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C opyr ight 2 005 BTE Technologies All Rights Reser ved In format i on i n t h is document is subject to change w i th ou t n ot i ce. Co mpanies , names and data used in exa mp l e s a r e f i c t i t i o u s u n l e s s ot h e r w i s e n ote d .
Warranty We g uaran tee t h at t h e B T E Technologies , Inc. r ehabilitation products are free of manufacturer defects in both workmanship and material. We will replace or repair defective par ts or equipment for a period o f t im e an d i n accord an ce with the conditions s et for th below: T h i s warran t y cover s t h e str uctur e and fr am ework for 1 year of nor mal in s t it ut i on al u se.
01 - Installation and Setup 02 - General Operation 03 - Client Information USER MANUAL 04 - Templates 05 - Calibration 06 - Protocols 07 - Reports 08 - Cervical Conditioning 09 - Maintenance 10 - The Melbourne Protocol 40 0 4 0 0 0 5 re v.
section 01 0 1 - I NS TA L L AT I O N & SE TU P Introduc tion 3 M CU ™ Compon en ts 3 M ulti-Cer v ica l ™ S ta tion 3 Calibra tion Tools 4 Co mpu ter Equ ipmen t a n d Ca r t 4 Ass e m bly In stru ction s 4 Setting up the MCU ™ S ta tion 4 Setting up the Computer Equipment and Car t 6 Stro ng ly Recommen ded Addition al P u rc h as e s 7 Comp uter Ca re 7 Ch e c k Compu ter Ca bles 7 Environ men t Requ iremen ts 7 40 0 4 0 0 0 5 re v.
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section 01 INSTALL ATION AND SETUP I. IN TRO D UCTION When you f ir st look at the MCU™, it may be dif f icult to imagine that a cer vical assessment can b e s o s i mple. H owever, onc e you familiarize yourself with the basic comp onents of the u n it a n d p r a ct i ce it s oper a t ion follow ing a pp rop riate training , you will wonder how you ever did asse ssments without it. This MCU™ Operator’s Manual will review the basic components of the Multi Cer vical™ Unit.
section 01 B . C A L I B R ATION TOO LS T h e M C U ™ c a l i b r a t i o n k i t c o n s i s t s o f ( 1 ) c a l i b r a t i o n b l o c k , ( 1 ) 10 l b . we i g h t , a n d ( 1 ) 15 l b . we i g h t ( F i g u r e 1 - 2 ) . Fig u r e 1-2. Calib ration Tool s C . C O M PUTER EQ UIP MEN T AN D CART T h e co mputer equipment c ons is t s of a comp uter car t, LC D monitor, CPU, p rinter, sp eake r s, i s o l a t i o n t r a ns for mer, a nd a w ir ele ss hub (Fig ure 1-3).
section 01 Step 2 . Locate the weight stack pins and ROM stop pin and place them in the correspondi n g holes on t h e c a lib r a t ion plate (Fig ure 1-5). F i gure 1 -5 . L oca ti on of Weig h t Stack P in s & RO M STop P in Step 3 . Loc a te t h e h ea d b r a c es and secure them to the calibrat i o n pla te (F igur e 1-6). Fig u re 1-6. H ead B races Secu r ed to Colu m n Step 4 . Locate the Velcro straps and RJ45 cables. These may be placed on the computer car t. Step 5 .
section 01 Step 7. Locate the arm rests, note which is labeled lef t and which is right, and attach t h e m to t h e s ea t on t h e a ppropriate sides (Fig ure 1-9). N ote that the armrest is inser te d b e l ow t h e pla s t ic piec e t h a t is w ithin the bracket. T h r ea d ed h ole on a r m r es t Ar m Res t Knob Arm Rest Bracket under Seat Inser t Arm Rest i n to B r a c ket Thread Knob into Threaded Hole Final Result F i gure 1 -9 . Atta chi n g th e Arm Rests Step 8 .
section 01 2. PRINTER Remove the printer from its box and place it on the 2 n d shelf of the computer car t. Following the instructions from the printer box, inser t the ink car tridges and plug in the power cord and USB cable. