapeuticefficacy. While this is happening, theMEMO symbol will be displayed over anychannels that are connected. To confirm the MEP threshold, press any of the active+/- buttons as soon as you see or feel amotor response.

    29a: Press the On/Off button to stop theprogramme or return to the previousscreen.29 b c d e: Press any of the active +/-buttons to confirm the MEP threshold.Once confirmed, the programme will startautomatically with the optimal stimulationenergy.

    NOTE: If no channels are connected, the

    electrode error symbol will be displayed.

    fig. 28   fig. 29

    6 - Denervated programmes

    The   Denervated   programmesare of the Specific Treatment type.Although these currents are not used for therapeutic purposes in the chest region,international standards require theinclusion of a warning against attachingelectrodes to this region (increased risk ofcardiac fibrillation).

    Compex 3   Denervated  programmesare not contraindicated in patients withosteosynthesis devices or other metalimplants

    Denervated programmes shouldonly be run with 2.1 mm pin-connector

    cables (grey cables supplied withstimulator) and carbon electrodes (black electrodes supplied with stimulator). Foroptimal results, apply conductor gel to theelectrodes before use.

    Do not use snap-connector cables or self-adhesive electrodes for   Denervatedprogrammes.

    There are 4 types of   Denervated treatments.

    30a: Press the On/Off button to return to the previous screen.30b: Use the channel 1 +/- button tochoose a programme.30e: Press the channel 4 +/- button toconfirm your choice.

    fig. 30

    28a 28b 28e  29a 29b 29c 29d 29e

    30a 30b 30e

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    A) Automatic mode

    he stimulator will automatically detectwhich channels are connected when inautomatic mode.

    Total automatic

    Full denervation with fixed parameters:

    Pulse width: 100 msPeriod: 2000 msProgramme duration: 8 min

    NOTE: These are the default valuesrecommended in the Total manual  mode.

    Partial automatic

    Partial denervation, with automaticcalculation of initial current ramp. Thewidth of the pulse before validation of theramp is 100 ms.

    How it works

    When you start the programme,stimulation will automatically begin through the first channel you are using. As soon as you perceive a muscle response, confirm the ramp by pressing the corresponding+/- button (under the MEMO symbol).The stimulator will display the value for thischannel (see Figure 31 below) andautomatically begin the search for the nextchannel.

    The Compex 3 can calculate and manage4 different initial current ramps.

    displayed above channel where

    ramp search is being performed

    displayed above inactive channels

    (channels that are not connected).

    displayed once intensity value for

    corresponding channel has been validated.

    31a: Press the On/Off button to stop theprogramme and return to the previous

    screen.31b: Press the +/- button under theMEMO symbol to confirm the currentintensity calculated during the rampsearch process. The width of the current(pulse length) does not change during this

    search. In the above example, the search isbeing performed in channel 1. Once theramp is validated, the  √  symbol will replace the MEMO symbol and, where applicable, the search will begin in the other channels.31 c d e: the +/- buttons for the otherchannels remain inactive while a search isbeing performed.

    When all the ramps for the active channelshave been calculated, the programme willstart automatically.

    When you increase the stimulationintensity, the pulse width will automaticallybe modified to maintain the appropriateinitial ramp.

    B) Manual mode

    Total manual

    Ful l denervation programme. Thisprogramme works with rectangular pulsesand allows the following parameters to bemodified:

    • Pulse width• Period• Programme duration

    32a: Press the On/Off button to return to the previous screen.32b: Use the channel 1 +/- button toselect the parameter you wish to edit:pulse width for each channel, period, orprogramme duration.

    32c: Use the channel 2 +/- button to edit the value of the parameter you haveselected.32e: Press the channel 4 +/- button toconfirm you wish to exit the programme.

    NOTE: The default values of the   Totalmanual  programme are the same as thedefault values of the   Total automaticprogramme.

    Partial manual

    Partial denervation with choice ofstimulation parameters to define thedesired ramp.

    fig. 31

    fig. 32

    31a 31b 31c 31d 31e

    32a 32b 32c 31e

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    How it works

    To use a ramp of your choice, first select the pulse width option in the correspondingchannel. Confirm your choice and increase the stimulation intensity to the desiredlevel.

    33a: Press the On/Off button to return to the previous screen.33b: Use the channel 1 +/- button to

    select the parameter you wish to edit:pulse width for each channel, period, orprogramme duration.

    33c: Use the channel 2 +/- button to edit the value of parameter you have selected.33e: Press the channel 4 +/- button toconfirm your choice.

