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LATAM Distributor Meeting

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Objectives• Basics of Electromagnetic Fields.

• How Electromagnetic waves interact with Human Tissues.

• Indications & Contraindications.

• Features & Benefits of the Chattanooga Intelect 100 SWD.

•Target Audiences.

•Questions.

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There are two kinds of waves

Mechanical wavesElectromagnetic waves

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Mechanical WavesSound is a mechanical wave ( air compression and refraction). Therapeutic Ultrasound is a mechanical wave.

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Electromagnetic Waves

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The electromagnetic wave can be described as a combination of an electric field and a magnetic field.. The electric field is produced by stationary charges, and the magnetic field by moving charges (currents.)

The electromagnetic wave is then accelerated becoming what we define as Short waves.

What is an electromagnetic wave ?

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Thermal Application:

Normally applied at levels to produce detectable heating.

Provides “deep heat” within the tissue whereas typical thermal treatments apply external heat.

Short Waves

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Short WavesNon Thermal Physiological Effects The mechanism of response to Electromagnetic energy is

thought to occur at several sites within the cell.

SWT was found to be effective in speeding the recovery of soft tissue injuries by increasing the activity of fibroblasts and the stimulation of ATP and protein synthesis (Cameron et al 1999)(Basal et al 1990) have shown CSWT to be effective by histochemical and histoenzimic findings and then time to reach complete wound healing.

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Tissues contain large numbers of ions, which are charge carriers

At 27.12MHz the movement is more than an oscillation but a collision result, leading to significant heating.

Thermal effects: A relatively high pulse power of 180 W and average power of about 50 W produces a mean temperature change in the tissue (3cm depth) of +3.7 C

-Garret 2000

Short Waves

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Short Waves and their clinical usagesThermal effect on body tissues Therapeutic effect

• Pain relief. • Reduction of muscle spasm. • Sedative effect on agitated conditions.• Increase in range of motion. • Infection (wound healing)• Contractures• As a precursor of other

treatments.

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Clinical Effects

InflammationAssists in removal of cellular debris and toxinsNon-thermal:

– Alters diffusion rate across the cell membraneThermal

– Increases intramuscular metabolism

Not to be used for acute injuries! Markets

• Sports / Pain ManagementClinics & Hospitals

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Clinical Effects

Tissue ElasticitySWD can vigorously heat deep tissues Alters collagen properties, allowing it to elongateRequires stretching during and/or immediately following the

treatmentMultiple treatments are required for best outcomes.

Markets• Neuro / Long Term Care Facilities

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Clinical Effects

Blood and Fluid DynamicsVasodilation increases:

– Blood flow– Capillary filtration– Capillary pressure– Oxygen perfusion

• Increased fibroblastic activity and capillary growth• Effects occur deeper than other forms of heat.

Markets• Hospitals / Clinics

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Clinical Effects

Wound HealingThermal SWD increases rate of phagocytosisNumber of mature collage bundles increaseATP activity increases (assisting wound regeneration)Necrosed muscle fibers decrease

Markets• Nursing Homes• Hospitals

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Electromagnetic Energy

Electromagnetic Energy absorption

Increase molecular KE Cell ion-binding properties, protein synthesis, ATP production

Thermal Effect Athermal Effect

Increased cell metabolism and function

Enhanced soft-tissue healing

CSWD (Continuous) PSWD ( Pulsed)

Effects Summary

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Pain/ Inflammation Neuralgia/Neuritis Myalgia Ischialgia Distortions, Dislocations, and

Contusions

Fracture Stimulate fracture repair

Rheumatology Osteoarthritis Chronic Polyarthritis of the Hip and

Shoulder Joints Spondylosis / Osteochondrosis

Musculoskeletal Tendinosis Carpal Tunnel Syndrome Torticollis Frozen Shoulder Rotator Cuff Tear/Repair Contracture

