BTL-5000 Magnetotherapy - Frank's Hospital Workshop · MAGNETOTERAPIE - UŽIVATELSKÁ PŘÍRUČKA BTL Physiotherapy page 5 of 31 2 MAGNETOTHERAPY – PHYSICAL BACKGROUND 2.1 MAGNETIC

V 1 0 0 R K 1 3 / 0 7 / 2 0 0 6

BTL-5000 Magnetotherapy

U S E R ’ S G U I D E

M A G N E T O T E R A P I E - U Ž I V A T E L S K Á PŘ Í R UČ K A B T L P h y s i o t h e r a p y

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CONTENTS 1 MAGNETOTHERAPY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 2 MAGNETOTHERAPY – PHYSICAL BACKGROUND.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 2.1 Magnet ic F ie ld . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 2.1.1 Stat ionary Magnet ic F ie ld . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 2.1.2 Al ternat ing Magnet ic F ie ld . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 2.1.3 Pulse Magnet ic F ie ld . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 2.1.3.1 Device Opt ions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 2.2 FMF Technology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 2.3 Magnet ic F ie ld Uni ts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 3 THERAPEUTIC EFFECTS OF MAGNETOTHERAPY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 3.1 Analges ic Ef fec t . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 3.2 Ant iph log is t ic Ef fect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 3.3 Trophic Ef fec t . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10 3.4 myore laxat ion and spasmolyt ic e f fec t , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10 3.5 Vasodi la tat ion Ef fect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10 3.6 Ant iedematous Ef fec t . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10 4 RECOMMENDED DOSAGE OF MAGNETOTHERAPY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11 5 BIBLIOGRAPHY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12 6 SETTING AND CONTROL OF MAGNETOTHERAPY – TECHNICAL PARAMETERS . . . . . . .15 6.1 Magnet ic F ie ld Intens i ty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15 6.2 Therapy T ime . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15 6.3 Phys io log ica l Ef fects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15 6.4 Select ion of Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15 6.4.1 Magnet ic Pulses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15 6.4.1.1 Pulse, Pause, Frequency – Set t ing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16 6.4.2 Ser ies of Magnet ic Pulses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16 6.4.2.1 Pulse, Pause, Frequency, Repeat ing – Set t ing o f Ser ies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16 6.4.3 Cont inuous Magnet ic F ie ld . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17 6.5 Pulse Shape . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17 6.5.1 Rectangular Pulses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17 6.5.2 Rectangular Prot racted Pulses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18 6.5.3 Exponent ia l Pulses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19 6.5.4 Sinusoida l Pulses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19 6.5.5 Tr iangular Pulses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19 6.6 Modulat ion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20 6.6.1 Random Frequency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20 6.6.2 Burst . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20 6.6.3 Sine Surges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20 6.6.4 Trapezoid Surges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20 6.6.5 Symmetr ic Surges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22 6.7 Test of Connected Appl icator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22 7 APPLICATORS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23 7.1 “DISC" Appl icator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23 7.1.1 Technica l Parameters. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23 7.1.2 Shape of the Magnet ic F ie ld of the Appl icator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24 7.2 “DOUBLE DISC" Appl icator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25 7.2.1 Technica l Parameters. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25 7.2.2 Shape of the Magnet ic F ie ld of the Appl icator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26 7.3 “Mul t i DISC" Appl icator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27 7.3.1 Technica l Parameters. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27 7.3.2 Shape of the Magnet ic F ie ld of the Appl icator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28 7.4 “Solenoid 30” Appl icator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29 7.4.1 Technica l Parameters. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29 7.4.2 Shape of the Magnet ic F ie ld of the Appl icator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29 7.5 “Solenoid 60” Appl icator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30 7.5.1 Technica l Parameters. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30 7.5.2 Shape of the Magnet ic F ie ld of the Appl icator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30 7.6 “L inear" Appl icator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31


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7 .6 .1 Technica l Parameters. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31 7.6.2 Shape of the Magnet ic F ie ld of the Appl icator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31


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1 M A G N E T O T H E R A P Y

Magnetotherapy is one of the bas ic phys io therapy procedures . I ts bas ic form - app l icat ion of s tat ic magnet ic f ie ld . i .e . the permanent magnet - has been used s ince t ime immemor ia l as one of natura l heal ing sources. However , on ly the coming of e lect ron ics and power fu l swi tch ing e lements enabled rap id development o f low- f requency pu lse magnet therapy, the ef fects o f which are severa l t imes h igher than those of the s tat ic magnet ic f ie ld . The recent ly per formed s tud ies imply that therapy per formed by means of pu lse e lec t romagnet ic f ie ld is up to 100 t imes more ef fect ive than the appl icat ion of s tat ionary magnet ic f ie ld . That is why the pu lse magnetotherapy is nowadays becoming one of widespread phys io therapy methods. At some condi t ions (e.g . chron ic pa ins in degenerat ive ar t icu lar d iseases) th is method has proven successfu l as therapy wi th long- last ing therapeut ic ef fect even when o ther therapy methods fa i led. Pu lse magnetotherapy can be very ef fect ive in case of correct ind icat ion and appl icat ion. I t can a lso be recommended for use in combinat ion wi th o ther therapy methods, such as pharmacotherapy, the ef fects o f wh ich are usual ly suppor ted by magnetotherapy. That is why magnetotherapy should ne i ther be le f t out in case of comprehensive approach to t reatment , nor g iven preference as monotherapy. The la test f ind ings about phys io log ica l response of the organism to the e lect romagnet ic f ie ld imply the fo l lowing ef fects o f magnetotherapy:

• ana lges ic ef fec t , • ant iedematous ef fect , • ant iph log is t ic ef fec t , • t rophic e f fect (accelerat ion of heal ing and growth) , • myore laxat ion and spasmolyt ic e f fect , • vasodi la tat ion e f fect .

The fo l lowing chapters conta in br ie f exp lanat ion of phys ica l background of magnetotherapy and phys io log ica l mechanisms of i ts e f fec t wi th emphasis on appl icat ion in ind iv idual f ie lds of medic ine. The Encyc lopaedia, wh ich is a separate a t tachment o f th is User ’s Guide, conta ins the l is t o f recommended parameters of magnetotherapy at se lected d iagnoses. The des ign ing of th is dev ice ut i l izes the exper ience acqui red dur ing the development , manufactur ing and long-standing c l in ica l operat ion of the BTL-09 dev ice and s tate-of - the-ar t dev ices of the BTL-4000 and BTL-5000 ser ies. Dur ing the des ign ing of new magnet ic appl icators for th is dev ice there was developed a brand new technology - so ca l led “FMF “ ( “Focused Magnet ic Field ” ) technology. Thus we managed to increase the e lect romagnet ic f ie ld in tens i ty on the pat ient s ide and s ign i f icant ly reduce the e lect romagnet ic f ie ld in tens i ty on the appl icator s ide, tu rned away f rom the pat ient . Col loquia l l y sa id , the magnet ic f ie ld was moved f rom the improper s ide to the s ide where i t i s des i red. Thanks to these const ruct ion e lements and thanks to s tate-of - the-ar t sources based on the pr inc ip le o f e lect ron ic swi tch ing e lements we have managed to reduce the power consumpt ion s ign i f icant ly whi le preserv ing the same e lect romagnet ic f ie ld in tens i t ies . Note The authors o f th is User ’s Guide are aware that such a smal l space is not suf f ic ient for deta i led descr ipt ion of the ent i re magnetotherapy issue. They therefore had to make some genera l izat ions and s impl i f icat ions resu l t ing f rom the l imi ted scope of th is tex t . More detai ls you can f ind in the avai lab le l i terature (see Chapter 5 Bibl iography )


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2 M A G N E T O T H E R A P Y – P H Y S I C A L B A C K G R O U N D

2 . 1 M A G N E T I C F I E L D

Magnet ic f ie ld is an in tegra l par t of e lect romagnet ic f ie ld wh ich cons is ts o f the e lec t r ic and the magnet ic components . Both components o f the e lect romagnet ic f ie ld are mutual ly c lose ly connected and cannot ex is t wi thout each other , , except in the fo l lowing two spec ia l cases:

• e lect rostat ic f ie ld in which the magnet ic component of the f ie ld is zero, and • stat ionary magnet ic f ie ld in which the e lect r ic component is zero.

