Continence Suite 3 - LifeMatters · Continence Suite 3.1 Thought Technology Ltd. 2180 Belgrave Avenue, Montreal, QC H4A 2L8 Canada Tel: (800) 361-3651 ٠ (514) 489-8251 Fax: (514)

Continence Suite 3.1

Thought Technology Ltd. 2180 Belgrave Avenue, Montreal, QC H4A 2L8 Canada Tel: (800) 361-3651 ٠ (514) 489-8251 Fax: (514) 489-8255 E-mail: [email protected] Webpage: http://www.thoughttechnology.com

mailto:[email protected]

http://www.thoughttechnology.com/

MyoTrac Infniti™ Continence Suite 2

The Manufacturer: Thought Technology Ltd. 2180 Belgrave Avenue Montreal, Quebec, Canada H4A 2L8

Product Name: MYOTRAC INFINITI U-CONTROL CONTINENCE SUITE

Product #: T9800 Device Name: Device #:

MYOTRAC INFINITI SA9800

0413


CLASSIFICATION

• Type BF Equipment • Internally powered equipment

• Continuous operation

• Read Instruction Manual

CAUTION • US Federal Law restricts this device to sale by or on order of licensed health care

practitioners.

WARNING • Do not operate active sensor within 10 feet of an operating cellular phone, similar radio

transmitting device, other powerful radio interference producing sources such as arc welders, radio thermal treatment equipment, x-ray machines or any other equipment that produces electrical sparks etc.

• All encoders are totally isolated from line (110 or 220VAC) power due to battery operation and fiber optic connections to computers. However, many hospitals and the FDA require that computers, printers and any other equipment used with medical devices be electrically isolated from line voltage to UL or CSA medical safety standards.

• Do not connect inputs or outputs of the encoder or sensors to line powered devices, except through the fiber optic cable.

• All encoders are totally isolated from line (110 or 220VAC) power due to battery operation and fiber optic connections to computers. However, many hospitals and the FDA require that computers, printers and any other equipment used with medical devices be electrically isolated from line voltage to UL or CSA medical safety standards.

• The PC used with Myotrac 3 must be placed outside the patient/client environment (more than 3 meters or 10 feet) or the PC must comply with EN60601-1.1 (system safety).

• After use, the Disposable Electrodes may be a potential biohazard. Handle, and when applicable, dispose of these materials in accordance with accepted medical practice and any applicable local, state and federal laws and regulations.

• To diminish the risk of spreading communicable diseases, always use good hygiene practices with re-usable EEG electrodes, particularly if abrasive substances are used. In all cases, refer to your facility’s infection control procedure.

• Radiated radio frequency electromagnetic fields can cause performance degradation in the MyoScan-Pro EMG sensor. In the worst case, an RF field strength of 22mV/M can cause an increase of 1μV in the signal reading from a MyoScan-Pro sensor. Be sure to keep in mind that a very relaxed muscle should provide an EMG reading of approximately 1-3μV.

• Radiated radio frequency electromagnetic fields can cause performance degradation in the Myoscan-Pro EMG sensor. In the worst case, an RF field strength of 22mV/M can cause a degradation of 1μV in the signal from the Myoscan-Pro sensor. Be sure to keep in mind that a very relaxed muscle should provide an EMG reading of approximately 1-3μV.

• Do not use in the presence of a flammable anesthetic mixture with air or with Oxygen or Nitrous Oxide.

• Not to be immersed in water.

ATTENTION • To prevent static discharge from damaging the sensor and/or encoders, use anti-static mats

or sprays in your working area. A humidifier may also be used to help prevent static environments by conditioning hot, dry air.

• Not for Diagnostic Purposes. Not Defibrillator Proof . Not for Critical Patient Monitoring. • To prevent voiding warranty by breaking connector pins, carefully align white guiding dot on

sensor plug with slot on sensor input. • Sharp bends or winding the fiber optic cable in a loop smaller than 4 inches (10cm) may

destroy the cable


destroy the cable.

• A fiber optic cable not fully pushed into its receptacle may cause the unit not to operate; make sure that both ends of the cable are fully inserted into their receptive jacks and the nuts are tightened firmly.

• Make sure to remove electrodes from sensor snaps immediately after use. • Apply conductive gel only to electrodes, never put gel directly on sensor snaps. • Always use electrodes between the subject and the sensor. • Do not plug third party sensors directly into instrument inputs. Plug only Thought

Technology Active Sensor cable connectors into instrument inputs. All EMG electrodes and third party sensors must be connected to active sensors, either directly or through an adapter.

• Remove batteries when the device is not being used for extended period of time. Please dispose of battery following national regulations.


INTENDED PURPOSE • Biofeedback, Relaxation & Muscle Re-Education purposes.

CONTRAINDICATIONS • None

NOTE • Wipe encoder with a clean cloth.

• No preventive inspections required, qualified personnel must perform maintenance. • The supplier will make available, upon request, circuit diagrams, component parts lists and

description or other information required for the repair of product by qualified personnel.

Manual SA7978 V.3.1


TABLE OF CONTENTS

INTRODUCTION.......................................................................................9

CONTINENCE SUITE FOR MYOTRAC INFINITI™ U-CONTROL........................................................................................ 9

OVERVIEW............................................................................................................................................................................ 9

SPECIAL THANKS ............................................................................................................................................................... 9

INSTALLATION AND SYSTEM REQUIREMENTS................................................... 10 Update Information ..................................................................................................................................................... 10

QUICK START ....................................................................................... 11

SETUP OF MYOTRAC INFINITI™ U-CONTROL SYSTEM................................................................................................ 11

RECORDING SESSIONS.................................................................................................................................................... 12 Starting the Program................................................................................................................................................... 12 First Time Run: Notch Filter Options........................................................................................................................... 13 To Start Recording a Session..................................................................................................................................... 13 Script Session............................................................................................................................................................. 14

• Select an existing Client ........................................................................................................................... 14 o To record with a new script: ...................................................................................................................... 14 o To record with a previously recorded script: ............................................................................................. 14 • Create a new Client .................................................................................................................................. 14

Open Display Session................................................................................................................................................. 15 First Time Run: Entering Key Codes .......................................................................................................................... 16

STOPPING A SESSION...................................................................................................................................................... 17

REPLAYING SESSIONS..................................................................................................................................................... 19

REVIEWING SESSIONS..................................................................................................................................................... 20 Review ........................................................................................................................................................................ 20 Reports ....................................................................................................................................................................... 21

TOOL BAR OPTIONS......................................................................................................................................................... 21 Toggling Between Screens......................................................................................................................................... 21 Adjusting Scales and Threshold ................................................................................................................................. 21

MODIFYING SCREENS WITH SCREEN EDITOR LITE .................................................................................................... 22

CHANGING SCRIPT SETTINGS ........................................................................................................................................ 22

SUITE DESCRIPTION ............................................................................... 24

INCONTINENCE TUTORIAL .............................................................................................................................................. 25

INCONTINENCE EVALUATON .......................................................................................................................................... 26

SCREENS............................................................................................................................................................................ 26 Assessment/ Review................................................................................................................................................... 26

MI UFI - 1Ch Linegraph for Review .................................................................................................................. 27 MI UFI - 1Ch linegraph raw 3D spec ................................................................................................................ 27 MI UFI - 2Ch 2 linegraphs................................................................................................................................. 27 MI UFI - 2Ch Assessment................................................................................................................................. 27 MI UFI - 2Ch Assessment-Histogram............................................................................................................... 28 MI UFI - 2Ch bargraphs-no sound.................................................................................................................... 28


MI UFI - 2Ch linegraph raw 3D spec ................................................................................................................ 28 MI UFI - 2Ch Multi-linegraph l-r scale ............................................................................................................... 28 MI UFI - 2Ch multi-linegraph............................................................................................................................. 29 MI UFI - 2Ch single-multi-linegraphs ................................................................................................................ 29

Relaxation ................................................................................................................................................................... 29 MI UFI - 1Ch bargraph...................................................................................................................................... 29 MI UFI - 1Ch Earth Puzzle................................................................................................................................ 30 MI UFI - 1Ch filled line-bar graphs.................................................................................................................... 30 MI UFI - 1Ch Growing Fractal 02...................................................................................................................... 30 MI UFI - 1Ch Parrot Puzzle............................................................................................................................... 30 MI UFI - 1Ch Parrot Puzzle bargraph ............................................................................................................... 31 MI UFI - 1Ch Smiley ......................................................................................................................................... 31 MI UFI - 2Ch line-filled graphs .......................................................................................................................... 31 MI UFI - 2Ch Relaxation Green light................................................................................................................. 31 MI UFI - 2Ch Relaxation with DVD ................................................................................................................... 32

Strengthening.............................................................................................................................................................. 32 MI UFI - 1Ch Dolphin Puzzle ............................................................................................................................ 33 MI UFI - 1Ch Fractal 06 .................................................................................................................................... 33 MI UFI - 1Ch Jumping Car................................................................................................................................ 33 MI UFI - 1Ch Jumping Puppet .......................................................................................................................... 33 MI UFI - 2Ch Butterflies .................................................................................................................................... 34 MI UFI - 2Ch Conditional DVD.......................................................................................................................... 34 MI UFI - 2Ch Drying Lake ................................................................................................................................. 34 MI UFI - 2Ch Fading Mouse ............................................................................................................................. 34 MI UFI - 2Ch Filled linegraph............................................................................................................................ 35 MI UFI - 2Ch filled linegraphs ........................................................................................................................... 35 MI UFI - 2Ch Flower Explosion......................................................................................................................... 35 MI UFI - 2Ch Hero Morph-fast .......................................................................................................................... 35 MI UFI - 2Ch Hero Morph-slow......................................................................................................................... 36 MI UFI - 2Ch Turtle ........................................................................................................................................... 36

