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2002 © JSC "Midaus"
Design by Viorix Studio
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Operating procedure1. Before session starts the electrostimulator components should be disinfected by means of double cleaning. The cleaning should be effected with the help of a napkin, moistened in 3% hydrogen peroxide (the span between cleanings should be 15 minutes). 2. Before you start working with KES, ensure, that PC casing grounding is not broken. Turn on PC and EU of the electrostimulator (see p. 5.5 of Installation Procedure). 3. After PC OS is loaded run stimul.exe program . 4. After electrostimulator monitoring program has started, the main window opens (fig. 1).  Fig.1. Main window of the program (Patient's Data tab is activated) NOTE: If electrostimulator is not connected to PC or if the power is turned off, the main operating buttons of the main window of the program will not be available (the buttons will look brighter than window field). In this mode one may only look through patients records and previously conducted stimulation sessions. If EU is turned on, unavailable buttons will be automatically activated. 5. Keeping and processing patients database. Kes software manages the database containing information about all the patients, sessions and stimulation parameters for each session. In Patients Profiles window (located in upper left of the main window(see. fig. 1), you can see the record of the patient selected from the database. Stimulation Sessions window contains the table containing date, number of stimulation cycles, the beginning and the end time for each previously conducted session. The other parameters will be shown at the bottom of the main window of KES program (Acupuncture Points Parameters window), after the cursor is moved to the specified session line. 5.1. Creating new patient record. 5.1.1. Click List of Patients tab in the main window(fig. 2). 
Fig.2. Main window of the program (List of Patients tab is activated) 5.1.2. Move the cursor to Patients Profiles window (see. fig. 2) . Open the menu, containing list of available operations and corresponding hotkeys, by right-clicking the "mouse": Add profile Ins Change profile Enter Delete profile Ctrl+Del To chose operation required move the cursor to the specified operation name and click the left button of the "mouse" or press corresponding hot keys on the keyboard. 5.1.3. In the menu appeared move the cursor to Add record line (the background color of the line will change to blue) and click the left button of the "mouse". Patient's Data window opens (see. fig. 3).
Fig. 3. Patient's Data window 5.1.4. Input the patient's data from PC keyboard, sequentially moving the cursor to each of the five fields:
In the last field you may enter any text, related to the patient. The text will appear in the main window when the patient record is chosen. 5.1.5. Click ÎÊ button. Patient's Data window closes, the main window opens. NOTES: The information in database is always sorted by patients' surnames. Thus, a new patient record will appear in the list of the patients in accordance with surname of the patient. 5.2. Changing patient's data . 5.2.1. Find the surname of the required patient in KES database. Search process is effected by input of patient's surname into the Search by Name field (see fig. 2) of KES main window. 5.2.2. Move the cursor to Patients profiles window(see fig. 2) and click the right button of the "mouse". 5.2.3. Press Enter button on the keyboard or click the left button of the "mouse" with the cursor positioned at Change Record line of the opened menu (see. p. 5.1.2). 5.2.4. Move the cursor to the corresponding field of the Patient's Data window (see fig. 3) and input the required alterations from the keyboard. 5.2.5. Click OK button . Patient's Datawindow closes, KES main window opens. 5.3. Removing patient's data. 5.3.1. Find the surname of the required patient in KES database. Search process is effected by input of patient's surname into the Search by Name field (see fig. 2) of KES main window. 5.3.2. Move the cursor to Patients Profiles window (see fig. 2) and click the right button of the "mouse". 5.3.3. Press Ctrl+Del key combination on the keyboard or left-click the "mouse" with the cursor positioned at Delete record line of the opened menu (see p. 5.1.2). In the opened window clickOK. 6. Search of active point 6.1. Clean a patient's skin with disinfectant solution. 6.2. Connect control electrode to the patient's body. For example, the patient may hold control electrode in his (her) hand. The skin should be moderately wet within the area of contact with the electrode. For this purpose it is recommended to use moisturizing cream. The position of patient's body should be comfortable as much as it is possible. It is desirable that the lights inside the room were dimmed during the session. Silence or quiet relaxing music is also desirable. 6.3. Click "Search" button in the main window of the program (see fig. 1, 2) to locate acupuncture point on the patient's body. The window Active Point Search opens (fig. 4).