Owing to the used f requencies up to 150 Hz and owing to the des ign of the BTL appl icators , the magnet ic component o f the f ie ld predominates over the e lect r ic . For shor t we wi l l ca l l the f ie ld by the commonly used term “magnet ic f ie ld” here inaf ter . The presence of a magnet ic f ie ld is sensed pr imar i ly through i ts force ef fects by wh ich i t a f fec ts magnet ica l ly conduct ive th ings, moving charges and conductors wi th e lect r ic current f lowing through them. The force ef fects are not very impor tant for our theory, because b io log ica l ob jects are d iamagnet ic . However , i t is necessary to take these force ef fects into account in case of metal implants , espec ia l ly those which are f ixed in sof t t issues and are not made of ant imagnet ic mater ia ls . Another in teract ion between the magnet ic f ie ld and the mat ter occurs a t the moment when the mat ter is exposed to the magnet ic f ie ld. At that moment , ind iv idual f ree molecules are or ientated in a way to min imize the energy ins ide the f ie ld . In case of b io log ica l ob jects , these forces act against the bonds between atoms, molecules and ions in the t issues, which consequent ly in f luences a lso the ce l lu lar processes. The ef fects impor tant fo r phys io therapy are based on electrodynamic induct ion d iscovered by the phys ic is t M. Faraday in the 19 t h century. In pract ice, i f you are moving the e lect r ic conductor in the magnet ic f ie ld, vo l tage appears on i t . I f you make a c losed loop of the moving conductor , e lect r ic cur rent wi l l f low through i t . As Faraday d iscovered, th is phenomenon a lso works the other way around – i f the magnet ic f ie ld moves or changes in the course of t ime ( ins tead of the conductor ) , a s imi lar e f fec t occurs . These d iscover ies were on ly a shor t remove f rom the appl icat ion of alternat ing magnet ic f ie lds in therapy. In case of l iv ing organisms, the moving charges ( the conductor moving in the magnet ic f ie ld) are represented by the c i rcu lat ing body f lu ids (b lood, l ymph) . In case of expos i t ion to a l ternat ing magnet ic f ie ld i t refers to i ts ind iv idual more e lect r ica l ly conduct ive par ts - the vascular bed ( inc lud ing c i rcu la t ing f lu ids) , per iphera l nerves, CNS neura l paths and, las t but not least , a lso ind iv idual ions and charges on ce l lu lar membranes.

2 . 1 . 1 S t a t i o n a r y M a g n e t i c F i e l d

Stat ionary magnet ic f ie ld ar ises around permanent magnets but a lso around moving e lect r ic charges which move at a constant speed (d i rect current ) E lect r ic charge may be carr ied e.g. by ions (e lect r ic cur rent f lowing in l iqu ids) and e lect rons (e lect r ic cur rent f lowing in conductors) . In the la t ter case, a magnet ic f ie ld s imi lar to that around the permanent magnet ar ises around the e lect r ic conductor wi th constant d i rect e lect r ic cur rent f lowing through i t .

2 . 1 . 2 A l t e r n a t i n g M a g n e t i c F i e l d

Time behaviour o f th is f ie ld is usual ly der ived f rom the s inusoida l mains vo l tage. In common pract ice, dev ices most o f ten generate the f ie lds of a f requency of 50 Hz and the s inusoida l waveform. The magnet ic f ie lds of these dev ices change the i r po lar i ty in the course of t ime. These f ie lds, even though wi th much lower in tens i ty, ex is t in the surrounding of each e lect r ic conductor , t ransformers and motors suppl ied f rom the AC mains.


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2 . 1 . 3 P u l s e M a g n e t i c F i e l d

This f ie ld is character ized by fast changes of f ie ld ; ind iv idual pu lses are c lose to rectangular pu lses, the i r edges are very s teep. That is why in the pu lse magnet ic f ie ld the e lect r ic component is h igher and is permanent ly present bes ide the magnet ic component . Some stud ies, which deal wi th compar ison of ind iv idual magnet ic f ie ld types, po in t out the very h igh ef f ic iency o f the pu lse magnet ic f ie ld in compar ison wi th the s tat ionary magnet ic f ie ld. Therefore the quest ion ar ises whether the pos i t ive resu l ts o f the pu lse magnet ic f ie ld are not caused by the more in tens ive e lect r ic component of the f ie ld . Out of a l l poss ib le pu lse types, the BTL – 5000 dev ice has been equipped wi th the fo l lowing ones. These pu lses cover the ent i re spect rum of requi red appl icat ions, f rom acute to chron ic s tates .

2 . 1 . 3 . 1 D e v i c e O p t i o n s

The dev ice can be se t to generate the fo l lowing pu lse types:

• rectangular pu lses, • rec tangular prot racted pulses, • exponent ia l pu lses, • s inusoida l pu lses, • t r iangular pu lses and • cont inuous magnet ic f ie ld .

A l l the above l is ted magnet ic f ie ld waveforms can be fur ther modulated and the fo l lowing surges of bas ic pu lses can be created:

• t rapezoid surges, • s ine surges, • symmetr ic surges.

I t is a lso poss ib le to create groups of magnet ic pu lses - so ca l led bursts . The opt ion of random sweep of the bas ic se lected f requency is ava i lab le too. A l l these parameters can be set in wel l -ar ranged manual mode. Preset programs and recommended d iagnoses are avai lab le too.

2 . 2 F M F T E C H N O L O G Y

FMF = Focused Magnet ic F ie ld In dependence on the i r spat ia l d is t r ibut ion, magnet ic f ie lds are d iv ided in to uniform and non-uni form . The un i form f ie ld has the same in tens i ty and the same d i rect ion in a l l po in ts of the space. The appl icators were des igned us ing s ta te-of the-ar t fer romagnet ic and magnet ic mater ia ls wh ich a l low to assemble h igh ly e f fect ive magnet ic concent rat ion sys tems. These e lements focus the e lect romagnet ic f ie ld in to the des i red space towards the t reated body par t . Therefore the magnet ic f ie ld o f the BTL appl icator is intent ional ly non-uniform and focused . Standard Magnet ic Appl icator FMF Technology Appl icator o f DISC Type


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The s ides of the appl icator are ident i f ied as the pat ient s ide, f rom which the magnet ic f ie ld is emi t ted to a h igher extent , and the operator s ide, a t which the f ie ld in tens i t ies are several t imes lower . b lue ind icator l ight

Pat ient / Appl icat ion Side of the Appl icator

Side turned away from the pat ient (operator side)

The s ide is marked wi th the p ic tograph of a “pat ient in the

magnet ic f ie ld” . The in tens i t ies a t th is s ide of the appl icator are much

h igher than those at the operator s ide. Dur ing the operat ion of the

dev ice the operator should not touch th is s ide of the appl icator .