Training ....................................................................................................................................................................... 36 MI UFI - 2Ch Animal game ............................................................................................................................... 37 MI UFI - 2Ch Car race ...................................................................................................................................... 37 MI UFI - 2Ch Green light................................................................................................................................... 37 MI UFI - 2Ch Growing Sphere .......................................................................................................................... 37 MI UFI - 2Ch Maze ........................................................................................................................................... 38 MI UFI - 2Ch template03 .................................................................................................................................. 38 MI UFI - 2Ch template04 .................................................................................................................................. 38 MI UFI - 2Ch template05 .................................................................................................................................. 38 MI UFI - 2Ch template06 .................................................................................................................................. 39 MI UFI - 2Ch template07 .................................................................................................................................. 39 MI UFI - 2Ch template08 .................................................................................................................................. 39 MI UFI - 2Ch template09 .................................................................................................................................. 39 MI UFI - 2Ch template10 .................................................................................................................................. 40 MI UFI - 2Ch template11 .................................................................................................................................. 40 MI UFI - 2Ch template12 .................................................................................................................................. 40 MI UFI - 2Ch template13 .................................................................................................................................. 40 MI UFI - 2Ch template14 .................................................................................................................................. 41

SCRIPTS ............................................................................................................................................................................. 41 Pelvic Muscle Dysfunction Assessment Script ........................................................................................................... 41 Pelvic Muscle Dysfunction Work-Rest Script .............................................................................................................. 43 Perineal Work-Rest Scripts......................................................................................................................................... 44

MI UFI – 2 Ch line-bar graph ............................................................................................................................ 45 MI UFI – 2Ch 5 cycles 4-4sec template............................................................................................................ 46 MI UFI – 2Ch 5 cycles 4-8sec template............................................................................................................ 46 MI UFI – 2Ch 5 cycles 6-6sec template............................................................................................................ 46 MI UFI – 2Ch 5 cycles 6-12sec template.......................................................................................................... 46 MI UFI – 2Ch 5 cycles 10-10sec template........................................................................................................ 47

Perineal Training Scripts............................................................................................................................................. 47 MI Controlled Perineal Contraction 0_1............................................................................................................ 48 MI Held Perineal Contractions 0_1................................................................................................................... 48 MI PC Hypertonicity 0_1 ................................................................................................................................... 49 MI PC Hypotonicity 0_1 .................................................................................................................................... 49 MI Perineal Control End-treatment 0_1 ............................................................................................................ 49 MI Perineal Control Mid-treatment 0_1............................................................................................................. 49 MI Perineal Control Start-treatment 0_1........................................................................................................... 50 MI Postpartum Perineal Tonicity 0_1................................................................................................................ 50 MI Relaxation of Perineal Muscles 0_1 ............................................................................................................ 50 MI Stress Incontinence 0_1 .............................................................................................................................. 50


TEMPLATES AND TEMPLATE TRAINING........................................................................................................................ 51 Perineal Training Templates ....................................................................................................................................... 51

Controlled Perineal Contractions ...................................................................................................................... 51 Held Perineal Contractions ............................................................................................................................... 51 PC Hypertonicity ............................................................................................................................................... 52 PC Hypotonicity ................................................................................................................................................ 52 Perineal Control End-Treatment ....................................................................................................................... 52 Perineal Control Mid-Treatment........................................................................................................................ 52 Perineal Control Start-Treatment...................................................................................................................... 52 Postpartum Perineal Tonicity............................................................................................................................ 53 Relaxation of Perineal Muscles ........................................................................................................................ 53 Stress Incontinence .......................................................................................................................................... 53

REQUIRED FILES FOR THE MYOTRAC INFINITI™ CONTINENCE SUITE ....................... 54 Channel Set ...................................................................................................................................................... 54 Screens............................................................................................................................................................. 54 Scripts............................................................................................................................................................... 55 Animations ........................................................................................................................................................ 55 MIDI .................................................................................................................................................................. 55 Pictures (Background) ...................................................................................................................................... 55 Prompts ............................................................................................................................................................ 55 Sounds.............................................................................................................................................................. 56 Templates ......................................................................................................................................................... 56 Waves............................................................................................................................................................... 56 Sample Data ..................................................................................................................................................... 56


INTRODUCTION

CONTINENCE SUITE FOR MYOTRAC INFINITI™ U-CONTROL Welcome to the MyoTrac Infiniti U-Control Continence Suite. This suite is a collection of scripts (protocols) and open display screens for tutoring, evaluating and training. Some of the scripts and open display screens use templates that will guide the user in the frequency and intensity of contractions.

OVERVIEW The first half of this manual will help you get your MyoTrac Infiniti U-Control system up and running, and to provide you with the basics of how to use the main features of the BioGraph Infiniti software:

• Installation and System Requiremnets • Quick Start

The second half gives descriptions of the screens and scripts along with some guidelines and suggestions on how to use them :

• Screens • Scripts • Templates and Template Training

SPECIAL THANKS We would like to thank Nancy Schully for her valuable contribution of Assessment-Review, Relaxation, Strengthening and Training screens, as well as for her part in writing this manual. Nancy Schully: Southern Biofeedback Corp. Please contact [email protected] for more details.

mailto:[email protected]


INSTALLATION AND SYSTEM REQUIREMENTS

If you do not have the BioGraph Infiniti software setup in your computer, please follow the Installation Instructions provided to install the program. Then follow similar steps to install the Continence Suite. Please make sure that your computer has the following requirements before installing the BioGraph Infiniti software:

Recommended

• IBM PC compatible (Intel/Pentium/Celeron family or AMD K6/Athlon/Duron family, CPU P4 speed 3 GHz or higher), Desktop or Laptop with two monitor capability

• Windows 2000/XP Professional or Home edition. • 50-60 gigabytes hard disk space for video recording and processing. (The software

needs 2.5 gigabytes to install and run on available hard drive space) • Memory, 512 MB of RAM or more • CD ROM or DVD drive • SVGA graphic card (1024 x 768) or higher resolution adapter & monitor • 32 bit Sound Blaster compatible sound card & speakers • 1 to 4 USB ports, depending on the desired number of MYOTRAC INFINITI U-

CONTROL encoders • Mouse or compatible pointing device • MS Word 97 or higher (for printing purposes) • Compact Flash Reader (For use with compact flash card only) • Webcam 30 frames per second (for video purposes only)

NOTE: When using certain more complex screens, you must adhere to the Recommended Computer Requirements.

Update Information Periodically updates may become available for the BioGraph Infiniti software. Please contact your local distributor or visit our website www.thoughttechnology.com for further information on how to obtain updates.

http://www.thoughttechnology.com/


QUICK START

The purpose of this guide is to help you set up your MyoTrac Infiniti U-Control system, and to provide you with a rapid overview of the main functions of the BioGraph Infiniti program as well as the Screen Editor Lite. Please refer to the on-line help manual for a more detailed description of all the functions and features of the program. To open the on-line help, simply press the F1 function key, on your keyboard, from any dialog box in the program. Because the on-line help manual is designed to provide contextual information, it will be automatically opened at the section that discusses the dialog box from which the help was called. Also, please consult the manual that came with your MyoTrac Infiniti U-Control unit.

SETUP OF MYOTRAC INFINITI™ U-CONTROL SYSTEM The following pictures illustrate the global connection of the MyoTrac Infiniti U-Control system.

Connect one end of the USB cable to your unit where it is marked with the symbol , and the other end to the USB port of your PC or laptop. For all the display screens in this suite, the rectal and vaginal sensors plug into Channel A, and the extender cables, for monitoring accessory muscles, plug into Channel B.

Channel B: Extender

cables Channel A: Vaginal/ Rectal

sensors or Extender cables

pre-gelled electrode

USB cable to computer

MyoTrac Infinti™ Unit

DIN cable


Sensor and extender cable connections

Connection to PC Connection to laptop

RECORDING SESSIONS With the BioGraph Infiniti software, two types of sessions can be recorded: Open Display and Script sessions. Open Display sessions are generally used for biofeedback training, when flexibility is important and you need to be able to rapidly change the session parameters, depending on the client's reactions. Script sessions, on the other hand, are important for recording assessment or follow-up sessions, where a standardized and constant approach is more appropriate. While both open display and script sessions can be used for trend reports, script sessions generally generate more comparable sessions. Starting the Program After making the necessary connections briefly described above, turn on your MyoTrac Infiniti U-Control unit. Start the BioGraph Infiniti software, which has the Continence suite installed. To start the program, simply double-click on the BioGraph Infiniti icon, on the Desktop, or find it in the Start Menu under Program Files\Thought Technology\Infiniti\:


The program always starts by showing the Main Menu screen:

Main Menu Screen

First Time Run: Notch Filter Options Before you start to record, make sure to set up the global notch filter to block certain frequencies caused by electrical interference from showing up in your data.

• Select “Options” at the top left of the main screen.

• Select “Notch Filter” from the drop-down

menu.

• Set Notch Filter Options to EMG and the frequency to 50 or 60 Hz depending on your region. This setting will remain until you change it.

Notch Filter dialog box

To Start Recording a Session

• Click on Start Script Session or Start Open Display Session.

• Select a Client file or create a new entry from the Start Session window.


Start Session window

Please refer to the BioGraph Infiniti Quick Start manual for other options by clicking on the “BioGraph Infiniti Docs & Editors” icon (p.12). Script Session

• Select “Start Script Session” from the Main Menu Screen, and then select a Client or create a new Client entry.

