L300 Accessories L300 Hydrogel Electrodes The L300 hydrogel electrodes are used with the L300 FS Cuff. See Figure 9. Two hydrogel electrodes are used to deliver stimulation from the L300 RF Stim Unit to the muscles in the lower leg. Each hydrogel electrode attaches to a hydrogel electrode base. The side of the electrode with the grid faces the electrode base. Do not use the L300 FS Cuff without electrodes. Always replace the plastic covers on the hydrogel electrodes between uses.
NESS L300 Plus L300 Hydrogel Electrode Bases The hydrogel electrode bases are for use with the L300 FS Cuff. See Figure 10. Your clinician will determine the best placement for the hydrogel electrode bases. The hydrogel electrodes attach to the hydrogel electrode bases. Always attach the grid side of the hydrogel electrodes to the hydrogel electrode bases. Do not move the electrode bases once your clinician has fit them, other than to replace them.
L300 Cloth Electrodes The L300 cloth electrodes are used to deliver stimulation from the L300 RF Stim Unit to the lower leg muscles. See Figure 11. They are designed to be skin friendly and provide an alternative for people who do not prefer the L300 hydrogel electrodes. They are also for people who have sensitivities to the L300 hydrogel electrodes or other known sensitivities (for example, allergy or skin sensitivity to tape/adhesive). The L300 FS Cuff uses two cloth electrodes.
NESS L300 Plus L300 Cloth Electrode Bases The L300 cloth electrode bases are for use with the L300 FS Cuff. See Figure 12. Your clinician will determine the best placement for the cloth electrode bases. The L300 cloth electrodes snap to the L300 cloth electrode bases. Do not move the electrode bases once your clinician has fit them, other than to replace them. Cloth electrode bases need to be replaced approximately once every two years. Cloth Electrode Base Figure 12: L300 cloth electrode base.
Wrist Strap, Neck Strap, and Belt Pouch The wrist strap, neck strap, and belt pouch are used to carry the L300 Plus Control Unit. The wrist and neck straps loop through the top of the Control Unit. See Figure 13. Neck Strap Wrist Strap Belt Pouch Figure 13: L300 Plus Control Unit carrying options.
NESS L300 Plus Replacement Battery, Gait Sensor The L300 Plus System Kit includes a replacement coin battery for the Gait Sensor. The battery will need to be replaced approximately every six months. See Figure 14. Gait Sensor Battery Figure 14: Gait Sensor battery.
Gait Sensor Pads The Gait Sensor pads are used to stabilize the Gait Sensor pressure sensor in the shoe. See Figure 15. One Gait Sensor pad is placed under the insole of the shoe of the affected leg. The Gait Sensor pressure sensor is then placed on top of the Gait Sensor pad. Finally, the insole of the shoe is lowered to cover both the pressure sensor and the Gait Sensor pad. Place the adhesive side of the Gait Sensor pad down.
NESS L300 Plus Shoe Spacers The shoe spacers are used to protect the rim of the shoe from the clamp of the gait sensor transmitter. See Figure 16. One shoe spacer is placed over the inner clamp of the Gait Sensor. Shoe Spacer Inner Clamp Figure 16: Attaching the shoe spacer. Phillips Screwdriver The Phillips screwdriver is used to replace the Control Unit and Gait Sensor batteries.
L300 Plus Accessories L300 Plus System Charger Set The L300 Plus system charger set is used to simultaneously charge the L300 RF Stim Unit, the Thigh RF Stim Unit, and the L300 Plus Control Unit. The system charger set includes a "W" cable and a charger, and a set of interchangeable blades for international outlets. The "W" cable and the charger must be assembled for use. See Figure 17.
NESS L300 Plus Thigh FS Cuff Distal Panel Subassembly, Large The Thigh FS Cuff has two panels: a proximal panel and a distal panel. The distal panel includes the cradle for the Thigh RF Stim Unit. The distal panel is available in two sizes: small and large. The Thigh FS Cuff in your L300 Plus System Kit features the small distal panel. A large distal panel subassembly is also provided, if needed. See Figure 18.