S ide marked wi th the BTL logo. I t is a lso equipped wi th b lue

ind icator lamp which ind icates the operat ion of the appl icator

(cont inuous l ight , fas t b l ink ing) and i ts readiness for operat ion (s low

b l ink ing)

Example of poss ib le use of the magnet ic appl icator wi th FMF technology:


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The magnet ic f ie ld of the so lenoid type appl icators is focused inward:

Standard appl icator and i ts FMF technology appl icator magnet ic f ie ld - focused magnet ic f ie ld

2 . 3 M A G N E T I C F I E L D U N I T S

Devices BTL-4000 and BTL-5000 use for the magnet ic f ie ld induct ion (B ) the un i t accord ing to the SI in ternat iona l un i t system – Tesla (T) or i ts one thousandth - mil l i tesla (mT) . Owing to the fact that the former ly used un i t Gauss (G) has the fo l lowing re la t ion to mi l l i tes la: 1mT = 10 G, the d isp lay shows the conver ted va lue in mT/10 . Then, 1mT/10 = 1G . Other magnetic f ie ld units: Then un i t of magnet ic f ie ld in tens i ty is ampere per meter (A/m) . An o lder un i t of in tens i ty is Oersted (Oe) . The re la t ion between these two un i t is : 1 Oe = 79.577 A/m . The re la t ion between the magnet ic induct ion and the magnet ic in tens i ty is the fo l lowing: B = µr . µo . H where: B is the magnet ic induct ion H i s the magnet ic intens i ty µo is the permeabi l i ty o f vacuum, which equals to 1.2566 . 10 - 6 µ r is the re la t ive permeabi l i ty o f the env i ronment which expresses the magnet ic proper t ies of the env i ronment

• fo r vacuum i t equals to 1 • fo r magnetical ly conduct ive mater ia ls the va lues are much h igher than 1 (e .g.

for s tee l the va lues range f rom 100 to 5800) • fo r air the va lue is s imi lar as for vacuum , i .e . approx imate ly 1 (1 .00000038 to be

accurate) • biological t issues f rom th is v iew can be compared to water , for which the va lue

equals to 0.999991 I t can be calcu la ted that for b io log ica l t issues a magnet ic f ie ld induct ion of 1mT cor responds to a magnet ic f ie ld intens i ty o f 795.8 A/m .


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3 T H E R A P E U T I C E F F E C T S O F M A G N E T O T H E R A P Y

Magnetotherapy is one of the commonly used phys io therapy procedures. Th is method has proved successfu l in some d iseases as therapy wi th long- las t ing therapeut ic e f fec t (e .g. at chron ic pa ins of ver tebrogenous aet io logy or a t degenerat ive jo in t d iseases) even when other therapy methods fa i led. However , i t is necessary to cons ider that , l i ke every therapeut ic procedure, magnetotherapy a lso has a cer ta in fa i lure rate . I t has been proved that for t reatment o f pat ients in acute s tages i t is bet ter to use s ta t ic magnet ic f ie ld a t the beginn ing; in chron ic d iseases i t is bet ter to use pu lse magnetotherapy. Appl icat ion of magnetotherapy must a lways be based on thorough medica l h is tory and deta i led examinat ion of the pat ient . I t is su i table to take in to account that the natura l magnet ic f ie ld o f the Ear th equals approx imate ly to 0 .04 – 0.05 mT (0.4 – 0 .5 Gauss) . Dev ices BTL-4000 / BTL-5000 work wi th magnet ic f ie lds the in tens i ty o f wh ich may be up to 1000 t imes h igher . Therefore the appl icat ion requi res par t icu lar caut ion, a lso wi th respect to the fact that man has no spec i f ic receptors for magnet ic f ie ld and therefore does not perce ive i t d i rect ly – un l ike e .g. e lect r ic cur rent . The la test f ind ings about phys io log ica l response of the organism to the e lect romagnet ic f ie ld imply the fo l lowing ef fects o f magnetotherapy:

• ana lges ic ef fec t , • ant iph log is t ic ef fec t , • t rophic e f fect (accelerat ion of heal ing and growth) , • myore laxat ion and spasmolyt ic e f fect , • vasodi la tat ion e f fect . • ant iedematous ef fect ,

3 . 1 A N A L G E S I C E F F E C T

The analges ic e f fect of magnetotherapy appl ies in most a lges ic s tates o f muscular as wel l as ar t icu lar aet io logy. Deta i led descr ip t ion of th is e f fect is qu i te compl icated; i ts phys io log ica l e f fects have been spec i f ied in recent years . Accord ing to these f ind ings, the analges ic ef fect o f magnetotherapy is accounted for by increased secret ion of endogenous opio ids caused by myore laxat ion, ant iph log is t ic and ant iedematous ef fect and maybe a lso the impact on pres inapt ic inh ib i t ion of noc icept ive s ignals at the leve l of medul lary dorsa l horns. The t reatment should be combined wi th a imed pharmacotherapy, manual t reatment and re laxat ion therapy, a t least in the in i t ia l s tage.

3 . 2 A N T I P H L O G I S T I C E F F E C T

This ef fect has not been conv inc ing ly exp la ined so far , but recent s tud ies agree on the fo l lowing pr inc ip le : The ant iph log is t ic e f fect is induced by increased phagocytos is o f neut rophi ls and increased product ion of hyperox ide. Th is is fo l lowed by induct ion of hyperox ide d ismutase bound to endothe l ium, which a l l probably leads to h igher concentrat ion of hydrogen perox ide in the exposed area. Owing to the fast that hyperox ide inh ib i ts the act iv i ty o f cata lase, the hydrogen perox ide is not degraded and thus i t is ab le to dest roy leucot r iens, which be long to the s t rongest act ivators o f phagocytos is . Th is mechanism a lso expla ins the in i t ia l cont rovers ia l ac t ing of the magnet ic f ie ld in s ter i le in f lammat ions as wel l as in the microb ia l ly induced in f lammat ions. Th is ef fec t a lso accounts for temporary impai rment o f rheumat ic condi t ions dur ing the f i rs t two or three expos i t ions, when the in f lammatory symptoms are in tensi f ied by increas ing ly produced hyperoxide. S imul taneous medicat ion and phys ica l therapy is necessary; the pat ient must be moni tored dur ing the therapy and in case of longer negat ive react ion the therapy must be s topped.


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3 . 3 T R O P H I C E F F E C T

The magnet ic f ie ld accelerates heal ing of the ske le ton and sof t t issues. I t is caused by bet ter b lood c i rcu la t ion in the exposed area and by i r r i ta t ion o f cytop lasmat ic membranes. This act ivates the metabol ic cha in , the key po in t of wh ich is the change of the cAMP/cGMP rat io. The accelerat ion of heal ing, espec ia l l y o f the ske le ton, is descr ibed in deta i ls in the l i te ra ture (Chvojka, 1993, 2000) .

3 . 4 M Y O R E L A X A T I O N A N D S P A S M O L Y T I C E F F E C T ,

Increased b lood c i rcu lat ion in the area improves washing away of ac id ic metabol i tes which cause pa in fu l i r r i tat ion. In the musc les exposed to the magnet ic f ie ld there a lso proceeds increased act iv i ty o f LDH ( lac tate dehydrogenase) and ef f lux o f the Ca2 + ion f rom muscle ce l ls .

3 . 5 V A S O D I L A T A T I O N E F F E C T

This ef fec t is caused by the ef f lux o f Ca2 + ions which causes re laxat ion of the tonus of the vascular musculature and precapi l la ry sphincters. Probably the n. vagus is a lso d i rect ly in f luenced and the increased metabol ic act iv i ty o f ce l ls in the exposed area resu l ts in creat ion of EDRF and prostacyc l ins .

3 . 6 A N T I E D E M A T O U S E F F E C T

This ef fect resu l ts f rom the two above descr ibed ef fects - ant iph log is t ic e f fect of the magnet and accelerat ion of heal ing and improved b lood c i rcu la t ion.


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4 R E C O M M E N D E D D O S A G E O F M A G N E T O T H E R A P Y

Sui tab le dosage for the par t icu lar appl icat ion can be est imated f rom the fo l lowing re la t ions. The resu l t ing dose r ises a long wi th :

• h igher va lue of magnet ic induct ion ( in tens i ty) o f the magnet ic f ie ld Bm a x [T] , • h igher s teepness of r is ing and fa l l ing edges of magnet ic f ie ld pu lses dB/dt [T /s] , • h igher f requency of magnet ic f ie ld pu lses f [Hz] and • longer t ime of expos i t ion ( in hours ) .

dose = Bm a x * dB/dt * t ime of exposi t ion * f

The opt imum dose should range f rom 4 to 8 . The fo l lowing procedure for se lect ing the opt imum does of magnetotherapy is recommended:

• The appl icators should be as c lose as poss ib le to the pat ient ’s body sur face. Direct contact wi th the body is not necessary, therapy may be appl ied through the c lo thes or bandage.