• Select an existing Client

o To record with a new script:

Click “Select New Script” to open the Script Database window. Select “MyoTrac Infinti” as the encoder communication protocol from the

drop-down menu at the top. Choose a script from the list, and click OK. A thumbnail of screens used

in the chosen script is available by enabling “Picture View”.

o To record with a previously recorded script:

Highlight a previously recorded script under the column “Session” from the Start Session window. This allows you to use the same display screens and any other changes you made during a previous session (see “CHANGING SCRIPT SETTINGS”, p.22).

• Create a new Client

o by clicking on “Add New Client”, and fill in the name at minimum. Then, follow the steps to record with a new script above.


• Click OK to go to the recording screen. If you are using your unit for the first time, you are required to enter key codes (see First Time Run: Entering Key Codes, p.16).

• Begin the script by clicking on the Start button , and follow the on-screen instructions.

Script Database window

Open Display Session

• Select “Start Open Display Session” from the main screen.

• Highlight your client’s name or add it to the list (see “Create a new Client”, p.14).

• Select “Define New Session” to open the Select up to 5 Screens for Open Display mode window.

• Choose MyoTrac Infiniti as the encoder communication protocol.

• Highlight the channel set MyoTrac Inf Rehab-Continence on the left.

• Choose a Screen from the list on the right. A thumbnail of screens is available by

enabling “Picture View” (See display screens, p.26).

Screens are listed by category. Pick a category by clicking on the drop down menu just above the screen list. You can select up to 5 screens by pressing down the CTRL key while clicking with the left mouse button.


Select up to 5 Screens for Open Display Mode window

• Click OK to go to the recording screen. If you are using your unit for the first time, you are required to enter key codes (see First Time Run: Entering Key Codes below).

• Start recording by clicking on the Start button . First Time Run: Entering Key Codes If it is the very first time you are using your MyoTrac Infiniti unit with your computer, you are required to enter key codes. A dialog box will appear after you have chosen the screens or script you want to record with and clicking OK on the Select up to 5 Screens for Open Display Mode or Script Database windows respectively.

• When the Encoder Key Codes dialog box opens, click to highlight your unit’s serial number in the left table (ex. EA1010. This is the same serial number you can see on the back of the unit).

• Type in the Encoder Key Code

(found inside the battery compartment) in the Key Code text box.

• Click on the “−−−>” arrow button to

move the serial number from the left table to the right table. The Serial number should now appear in the Configuration Table.

• When done, click OK.


• Now enter the Application Key Code for your system. This number is found with the encoder key code. Enter the number and click OK when done:

Note: If you are using more than one encoder, you only need to enter one Application Key Code.

If the key codes have been entered properly and there is no problem with your encoder setup or your sensor connections, you should now be seeing the recording screen:

STOPPING A SESSION To end recording a session, click the Stop button:

• The program asks if you want to save the recorded data. You can decide to save the session in a compressed format, but, unless you are really tight on hard drive space or you do not need to review the saved sessions, we recommend that you always Save, which will use the non-compressed format:

• Then the Session Notes pop-up appears so you can enter, if you want, a treatment code, a session description and some notes:


• Click OK to continue. Next, you are asked if you would like to review the session right away. You can switch to the review mode or the replay mode.

• If you click No, the program asks if you want to record another session with the same settings:

• If you click No, the program reminds you to turn your encoder off:

• Clicking OK, takes you back to the Main

Menu Screen.


REPLAYING SESSIONS

• Select “Database” from the main screen.

• Highlight the client whose session you wish to view from the Main Database window.

Main Database window

• Select a session on the right. A script session has the name of the script ending in “.prt”, and an open display session has the name of the channel set ending in “.chs”.

Review/Replay Session Confirmation

window

• Click on “Replay Session” at the bottom.

o If you are replaying a Script Session: close the

Edit Channel Set Setting for Current Client window to go into replay mode.

o Or if you are replaying an Open Display

Session:

Click on “Select Screens” from the Review/Replay Session Confirmation window.

From the Select Screens window highlight

up to 5 screens, then click OK.


window

Select Screens window

Click OK on the Review/Replay Session Confirmation” window to go into replay mode.

• Click on the Start button to begin.

REVIEWING SESSIONS After recording a session you can analyze the data by going into review mode. This mode allows you to scroll through the graphs, look at statistics, and print out a report displaying the data in graphical and/or statistical form. Review

• Select “Database” from the main screen.

• Highlight the client whose session you want to review from the Main Database window (p.13).

• Highlight a session on the right. A script session has the name of the script ending in

“.prt”, and an open display session has the name of the channel set ending in “.chs”.

• Click on “Review/Report” to open the Review/Replay Session Confirmation window.

• Click on “Select Screens” to open the Select Screens window (p.16).

• Click on the column heading for Category to reoder the screens into groups, and scroll down to Assessment-Review screens and highlight up to 5 screens. Click OK.


• Click OK on the Review/Replay Session Confirmation window to go into review mode. Reports

• Click on “Options” at the top of the display screen in review mode.

• Select “Set Open Display Statistics” from the drop-down menu.

• Choose “Show only channels marked as statistics”, and highlight the statistics you wish to show.

Note: This option is disabled for script sessions since the statistics are predefined.

• Press the print icon located on the top right.

• The Print Session window will appear;

make selections as to what you wish to show.

• Click Print, and an MS Word file will open;

you can then print your report.

Print Session window

TOOL BAR OPTIONS While recording, replaying or reviewing an open display session there are certain options that are available on a tool bar found near the top of the display screen. To learn more about the tool bar, refer to the online help by pressing F1 while the mouse is resting on one of the tool bar buttons (see picture of tool bar below). Toggling Between Screens If you have chosen more than one screen you can view each one by clicking on the numerical buttons on the toolbar at the top. Only up to five screens can be viewed (in the example below, there are four, where the third screen is currently on display).

Adjusting Scales and Threshold By clicking on a graph instrument you can enable any of the scale and threshold options on the toolbar shown below.


• Vertical scale: the minimum and maximum scale values can be changed by clicking on the up and down arrows to the right of the text boxes labeled with “Max” and “Min”. The

numbers increase or decrease by 0.1, but when you click on the button , the numbers change by 1.

• Multi line-graph Y1 and Y2 axes toggle: the multi-linegraph has a left and a right

vertical scale that can be adjusted independently of each other by clicking on the toggle button.

o Left vertical scale enabled:

o Right vertical scale enabled:

• Threshold: the threshold line on a bargraph, linegraph and animation scale can be adjusted in the same way as the vertical scale. The text box labeled “Thr1” is for single threshold graphs, while “Thr2” is for double threshold graphs like the multi-linegraph that can have up to two guidelines.

• Time scale: the default time for all the screens is 30 seconds. You can select a new

time scale by clicking on the drop-down menu.

MODIFYING SCREENS WITH SCREEN EDITOR LITE Display screens can be modified with the Screen Editor Lite program. You can change certain instrument settings, sounds and text without going into the details of the full Screen Editor. To learn more about the Screen Editor Lite please refer to the manual provided by clicking on the “BioGraph Infiniti Docs & Editors” icon, p.12.

CHANGING SCRIPT SETTINGS The number and duration of activities in a given script session can be modified within the BioGraph Infiniti software. You may want to change the screens that appear in a script as well as the duration of the session. The changes are made just before the recording. To learn more about this feature please refer to the manual provided by clicking on the “BioGraph Infiniti Docs & Editors” icon, p.12.


• Highlight the script you wish to modify from the Script Database window.

• Click on “Edit Script Settings” (see picture below).

• Highlight the activity to access the step(s) you wish to change.

• Highlight the step and click on “Change Screen” to use a different screen, or “Step

Duration” to change the time length. Depending on the type of step, any of these buttons may be disabled.

Note: The changes are only saved for that particular session.

Edit Script Settings window


SUITE DESCRIPTION

Most incontinence problems can be improved by biofeedback. Patients can acquire more control over their pelvic floor muscle through strengthening, reducing excessive muscle activity or using the muscles appropriately. The screens and scripts of this suite are designed to meet this goal. To start, are two scripts, Incontinence Tutorial.prt and Incontinence Evaluation.prt, that give you an overview of the system and allow you to practice recording a script session. What follows are screens grouped into categories:

• Assessment-Review • Relaxation • Strengthening • Training

The rest are screens with templates grouped under Perineal Reeducation and are described along with the training and work-rest scripts that use them (see Scripts, p.41). There is a final set of screens under the category Open Display. These consist of displays from the other groups; mostly from Perineal Reeducation, and some from Training and Assessment-Review. Their names start with ″MI od″. You willl notice that they are mostly the template screens except that these templates are repeated endlessly until the recording is stopped. Technically, all the screens in this suite can be used for Open Display sessions. However for faster access when choosing a screen to record an open session, these particular ones were grouped under this category. Also, you will find that not all of the screens have been renamed to go into the Open Display category. Most of the screens show statistics where (1) some are calculated progressively and (2) the rest are calculated periodically. The template screens have statistics that are of the first type, so when the recording stops you get statistics over the whole session. The screens with no templates show statistics of the second type and at the end of the session they show statistics of the last time period. The kinds of feedback found on these screens are various types of audio, such as music, tones, sounds and voice prompts. There are also visual media, such as animations, and different graphs that change colour when the signals pass their threshold markers.


INCONTINENCE TUTORIAL This tutorial will guide you on how to use the sensors and highlight what events to look for in an assessment. The screens shots below are shown in sequence as in the script. To view the incontinence tutorial:

• Follow the steps above on how to replay a script, p.19. • Select the client name, “Incontinence TUTORIAL”, • Select the session, “17/07/2006 4:02:18 PM MI Incontinence Tutorial.prt,

00:00:35.000” (MI Incontinence Tutorial).