Thigh FS Cuff Elongation Bar Lock Set During your L300 Plus fitting session, your clinician will adjust the elongation bar on the Thigh FS Cuff. The elongation bar is used to adjust the distance between the Thigh FS Cuff distal and proximal panels. Once the elongation bar is adjusted, your clinician will lock the position using the lock set. See Figure 19. Do not attempt to adjust the elongation bar. Figure 19: Thigh FS Cuff elongation bar lock set.
NESS L300 Plus Thigh FS Cuff Electrode Marking Ring Set The electrode marking rings are used to ensure accurate, repeatable positioning of the Thigh FS Cuff cloth electrodes on the Thigh FS Cuff. During your L300 Plus fitting session, your clinician will determine the best position for the Thigh FS Cuff cloth electrodes. Your clinician will then use the electrode marking ring set to mark the electrode position on the Thigh FS Cuff. See Figure 20. Figure 20: Thigh FS Cuff electrode marking ring set.
Thigh FS Cuff Cloth Electrodes The Thigh FS Cuff uses two cloth electrodes to deliver stimulation from the Thigh RF Stim Unit to the muscles in your thigh. See Figure 21. The larger cloth electrode is placed on the proximal panel. The smaller cloth electrode is placed on the distal panel. The Thigh FS Cuff cloth electrodes are larger than the L300 FS Cuff electrodes, and they do not require electrode bases. The Thigh FS Cuff cloth electrodes must be wet before use and after every four hours of use.
NESS L300 Plus 48 User’s Guide
Putting On and Taking Off the FS Cuffs Preparing the Skin Before you put on the FS Cuffs, you must prepare the skin where the electrodes will adhere. To prepare the skin: 1. Clean the skin where the electrodes will touch with a wet washcloth. If any lotions are on the skin, clean the skin with soap and water. Rinse well. 2. If necessary, trim excess body hair from the area using scissors. Do not use a razor. A razor can irritate the skin. 3. Check the skin for signs of irritation.
NESS L300 Plus Positioning the L300 FS Cuff To position the L300 FS Cuff: 1. While seated, slightly straighten your leg as shown in Figure 22. The outline of your kneecap should be clearly defined. (Place your foot on a footrest, if necessary.) The Locator of the L300 FS Cuff Fits Under the Kneecap Figure 22: Recommended knee angle for positioning the L300 FS Cuff.
2. Make sure the electrodes are attached to the electrode bases. Then, grasp the front of the FS Cuff by the cradle and tilt the bottom of the FS Cuff up. Slide the locator up your leg until it rests snugly and comfortably below your kneecap. See Figure 23. Locator Hook and Loop Fasteners Strap Handle Figure 23: Tilting the L300 FS Cuff for placement on your leg.
NESS L300 Plus 3. Hold the locator in place and lower the L300 FS Cuff until it rests flush against your leg. The L300 FS Cuff should gently grip your leg. 4. Grasp the handle of the L300 FS Cuff strap. See Figure 24. With your thumb on the L300 RF Stim Unit cradle, fasten the strap handle around the cradle. Locator Below the Kneecap Thumb on the Cradle and Fingers on the Strap Handle Figure 24: Fastening the L300 FS Cuff strap.
5. Make sure the L300 FS Cuff is correctly positioned. See Figure 25. If it is not, take off the L300 FS Cuff and reposition it. Adjust the hook and loop fasteners (see Figure 5) to ensure a snug fit. Locator Below the Kneecap Strap Handle Around the Cradle L300 RF Stim Unit Figure 25: L300 FS Cuff fastened on the right leg.
NESS L300 Plus Removing the L300 FS Cuff To remove the L300 FS Cuff: 1. Turn off the Control Unit. 2. Unhook the L300 FS Cuff strap handle from the cradle. 3. Slowly lift the L300 FS Cuff away from your skin. 4. Gently peel the electrodes from your skin. 5. If using hydrogel electrodes, reapply the electrode covers to the electrodes. 6. If using cloth electrodes, allow the electrodes to dry. 7. Fully charge the Control Unit, Thigh RF Stim Unit, and L300 RF Stim Unit batteries.
Positioning the Thigh FS Cuff on the Quadriceps To position the Thigh FS Cuff on the quadriceps: 1. Sit in a stable position on the edge of a chair. See Figure 26. Figure 26: Recommended seated position for putting the Thigh FS Cuff on. 2. Loosen the Thigh FS Cuff straps.