Fig.4. Active Point Search window 6.4. Moving search electrode along patient's body, look after the indications in Active Point Search window (fig. 4). Maximal increase of AP Conductivity indication red band shows that acupuncture point is located. You may also search AP, judging by the sound tone of computer system dynamic (the higher the tone - the higher the conductivity of the current point and the closer the active point location). To turn on this option left-click the "mouse" (the cursor is positioned at Sound Signal check-box COMMENTS: 1. If the red band does not appear or, vice-versa, does not decrease , EU sensitivity should be changed correspondingly, by means of dragging Sensitivity scroll-bar 2. To avoid possible pain, the active point search process should be started with the minimal sensitivity preset. 6.5. Stick acupuncture needle into the active point. 6.6. Connect stimulation electrode (with corresponding number) to the needle stuck in the active point. While connecting stimulation electrodes, avoid cable strain and consequent needle displacement, using cable length adjustment means. 6.7. Find all the necessary APs, sequentially repeating steps 7.6.4 - 7.6.6 for each point. 6.8. Click ÎÊ button in the Active Point Search window (fig. 4) after the last required AP is found. Active Point Search window (fig. 4) closes, the main window of the program opens (fig. 1, 2). 7. Managing stimulation sessions. 7.1. Move the cursor to Stimulation Session window (fig. 5). Open the menu, containing list of available operations and corresponding hot keys, by right-clicking the "mouse":
Click "New session"(or press Ins key) to input new session presets; "Repeat session" (or press Enter keys) to start session again; "Delete session" (or press Ctrl+Del keys) to remove session, that has been preset, but not conducted. NOTES: The program forbids removal of the session that has been already conducted. "Copy" (or press Ctrl+ Ins keys) to copy the session with parameters similar to required ones for subsequent correction of several parameters. "Insert" (or press Shift + Ins keys) to insert the copied session. To chose the operation required left-click the "mouse" with the cursor positioned at operation name in the menu, or else, press the corresponding key(s). 7.2. Stimulation parameters preset. 7.2.1. Left-click the "mouse" at New session line of the menu (see p. 7.1) or at New button of the main window (fig. 1, 2). Stimulation Session window opens (fig. 5). The window contains the table to input stimulation session parameters for each of required APs (the maximal number of points — 16). Toned callouts on fig. 5 correspond to parameters, the values of which should not be input manually but will be determined automatically in the process of adaptation and stimulation(see p. 9).
Fig. 5. Stimulation Session window 7.2.2. Move the cursor to Stimulation Session window (see fig. 5). Open the menu, containing list of available operations and corresponding hotkeys, by clicking the right button of the "mouse":
Click "Add the point" (or press Ins key) to input the new point before the point at which the cursor is positioned; To go to the next line (to the next AP) use â key. "Change point" (or press Enter key) — to correct the parameters of previously input point; "Delete point"(or press Ctrl+Del) — to delete the point, parameters of which has been preset, but the session has not been conducted. To chose the operation required left-click the "mouse" with the cursor positioned at the operation name in the menu, or else, press the corresponding key(s). 7.2.3. In the window opened move the cursor to Add the point (the background color of the line will change to blue) and left-click the "mouse". Acupuncture Point Parameters window opens (see fig. 6).
Fig. 6. Acupuncture Point Parameters window The names of the parameters are indicated at the left of the window, the valid ranges of stimulation parameters' values are given in the right part of the window (in parentheses). Several fields of the window has ▼ button, which, if clicked, opens drop-down menu to chose one of the values given. White fields are to input numerical values from the keyboard: Electrode number: any integer value from 1 up to 16; Impulse type: 1 — positive polarity, 2 — negative polarity (see images at the top right corner of "Stimulation session" window); Duration, msec.: any integer value from 4 up to 750; Frequency, Hz: should be chosen out of 10 valid values (indicated in corresponding field drop-down menu) based on selected impulse duration value; Time, sec.: any integer value from 1 up to 60; Stimulation amplitude, V: any value from 0 up to 10, step 0,1 V (optional: if the field is not filled in, the value will be determined automatically after the "Adaptation" session — see p. 9); Location: the description of point location on the patient's body (optional). 7.2.4. Input stimulation parameters values required for the first AP in "Acupuncture point parameters" window (fig. 6). Click OK button. Acupuncture Point Parameters window closes, Stimulation Session window (fig. 5) is re-activated (now it contains the filled in row with stimulation parameters for the first electrode\AP). 7.2.5. Proceed setting up parameters for the rest points (up to 16 in total) according to p. 7.2.2 — 7.2.4. After the last point parameters have been set up, all the required points and corresponding parameters are shown in "Stimulation session" window. You may enter any text information related to the specified session in Notes field, located at the bottom of Stimulation Session window. The notes may be corrected before and after adaptation processes. 7.2.6. Input the necessary number of cycles into the field Number of cycles of Stimulation Session window. The permissible number of cycles varies from 1 to 100. 7.2.7. If the session parameters are preset, but the session has not been conducted yet due to some reasons, then, after Stimulation Session window is closed, the inquiry window appears, asking if it is necessary to input the session tî the database. 