INCONTINENCE EVALUATON This script will guide you through the process of evaluating incontinence, and is to be used after the incontinence tutorial. The second screen, MI UFI - Description EVAL.scr summarizes the electrode placement and the script. The third screen, MI UFI - Linegraph EVAL.scr can be used in open display mode.

SCREENS The objective of using an open display is to provide variety and engage the patient in more challenging feedback. Note: Some screen descriptions mention “animation cycles”: this is the length of time it

takes for the animation to play from start to finish. The times indicated are only approximates as they vary across computer systems. They also vary when the frame rate is changed.

Note: Counter displays are not chronometrically accurate: they can be used to count or

be used as points when conditions are met and/or sustained. Assessment/ Review The purpose of these screens is to analyze the state of the patient’s muscles at each step of their recovery and training. The various signal displays like linegraphs, 3-D spectra, histograms, and the accompanying statistics and median frequency give a level of awareness of the muscle performance. By comparing the values from the previous session with the current one you can see what needs to be improved in the next session. In addition, you can see which technique to use to improve muscle activity.


MI UFI - 1Ch Linegraph for Review

A simple screen displaying the signal from channel A. Numerical displays show the current value, some statistics and the median frequency. This sample screen was provided by the Biofeedback Foundation of Europe; designed by Nancy Schully,( p.9).

MI UFI - 1Ch linegraph raw 3D spec

A single channel display showing the raw signal from A, and a 3-D spectrum showing the signal’s frequencies from 20 to 400Hz. The numerical displays are the current value, statistics and median frequency.

MI UFI - 2Ch 2 linegraphs

The top linegraph connects to channel A, and the one below it to channel B. The numerical displays are the current values of each channel as seen at the top right, and the statistics are found near the bottom.

MI UFI - 2Ch Assessment

The signals of channel A and B are depicted in different formats: single linegraph, 3-D spectrum and numerical displays. The numbers show the current values of each signal and their statistics.


MI UFI - 2Ch Assessment-Histogram

This is for a more involved assessment or review. The histogram displays the mean of channel A every 5 seconds. The first multi-linegraph connects to both channels A and B, and the second multi-linegraph shows the median frequency. The two single linegraphs are the raw signals, and the 3-D spectra show the frequencies from 20 to 200Hz. The numerical displays are the current values and statistics.

MI UFI - 2Ch bargraphs-no sound

The purpose of this screen is to see whether the signal of A can be maintained above or below threshold for a specified duration. In the meantime B should remain below threshold. This display can also be used for training (p.36). Opening the screen in Screen Editor Lite (p.22)you can enter the value for the duration. by double-clicking beside “Seconds”.

MI UFI - 2Ch linegraph raw 3D spec

This is a 2-channel version of MI UFI - 1Ch linegraph raw 3D spec., p.27.

MI UFI - 2Ch Multi-linegraph l-r scale

Both channels A and B are shown on a mulit-linegraph to easily compare the shape of the signals. The numerical displays are the current values, statistics and median frequencies. Note: to measure the height of channel A’s signal use the left vertical scale, and for B’s use the right vertical scale. Open Display: MI od UFI - 2Ch Multi-linegraph l-r scale This sample screen was provided by the Biofeedback Foundation of Europe; designed by Nancy Schully ( p.9).


MI UFI - 2Ch multi-linegraph

This is similar to MI UFI - 2Ch Multi-linegraph l-r scale above, but both signals share the same vertical scale on the left and there is no median frequency

MI UFI - 2Ch single-multi-linegraphs

The signals from channel A and B can be compared or analyzed separately. The numerical displays are the current values found on the top right, and the statistics and median frequencies found at the bottom. Note: to measure the height of channel A’s signal use the left vertical scale, and for B’s use the right vertical scale. This sample screen was provided by the Biofeedback Foundation of Europe; designed by Nancy Schully ( p.9).

Relaxation The relaxation screens are designed to reinforce lowering levels of EMG activity. The rewards are typically set to encourage EMG activity to fall below its threshold. As the patient releases muscle tension/activity they are rewarded through audio and visual feedback usually linked to an animation or signal display.

MI UFI - 1Ch bargraph

A simple bargraph display ideal for individuals that need help focusing on relaxation. When the threshold is set above the patient’s resting level soft music is heard as long as the signal stays below its threshold. The objective is to assist relaxation through soothing audio feedback.


MI UFI - 1Ch Earth Puzzle

A more actively challenging display for relaxation when you set the animation threshold below the patient’s resting level. As the EMG activity relaxes, the patient is rewarded by puzzle pieces filling in fast and a constant low pitch tone is heard. A single tone alarm is heard whenever the EMG activity returns to a level above the animation’s threshold.

MI UFI - 1Ch filled line-bar graphs

A simple filled linegraph display. As the EMG activity falls below the linegraph’s threshold, hearing music will reward the patient.

MI UFI - 1Ch Growing Fractal 02

This display assists a patient to differentiate between contracting and relaxing their muscles. Set the animation scale to a maximum value that is appropriate for a low sub-maximal contraction. Set the animation threshold in the middle of this scale. As the patient sustains a sub-maximal contraction and the EMG activity goes above the threshold, the fractal will fill in. As the patient releases the contraction and the EMG activity falls below its threshold the fractal will slowly open and a relaxing song is heard. The complete animation cycle takes approximately 20 seconds, 10 on each side of the threshold. This sample screen was provided by the Biofeedback Foundation of Europe; designed by Nancy Schully( p.9).

MI UFI - 1Ch Parrot Puzzle

A simple display screen consisting of an animation and a linegraph. A sustained contraction of about 20 seconds above threshold removes the puzzle pieces. A release of the muscle activity of about the same duration below threshold fills in the puzzle and plays a relaxing song. This sample screen was provided by the Biofeedback Foundation of Europe; designed by Nancy Schully( p.9).


MI UFI - 1Ch Parrot Puzzle bargraph

This screen consists of an animation and a bargraph. The animation cycle is approximately 40 seconds. A sustained contraction of about 20 seconds above threshold removes all the puzzle pieces. A sustained release/relaxation of about 20 seconds below threshold completes the puzzle, and rewards the patient with soft music. As soon as the signal goes below the threshold, soft music plays, but the pieces only start filling in after 3 seconds. This display can also be used for strengthening.

MI UFI - 1Ch Smiley

A sustained contraction of about 3-4 seconds above threshold turns the smiley face into a frowning one and eliminates the music. Relaxing the muscle activity for about 3-4 seconds below threshold returns to a smiley face and plays a joyful song.

MI UFI - 2Ch line-filled graphs

Channel A is the filled linegraph and channel B the single linegraph. Both signals change color when crossing the threshold. Soft music is heard when both channels are below threshold. If either channel moves above threshold the music stops.

MI UFI - 2Ch Relaxation Green light

As channel A goes below the threshold notice the signal’s colour changing, music playing, and the green light brightening. A counter linked to the blue linegraph represents the length of time channel A activity is staying below its threshold. If A crosses above the threshold the counter resets to 0 and the music stops This sample screen was provided by the Biofeedback Foundation of Europe; designed by Nancy Schully( p.9).


MI UFI - 2Ch Relaxation with DVD

The DVD will play as long as both channels are below their threshold. If either goes above threshold the DVD pauses. This sample screen was provided by the Biofeedback Foundation of Europe; designed by Nancy Schully( p.9).

Strengthening The strengthening screens described here are primarily used for reinforcing muscle contractions of channel A. Feedback is initiated when the signal crosses the threshold of the graph or scale displaying that signal. In order for the reward to be effective, the contraction must be sustained above the threshold for a period of time. Therefore, the threshold setting is not a goal in and of itself; the sustained contraction is the goal. Set the threshold such that it is attainable by the patient. For instance, 40% of the average of a 10 second contraction would be achievable. Most clinicians make a judgement call for each patient depending on how the person performed during their assessment from that session. In order for the muscle to improve its ability to sustain a contraction it must have time to rest and recover between contractions. However, open display screens do not have built-in cycles of work and rest; therefore, you must remember to cue the patient during a rest. Several of the strengthening screens have conditional requirements for both channels A and B. Typically, channel A must stay above its threshold and channel B must stay below for the reward to kick in. If one of the conditions is not met, then the reward is not provided or the animation is reset to the beginning of its cycle. (Note that some of the animation cycles are short and some of them are as long as 45 seconds). Even though both conditions must be maintained for the reward, a beginning patient with extremely poor muscle tone can utilize all of these open display screens. The variable in using these screens for well-conditioned muscle tone vs. extremely poor muscle tone is the scale of the animation and/or the threshold setting.


MI UFI - 1Ch Dolphin Puzzle

A song will be heard immediately when the signal goes above the threshold setting on the bargraph. But, a sustained contraction of at least 3 seconds above threshold is required before pieces start to fill in the Dolphin puzzle. When the signal goes below threshold, the song stops as well as the animation. Both resume as soon as the signal goes above the threshold. Changing the scales on the bargraph will not impact the display; the threshold setting controls the display.

MI UFI - 1Ch Fractal 06

The fractal partially closes when the signal is above the threshold, and opens up and disappears when the signal is below. The complete animation cycle is about 40 seconds. Audio feedback is available both above and below the threshold. Above is a song, and below are birds. This sample screen was provided by the Biofeedback Foundation of Europe; designed by Nancy Schully( p.9).