    NOTE: Hold down the i button when in thestimulation or end of programme screen to access the parameters for theprogramme you are using.

    fig. 33

    33a 33b 33c 33e

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    7 - Electricity consumptionand recharging

    Never recharge the stimulator withoutfirst disconnecting the stimulation cables.Never recharge the battery with a charger

    other than that supplied by Compex.

    The Compex 3 is powered by arechargeable battery unit. The battery’s life varies according to the programmes andstimulation energies used.We strongly recommend you fully charge the battery before using it for the first timeas this will extend its battery life and lifespan. If you do not use your stimulator forlong periods of t ime, remember torecharge the battery regularly.

    A) Electricity consumption

    The charge state of the battery is indicatedby a small battery icon on the screen.If the battery icon contains just two lines, this means that power is running low. Stop the session and recharge the unit.

    If the START symbol normally displayedabove the channel 4 +/– button is not visible and the battery icon is flashing, thismeans that the battery is completely

    discharged. The stimulator can no longerbe used. Recharge immediately.

    B) Recharging

    Remove all stimulation cables from the

    stimulator before recharging it. Connect the charger to the mains and thenconnect the stimulator to the charger. Thecharge menu shown below willautomatically appear on the screen.

    The duration of the recharging operationis displayed on the screen. The quick charger supplied with the stimulator fullyrecharges the stimulator within 60 to 90minutes;

    The battery icon is animated while thebattery is recharging. When fully charged, the icon will be full and the total time taken

     to recharge the battery will flash on thescreen. Simply disconnect the charger and the Compex 3 will turn off automatically.

    NOTE: You can also use the dockingstation supplied with the Compex 3 torecharge your stimulator. (See chapter"Compex 3 Software").

    Battery charge state icon

    fig. 34

    fig. 35

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    8 - Troubleshooting

    A) Electrode error

    The Compex 3 will beep and alternatelydisplay a pair of electrodes and an arrow

    pointing to the channel where the problemwas detected. In the example above, thestimulator has detected an error inchannel 1.

    The electrode error message can mean that:

    - there are no electrodes connected to thischannell,

    - the electrodes are old, worn, and/or thecontact is poor: try using new electrodes,

    - the el ectrode cabl e is faulty: tryconnecting it to another channel. If theproblem persists, replace the cable.

    If this message appears, disconnect thecharger. The unit will automatically turn off.Contact your customer support serviceand quote the corresponding error code.If you experience any other problems with your unit, contact your nearest authorizedcustomer service support service.

    B) Memory full

    Programme statistics are stored in the

    Compex 3’s memory as compiled. When this memory is full, the following screen willappear.

    38a: Press the On/Off button to turn off the unit.38b: Press the channel 1 +/- button to

    access the screen shown in Figure 39 andempty the memory without saving thedata.38e: Press the channel 4 +/- button tocontinue using the stimulator withoutemptying the memory. If you choose thisoption, no further programme data will bestored.

    NOTE: If you are using Compex 3software, you can store all the data from your stimulator in your PC. (See"Sinchronizing" in the "Compex 3 Software"

    chapter.

    39a: Press the On/Off button to turn off the unit.39b: Press the channel 1 +/- button toreturn to the previous screen.39e: Press the channel 2 +/- button toconfirm your choice. This will erase all thedata stored in the Compex 3 withoutstoring it in your computer.

    fig. 36

    fig. 38

    fig. 39

    38a 38b 38e

    39a 39b 39e

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     VI LIST OF PROGRAMMES

    Categories Programmes   m-3 m-5 m-1 m-6  Channel

    TENS

    COMMON TREATMENT

    Rehabilitation   Disuse atrophy     2

    Prev of disuse atrophy     2

    Reinforcement     2

    Hip prosthesis     2

    Patellar syndrome     1

    Rotator cuff     2

    ACL  

    Muscle lesion     2

    Motor Point

    Analgesic   TENS  

    Modulated TENS  

    Endorphinic     2

    Decontracture     2

    Cervical pain     2

    Thoracic back pain     2

    Low back pain     2

    Lumbosciatica     2

    Lumbago     2

    Epicondylitis  

    Torticolis     2

    Arthralgia  

     Vascular   Heavy legs  

    Venous insufficiency 1  

    Venous insufficiency 2  

    Arterial insufficiency 1  

    Arterial insufficiency 2  

    Cramp Prevention  

    Capillarization  

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    Categories Programmes   m-3 m-5 m-1 m-6  Channel

    TENS

    SPECIFIC TREATMENT

    Direct current   Iontophoresis

    Hyperhidrosis

    Oedema

    Denervated   Total automatic

    Partial automatic

    Total manual

    Partial manual

    Reinforcement 1/1  

    Ago/Antago   Atrophy 1/1  

    Atrophy 2/1  

    Reinforcement 2/1  

    Incontinence   Stress incontinence

    Urge incontinence

    Mixed incontinence

    Post partum prev.