• Magnetotherapy should be appl ied as soon as poss ib le - i t wi l l bet ter inf luence funct ional d isorders , not s t ructura l changes.

• For s ter i le in f lammat ions i t is su i table to use f requency up to 10 Hz. • For microb ia l l y induced in f lammat ions (s inus i t ises, osteomyel i t ises) i t is su i tab le to use

pu lse f requency about 25 Hz. • In degenerat ive d iseases of locomot ive organs the recommended pu lse f requency is

above 10 Hz. • When t reat ing tennis e lbows and f rozen shoulders i t is su i tab le to expose the C-sp ine

a t the same t ime. • When t reat ing subacute and acute ver tebrogenous t roubles i t is a lso recommended to

expose the pa in t r igger po in ts (TPs) . • Ind iv idual expos i t ions must be long enough and repeated. The min imum exposi t ion t ime

is at least 10 minutes, the min imum number o f expos i t ions is 10 to 15. • The total dai ly t ime of exposit ion should not exceed 40 minutes. • The best resu l ts are ach ieved when the f i rs t 5 to 10 expos i t ions are per formed dai ly or

twice a day. • I f magnetotherapy does not s tar t to work wi th in 20 procedures, i t fa i ls . An except ion is

the t reatment o f pseudo-ar throses, where the f i rs t v is ib le s igns of heal ing can be observed, us ing d isp lay methods, not sooner than af ter 30 procedures.

• In approx imate ly 30% of rheumat ics there can be expected subject ive impai rment o f the condi t ion af ter f i rs t 3 expos i t ions.

• I f poss ib le, do not end magnetotherapy at once, but by gradual pro longat ion of in terva ls between ind iv idual expos i t ions.

Spec ia l a t tent ion shal l be pa id to pat ients wi th hypotens is and hyper tens is . Dur ing therapy the s ign i f icant drop of b lood pressure may occur , inc lud ing a l l s ide ef fects . Th is react ion usual ly d isappears wi th in 30 minutes af ter the end of therapy and the adaptat ion occurs approx imate ly a f ter 5 expos i t ions. For cont ra ind icat ions see the main User ’s Manual o f the dev ice - document “BTL-5000 Series – User ’s Manual ” , Chapter 6.4 “Contraindicat ions ” .


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5 B I B L I O G R A P H Y

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J . D. Heckman, A. J . Ingram, R. D. Loyd, J . V. Luck Jr . , and P. W. Mayer , “Nonunion Treatment wi th Pulsed Elect romagnet ic F ie lds” , C l in ica l Or thopaedics and Related Research, 161, 1981, pp. 58-66. Hinman, M. R. , Ford, J . , and H. Heyl , "Ef fects of s tat ic magnets on chron ic knee pa in and phys ica l funct ion: A double-b l ind s tudy" , A l ternat ive Therapies in Heal th and Medic ine, Vol . 8, No. 4, 2002, pp. 50-55. M. Ieran, S. Zaf fu to, M. Bagnacani , M. Annov i , A. Morat t i , and R. Cadoss i , “Ef fec t of Low Frequency Puls ing Elect romagnet ic F ie lds on Sk in Ulcers o f Venous Or ig in in Humans:A Double-b l ind Study” , Journal o f Or thopaedic Research, 8, 2 , 1990, pp. 276-282. H. I to, Y. Shi ra i and Y. Gembun, "A Case of Congeni ta l Pseudar thros is of the T ib ia Treated wi th Puls ing Elect romagnet ic F ie lds, 17-Year Fo l low-up" , J Nippon Med Sch; 67,3, 2000, pp. 198-201. J . I . Jacobson, R. Gorman, W. S. Yamanashi , B. B. Saxena, and L. Clayton, “Low-ampl i tude, Ext remely Low Frequency Magnet ic F ie lds for the Treatment o f Osteoar thr i t ic Knees: A Double-b l ind Cl in ica l Study” , A l ternat ive Therapies, 7, 5 , 2001, pp. 54-69. Je řábek J . , "Magnetoterap ie" , Rehabi l i tace a fyz iká ln í léka řstv í ; 3 (2) , 1996, pp. 55-62. W. A. Jorgensen, B. M. Frome, and C. Wal lach, “E lect rochemica l Therapy of Pelv ic Pain: Ef fects of Pulsed Elect romagnet ic F ie lds (PEMF) on T issue Trauma” , The European Journal o f Surgery, 574 (Supplement) , 1994, pp. 83-86. M. Kanje, A. Rusovan, B. S isken, and G. Lundborg, “Pret reatment of Rats wi th Pulsed Elect romagnet ic F ie lds Enhances Regenerat ion of the Sc ia t ic Nerve” , B ioe lect romagnet ics , 14, 1993, pp. 353-359. K. Konrad, K. Sevc ic , K. Fõ ldes, E. P i roska, and E. Molnár , “Therapy wi th Pulsed Elect romagnet ic F ie lds in Asept ic Loosening of Tota l H ip Pros theses: A Prospect ive Study” , C l in ica l Rheumato logy, 15, 4, 1996, pp. 325-328. Kuba, J . , Procházka, M. , "K l in ické testování p ř ís t ro je k terap i i magnet ickým pulzním polem s kr i tér i i dvo j i tě s lepě uspo řádané s tud ie" , Rehabi l i tace a fyz iká ln í léka řstv í , 7 (1) , 2000, pp. 24-27. R. A. Marks, “Spine Fus ion for Discogenic Low Back Pain : Outcomes in Pat ients Treated wi th or wi thout Pulsed Elect romagnet ic F ie ld St imulat ion” , Advances in Therapy, 17, 2 , 2000, pp. 57-67. H. Matsumoto, M. Ochi , Y. Ab iko, Y. H i rose, T. Kaku, K. Sakaguchi , “Pu lsed Elect romagnet ic F ie lds Promote Bone Format ion around Denta l Implants Inser ted into the Femur o f Rabbi ts” , C l in ica l Oral Implants Research, 11, 2000, pp. 354-360 V. Mooney, “A Randomized Double-b l ind Prospec t ive Study of the Ef f icacy of Pulsed Elect romagnet ic F ie lds for Interbody Lumbar Fus ions” , Sp ine, 15, 7, 1990, pp. 708-712. F. Papi , S. Ghione, C. Rosa, C. Del Seppia, and P. Luschi , “Exposure to Osc i l la t ing Magnet ic F ie lds Inf luences Sens i t iv i ty to E lect r ica l St imul i . I I . Exper iments on Humans” , B ioe lect romagnet ics , 16, 1995, pp. 295-300. P ip i tone, N. and D. L . Scot t . "Magnet ic Pulse Treatment for Knee Osteoar thr i t is : A Randomised, Double-Bl ind, P lacebo-Contro l led Study" , Current Medica l Research and Opin ion, Vol . 17, No. 3 , 2001, pp. 190-196. T . L . R ichards, M. S. Lappin, J . Acosta-Urquid i , G. H. Kraf t , A. C. Heide, F. W. Lawr ie , T . E. Merr i l l , G. B. Mel ton, and C. A. Cunningham, “Double-b l ind Study o f Puls ing Magnet ic F ie ld Ef fects on Mul t ip le Sc leros is” , The Journal of A l ternat ive and Complementary Medic ine, 3, 1, 1997, pp. 21-29. N. J . Roland, J . B. Hughes, M. B. Daley, J . A. Cook, A. S. Jones, and M. S. McCormick, “E lect romagnet ic St imulat ion as a Treatment o f T inn i tus: A Pi lo t Study” , C l in ica l Oto laryngology and Appl ied Sc iences, 18, 1993, pp. 278-281. Sadlonova, J . , Korpas, J . , Sa lat , D. , Miko, L . , Kudl icka, J . , "The ef fect of the pu lsat i le e lect romagnet ic f ie ld in ch i ldren suf fer ing f rom bronchia l asthma", Acta Phys io l Hung. , 90(4) , 2003, pp. 327-34. Sadlonova J , Korpas J , Vrabec M, Sala t D, Buchancova J , Kudl icka J . , " "The ef fec t o f the pu lsat i le e lect romagnet ic f ie ld in pat ients suf fer ing f rom chron ic obst ruct ive pu lmonary d isease and bronchia l as thma"" , Brat is l Lek L is ty; 103 (7-8) , 2002, pp. 260-265." E. R. Sansever ino, A. Vannin i , and P. Caste l lacc i , “Therapeut ic Ef fects o f Pulsed Magnet ic F ie lds on Join t Diseases" , Panminerva Medica, 34, 4, 1992, pp. 187-196.