MI UFI - 1Ch Jumping Car

The car morphs to upbeat music when the signal is above the threshold. The music softens as the signal nears the orange line from above, and gets louder as the signal moves away. The car stops moving and a constant tone can be heard when the signal is below the threshold. This sample screen was provided by the Biofeedback Foundation of Europe; designed by Nancy Schully( p.9).

MI UFI - 1Ch Jumping Puppet

The puppet’s posture is dependent on the scale of the animation; therefore, the puppet is completely extended when the EMG is above the maximum scale setting. Try changing the upper scale of the animation as if it was a threshold. There is no audio feedback. This sample screen was provided by the Biofeedback Foundation of Europe; designed by Nancy Schully( p.9).


MI UFI - 2Ch Butterflies

Butterflies and flowers appear to the sound of chirping birds when the signal goes above the threshold. But the butterflies and flowers disappear as a relaxing song plays when the signal goes below the threshold. The animation cycle is very short: about 3-4 seconds. This display can also be used for relaxing.

MI UFI - 2Ch Conditional DVD

The DVD stays on when the Channel A signal is above its threshold and Channel B signal stays below. If either condition is not met the DVD stops playing.

MI UFI - 2Ch Drying Lake

The water recedes and seagulls can be heard as channel A stays above the threshold and the channel B stays below. Both animation and sound stop when the Channel A falls below the threshold. The animation resets once the Channel B goes above the threshold. The animation can be reset manually and its cycle is about 20 seconds.

MI UFI - 2Ch Fading Mouse

As Channel A stays above its threshold on the bargraph and Channel B stays below, the picture will focus. The counter will display the length of time this condition is being met. If Channel B exceeds its threshold the animation and the counter reset. This animation can be reset manually. There is no audio feedback on this display, and the animation cycle is about 47 seconds.


MI UFI - 2Ch Filled linegraph

The audio feedback is conditional to both channels of EMG. Music will play when Channel A is above its threshold and Channel B is below. If B exceeds its threshold the music stops. Also notice the color changes on the graphs as the signal crosses threshold. Open display: MI od UFI - 2Ch Filled linegraph

MI UFI - 2Ch filled linegraphs

The audio feedback is a midi splitter musical piece. Each channel represents different parts of the musical piece. When Channel A is above its threshold and Channel B is below its threshold both parts are heard. When both channels are out of condition the song stops playing. If either condition is not met only one part is heard.

MI UFI - 2Ch Flower Explosion

The animation is conditional to both channels. As Channel A stays above its threshold and Channel B stays below the flower explodes. A counter represents the length of time A is above and B is below. If Channel A falls below its threshold the cycle is suspended. If Channel B exceeds its threshold the flower and the counter reset to the beginning. The complete animation cycle is about 30 seconds.

MI UFI - 2Ch Hero Morph-fast

The animation represents Channel A and is dependent on the scale on the left. The boy morphs into a superman when Channel A’s signal is toward the upper range of the scale. As the signal comes down the scale, the superman returns to a boy. No audio feedback.


MI UFI - 2Ch Hero Morph-slow

The animation is connected to Channel A, and is threshold dependent. Once the signal goes above its threshold the boy slowly morphs into a superman. The complete animation cycle is about14 seconds. There is an audio tone heard when the signal is above threshold. If Channel B exceeds its threshold the animation resets to the beginning. The animation can also be reset manually.

MI UFI - 2Ch Turtle

The picture of a turtle will slowly zoom in when Channel A is above its threshold and B is below. The picture will freeze if A falls below its threshold. Both picture and counter will reset if Channel B exceeds its threshold. The counter maintains the length of time these conditions are met. The complete animation cycle takes about 24 seconds.

Training After the patient has gained some muscle control they can test their newly developed skill with more difficult screens. The first few displays provide different exercises involving contractions and releases using various animations. A couple of screens deal with sustaining release below resting levels. The remaining screens have simple templates that the patient can follow. The templates shown are for one cycle and only go up as high as 10µV. Also, in an open display recording these guides will go on continuously until the session is stopped. When the patient reaches the lowest level of the template allow them to go lower if they can. For more complicated templates and suggestions on how to train with them see Templates and Template Training below (p.51).


MI UFI - 2Ch Animal game

An exercise to control muscle contraction by lining up the cartoon man with the animal as shown in the blue square while the line-up of animals constantly changes. Channel A is connected to the animation. The stronger the contraction the further the man moves to the right, and to keep the man moving the signal from channel B should remain below its threshold. Adjusting the maximum scale setting on the animation can make the game easier or more difficult. The higher the scale setting the stronger the contraction must be to move the man to the far right. See Adjusting Scales and Thresholds (p.21).

MI UFI - 2Ch Car race

The aim is to make the blue car of channel A pass the finish line (the white bar on the far right of each track) before the yellow car of channel B. To meet this goal, A must stay above its threshold while B stays below. The points for A increment when both channels are in condition, and the points for B increment when B is above threshold.

MI UFI - 2Ch Green light

This display focuses on training the muscle of channel A to go below its resting level so as to reinforce the notion of release. With practice, the patient learns how to reverse a muscle spasm towards a sustained release of a relaxed muscle. As channel A goes below threshold, the green light turns on. The points represent the length of time the signal stays below the threshold (assuming resting levels are about 2µV). Channel B linegraph does not influence the animation, but simply to monitor accessory muscles.

MI UFI - 2Ch Growing Sphere

Channel A controls the ball. Relaxing the muscle enlarges the ball and contracting it shrinks the ball. Like the screen MI UFI – 2Ch Green light, above, this one can also be used to maintain release below resting levels. Channel B changes colour when it passes the threshold. Adjusting the maximum scale setting on the animation can make the task easier or more difficult. See Adjusting Scales and Thresholds, p.21. This sample screen was provided by the Biofeedback Foundation of Europe; designed by Nancy Schully( p.9).


MI UFI - 2Ch Maze

To complete the maze the muscle of channel A must be contracted enough for the dot to reach the center. The animation stops when channel B goes above threshold. Adjusting the maximum scale setting on the animation can make the task easier or more difficult. The higher the scale setting the stronger the contraction must be to complete the maze. See Adjusting Scales and Thresholds, p.21.

MI UFI - 2Ch template03

Open display: MI od UFI - 2Ch template03 This sample screen was provided by the Biofeedback Foundation of Europe; designed by Nancy Schully( p.9).

























The exercise to be performed is • start with 4 seconds of rest. • then 4 to 5 seconds of work • followed by 3 seconds of rest • repeat the work and rest 2 more times • then end with 10 to 20 seconds of rest.

This template is set to cycle only once during an open display recording as well as during replay. Open display: MI od UFI - 2Ch template14 This sample screen was provided by the Biofeedback Foundation of Europe; designed by Nancy Schully( p.9).

SCRIPTS Scripts allow the development of predefined protocols that provide clinicians the ability to group together varied types of activities with specific display screens. The results are a set statistics that can be trended across sessions reflecting patient progress and can help determine the type of exercise and/or practice that is needed by that patient. The first two are general scripts for pelvic muscle dysfunction: one is an assessment and the other a work-rest exercise. The next set is a series of work-rest and training scripts focusing on perineal reeducation. These work-rest scripts provide short exercise sessions with simple templates. The training scripts are longer sessions with complex templates and they can be used in the design of a treatment program. Although the screens featured in this section are used for scripts, they can also be used in open display sessions. For simplicity, only the screen that characterizes the script will be shown. In the case of the perineal training scripts, only the screen for its Level 1 is shown (see Templates, p.51). Pelvic Muscle Dysfunction Assessment Script There are many types of biofeedback assessments for the pelvic muscles and are typically dependent upon the type of incontinence and or muscle dysfunction the patient presents. One of the scripts included within the Continence Suite is “MI PMD Assessment 5 Activities.” This is a basic assessment protocol that allows the clinician an objective measurement of pelvic muscle function and progress. The 5-activity assessment looks at the “Resting Level” of the Pelvic Muscles before and after a series of exercises. The purpose is to see the statistical mean of the resting levels of both channels A and B. The assessment also includes exercises for “Quick Contractions,” “Contract & Hold” and “Endurance”. Each type of exercise results in a different outcome that is then utilized to determine what type of exercise is needed for that day’s session and how to best individualize the various open display screens for that patient. For instance, the resting level mean obviously is used as a guide for establishing the threshold value for “relaxation” type open display screen exercises. During the “Quick Contraction” exercise, the maximum value is representing a value that would be appropriate to set the y-axis maximum scales on either the animation or graph displays. “Contract & Hold” ‘s result in a mean value for both the work cycle and rest cycle that can then help to calculate the 40% upper


threshold setting on “strengthening” open display screens. And finally the mean value on channel A from the endurance can provide you with a sub-maximal threshold value. As mentioned the script is divided into 5 activities: 1. Pre-baseline; divided into 3 steps:

a. Verify signal: take the time to make sure the sensor and cables are connected properly. No data is recorded. Pressing any key on your keyboard allows you to advance to the next step.

b. Read instructions: gives you an overview of what to expect; no data is recorded; press any key when you are done.

c. Pre-baseline: relax muscles to determine initial resting level. Duration is 60 seconds. Statistics calculated: mean and median frequency for both channels

2. Quick contractions; divided into 2 steps and repeats 3 times:

a. Relax: duration is 4 seconds. Statistics calculated: mean and median frequency for both channels.

b. Quick contractions: contract quickly 1 to 3 times during 6 seconds. Statistics calculated: maximum for both channels and median frequency for A.

3. Contract and hold; divided into 2 steps and repeats 3 times:

a. Relax: duration is 10 seconds. b. Contract and hold: maintain contraction for 10 seconds.