    Spasticity   Hemiplegic foot  

    Spasticity  

    Shoulder subluxation     2

    Haemophilia   H Disuse atrophy     2

    H Reinforcement     2

    Aesthetic   Toning  

    Firming  

    Shaping  

    Refinement  

    Abs  

    Buttocks  

    Elasticity  

    Calorilysis  

    Adipostress

    Personalized

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    Categories Programmes   m-3 m-5 m-1 m-6  Channell

    TENS

    CONDITIONING

    Sport   Potentiation  

    Endurance  

    Resistance  

    Strength  

    Explosive strength  

    Plyometry  

    Hypertrophy  

    Regeneration  

    Stretching  

    Core stabilization  

    Low back reinforcement  

    Active recovery  

    Recovery plus  

    Fitness   Muscle building  

    Body building  

    Muscle definition  

    Aerobic  

    Anaerobic  

    Power  

    Step  

    Cross-endurance  

    Cross-training   Fartlek  

    Cross-resistance  

    Cross-explosivity  

    Massage   Toning massage  

    Relaxing massage  

    Reviving massage  

    Anti-stress massage  

    Undulated massage 1  

    Undulated massage 2  

    Test   Demo  

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     VII COMPEX 3 SOFTWARE

    1 - Scope

     Your Compex 3 stimulator comes with aCompex 3 software programme that willhelp you to manage your patients.

    The programme offers 3 main features that will allow you to:• Create a list of patients under treatment• Create a patient history• Create personalised programmes

    A) Creating a patient listCompex 3 software allows you to create alist of patients on your computer andassign each patient a list of treatments tobe performed. You can then transfer thisinformation to the Compex 3 stimulator,where you will have direct access topriority treatments and be able to ensure that the treatments performed, by you or acolleague, are consistent with your therapeutic choices.The option also allows you to initiate an

    electrotherapy session without having tofirst consult the patient’s file on yourcomputer.

    B) Creating a patient history

    Any treatments performed on a patientare recorded by the stimulator and can then be transferred to the patient’s historyfile stored on the computer.In addition to creating a patient history, youcan also consult statistics on stimulatoruse and check which treatments havebeen used most.

    C) Creating a personalisedprogramme

    The software also allows you to design yourown treatment programmes, which can then be transferred to the stimulator andused like any other programmes.

    NOTE: Compex 3 software is optional. It isnot a requirement for using the Compex 3stimulator.

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    2 - Mode of operation

    Once the software is installed on yourcomputer, you will see the following task bar on your screen.

    This bar allows you to access the differentfeatures of the programme.

    A) Creating a patient file

    Click on the PATIENTS button to bring up the following screen:

     A) B) C) D)

    12

    3  4

    5

    67

    This screen allows you add, edit, ordelete a patient’s file or consult his history.

     Add : Use this to create a new patient file.1

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    Two of the fields in the patient file areobligatory:- the patient’s surname- l the user name that you wish to use in thestimulator. The programme willautomatically propose a user nameconsisting of the patient’s surname and the first letter of his first name. If the namealready exists, you will be asked to changeit. You can assign any user name you wish

    as long as it does not exceed 20characters (including spaces).All of the other fields are optional.

    OK : Click this to create a new patient.

    Cancel : Click this to cancel the creation ofa new patient.

    Edit : Click this to modify a new patient file.

    Delete : Click this to permanently removea patient file from the computer’s memory.

    History : Click this to consult a patient’shistory.

    These files are stored in your computerand can be used to define theelectrotherapy treatments (type of treatment and number of sessions) youwish to assign to each patient.

    To select a patient, click and choose thename you want from the drop-down list.

    NOTE: To make it easier to find a particularpatient, key in the first letter of his name orright click to search by surname, first name,or user name.

    Use this box to enter details of thepatient’s pathology.

    Use this box to enter any additionalcomments.

    Use these options to add, edit, or delete a treatment from the patient’s protocol (if youadd a treatment, it will be added to area no. 6).

     Add : Click this to add a new treatment.

