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EMG Parameters Program duration: 99 minutes maximum Threshold: 0.6 – 2000 µV; During Work period the user/patient is prompted to contract above threshold. In the Rest period the user / patient is prompted to relax the muscles. Filter: Wide / Narrow Biofeedback: Above / Below / Continue / OFF; Above the threshold; Below the threshold; Continue-sound; OFF – no bar graph sound. Work / Rest time: 2 – 99 seconds Threshold setting: Auto / Manual Trial: Number of Work / Rest repetitions, 2 – 99 EMG and ETS Threshold   Threshold is an EMG value measured in microvolts (µV). Stronger muscles which perform strong contractions have a higher threshold than weak or flaccid muscles. In ETS mode (EMG Triggered Stimulation), the user / patient needs to exceed to contract the muscles above the target threshold to trigger stimulation. Nu-Tek Maxi Plus2 enables you to select from an Automatic Threshold or Manual Threshold. Automatic Threshold is pre-set at 80% of the actual (previous) Work Average, whilst the Manual Threshold is manually adjustable by the therapist or the user. Conditions known to respond well to EMG Incontinence Pelvic Floor Pain Pain in the Limbs Pain in Lower Back Neck and Shoulder Pain Spinal Conditions Repetitive Strain Injury Stroke Weak Pelvic Floor Muscle Activation Retraining Muscle Activation Coordination training Muscle Relaxation Training Muscle Re-Education Nu-Tek Maxi Plus2 ETS ETS treatment is especially useful for stroke rehabilitation and for pelvic floor rehabilitation in a variety of pelvic floor conditions. ETS starts with EMG Work / Rest training. Automatic or Manual Thresholds can be selected as preferable or required. If the patient/user reaches the threshold target the EMG triggers stimulation, which helps the patient/user hold the muscle contraction, The ETS mode in the Nu-Tek Maxi Plus2 enables the patient/user to stimulate weak muscles over the fixed periods of time after triggering, not just until the end of the Work period of the ETS EMG. The ETS function has 2 custom programs and these can be set with 1 ETS phase furnished with required parameters. ETS Parameters   Program duration: 99 minutes maximum Threshold: 0.6 – 2000 µV; During Work period the user/patient is prompted to contract above threshold. In the Rest period the user / patient is prompted to relax the muscles. Filter: Wide / Narrow Biofeedback: Above / Below / Continue / OFF; Above the threshold; Below the threshold; Continue-sound; OFF – no bar graph sound. Work / Rest time: 2 – 99 seconds Threshold setting: Auto / Manual Trial: Number of Work / Rest repetitions, 2 – 99 STIM time: 1 – 99 seconds Frequency: 2 – 100 Hz Pulse width: 50 – 450 µS Ramp up / Ramp down time: 0.1 – 9.9 seconds For Custom Programs, the therapist /user can change all the EMG Biofeedback and Stimulation settings. Nu-Tek Maxi Plus2 STIM Mode Operation Nu-Tek Maxi Plus2 enables selection from the following modes: Urology Rehabilitation Pain Sport Fitness Stimulation intensity is adjustable and should be set to a comfortable level. At the end of each session, average current intensity in mA is displayed. Continuous Stimulation (CON): Stimulation can be continuous with frequency (HZ) and pulse duration (µS) staying the same throughout the program. Synchronous Stimulation (SYN): Synchronous stimulation is Work/Rest stimulation with constant Hz and µS during Work time. Alternating Stimulation (ALT): Alternating stimulation enables agonist and antagonist muscles stimulation (i.e. biceps/triceps) with one channel stimulation for a given time and alternating to the other channel stimulation for a given time – only one channel is stimulating at the given time). Modulated Stimulation (MOD): In modulated stimulation, Work time stimulation is characterised by high Hz and low µS, whilst Rest time has low Hz and high µS. Ramp up and Ramp down frequency and pulse width modulate from high to low and vice versa. Level of mA remains the same on all channels. During Work / Rest continuous stimulation is applied. STIM Parameters Program time: 1 – 99 seconds Phase type: SYN, ALT, CON, MOD Phase time: 1 – 99 minutes Frequency: 2 – 100 Hz Pulse Width: 50 – 450 µS Ramp up / Ramp down: 0.1 – 9.9 seconds Work / Rest time: 1 – 99 seconds Conditions known to respond well to Stimulation Urinary and Rectal (Faecal) Incontinence Spasticity and Compromised / Weak Muscles Muscle Spasm Poor Muscle Tone Muscle Atrophy and Pain in Arthritis Poor Muscle Mobility and Range of Movements Poor Circulation and Compromised Muscle Blood Supply Warm up prior to exercise Fitness issues Sports Neurological complaints Daily Progress Reports Nu-Tek Maxi Plus2 has a built-in ability to store the Daily Compliance data as well as send the Daily Compliance data for storage and further analysis to a PC via the optional Nu-Tek System Software. Nu-Tek Maxi Plus2 Statistics After a session is completed, Nu-Tek Maxi Plus2 displays the statistics on its LCD screen. Additionally, for training EMG, ETS and STIM, it stores the first statistics and