Statistics calculated: mean for both channels, and maximum and median frequency for A.

4. Endurance; divided into 2 steps:

a. Relax: duration is 5 seconds b. Contract and hold: maintain contraction for 20 seconds.

Statistics calculated: mean for both channels, and median frequency for A.

5. Post Baseline: relax muscles to determine new resting levels; duration is 60 seconds.

Statistics calculated: the same as activity 4.

1a. Verify signal 1b. Instructions 1c. Pre-baseline


2a,b. Relax, Quick contractions 3a,b. Relax, Contrac and hold 4a,b. Relax, Sustain contraction

5. Post baseline

This sample script was provided by the Biofeedback Foundation of Europe; designed by Nancy Schully( p.9). Pelvic Muscle Dysfunction Work-Rest Script The script is divided into 3 activities:

1. Pre-baseline; divided into 3 steps: a. Verify signal: take the time to make sure the sensor and cables are connected

properly. No data is recorded. Pressing any key on your keyboard allows you to advance to the next activity.

b. Read instructions: gives you an overview of what to expect; no data is recorded; press any key when you are done.

c. Pre-baseline: relax muscles to determine initial resting level. Duration is 60 seconds.

2. Rest-work cyle: divided into 2 steps and repeated 10 times:

a. Rest: relax muscles for 10 seconds. b. Work: contract and hold for 10 seconds.

3. Post baseline: relax muscles to determine new resting levels; duration is 60 seconds.

Statistics calculated for parts 1c, 2a, 2b and 3: mean and median frequency for both channels.


1a. Verify signal 1b. Instructions 1c. Pre-baseline

2. Rest-Work 3. Post basline

This sample script was provided by the Biofeedback Foundation of Europe; designed by Nancy Schully( p.9). Perineal Work-Rest Scripts Each script is made up of 3 activities: 1. Pre-baseline; divided into 2 steps:

a. Verify signal: take the time to make sure the sensor and cables are connected properly. No data is recorded. Pressing any key on your keyboard allows you to advance to the next activity.

b. Pre-Baseline: relax muscles to determine initial resting level. Duration is 15 seconds.

2. Work-Rest: template exercise starting with a contraction then a relaxation cycling 5 times.

Duration depends on the work and rest parts.

3. Post-Baseline: relax muscles to determine new resting level. Duration is 15 seconds. Statistics calculated by default for parts 1b, 2 and 3: maximum, minimum, mean, standard deviation, and variability for both channels.


1a. Verify Signal 1b. Pre-Baseline 2. Work-Rest

3. Post Baseline

The displays shown below are under the category of Perineal Reeducation. As well, listed beside them are theirs names, the scripts that use them, the duration of each work and rest parts, their Open Display screen names, and the maximum height of their templates. Also, their templates have 5 cycles of work and rest.

MI UFI – 2 Ch line-bar graph

An overview screen where the linegraph connects to channel A and the bargraph to channel B. A midi tone playing when A goes below its threshold and B goes above its threshold. Digital displays of minimum, maximum and mean are shown at the bottom. Note: This screen is the base for all the template screens including the ones under the Training (p.36) category found above. Open display: MI od UFI – 2 Ch line-bar graph


MI UFI – 2Ch 5 cycles 4-4sec template

Used in the script: Perineal Reeducation 4-4 sec Work: 4 sec Rest: 4 sec Open display: MI od UFI – 2Ch 5 cycles 4-4sec template Max template height: 15µV










Perineal Training Scripts The scripts in this section allow you to customize a treatment itinerary for you patient. Each planned exercise has a template screen that the person can follow. As a guide, there are three scripts that are designated as the start, middle and end of the treatment:

• Perineal Control Start-treatment • Perineal Control Mid-treatment • Perineal Control End-treatment

As well, the scripts have different levels of difficulty catering to patients of varying abilities. A beginning patient can start with the easiest exercise and then work their way up to the more difficult ones as they improve. To look at the different levels see the Templates, p.51. Each script is made up of 3 activities:

1. Verify signal: take the time to make sure the sensor and cables are connected properly. No data is recorded. Pressing any key on your keyboard allows you to advance to the next activity.

2. Template exercise: follow the mauve line by controlling muscle contractions. Data is

recorded. The duration of this part depends on the template.

3. Relax: release muscle. The same statistics are calculated, and the duration is 15 seconds.

Statistics calculated by default for parts 2 and 3: maximum, minimum, mean, standard deviation, and variability for both channels.


1. Verify signal 2. Template exercise 3. Relax

The displays shown below are under the category of Perineal Reeducation. As well, listed beside them are theirs names for each level, the scripts that use them, the script duration, and their Open Display screen names.

MI Controlled Perineal Contraction 0_1

MI Controlled Perineal Contraction 1 MI Controlled Perineal Contraction 2 MI Controlled Perineal Contraction 3 Used in the scripts: (Duration: 14 minutes) _MI Controlled Perineal Contraction-0_1 / …1 / …2 / …3 Open displays: MI od Controlled Perineal Contraction 0_1 / …1 / …2 / …3

MI Held Perineal Contractions 0_1

MI Held Perineal Contractions 1 MI Held Perineal Contractions 1_1 MI Held Perineal Contractions 2 MI Held Perineal Contractions 3 Used in the scripts (Duration: 12 minutes): _MI Held Perineal Contraction-0_1 / …1 / …1_1 / …2 / …3 Open displays: MI od Held Perineal Contractions 0_1 / …1 / …1_1 / …2 / …3


MI PC Hypertonicity 0_1

MI PC Hypertonicity 1 MI PC Hypertonicity 2 Used in the scripts (Duration: 4 minutes): _MI PC Hypertonicity-0_1 / …1 / …2 Open displays: MI od PC Hypertonicity 0_1 / …1 / …2 Template cycles only once.

MI PC Hypotonicity 0_1

MI PC Hypotonicity 1 MI PC Hypotonicity 2 Used in the scripts (Duration: 15 minutes): _MI PC Hypotonicity-0_1 / …1 / …2 Open displays: MI od PC Hypotonicity 0_1 / …1 / …2

MI Perineal Control End-treatment 0_1

MI Perineal Control End-treatment 0_2 MI Perineal Control End-treatment 1 MI Perineal Control End-treatment 2 MI Perineal Control End-treatment 3 Used in the scripts (Duration: 10 minutes): _MI Perineal Control End-treatment-0_1 / …0_2 / …1 / …2 / …3 Open displays: MI od Perineal Control End-treatment 0_1 / …0_2 / …1 / …2 / …3

MI Perineal Control Mid-treatment 0_1

MI Perineal Control Mid-treatment 1 MI Perineal Control Mid-treatment 1 MI Perineal Control Mid-treatment 1 Used in the scripts (Duration: 10 minutes): _MI Perineal Control Mid-treatment-0_1 / …1 /…2 / …3 Open displays: MI od Perineal Control Mid-treatment 0_1 / …1 /…2 / …3


MI Perineal Control Start-treatment 0_1

MI Perineal Control Start-treatment 1 MI Perineal Control Start-treatment 2 MI Perineal Control Start-treatment 2_1 MI Perineal Control Start-treatment 3 Used in the scripts (Duration: 10 minutes): _MI Perineal Control Start-treatment-0_1 / …1/ …2 / …2_1 / …3 Open Displays: MI od Perineal Control Start-treatment 0_1 / …1/ …2 / …2_1 / …3

MI Postpartum Perineal Tonicity 0_1

MI Postpartum Perineal Tonicity 1 MI Postpartum Perineal Tonicity 1_1 MI Postpartum Perineal Tonicity 2 MI Postpartum Perineal Tonicity 3 Used in the scripts (Duration: 15 minutes): _MI Postpartum Perineal Tonicity-0_1 / …1 / …1_1 / …2 / …3 Open displays: MI od Postpartum Perineal Tonicity 0_1 / …1 / …1_1 / …2 / …3

MI Relaxation of Perineal Muscles 0_1

MI Relaxation of Perineal Muscles 1 Used in the scripts (Duration: 1.5 minutes): _MI Relaxation of Perineal Muscles-0_1 / …1 Open display: MI od Relaxation of Perineal Muscles 0_1 / …1 Template cycles only once.

MI Stress Incontinence 0_1

MI Stress Incontinence 0_2 MI Stress Incontinence 1 MI Stress Incontinence 1_1 MI Stress Incontinence 2 MI Stress Incontinence 3 Used in the scripts (Duration: 10 minutes): _MI Stress Incontinence-0_1 / …0_2/ …1 / …1_1 / …2 / …3 Open display: MI od Stress Incontinence 0_1 / …0_2/ …1 / …1_1 / …2 / …3


TEMPLATES AND TEMPLATE TRAINING Templates give a means of setting a goal line that varies in the type of contractions to be done. In a sense they provide a lesson plan for the patient to follow as opposed to having the exercise verbalized. In general these templates combine gradual, quick and sustained contractions with gradual and sustained release. Sharp peaks represent quick contractions; plateaus higher than 2µV are sustained contractions; and plateaus at 2µV or lower for sustained release/relaxation (this is assuming the resting level is around 2µV). Naturally, following a template requires practice and precise muscle control. With unstable muscle activity it is difficult to trace the lines with the EMG signal. For a beginning patient select a level that they can easily achieve, that is, a level within the range of their contractions. Then gradually increase the level as their skill improves. Different positions can also used to help the muscle in template training. Work incrementally at each stage starting with the supine position where muscles are relaxed, then the sitting position where the back muscles come into play, and finally the standing position, which is the most difficult since more muscles are used to stay upright. When the patient reaches the lowest point on a template, allow them to release completely even if it goes below resting levels. This gives a chance for the muscle to fully relax between contractions. Perineal Training Templates For clarity, only one cycle of each of the templates is shown. However, many of them are repeated a number of times to give a total duration appropriate for the training to be undertaken. These templates are provided with different levels of intensity for guiding patients of different levels of ability.