    Select all : Click this to assign all the

    checked treatments to your patient. You can also assign treatments manuallyby double clicking on the correspondingline.

    Delete : Click this to delete checked treatments.

    View : Click this to view details of checked treatments:• normal mode shows the patient’s

    personal details, treatments received,and any comments added by the therapist.

    • detailed mode shows the sameinformation as above in addition todetails of maximum and average energylevels and programme parameters.

    NOTE: You can print or save any of the files you view.

    Close : Click this to close the window.

    NOTE: Click the heading of thecorresponding column to sort the entriesby date or treatment.

    Use option 2 to select a patient.The patient list contains a list of all thepatients for whom you have created a fileusing the Compex 3 software programme.

    2

    3

    4

    5

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    a

    b

    c

    d

    e

    f

    The window on the left of this screencontains a list of standard programmesa nd their respective categories.Personalised programmes are at the endof the list.Click on any of the plus signs to view a listof options within the corresponding

    category.Once you have selected a programme (byclicking on its name), you will be able todefine different usage parameters by using

     the arrows (For meaning of symbols, refer to chapter "Neurosimulation programmes,Personalising a programme" in page 23.

    a) choose muscle groupb) choose warm-upc) choose level of work d) choose TENS optione)   choose m-1 or Personalised   TENS

    optionf)  choose number of times you wish each

     treatment to be performed

    OK : Click this to create a new treatment.

    Cancel : Click this to exit without saving your changes.

    Edit : Click this to edit the parameters for the treatment that is highlighted in theprotocol.

    Delete : Click this to remove the treatment that is highlighted in the protocol.

    This window allows you to view thecontents of a patient’s protocol.

    To change the order of treatments, use theprogramme’s drag and drop option. Inother words, left click on the treatment youwish to move, drag it to its new position,and release the mouse button.

    NOTE: maximum of 50 treatments can be

    added to any protocol.

    Option 7 allows you to personalise apatient’s entire protocol.

    Option menu access : This option, whichis enabled by default, allows the user toaccess the stimulator’s treatment optionsscreen and edit the corresponding options(muscle group, warm-up, level of work, etc.).If you wish to prevent access to this menu,uncheck the corresponding box.

    Fixed execution order : This option,which is unchecked by default, can be used

     to execute treatments in the order youwant. By checking this box, you will ensure

     that the treatments in the list are executedin the order shown (starting from the top).

    100% treatment execution  compulsory :   T his opt ion, w hich isunchecked by default, can be used to add

     treatments that have only been 100%completed to the patient’s history. If leftunchecked, any treatment that has been

    10% completed will be added. This option isparticularly useful when the stimulator isgiven to a patient to use at home.

    6

    7

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    B) Preparing data to transferto Compex 3

    Once you have created a patient list usingCompex 3 software, it is a good idea to

     transfer a list of patients that are currentlyb ei ng tr ea te d, t oge the r w it h t heir

     treatm ent protocol , to the Comp ex 3

    stimulator. It does not make much sense to transfer all the patients in the computer’sdatabase to the stimulator.Click on the COMPEX 3 button to bring up

     the following screen.

    21

    3

    This screen allows you to view thepatients that will be transferred to the stim-ulator during the next synchronisationprocess. The user names in this list willappear on the stimulator’s screen followingsynchronisation.

    NOTE: A maximum of 50 patients can be transferred to the stimulator.

    Edit : Click this to edit the list, i.e. add orremove patients.

    1

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    Double click on the lines containing thepatients you wish to transfer to yourstimulator. Their names will appear in area1. To remove a patient from the list simplyuncheck the corresponding box.

    OK : Click this to confirm your choices.

    Cancel : Click this to exit without saving your changes.

    This window shows the list ofpersonalised programmes that will be transferred to the stimulator during thenext synchronisation process. The namesof these programmes will appear on thestimulator’s screen followingsynchronisation.

    NOTE: A maximum of 100 personalisedprogrammes can be added to thestimulator.

    Edit : Click this to edit the list, i.e. add orremove personalised programmes.

    Double click on the lines corresponding to

     the programmes you wish to transfer to your stimulator and view theircorrespondi ng parameters. Theprogrammes will be stored in thePersonalised programmes category of theSpecific Treatment type of the Compex 3stimulator.To remove a programme from the listsimply uncheck the corresponding box.

    OK : Click this to confirm your choices.

    Cancel : Click this to exit without saving

     your changes.

    This section of the screen contains aseries of advanced options than can beused to define your plans. A plan contains the different data that you wish to transfer to the stimulator. The