7.3. Session parameters alteration. 7.3.1. In the window Stimulation Session (see fig. 5) move the cursor to the line containing the number of the point to correct the parameters (the background color changes to blue). 7.3.2. Right-click the "mouse", in the window opened point to Change the Line line (background color changes to blue) and left-click the "mouse". "Acupuncture point parameters" window opens (see fig. 6). COMMENTS:You may enter Acupuncture Point Parameters window (see fig. 6) (to change AP parameters according to p. 7.2.2), by pressing Enter key after p. 7.3.1 is executed. 7.3.3. Make the required alterations of the parameters and click ÎÊ button. 7.4. Removing AP from stimulation session. 7.4.1. In Stimulation Session" window (see fig. 5) move the cursor to the line containing the number of point to be deleted. 7.4.2. Right-click the "mouse"; in the menu opened (see p. 7.2.2) place the cursor at Delete Point line (the line background color changes to blue) and left-click the "mouse". COMMENTS:The point may also be removed by pressing Ctrl+Del key combination after p. 7.4.1 is executed. 7.4.3. In the query window opened click ÎÊ button. 7.5. Copying stimulation session. 7.5.1. In Stimulation Session window move the cursor to the line to be copied (see fig. 1,2). The line background color will change to blue and the table containing specified session parameters will open in Acupuncture Point Parameters" window of the main window. 7.5.2. Right-click the "mouse", in the menu opened and position the cursor at Copy line (the line background color changes to blue) and left-click the "mouse". COMMENTS:The session may also be copied, by pressing Ctrl+Ins key combination after p. 7.5.1 is executed. 7.5.3. Find the patient required in the database to insert new session into his profile (p. 5.2.1) or else, add new patient(p. 7.5.1). 7.5.4. Left-click the "mouse" in Stimulation sessions window of the main window of the program (see fig. 1, 2). 7.5.5. Right-click the "mouse"; in the menu opened move the cursor to "Insert" line and then left-click the "mouse". COMMENTS: The session copied may also be inserted by pressing Shift+Ins key combination. 7.6. Repeating stimulation session. If the parameters of scheduled session coincide with (or slightly differ from) parameters of previously conducted session, then, in the list of sessions of the main window, chose the session with parameters similar to required and click "Repeat" button instead of "New session". The Stimulation window containing new session table (with copied stimulation parameters for all the APs) will open. However, the columns Rb, Ra and Àa will stay empty, the "after session" value of impulse amplitude Àa of the session repeated will be transferred to new session Àb column. 8. Manipulator adjustment. 8.1. Click Settings button in Stimulation Session window. In Settings window appeared (fig. 7) left-click the "mouse" pointing to required parameter check-box, to set up necessary step for stimulation impulse amplitude alteration (depends on pressing manipulator's buttons ↓ or ↑ during stimulation process (see p. 9.3.5, 9.3.9).
Fig.7. Settings window 8.2. Click ÎÊ button. "Settings" window closes, Stimulation Session window is activated (fig. 1, 2). 9. Conducting simulation. 9.1. Conducting adaptation session. 9.1.1. The adaptation session is destined to adjust stimulation impulses amplitude . The adjustment is effected by patient himself on the basis of his own perception. During adaptation session KES gradually increases impulses amplitude, alternately for each acupuncture point. After ↓ button of the manipulator is pressed the amplitude increase stops, KES lowers "pain" amplitude by the value set up according p. 7.8, and inputs the resulting amplitude into Àb column (see fig. 5). 9.1.2. Instruct the patient that he (she) should press ↓ button of the manipulator at the moment he (she) feels pain during adaptation (p. 9.1.4). 9.1.3. Give manipulator to the patient to hold in his free hand. 9.1.4. Click Adaptation button to start the session. KES starts conducting adaptation session in automatic mode alternately for each of APs preset. The duration of adaptation process is about 30 sec. per one AP. After all the preset points investigated, the device stops adaptation process. NOTE! The adaptation process may be interrupted at any desirable time. To do this click Interrupt button of Stimulation Session window (fig. 5). 9.2. Conducting stimulation session. 9.2.1. Inform the patient that during the session he (she) can change impulse amplitude or interrupt the stimulation by himself (herself). In case of loss of sensitivity in stimulated AP the patient can press ↑ key of the manipulator to increase amplitude. If pain appears the patient can press ↓ key to lower amplitude. While ↓ key is being pressed and hold the stimulation is suspended. After stimulation session ends the amplitude corrected by the patient for each point will be indicated in Àa column of the table of Stimulation Session window(fig. 5). 9.2.2. Click Stimulation button to start stimulation session with parameters preset for all the APs. Before and after stimulation process starts, KES measures electrical resistance of AP and automatically fills in the corresponding fields of APs parameters table (fig. 5). Before starting and after finishing stimulation of each point the system gives a short notifying beep sound. During stimulation process the red indication lamp (located on the front panel of the device) lights to signal system's active state. NOTE! The session may be interrupted at any desirable moment. To do this click Interrupt button During a session, the stimulation progress indicator shows the time elapsed since the beginning and remained till the end of the session . 10. Disconnect stimulation electrodes from acupuncture needles and fix the cables in the holder. Take the needles out of APs. Disinfect patient's skin. The session is over. |
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