Controlled Perineal Contractions

Duration: 14 minutes (10 repetitions) Level 0_1 – 3/6/8/10µV

Level 1 – 5/10/15/20/25µV

Level 2 – 5/15/25/35/45µV

Level 3 – 5/20/40/60/80µV

Held Perineal Contractions

Duration: 12 minutes (10 repetitions) Level 0_1 – 4/7/10µV

Level 1 – 5/15/30µV

Level 1_1 – 5/25/45µV

Level 2 – 5/30/60µV

Level 3 – 5/60/90µV


PC Hypertonicity

Duration: 4 minutes (1 repetition) Level 0_1 – 3/6/8/10µV

Level 1 – 5/10/15/25µV

Level 2 – 5/10/20/35µV

PC Hypotonicity

Duration: 15 minutes (20 repetitions) Level 0_1 – 4/7/10µV

Level 1 – 5/10/20µV

Level 2 – 5/20/40µV

Perineal Control End-Treatment


Level 0_2 – 5/10/15/25µV

Level 1 – 5/10/30/50µV

Level 2 – 5/15/50/70µV

Level 3 – 5/20/60/90µV

Perineal Control Mid-Treatment


Level 1 – 5/10/15/20/25µV

Level 2 – 5/15/25/35/45µV

Level 3 – 5/20/40/60/80µV

Perineal Control Start-Treatment


Level 1 – 5/10/15/20µV

Level 2 – 5/15/25/35µV

Level 2_1 – 5/15/30/45µV

Level 3 – 5/20/40/60µV


Postpartum Perineal Tonicity


Level 1 – 5/10/15/20/25µV

Level 1_1 – 5/15/25/35/45µV

Level 2 – 5/20/30/40/50µV

Level 3 – 5/30/50/70/90µV

Relaxation of Perineal Muscles

Duration: 90 seconds (1 repetition) Level 0_1 – 4/6/8/10µV

Level 1 – 5/10/15/25µV

Stress Incontinence

Duration: 10 minutes (10 repetitions) Level 0_1 – 3/4/5/6/8/10µV

Level 0_2 – 4/8/12/16/20/25µV

Level 1 – 5/10/15/20/25/30µV

Level 1_1 – 5/10/15/25/35/45µV

Level 2 – 5/20/30/40/50/60µV

Level 3 – 5/20/40/60/80/100µV


REQUIRED FILES FOR THE MYOTRAC INFINITI™ CONTINENCE SUITE

Channel Set

MyoTrac Inf Rehab-Continence.chs

Screens

MI Controlled Perineal Contraction 0_1.scr MI Controlled Perineal Contraction 1.scr MI Controlled Perineal Contraction 2.scr MI Controlled Perineal Contraction 3.scr MI Held Perineal Contractions 0_1.scr MI Held Perineal Contractions 1.scr MI Held Perineal Contractions 1_1.scr MI Held Perineal Contractions 2.scr MI Held Perineal Contractions 3.scr MI Instructions - PMD Assessment.scr MI Instructions - Rest Work Cycles.scr MI od Controlled Perineal Contraction 0_1.scr MI od Controlled Perineal Contraction 1.scr MI od Controlled Perineal Contraction 2.scr MI od Controlled Perineal Contraction 3.scr MI od Held Perineal Contractions 0_1.scr MI od Held Perineal Contractions 1.scr MI od Held Perineal Contractions 1_1.scr MI od Held Perineal Contractions 2.scr MI od Held Perineal Contractions 3.scr MI od PC Hypertonicity 0_1.scr MI od PC Hypertonicity 1.scr MI od PC Hypertonicity 2.scr MI od PC Hypotonicity 0_1.scr MI od PC Hypotonicity 1.scr MI od PC Hypotonicity 2.scr MI od Perineal Control End-treatment 0_1.scr MI od Perineal Control End-treatment 0_2.scr MI od Perineal Control End-treatment 1.scr MI od Perineal Control End-treatment 2.scr MI od Perineal Control End-treatment 3.scr MI od Perineal Control Mid-treatment 0_1.scr MI od Perineal Control Mid-treatment 1.scr MI od Perineal Control Mid-treatment 2.scr MI od Perineal Control Mid-treatment 3.scr MI od Perineal Control Start-treatment 0_1.scr MI od Perineal Control Start-treatment 1.scr MI od Perineal Control Start-treatment 2.scr MI od Perineal Control Start-treatment 2_1.scr MI od Perineal Control Start-treatment 3.scr MI od Postpartum Perineal Tonicity 0_1.scr MI od Postpartum Perineal Tonicity 1.scr MI od Postpartum Perineal Tonicity 1_1.scr MI od Postpartum Perineal Tonicity 2.scr MI od Postpartum Perineal Tonicity 3.scr MI od Relaxation of Perineal Muscles 0_1.scr MI od Relaxation of Perineal Muscles 1.scr MI od Stress Incontinence 0_1.scr MI od Stress Incontinence 0_2.scr MI od Stress Incontinence 1.scr MI od Stress Incontinence 1_1.scr MI od Stress Incontinence 2.scr

MI od Stress Incontinence 3.scr MI od UFI - 2 Ch line-bar graph.scr MI od UFI - 2Ch Filled linegraph.scr MI od UFI - 2Ch Multi-linegraph l-r scale.scr MI od UFI - 2Ch template03.scr MI od UFI - 2Ch template04.scr MI od UFI - 2Ch template05.scr MI od UFI - 2Ch template06.scr MI od UFI - 2Ch template07.scr MI od UFI - 2Ch template08.scr MI od UFI - 2Ch template09.scr MI od UFI - 2Ch template10.scr MI od UFI - 2Ch template11.scr MI od UFI - 2Ch template12.scr MI od UFI - 2Ch template13.scr MI od UFI - 2Ch template14.scr MI od UFI - Line graph EVAL.scr MI PC Hypertonicity 0_1.scr MI PC Hypertonicity 1.scr MI PC Hypertonicity 2.scr MI PC Hypotonicity 0_1.scr MI PC Hypotonicity 1.scr MI PC Hypotonicity 2.scr MI Perineal Control End-treatment 0_1.scr MI Perineal Control End-treatment 0_2.scr MI Perineal Control End-treatment 1.scr MI Perineal Control End-treatment 2.scr MI Perineal Control End-treatment 3.scr MI Perineal Control Mid-treatment 0_1.scr MI Perineal Control Mid-treatment 1.scr MI Perineal Control Mid-treatment 2.scr MI Perineal Control Mid-treatment 3.scr MI Perineal Control Start-treatment 0_1.scr MI Perineal Control Start-treatment 1.scr MI Perineal Control Start-treatment 2.scr MI Perineal Control Start-treatment 2_1.scr MI Perineal Control Start-treatment 3.scr MI Postpartum Perineal Tonicity 0_1.scr MI Postpartum Perineal Tonicity 1.scr MI Postpartum Perineal Tonicity 1_1.scr MI Postpartum Perineal Tonicity 2.scr MI Postpartum Perineal Tonicity 3.scr MI Relaxation of Perineal Muscles 0_1.scr MI Relaxation of Perineal Muscles 1.scr MI Stress Incontinence 0_1.scr MI Stress Incontinence 0_2.scr MI Stress Incontinence 1.scr MI Stress Incontinence 1_1.scr MI Stress Incontinence 2.scr MI Stress Incontinence 3.scr MI UFI - 1Ch bargraph.scr MI UFI - 1Ch Dolphin Puzzle.scr

MI UFI - 1Ch Earth Puzzle.scr MI UFI - 1Ch filled line-bar graphs.scr MI UFI - 1Ch Fractal 06.scr MI UFI - 1Ch Growing Fractal 02.scr MI UFI - 1Ch Jumping Car.scr MI UFI - 1Ch Jumping Puppet.scr MI UFI - 1Ch Linegraph for Review.scr MI UFI - 1Ch linegraph raw 3D spec.scr MI UFI - 1Ch Parrot Puzzle bargraph.scr MI UFI - 1Ch Parrot Puzzle.scr MI UFI - 1Ch Smiley.scr MI UFI - 2 Ch line-bar graph.scr MI UFI - 2Ch 2 linegraphs.scr MI UFI - 2Ch 5 cycles 4-4sec template.scr MI UFI - 2Ch 5 cycles 4-8sec template.scr MI UFI - 2Ch 5 cycles 6-6sec template.scr MI UFI - 2Ch 5 cycles 6-12sec template.scr MI UFI - 2Ch 5 cycles 10-10sec template.scr MI UFI - 2Ch Animal game.scr MI UFI - 2Ch Assessment.scr MI UFI - 2Ch Assessment-Histogram.scr MI UFI - 2Ch bargraphs-no sound.scr MI UFI - 2Ch Butterflies.scr MI UFI - 2Ch Car race.scr MI UFI - 2Ch Conditional DVD.scr MI UFI - 2Ch Drying Lake.scr MI UFI - 2Ch Fading Mouse.scr MI UFI - 2Ch Filled linegraph.scr MI UFI - 2Ch filled linegraphs.scr MI UFI - 2Ch Flower Explosion.scr MI UFI - 2Ch Green light.scr MI UFI - 2Ch Growing Sphere.scr MI UFI - 2Ch Hero Morph-fast.scr MI UFI - 2Ch Hero Morph-slow.scr MI UFI - 2Ch line-filled graphs.scr MI UFI - 2Ch linegraph raw 3D spec.scr MI UFI - 2Ch Maze.scr MI UFI - 2Ch Multi-linegraph l-r scale.scr MI UFI - 2Ch multi-linegraph.scr MI UFI - 2Ch Relaxation Green light.scr MI UFI - 2Ch Relaxation with DVD.scr MI UFI - 2Ch single-multi-linegraphs.scr MI UFI - 2Ch template03.scr MI UFI - 2Ch template04.scr MI UFI - 2Ch template05.scr MI UFI - 2Ch template06.scr MI UFI - 2Ch template07.scr MI UFI - 2Ch template08.scr MI UFI - 2Ch template09.scr MI UFI - 2Ch template10.scr MI UFI - 2Ch template11.scr MI UFI - 2Ch template12.scr