NESS L300 Plus 3. Place the Thigh FS Cuff on the front of your thigh (quadriceps muscle), with the locator arrow facing up and pointing toward the center of your knee. See Figure 27. Figure 27: Using the locator to position the Thigh FS Cuff on the quadriceps.
4. Position the edge of the distal panel approximately 2 inches (5 cm) above your knee. See Figure 28. Figure 28: Positioning the distal panel above the knee.
NESS L300 Plus 5. Fasten the FS Cuff distal straps, and tighten the straps to fit. See Figure 29. Figure 29: The distal straps fastened.
6. Fasten the FS Cuff proximal straps, and tighten the straps to fit. See Figure 30. Figure 30: The proximal straps fastened.
NESS L300 Plus Positioning the Thigh FS Cuff on the Hamstrings To position the Thigh FS Cuff on the hamstrings: 1. Sit in a stable position on the edge of a chair. See Figure 31. Figure 31: Recommended seated position for putting the Thigh FS Cuff on. 2. Loosen the Thigh FS Cuff straps.
3. Place the Thigh FS Cuff on the front of your thigh, with the locator arrow facing up and pointing toward the center of your knee. See Figure 32. The edge of the distal panel should be two to three inches above the knee. Figure 32: Using the locator to position the Thigh FS Cuff on the quadriceps before rotating the FS Cuff to the hamstrings.
NESS L300 Plus 4. While holding the elongation bar, slowly rotate the FS Cuff to the back of your thigh. Rotate the FS Cuff until the elongation bar is centered on the back of the thigh (the hamstrings). See Figure 33. Figure 33: Positioning the Thigh FS Cuff on the hamstrings.
5. Fasten the Thigh FS Cuff distal straps and tighten them to fit. See Figure 34. Figure 34: The distal straps fastened.
NESS L300 Plus 6. Fasten the FS Cuff proximal straps, and tighten them to fit. See Figure 35. Figure 35: The proximal straps fastened. Note: The fasteners should be centered along the top of the thigh.
Removing the Thigh FS Cuff To remove the Thigh FS Cuff: 1. Turn off the L300 Plus Control Unit. 2. Loosen the Thigh FS Cuff straps. 3. Unfasten the Thigh FS Cuff straps. 4. Slowly lift the Thigh FS Cuff away from your skin. 5. Allow the electrodes to dry. 6. Fully charge the Control Unit, Thigh RF Stim Unit, and L300 RF Stim Unit batteries. Caution: The Thigh FS Cuff should be removed from the skin every 3 to 4 hours for 15 minutes to allow the skin to breathe.
NESS L300 Plus 66 User’s Guide
Placing the Gait Sensor in the Shoe The Gait Sensor pressure sensor is placed under the insole of your shoe. If your shoe does not have a detachable insole, place the sensor on top of the insole. Then, place a generic soft, thin (one layer versus two) insole over it. Generic insoles can be purchased from drugstores, shoe stores, or Bioness. Caution: Do not use the Gait Sensor with a rigid insole, such as a custom rigid orthosis or an ankle foot orthosis. To position the Gait Sensor: 1. Lift the shoe insole.
NESS L300 Plus 3. Point the wire of the pressure sensor toward the toe of the shoe. Then, attach the pressure sensor to the Gait Sensor pad. See Figure 37. Refer to the foot image on the pressure sensor for positioning. Gait Sensor Pad Foot Image on Pressure Sensor Figure 37: Positioning the pressure sensor in the shoe 4. Cover the inner clamp on the transmitter with the shoe spacer, if desired. See Figure 38. The teeth of the clamp may scuff the shoe, if not covered.
5. Clamp the Gait Sensor transmitter on to the inner rim of the shoe. Face the NESS logo on the transmitter away from the ankle. See Figure 39. NESS Logo Faces away from Ankle Transmitter Clamp to Inner Rim of Shoe Left Shoe Pressure Sensor Figure 39: Clamping the transmitter to the inner rim of the shoe.