Wound healing Skin ulcers Pressure sores

Key Indications

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Special conditions Hemorrhages or risk of hemorrhage Septic conditions Malignant tumors Acute inflammations Vein and Arterial disease

At a certain time Pregnancy During the menstrual cycle. The epiphysis of growing bones in

children

Over certain areas Pregnant or potentially pregnant uterus Reproductive organs Eyes The carotid sinuses

Presence of metal Implanted electronic device such as a

cardiac pacemaker Implanted metallic leads Metal in the close environment (Jewelry,

body piercing earrings, watches… treatment tables, standard chairs,

wheelchairs

Key Contraindications

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OverviewColor touch screen interface

360 swivel interface for convenient viewing

Grab bar for ease of movement around the facility

Fully adjustable electrode arms

Pull out storage bin

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#1 Capacitive (Dielectric) Field Method:• Body part is within the electric field between two

electrodes forming a “capacitor”

• The “radiation” produces a warming of the body part located within the fieldSuperficial and high density

tissues are warmed more effectively: skin, tendon, ligament, joint capsule & bone

• Electrodes:Capacitive platesFlexible rubber electrodes

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#2 Induction Field Method:• Body area is within a magnetic field produced from a

coil in a drum

• Produces high frequency currents within the tissueEffectively heats tissue with

low impedance, such as muscles

• Electrodes:Monode “drum”Diplode

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Continuous Mode - CSWD: Thermal or soft tissue efffect) Delivers continuous shortwave energy up to 100W

Pulsed Mode - PSWD: (Mechanical effect on joints) Delivers shortwave energy in short pulses or bursts

• Typical pulse width (duration) range: 20 – 400 µsec• Typical pulse frequency (repetition): 50 – 800 Hz

• Pulsed output allows mean power to be very low and still provide effective treatment

Max peak power: 200WAverage (mean) power: 64W

Modes of Operation

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Features & Benefits-

Fully adjustable electrode arms Allow secure and precise electrode positioning for any anatomical area.

Multi-jointed and pivoting arms.

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Capacitive Plates: 120mm and 165mm

Flexible rubber with pad & cover: 180x120mm, 250x145mm

Features & Benefits

Full ranges of electrode applicators:

DiplodeMonode

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Treatment & Set up Tips: Electrode Positioning:

• Position the required electrodes on the part of the body to be treated according to the medical indication.

• Electrode Skin Distance (ESD) varies from 1 cm – 3 cm for capacitive electrodes depending on anatomical girth.

• Inductive electrodes are generally placed in contact with the body.

• Electrode surfaces must be nearly parallel to the area being treated.

• Correct positioning of the electrodes allows for equal distribution and concentrated heating effect.

Correct

Incorrect

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How this modality still benefits the Clinician.

One of the few unattended modalities around. It remains a benign safe treatment for the aging

population. It has multiple applications for other then

musculoskeletal disorders. It has a quick set up and is easy to apply.

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Standard Package: Intelect Shortwave 100

120mm capacitive plate electrodes (2x)

Electrode connection cables (2x)

Electrode arms (2x)

Indicator discharge tube

User manual on CD

Quick start guide

Optional:

Monode

Diplode

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Additional Features Multilingual software

English

German

Spanish

French

Turkish

Portuguese

Italian

Dutch

Danish

Swedish

Norwegian

Finish

Greek

Czech

Polish

Russian

Korean

Japanese

Chinese

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Target Customers

Physiotherapy clinics, Hospitals, and any extended care facility for elderly.

SWT provide efficient treatment for most benign indications.

Safe No disturbance. Unattended! Easy to use Affordable

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Constantly trying to improve .

Recent Voice of Customer suggests overall extreme satisfaction with current product.

However, we are investigating the potential of making subtle improvements to ensure continued satisfaction.

No projected date as yet.

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Please address questions to :

Farley Brown PM760-734-3508

Farley.Brown@djoglobal.com