MI UFI - 2Ch template13.scr MI UFI - 2Ch template14.scr MI UFI - 2Ch Turtle.scr MI UFI - 2EMG linegraph.scr MI UFI - Assessment Protocol.scr MI UFI - Contents.scr

MI UFI - Description1.scr MI UFI - Description2.scr MI UFI - Description3.scr MI UFI - Description EVAL.scr MI UFI - Electrode Placement1.scr MI UFI - Electrode Placement2.scr

MI UFI - Electrode Placement3.scr MI UFI - End of Tutorial2.scr MI UFI - End of Tutorial.scr MI UFI - Line graph EVAL.scr MI UFI - Welcome.scr MI UFI - WelcomeEVAL.scr

Scripts

_MI Controlled Perineal Contraction-0_1.prt _MI Controlled Perineal Contraction-1.prt _MI Controlled Perineal Contraction-2.scr _MI Controlled Perineal Contraction-3.prt _MI Held Perineal Contraction-0_1.prt _MI Held Perineal Contraction-1.prt _MI Held Perineal Contraction-1_1.prt _MI Held Perineal Contraction-2.prt _MI Held Perineal Contraction-3.prt _MI PC Hypertonicity-0_1.prt _MI PC Hypertonicity-1.prt _MI PC Hypertonicity-2.prt _MI PC Hypotonicity-0_1.prt _MI PC Hypotonicity-1.prt _MI PC Hypotonicity-2.prt _MI Perineal Control End-treatment-0_1.prt _MI Perineal Control End-treatment-0_2.prt

_MI Perineal Control End-treatment-1.prt _MI Perineal Control End-treatment-2.prt _MI Perineal Control End-treatment-3.prt _MI Perineal Control Mid-treatment-0_1.prt _MI Perineal Control Mid-treatment-1.prt _MI Perineal Control Mid-treatment-2.prt _MI Perineal Control Mid-treatment-3.prt _MI Perineal Control Start-treatment-0_1.prt _MI Perineal Control Start-treatment-1.prt _MI Perineal Control Start-treatment-2.prt _MI Perineal Control Start-treatment-2_1.prt _MI Perineal Control Start-treatment-3.prt _MI Perineal Reeduction 4-4 sec.prt _MI Perineal Reeduction 4-8 sec.prt _MI Perineal Reeduction 6-6 sec.prt _MI Perineal Reeduction 6-12 sec.prt _MI Perineal Reeduction 10-10 sec.prt

_MI Postpartum Perineal Tonicity-0_1.prt _MI Postpartum Perineal Tonicity-1.prt _MI Postpartum Perineal Tonicity-1_1.prt _MI Postpartum Perineal Tonicity-2.prt _MI Postpartum Perineal Tonicity-3.prt _MI Relaxation of Perineal Muscles-0_1.prt _MI Relaxation of Perineal Muscles-1.prt _MI Stress Incontinence-0_1.prt _MI Stress Incontinence-0_2.prt _MI Stress Incontinence 1.prt _MI Stress Incontinence-1_1.prt _MI Stress Incontinence-2.prt _MI Stress Incontinence-3.prt MI Incontinence Evaluation.prt MI Incontinence Tutorial.prt MI PMD 10-10 sec 10 cycles.prt MI PMD Assessment 5 Activities.prt

Animations

Binary Green Light.avi Circular EMG Animal Game Leader.avi Circular Jumping Car.avi Linear Butterflies.avi linear car-blue.avi linear car-orange.avi Linear Drying Lake.avi Linear EMG Animal Game Buddy.avi

Linear Fading Earth Puzzle.avi Linear Fading Mouse.avi Linear Flower Explosion.avi Linear Growing Fractal 02.avi Linear Growing Fractal 06.avi Linear Growing Sphere.avi Linear Maze.avi Linear Morph Boy to superhero.avi

Linear Puzzle 03.avi Linear Puzzle Dolphin.avi Linear Rising Puppet.avi Linear smiley.avi Linear turtle.avi Linear Zooming Fractal 05.avi UFI_MI_script_session.avi

MIDI

2 Voices Classical Lutins.mid 2 Voices LR Claire De Lune Duet.mid Bourree.mid Cartoon Classics Game Theme.mid Classical Air G String.mid Classical Canon.MID Classical Claire de Lune.mid Classical Harpsichord.mid -- extra --

2 Voices Classical Piano.mid 2 Voices Classical Tarantelle.mid Cartoon Classics Lullaby.mid Cartoon Classics March.mid Classical Greensleeves.mid Classical Tarantelle.mid Classical Toccata.mid Fast Jazz 01.mid Fast Jazz 02.mid

Fast Samba.mid Fast Techno 02.mid furelise.mid International Bier Garten.mid Popular Danse.mid Relax 01.mid Small Pipers 2.mid

Pictures (Background)

BackgroundOlive.bmp UFI_description_eval.bmp UFI_electrodes_emg.bmp

UFI_electrodes_r.bmp UFI_electrodes_v.bmp UFI_graph.bmp

UFI_graph_electrodes.bmp UFI_pelvicfloor.bmp

Prompts

Prompt_Woman_Contract.wav Prompt_Woman_Relax.wav Prompt_Woman_Rest.wav Woman_Please Verify.wav

-- extra -- Prompt_Man_Contract.wav Prompt_Man_Flick.wav Prompt_Man_Relax.wav

Prompt_Man_Rest.wav Prompt_Man_Work.wav Prompt_Woman_Flick.wav Prompt_Woman_Work.wav


Sounds

Ocean Surf.mp3 -- extra --

Cartoon Classics Felix.mp3 Jazzy01.mp3

ShortLoveSongLoop.mp3 TechnoDrumLoop2.mp3

Templates

Controlled Perineal Contraction 0_1.tlt Controlled Perineal Contraction 1.tlt Controlled Perineal Contraction 2.tlt Controlled Perineal Contraction 3.tlt Held Perineal Contraction 0_1.tlt Held Perineal Contraction 1.tlt Held Perineal Contraction 1_1.tlt Held Perineal Contraction 2.tlt Held Perineal Contraction 3.tlt PC Hypertonicity 0_1.tlt PC Hypertonicity 1.tlt PC Hypertonicity 2.tlt PC Hypotonicity 0_1.tlt PC Hypotonicity 1.tlt PC Hypotonicity 2.tlt Perineal Control End-treatment 0_1.tlt Perineal Control End-treatment 0_2.tlt Perineal Control End-treatment 1.tlt Perineal Control End-treatment 2.tlt Perineal Control End-treatment 3.tlt

Perineal Control Mid-treatment 0_1.tlt Perineal Control Mid-treatment 1.tlt Perineal Control Mid-treatment 2.tlt Perineal Control Mid-treatment 3.tlt Perineal Control Start-treatment 0_1.tlt Perineal Control Start-treatment 1.tlt Perineal Control Start-treatment 2.tlt Perineal Control Start-treatment 2_1.tlt Perineal Control Start-treatment 3.tlt Postpartum Perineal Tonicity 0_1.tlt Postpartum Perineal Tonicity 1.tlt Postpartum Perineal Tonicity 1_1.tlt Postpartum Perineal Tonicity 2.tlt Postpartum Perineal Tonicity 3.tlt Relaxation of Perineal Muscles 0_1.tlt Relaxation of Perineal Muscles 1.tlt Stress Incontinence 0_1.tlt Stress Incontinence 0_2.tlt Stress Incontinence 1.tlt Stress Incontinence 1_1.tlt

Stress Incontinence 2.tlt Stress Incontinence 3.tlt template_p3.tlt template_p4.tlt template_p5.tlt template_p6.tlt template_p7.tlt template_p8.tlt template_p9.tlt template_p10.tlt template_p11.tlt template_p12.tlt template_p13.tlt template_p14.tlt work-rest 4-4sec 5 cycles.tlt work-rest 4-8sec 5 cycles.tlt work-rest 6-6sec 5 cycles.tlt work-rest 6-12sec 5 cycles.tlt work-rest 10-10sec 5 cycles.tlt

Waves

Birds On Lake.wav Left Pad.wav -- extra -- Bird.wav clang.wav Ding.wav

Falling.wav Frog_Pond.wav hoo-ahh.wav Laugh1.wav Laugh2.WAV Ocean.wav

run.wav Short Loop Techno.wav Techno_Music.wav whoopie.wav woohoo.wav

Sample Data

CLIENT NAME SESSION Incontinence TUTORIAL 17/07/2006 4:02:18 PM MI Incontinence Tutorial.prt 00:00:35.000

Documents

Continence Suite 3 - LifeMatters · Continence Suite 3.1 Thought Technology Ltd. 2180 Belgrave Avenue, Montreal, QC H4A 2L8 Canada Tel: (800) 361-3651 ٠ (514) 489-8251 Fax: (514)