records them on a daily basis (i.e. per calendar date). When all phases of the session are completed, the statistics are displayed on the LCD. The statistics collected include Work Average, Rest Average, Onset Time, Relax Time, Work / Rest Peak, Work Deviation, Rest Deviation, Stim Time, ETS Average, Threshold Average, ETS Score, STIM Average. Nu-Tek Maxi Plus2 features Lock Mode and Memory Function. Stimulation Electrodes to use with the Nu-Tek Maxi Plus2: Nu-Tek Maxi Plus2 can be used with self-adhesive skin electrodes and with internal electrodes (i.e. vaginal probe, anal probe). Most commonly used self-adhesive skin electrodes sizes: 50 x 50 mm, 50 x 100 mm, 40 x 40 mm or 30 mm diameter. Nu-Tek Maxi Plus2 Technical Specifications EMG Specifications Single channel EMG EMG range: 0.2 – 2000 µV RMS (continuous) Sensitivity: 0.1 µV RMS Accuracy: 4% of µV reading +/- 0.3 µV at 200 Hz Selectable Band pass filter – 3db Bandwidth Wide: 18 Hz +/- 4 Hz to 370 Hz +/- 10% Narrow: 100 Hz +/- 5% to 370 Hz +/- 10% Notch filter: 50 Hz (Canada 60 Hz) – 33 dbs (0.1% accuracy) Common Mode Rejection Ratio: 130 dbs Minimum @ 50 Hz Battery: 4 x 1.5 V AA batteries Work / Rest periods: 2 – 99 seconds Number of Trials: 2 – 99 STIM (Neuromuscular Stimulation)     Dual Channel Stimulator Amplitude: 0 – 90 mA into 1000 Ohm load – actual mA will tend to be less than indicated due to Electrode impedance Type: Constant current, maximum output voltage 90 Volts + 10 / -10 Volts Waveform: Symmetrical, rectangular, bi-phasic with net zero DC current Pulse width selection: 50 – 450 µS (2% accuracy) Pulse rate selection: 2 – 100 Hz (2% accuracy) Work / Rest periods: 1 – 99 seconds Time: 1 – 99 minutes Ramp up time: 0.1 – 9.9 seconds Pre-set programs and user programmable treatment programs Lock Mode and Memory Function Automatic output shut off with detection of open electrode above 1 mA Low battery indication at 4V +/- 0.2 V, automatic shut off when voltage drops below the low indication Automatic shut off to save energy, when device is not in use for over 3 minutes Maxi Plus2 Dual Channel EMG Biofeedback with ETS & STIM features 5 pre-set clinical modes for the following medical and sports applications: Continence Rehabilitation Pain Relief Sports Fitness Each of the clinical modes has a number of pre-set STIM programs with up to 5 program phases. The pre-set programs for different clinical modes are as follows: Continence: 20 pre-set STIM programs: Urge incontinence (female), Stress incontinence (female),Frequency, Mixed incontinence (Stress, Urge, Frequency), Pelvic floor exercise workout, Rectal stimulation (male / female via anal probe), Pain relief, Neuro degeneration of sensory nerves (female lack of sensitivity), Sensory nerve test, Prolapse (Cystocele), Maximum Pelvic Floor Exercise Shoot Bursts, Pelvic Floor Endurance, Weekly Pelvic Floor Maintenance, New Mums, Hysterectomy, Sexual improvement, Overactive bladder stimulation via external skin electrodes (skin electrodes placed on lower legs above the ankle – Tibial Nerve Stimulation), Stress incontinence stimulation via external skin electrodes (skin electrodes placed on lower back in spinal S1 – S2 area), Stress incontinence stimulation via skin electrodes (skin electrodes placed on the buttocks). Rehabilitation: 7 pre-set programs: Stroke; Chronic Facial Paralysis; Acute Facial Paralysis; Multiple Sclerosis; Arthritis; Knee Pain, Muscle Wasting & Oedema; Disuse Atrophy. Pain Relief: 10 pre-set stimulation programs: Pain Blocking (2 programs); Acupuncture (2 programs); Analgesic (2 programs); To minimise accommodation – Prevention of Tolerance Development (3 programs); Professor Hans Mode. Sports: 14 pre-set STIM programs: Warm Up; Active Recovery; Muscle Toning; Anaerobic Activity; Aerobic Activity; Sports Endurance; Sports Resistance ( 2 programs); Sports Strength (2 programs); Sports Explosive Strength; Sports Maximum Contraction; Sports Muscle Relaxation; Sports Resume Training. Fitness: 8 pre-set programs: Warm Up; Muscle Toning; Aerobic; Anaerobic; Massage; Endurance; Muscle relaxation; Tired Legs. Feature Combination of three modes: EMG, Electrical Stimulation and EMG triggered stimulation For use in clinic as a flexible device 2.8” Color display-dot matrix Over 50 pre-set stimulation programs for: Sports, Rehabilitation, Continence, Pain relief and Fitness Custom programs for EMG/ETS ( 1 phase) and STIM (up to 5 stimulation phase) mode When connected to the software installed on a desktop or laptop, the functionality increases even further Features of the software; Designed for therapist tool, to be used for a wide range of physiotherapy applications Structured protocols for consistency of patient evaluation. Edits newly developed programs to keep abreast of any clinical trials and downloads to Nu-Tek® EMG / ETS device. Data from the Nu-Tek® EMG / ETS device are being sent to the PC/Laptop using the safe USB connection. PC database system for Patients Sessions and Clinical Report that can be analyzed, printed and emailed. Displays EMG as low as 0.2μV and up to 2000μV.