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F . Sar tucc i , L . Bonf ig l io , C. Del Seppia, P. Luschi , S. Ghione, L . Murr i , and F. Papi , “Changes in Pain Percept ion and Painduced by Exposure to Osc i l la t ing Magnet ic F ie lds” , Bra in Research, 769, 1997, pp. 362-366. B. F. S isken, M. Kanje , G. Lundborg, E. Herbst , and W. Kur tz , “St imulat ion of Rat Sc iat ic Nerve Regenerat ion wi th Pulsed Elect romagnet ic F ie lds” , Bra in Research, 485, 1989, pp. 309-316. M. J . St i l le r , G. H. Pak, J . L. Shupack, S. Thaler , C. Kenny, and L. Jondreau, “A Por tab le Pulsed Elect romagnet ic F ie ld (PEMF) Device to Enhance Heal ing of Recalc i t rant Venous Ulcers : A Double-b l ind, P lacebo-cont ro l led Cl in ica l T r ia l , ” Br i t ish Journal o f Dermato logy, 127, 1992, pp. 147-154. Sweeney, K . B. , Merr ick , M. A. , Ingerso l l , Ch. , D. , and J . A.Swez, "Therapeut ic Magnets Do Not Af fect T issue Temperatures" , J . Ath l . Tra in . , 36 (1) , 2001 March, pp. 27-31. F . Tabrah, M. Hof fmeier , F . Gi lber t J r . , S. Batk in, and C. A. L . Basset t , “Bone Densi ty Changes in Osteoporos is prone Women Exposed to Pu lsed Elect romagnet ic F ie lds (PEMFs)” , Journal of Bone and Minera l Research, 5 , 5 , 1990, pp. 437-442. G. C. Tra ina, L . Romanin i , F . Benazzo, R. Cadoss i , V. Canè, A. Chiabrera, M. Marcer , N. Marchet t i , and F. S. Snator i , “Use of E lect r ic and Magnet ic St imulat ion in Or thopaedics and Traumato logy: Consensus Conference” , I ta l ian Journal of Or thopaedics and Traumato logy, 24, 1 , 1998, pp. 1-31. D. H. Wi lson and P. Jagadeesh, "Exper imenta l Regenerat ion in Per iphera l Nerves and the Spina l Cord in Laboratory Animals Exposed to a Pulsed Elect romagnet ic F ie ld” , Parapleg ia, 14, 1976, pp. 12-20.


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6 S E T T I N G A N D C O N T R O L O F M A G N E T O T H E R A P Y – T E C H N I C A L P A R A M E T E R S

6 . 1 M A G N E T I C F I E L D I N T E N S I T Y

The magnet ic f ie ld intens i ty can be set f rom 1 mT/10 ( i .e . 1 Gauss) and i ts maximum value depends on the appl icator type and the type of the se lected therapy appl icat ion. For the maximum values in dependence on the appl icator type see Chapter 7 Appl icators . The s tep of set t ing is 1 mT/10 ( i .e. 1 Gauss) . The set in tens i ty va lue represents the maximum intens i ty in space and t ime The accuracy of the set in tens i ty va lue is ± 30%.

6 . 2 T H E R A P Y T I M E

Can be set wi th in the range f rom 1 second to 100 minutes, i .e. f rom 00:01 to 99:59 [m:s ] . The s tep of set t ing is 1 second The accuracy of the set t ime is 2%.

6 . 3 P H Y S I O L O G I C A L E F F E C T S

The ef fects are def ined for preset d iagnoses and the user can def ine them for customer d iagnoses and programs, created and saved by the user . Legend:

• A – analges ic • E – ant iedematous • F –ant iph log is t ic • S – t rophic , acce lerat ion of heal ing • R – myore laxat ion and spasmolyt ic (vasodi la tat ion, ant iedematous, . . . )

6 . 4 S E L E C T I O N O F T H E R A P Y

Press the [ therapy] but ton to open the d ia log box (see p ic ture) for se lect ion of the best magnet ic f ie ld therapy. The fo l lowing therapy opt ions are ava i lab le :

• magnet ic pulses • ser ies o f magnet ic pu lses • cont inuous magnet ic f ie ld .

The proper t ies of ind iv idual therap ies are descr ibed in the paragraphs be low.

6 . 4 . 1 M a g n e t i c P u l s e s

Standard waveforms of magnet ic pu lses; i t is poss ib le to se lect between constant and randomly swept f requency of the se lected pulses . For se lect ion of the pu lse shape use the [pulse shape] but ton. The fo l lowing opt ions are ava i lab le :

• rectangular pu lses, • rec tangular prot racted pulses, • exponent ia l pu lses, • s inusoida l pu lses and • t r iangular pu lses.


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The fo l lowing modulat ions can be appl ied on the magnet ic pu lses:

• burs t , • s ine surges, • t rapezoid surges and • symmetr ic surges.

6 . 4 . 1 . 1 P u l s e , P a u s e , F r e q u e n c y – S e t t i n g

On press ing of the d isplayed window the d ia log box opens, in wh ich i t is poss ib le to set the fo l lowing pu lse parameters : pu lse length, pause between pu lses and pu lse f requency. Owing to the fact that these va lues are mutual ly in terconnected through mathemat ica l def in i t ions, any change of a va lue impl ies automat ic changes of the other va lues. At set t ing i t is necessary to rea l ize that the pause length must be a lways longer than the pu lse length (const ruct ion l imi ts ) . The l imi ts for set t ing d i f fer for var ious pu lse shapes - for deta i ls see Chapter 6.5 Pulse Shape .

6 . 4 . 2 S e r i e s o f M a g n e t i c P u l s e s

These very in terest ing magnet ic pu lse waveforms were f i rs t used in the BTL-09 dev ice, but were l imi ted to rectangular pu lses on ly. Dev ices BTL-4000 / 5000 o f fer these pu lses for a l l pu lse shapes:

• rectangular pu lses, • rec tangular prot racted pulses, • exponent ia l pu lses, • s inusoida l pu lses and • t r iangular pu lses.

In pr inc ip le is i t a mix of pu lses of var ious length and f requency in one ser ies to be repeated. I t is advantageous to combine for example long pu lses of low f requency wi th very shor t pu lses of h igh repeat ing f requency and thus cumulate the therapy ef fec t . I t is a lso poss ib le to se lect between constant and randomly swept f requency o f the se lected pu lses. The fo l lowing modulat ions can be appl ied on the magnet ic pu lses:

• s ine surges, • t rapezoid surges and • symmetr ic surges.

6 . 4 . 2 . 1 P u l s e , P a u s e , F r e q u e n c y , R e p e a t i n g – S e t t i n g o f S e r i e s

After press ing of the d isp layed but ton the d ia log box opens, in wh ich i t is poss ib le to set the fo l lowing parameters o f the ser ies o f pu lses: pu lse length, pause between pulses, pu lse f requency, number in the ser ies and length of the ser ies. For each per iod – par t o f the ser ies – i t is poss ib le to set the s tandard pu lse parameters :

• pulse length , • length of pause between pulses, • pu lse f requency and • number of pulses wi th th is set t ing to be

generated. Af ter the end of generat ion of th is par t the program passes to another one.