NESS L300 Plus 6. Cover the pressure sensor with the insole. Tuck any excess wire under the insole. See Figure 40. Left Shoe Figure 40: Insole covering the pressure sensor and wire. Switching Shoes/Gait Sensors When switching the Gait Sensor to a different shoe, make sure to place a Gait Sensor pad in the other shoe first. If multiple Gait Sensors are placed in multiple shoes and you want to switch shoes: 1. Turn off the system. 2. Switch shoes. 3. Turn the system back on.
Operating the L300 Plus Control Unit RF Communication Safety Features The L300 Plus Control Unit, L300 RF Stim Unit, Thigh RF Stim Unit, and Gait Sensor must be within RF communication range of each other and their batteries charged for the L300 Plus System to operate. If the components become separated, or if a battery is discharged, RF communication will be lost.
NESS L300 Plus Single Component Mode If communication with the Thigh RF Stim Unit fails and cannot be restored, you can turn off the RF communication failure indicators for the Thigh RF Stim Unit and use the L300 FS Cuff in single component mode. In single component mode, the Thigh RF Stim Unit visual and audio indicators are disabled. To turn off communication with the Thigh RF Stim Unit, press the button for three seconds. mute When the Control Unit is turned off, the default settings will be restored.
Turning On/Off the Control Unit To turn on the L300 Plus Control Unit, press the on/off button once. The system will start in standby mode. All display indicators will light up for a few seconds while the system performs a self-test. The on/off button will flash GREEN to indicate the system is on. To turn off the Control Unit, press the on/off button once. Selecting an Operating Mode Selecting Gait Mode To select gait mode, turn on the Control Unit, and press the mode button briefly.
NESS L300 Plus Adjusting Stimulation Intensity When the Control Unit is first turned on, the stimulation intensity level will be “5”. This level is set by your clinician. Normally, you will not need to adjust stimulation intensity other than when walking on different surfaces or in different shoes. The L300 Plus Control Unit allows you to adjust stimulation intensity individually for each RF Stim Unit using the RF Stim Unit selection buttons and the plus and minus buttons.
2. Press the plus or minus intensity adjustment button on the Control Unit to change the intensity level. The Control Unit will beep with each change in level. The new level will show in the digital display. Note: An intensity level of “0” equals no stimulation. Adjustment Guidelines If your foot slightly drags or catches on the floor while walking, increase stimulation intensity in the L300 RF Stim Unit to lift the foot higher.
NESS L300 Plus Adjusting the Thigh RF Stim Unit To adjust stimulation intensity for the Thigh RF Stim Unit: 1. Press the "up" button to select the Thigh RF Stim Unit. The Thigh RF Stim Unit indicator and the arrow next to the Thigh RF Stim Unit indicator will light GREEN to confirm the selection. See Figure 42. Figure 42: Thigh RF Stim Unit selected. 2. Press the plus or minus intensity adjustment button on the Control Unit to change the intensity level.
Adjustment Guidelines If your knee is hyper-extended or not straight enough while stepping, then increase the stimulation intensity level in the Thigh FS Cuff. If your knee is under-extended or too bent while stepping, then decrease the stimulation intensity level.
NESS L300 Plus Testing Stimulation The stimulation test button is used to manually check the position of the FS Cuff on the leg. Each FS Cuff can be tested individually. Testing the L300 FS Cuff To test the position of the L300 FS Cuff: 1. Place the Control Unit in standby mode. 2. Press the "down" button to select the L300 RF Stim Unit. The L300 RF Stim Unit indicator and the arrow next to the L300 RF Stim Unit indicator will light GREEN to confirm the selection. 3.
Turning on Audio Feedback During Stimulation The NESS L300 Plus System can be configured to provide audio feedback during stimulation. You can turn on the audio feedback feature for each RF Stim Unit individually using the RF selection buttons and the mute button. Turning on Audio Feedback for the L300 FS Cuff To turn on audio feedback during stimulation for the L300 FS Cuff: 1. Place the Control Unit in standby mode. 2.
NESS L300 Plus Muting the Audio Alerts Use the mute button to mute the audio alerts. Only noncritical audio alerts will be muted. When the system is turned off, the default volume setting is automatically restored. Muting the Thigh RF Stim Unit Alerts Your L300 Plus System is designed to operate with or without the Thigh FS Cuff on or operating. However, the L300 Plus Control Unit will recognize that the Thigh FS Cuff is not on or operating and will emit visual and audio alerts.