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The l imi ts for set t ing of the pu lse length, pause and f requency d i f fer for var ious pu lse shapes – for deta i ls see Chapter 6.5 Pulse Shape. The number of repet i t ions of ind iv idual pu lses can be set wi th in the range f rom 1 to 255 . The s tep of set t ing is 1 . The window d isp lays the to ta l number o f par ts in the ser ies and the [add new] but ton, the f ie ld for d isp laying the number o f the par t be ing ed i ted (10 in th is case) and the but ton for de le t ing of the se lected par t o f the ser ies. In to ta l i t is poss ib le to set 13 parts in one ser ies . Owing to the fact that the va lues of the pu lse length, pause and f requency are mutual ly in terconnected through mathemat ica l def in i t ions, any change of a va lue impl ies automat ic changes of the other va lues. At set t ing i t is necessary to rea l ize that the pause length must be a lways longer than the pu lse length (const ruct ion l imi ts) .

6 . 4 . 3 C o n t i n u o u s M a g n e t i c F i e l d

The BTL 4000 / 5000 dev ices enable to generate s tat ionary magnet ic f ie ld , wh ich is s imi lar to the f ie lds around permanent magnets . Th is f ie ld is recommended for the appl icat ions where the ef fects o f the pu lse e lect romagnet ic f ie ld could cause ser ious prob lems and i t is therefore cont ra ind icated - e .g . in case of increased b leeding condi t ions, acute s ta tes , post -operat ive condi t ions etc . The ef fect o f th is f ie ld is a lso increased by the presence of permanent magnets in our “disc ” type appl icators . The appl icat ion of th is type of f ie ld is recommended in the f i rs t s tages of magnetotherapy; approx imate ly a f ter the f i rs t or second week i t is recommended to change over to the pu lse f ie ld. Cont inuous magnet ic f ie ld can be modulated by s low magnet ic f ie ld surges of a length of severa l seconds or more.

• s ine surges, • t rapezoid surges and • symmetr ic surges.

6 . 5 P U L S E S H A P E

This but ton serves for se lect ion of the requi red shape of magnet ic pu lses. The fo l lowing opt ions are ava i lab le :

• rectangular pu lses • rec tangular prot racted pulses • exponent ia l pu lses • s inusoida l pu lses • t r iangular pu lses.

6 . 5 . 1 R e c t a n g u l a r P u l s e s

These pu lses are a sor t o f “go ld s tandard” in pu lse magnetotherapy. In addi t ion to the opt ions that are avai lab le in the BTL-09 dev ice, dev ice BTL 4000 / 5000 prov ides a lso modulat ion of contour o f the fo l lowing pu lses:

• t rapezoid surges, • s ine surges, • symmetr ic surges and • burs ts .

Rectangular pu lses can be set wi th in the fo l lowing range:

• pu lse length t p f rom 3 ms to 255 ms o s tep of set t ing: 1 ms ( f rom 3 ms to 30 ms)

2 ms ( f rom 30 ms to 50 ms) 5 ms ( f rom 50 ms to 100 ms) 10 ms ( f rom 100 ms to 255 ms)

o a spec i f ic va lue (e .g. 58 ms) can be set us ing the keyboard • pause between pulses t i f rom 3 ms to 65,000 ms

o the set pause is a lways longer than the set pu lse length: t i > t p


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o s tep of set t ing: 1 ms ( f rom 3 ms to 30 ms) 2 ms ( f rom 30 ms to 50 ms) 5 ms ( f rom 50 ms to 100 ms) 10 ms ( f rom 100 ms to 200 ms) 20 ms ( f rom 200 ms to 500 ms) 50 ms ( f rom 500 ms to 1000 ms) 100 ms ( f rom 1,000 ms to 65,000 ms)

o a spec i f ic va lue (e .g. 583 ms) can be set us ing the keyboard • the f requency of pu lses can be set wi th in the range f rom 0.015 Hz to 166 Hz

o s tep of set t ing: 0 .01 Hz ( f rom 0.01 Hz to 0 .30 Hz) 0 .02 Hz ( f rom 0.30 Hz to 0 .50 Hz) 0 .05 Hz ( f rom 0.50 Hz to 1 .00 Hz) 0 .10 Hz ( f rom 1.00 Hz to 5 .00 Hz) 0 .50 Hz ( f rom 5.00 Hz to 10.0 Hz) 1 .00 Hz ( f rom 10.0 Hz to 30.0 Hz) 2 .00 Hz ( f rom 30.0 Hz to 50.0 Hz) 5 .00 Hz ( f rom 50.0 Hz to 70.0 Hz) 10.0 Hz ( f rom 70.0 Hz to 100 Hz) 15.0 Hz ( f rom 100.0 Hz to 166 Hz)

o the spec i f ic va lue is ca lcu la ted by the dev ice f rom the va lues of pu lse length and pause length f = 1 / ( t i + t p )

6 . 5 . 2 R e c t a n g u l a r P r o t r a c t e d P u l s e s

On the bas is o f our exper ience wi th pu lse magnet ic f ie lds we des igned th is new type of cur rents which ut i l i zes the advantageous proper t ies o f rectangular pu lses – b ig s teepness of the r is ing and fa l l ing edges. At the same t ime i t s ign i f icant ly reduces the power consumpt ion of the generated magnet ic f ie ld pu lses and extends the durat ion of the pu lse. So i t is poss ib le to generate pu lses of h igher in tens i t ies than at s tandard rectangular pu lses wi th the same power consumpt ion ( the same heat ing of the appl icators) . S imi lar ly as in s tandard rectangular pu lses, a l l modulat ions of pu lse contours are ava i lab le here, inc luding random f requency sweep, preset programs and recommended d iagnoses. Prot racted rectangular pu lses can be set wi th in the fo l lowing range:

• pu lse length t p f rom 6 ms to 510 ms o s tep of set t ing: 1 ms ( f rom 6 ms to 30 ms)

2 ms ( f rom 30 ms to 50 ms) 5 ms ( f rom 50 ms to 100 ms) 10 ms ( f rom 100 ms to 510 ms)

o a spec i f ic va lue (e .g. 58 ms) can be set us ing the keyboard • pause between pulses t i f rom 6 ms to 65,000 ms

o the set pause is a lways longer than the set pu lse length: t i > t p o s tep of set t ing: 1 ms ( f rom 6 ms to 30 ms)

2 ms ( f rom 30 ms to 50 ms) 5 ms ( f rom 50 ms to 100 ms) 10 ms ( f rom 100 ms to 200 ms) 20 ms ( f rom 200 ms to 500 ms) 50 ms ( f rom 500 ms to 1000 ms) 100 ms ( f rom 1,000 ms to 65,000 ms)

o a spec i f ic va lue (e .g. 583 ms) can be set us ing the keyboard • the f requency of pu lses can be set wi th in the range f rom 0.015 Hz to 83.3 Hz

o s tep of set t ing: 0 .01 Hz ( f rom 0.01 Hz to 0 .30 Hz) 0 .02 Hz ( f rom 0.30 Hz to 0 .50 Hz) 0 .05 Hz ( f rom 0.50 Hz to 1 .00 Hz) 0 .10 Hz ( f rom 1.00 Hz to 5 .00 Hz) 0 .50 Hz ( f rom 5.00 Hz to 10.0 Hz) 1 .00 Hz ( f rom 10.0 Hz to 30.0 Hz) 2 .00 Hz ( f rom 30.0 Hz to 50.0 Hz) 5 .00 Hz ( f rom 50.0 Hz to 70.0 Hz) 10.0 Hz ( f rom 70.0 Hz to 83.3 Hz)


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o the spec i f ic va lue is ca lcu la ted by the dev ice f rom the va lues of pu lse length and pause length f = 1 / ( t i + t p )

6 . 5 . 3 E x p o n e n t i a l P u l s e s

Simi lar ly as in e lect rotherapy, these pu lses are very in terest ing thanks to the i r mi ld gradual r is ing and, a t the same t ime, h igh pu lse in tens i t ies , wh ich they ach ieve at very low power consumpt ion. That is why they are su i tab le espec ia l ly in the appl icat ions where h igh energy of the e lect romagnet ic f ie ld is undes i rab le but the h igh pu lse in tens i ty is requi red. These pu lses apply espec ia l ly a t s t imulat ion of neura l paths by induced currents . At exponent ia l pu lses i t is a lso poss ib le to apply surge modulat ions s imi lar ly as a t rectangular pu lses. Exponent ia l pu lses can be set wi th in the fo l lowing range:

• pu lse length t p f rom 6 ms to 510 ms o s tep of set t ing: the same as for rectangular protracted pulses o a spec i f ic va lue (e .g. 58 ms) can be set us ing the keyboard

• pause between pulses t i f rom 6 ms to 65,000 ms o the set pause is a lways longer than the set pu lse length: t i > t p o s tep of set t ing: the same as for rectangular protracted pulses o a spec i f ic va lue (e .g. 583 ms) can be set us ing the keyboard

• the f requency of pu lses can be set wi th in the range f rom 0.015 Hz to 83.3 Hz o s tep of set t ing: the same as for rectangular protracted pulses o the spec i f ic va lue is ca lcu la ted by the dev ice f rom the va lues of pu lse length

and pause length f = 1 / ( t i + t p )

6 . 5 . 4 S i n u s o i d a l P u l s e s

Class ic s inusoida l pu lses der ived f rom the mains vo l tage. They are used par t icu lar ly for wel l - t r ied s tandard therap ies . The set t ing opt ions are the same as for rectangular pu lses, inc lud ing modulat ion. Set t ing opt ions:





6 . 5 . 5 T r i a n g u l a r P u l s e s

Symmetr ic t r iangular pu lses wi th the same r is ing t ime and fa l l ing t ime. In some count r ies the i r use is very widespread. The set t ing opt ions are the same as for rectangular pu lses, inc lud ing modulat ion. Set t ing opt ions:






page 20 o f 31

6 . 6 M O D U L A T I O N

For deta i led modulat ion set t ings press the [mag. param.] window.

6 . 6 . 1 R a n d o m F r e q u e n c y

Can be se lected for a l l pu lse types. The opt ion swi tches on the sweep o f the set pause length wi th in the range f rom 0 to + 30%. In the prev ious dev ice BTL-09 th is funct ion was ca l led “wave swing” . For the BTL-4000 / 5000 dev ices we dec ided to un i fy the name wi th the other types of phys io therapy, such as e lect rotherapy etc .

6 . 6 . 2 B u r s t

This opt ion cannot be used in the ser ies o f magnet ic pu lses and the cont inuous f ie ld. I t i s poss ib le to set the number of pulses in one burs t wi th in the range f rom 3 to 10. The length of so def ined burs t in [ms] is d isp layed in the [burst] window. The length of pause between ind iv idual burs ts can be set wi th in the l imi t f rom 1 to 255 s . The s tep of set t ing is :

• 1 s ( f rom 1 s to 30 s) • 2 s ( f rom 30 s to 50 s) • 5 s ( f rom 50 s to 100 s) • 10 s ( f rom 100 s to 255 s) • a spec i f ic va lue (e .g. 236 s) can be set us ing the keyboard.

Bes ides these opt ions i t is poss ib le to use some predef ined set t ings – see p ic ture, the va lue is d isp layed as the number of pulses in burst / length of pause between bursts .

6 . 6 . 3 S i n e S u r g e s

The surge length and the pause length can be set separate ly, both wi th in the range f rom 1 s to 255 s . The s tep of set t ing of both va lues is :

• 1 s ( f rom 1 s to 30 s) • 2 s ( f rom 30 s to 50 s) • 5 s ( f rom 50 s to 100 s) • 10 s ( f rom 100 s to 255 s) • a spec i f ic va lue (e .g . 236 s) can be set us ing

the keyboard. I t is again poss ib le to use predef ined surges for set t ing.

6 . 6 . 4 T r a p e z o i d S u r g e s

I t i s possib le to set :

• surge r ise f rom 1 s to 255 s • surge durat ion f rom 1 s to 255 s • fa l l of in tens i ty f rom 1 s to 255 s and


page 21 o f 31

• pause f rom 1 s to 255 s . The s tep of set t ing of both va lues is :

• 1 s ( f rom 1 s to 30 s) • 2 s ( f rom 30 s to 50 s) • 5 s ( f rom 50 s to 100 s) • 10 s ( f rom 100 s to 255 s) • a spec i f ic va lue (e .g. 236 s) can be set us ing the keyboard.

I t is again poss ib le to use predef ined surges for set t ing.


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6 . 6 . 5 S y m m e t r i c S u r g e s

Another way of set t ing of t rapezoid surges, very widespread in some EU count r ies . I t i s poss ib le to set the "sweep t ime ” , the t ime of detun ing and s tab i l izat ion of the surge, wi th in the range f rom 1 s to 255 s . The s tep of set t ing is :

• 1 s ( f rom 1 s to 30 s) • 2 s ( f rom 30 s to 50 s) • 5 s ( f rom 50 s to 100 s) • 10 s ( f rom 100 s to 255 s) • a spec i f ic va lue (e .g. 236 s) can be set us ing

the keyboard. The “contour ” parameter is the rat io between the change and the s tab le par t of the surge. I t can be set wi th in the range f rom 1% to 100% change. The s tep of set t ing is 1%; the in f luence of set t ing is best seen on the an imated icon on the dev ice. I t is again poss ib le to use predef ined surges for set t ing.

6 . 7 T E S T O F C O N N E C T E D A P P L I C A T O R

To ver i fy the funct ion of ther connected appl icator press the [ Induct ion of Magnet Accessories] but ton. For correct eva luat ion of the test i t is necessary to per form the test on a non-conduct ing suface - wooden or p last ic . In addi t ion i t is necessary that the double disk or mult idisk appl icators are not on top of each other dur ing the measur ing, but bes ide each other . The test measures the temperature and magnet ic induct iv i ty o f the connected appl icator . Af ter the measur ing the measured va lues are compared wi th the s tandard va lues and on the bas ic of th is compar ison the dev ice eva luates whether the appl icator works proper ly. I f the resu l t ing test va lue is “ok ” , the appl icator works proper ly. I f the test resu l t is ind icated “ low value ” or “high value ” (see p ic ture) , the appl icator probab ly works improper ly and i t is necessary to contact the serv ice. Note: Induct iv i ty is a phys ica l quant i ty wh ich expresses the d imension of the magnet ic induct ion f lux through the co i l . Induct iv i ty is one of bas ic character is t ics of the co i l - i t expresses the ab i l i ty o f the co i l to change e lect r ic power to magnet ic f ie ld energy.


page 23 o f 31

7 A P P L I C A T O R S

The parameters of the magnet ic appl icators have been opt imized wi th respect to the recommended therapeut ic app l icat ions. Us ing the FMF technology, the magnet ic f ie ld is focused to the t reated area, which enables, wh i le preserv ing the same output in tens i ty, to reduce the power consumpt ion of the magnetotherapy dev ice as wel l as the spur ious magnet ic f ie ld on the non-pat ient s ide of the appl icators , which may potent ia l ly h i t the operator . The be low descr ibed types of appl icators can be connected to the BTL-4000 / 5000 dev ice.

7 . 1 “ D I S C " A P P L I C A T O R

The Disc appl icator is made of p las t ic . The par t which comes in to contact wi th the pat ient is coated wi th f ine durable leatheret te . The appl icator is des igned us ing the FMF technology - the pat ient s ide emi ts focused magnet ic f ie ld , whi le on the other s ide the magnet ic f ie ld is screened so that i ts impact on the surroundings is as low as poss ib le.

Pat ient / appl icat ion side of the appl icator









b l ink ing)

The magnet ic appl icator conta ins a lso a permanent magnet to increase the ef fect o f sooth ing the t issue at t raumat ic and b leeding condi t ions.

7 . 1 . 1 T e c h n i c a l P a r a m e t e r s

Ident i f icat ion - Type: BTL-239-1 Name: Disc Dimensions: 130 x 130 x 30 mm Weight : 1 .05 kg In tens i ty o f the Permanent Magnet F ie ld : 23 mT (230 Gauss) Max. In tens i ty o f Pulse Magnet ic F ie ld : 102 mT (1020 Gauss) Max. In tens i ty o f Magnet ic F ie ld in Tota l : 125 mT (1250 Gauss) Res is tance of the Appl icator : 4 .2 Ω


page 24 o f 31

7 . 1 . 2 S h a p e o f t h e M a g n e t i c F i e l d o f t h e A p p l i c a t o r

The p ic ture shows the shape of the appl icator ’s magnet ic f ie ld on the pat ient s ide. The un i t o f the in tens i ty va lues is mT/10 , i .e . Gauss, and the va lues are va l id at the maximum current f lowing through the appl icator . The sum of in tens i ty o f the permanent magnet f ie ld and in tens i ty o f the pu lse magnet ic f ie ld is s ta ted. The va lue 1250 mT/10 is in the cent re , on the sur face of the appl icator .

0 5 10 15 205101520 [cm]

3

5

10

20

50100

200500

[mT/10]

0

5

10

15

20

25

[cm]

1250

1000


page 25 o f 31

7 . 2 “ D O U B L E D I S C " A P P L I C A T O R

The double d isc appl icator cons is ts o f ser ies in terconnect ion of two d isc appl icators . The appl icators are mutual ly or ientated in the way that a l inear ized magnet ic f ie ld ar ises between them. S imi lar ly as d isc , the “double d isc” appl icator is made of p last ic . The par t which comes in to contact wi th the pat ient is coated wi th f ine durab le leatheret te. The appl icator is des igned us ing the FMF technology - the pat ient s ide emi ts focused magnet ic f ie ld , whi le on the other s ide the magnet ic f ie ld is screened so that i ts impact on the surroundings is as low as poss ib le.










b l ink ing)



Ident i f icat ion - Type: BTL-239-4 Name: double d isc Dimensions: 2x 130 x 130 x 30 mm Weight : 2 .15 kg In tens i ty o f the Permanent Magnet F ie ld : 23 mT (230 Gauss) Max. In tens i ty o f Pulse Magnet ic F ie ld : 72 mT (720 Gauss) Max. In tens i ty o f Magnet ic F ie ld in Tota l : 95 mT (950 Gauss) Res is tance of the Appl icator : 8 .4 Ω


page 26 o f 31


The p ic ture shows the shape of the appl icator ’s magnet ic f ie ld between the pat ient s ides. The un i t o f the in tens i ty va lues is mT/10 , i .e . Gauss, and the va lues are va l id a t the maximum current f lowing through the appl icator . The sum of in tens i ty o f the permanent magnet f ie ld and in tens i ty o f the pu lse magnet ic f ie ld is s ta ted. The h ighest va lue 950 mT/10 is in the cent re , on the sur face of the appl icator .

[cm]

[cm]

950 750

950100

50

25

10

500250

mT/10


page 27 o f 31

7 . 3 “ M U L T I D I S C " A P P L I C A T O R

The mul t i d isc appl icator cons is ts o f ser ies-para l le l in terconnect ion of four d isc appl icators . The appl icators are mutual ly or ien tated in the way that a l inear ized magnet ic f ie ld ar ises between them. The mul t i d isc appl icator was des igned as a por tab le subst i tu te for the so lenoid 60 appl icator . I t can be wel l used for the appl icat ions which requi re the use of two double d iscs (appl icat ion on the ext remi t ies) . See recommended d iagnoses for deta i ls . S imi lar ly as d isc , the mul t i d isc appl icator is made of p last ic - harmless po lypropylene. The par t which comes into contact wi th the pat ient is coated wi th f ine durable leatheret te . The appl icator is des igned us ing the FMF technology - the pat ient s ide emi ts focused magnet ic f ie ld , whi le on the other s ide the magnet ic f ie ld is screened so that i ts impact on the surroundings is as low as poss ib le.










b l ink ing)



Ident i f icat ion - Type: BTL-239-5 Name: mul t i d isc Dimensions: 4x 130 x 130 x 30 mm Weight : 4 .30 kg In tens i ty o f the Permanent Magnet F ie ld : 23 mT (230 Gauss) Max. In tens i ty o f Pulse Magnet ic F ie ld : 72 mT (720 Gauss) Max. In tens i ty o f Magnet ic F ie ld in Tota l : 95 mT (950 Gauss) Res is tance of the Appl icator : 4 .2 Ω


page 28 o f 31


The funct ion of the mul t i d isc appl icator is s imi lar to that o f the double d isc appl icator where four d isc appl icators are on s imul taneously dur ing the therapy. The in tens i ty va lues are l is ted in Chapter 7.3.1 Technical Parameters ( the un i t is mT/10 , i .e . Gauss, and the va lues are va l id at the maximum current f lowing through the appl icator ) . Then there is s tated the sum of in tens i ty o f the permanent magnet f ie ld and in tens i ty o f the pu lse magnet ic f ie ld . The value 950 mT/10 is in the cent re , on the sur face of the appl icator . The shape of the magnet ic f ie ld o f one pa i r o f d iscs o f the mul t i d isc is the same as for the double d isc .


page 29 o f 31

7 . 4 “ S O L E N O I D 3 0 ” A P P L I C A T O R

The bas is o f const ruct ion of th is tube-shaped appl icator is a carry ing tube made o f po lypropylene (PP) , wh ich was chosen because of i ts favourable mechanica l parameters and low weight . S ing le- layer l inear co i l is wound on the tube; the externa l magnet ic f ie ld is screened of f us ing the FMF technology . The des ign of the appl icator was adapted to the requi rement to create l inear magnet ic f ie ld in as large as poss ib le par t o f the appl icator .


Ident i f icat ion - Type: BTL-239-2 Name: so lenoid 30 Dimensions: 340 x 340 x 300 mm Inner Diameter : 295 mm Weight : 5 .75 kg Max. In tens i ty o f Pu lse Magnet ic F ie ld : 9 .3 mT (93 Gauss) Res is tance of the Appl icator : 3 .5 Ω


The p ic ture shows the shape of the appl icator ’s magnet ic f ie ld The un i t o f the in tens i ty va lues is mT/10 , i .e . Gauss, and the va lues are va l id a t the maximum current f lowing through the appl icator .

1015203040506070

80

9093

70

80

9093

10 15 20 30 40 50 60

0 5 10 15 20510152025 25 [cm]

[mT/10]


page 30 o f 31

7 . 5 “ S O L E N O I D 6 0 ” A P P L I C A T O R

The bas is o f const ruct ion of th is tube-shaped appl icator is a carry ing tube made o f po lypropylene (PP) , wh ich was chosen because of i ts favourable mechanica l parameters and low weight . S ing le- layer l inear co i l is wound on the tube; the externa l magnet ic f ie ld is screened of f us ing the FMF technology . The des ign of the appl icator was adapted to the requi rement to create l inear magnet ic f ie ld in as large as poss ib le par t o f the appl icator .


Ident i f icat ion - Type: BTL-239-3 Name: so lenoid 60 Dimensions: 620 x 540 x 300 mm Inner Width: 580 mm Inner Height : 480 mm Weight : 10.0 kg Max. In tens i ty o f Pu lse Magnet ic F ie ld : 8 .5 mT (85 Gauss) Res is tance of the Appl icator : 6 .2 Ω



0 5 10 15 20510152025 25 [cm]

1020304045

50

60

70

8085

50

60

70

80

[mT/10]

10 20 30 40 45


page 31 o f 31

7 . 6 “ L I N E A R " A P P L I C A T O R

The sur face of the l inear appl icator is made of harmless and durab le leatheret te. The same type of leatheret te is used on the other appl icator types.


Ident i f icat ion - Type: BTL-239-6 Name: L inear Dimensions: 600 x 290 x 20 mm Weight : 6 .10 kg Max. In tens i ty o f Magnet ic F ie ld in Tota l : 36 mT (360 Gauss) Res is tance of the Appl icator : 3 .0 Ω



59 cm

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BTL-5000 Magnetotherapy - Frank's Hospital Workshop · MAGNETOTERAPIE - UŽIVATELSKÁ PŘÍRUČKA BTL Physiotherapy page 5 of 31 2 MAGNETOTHERAPY – PHYSICAL BACKGROUND 2.1 MAGNETIC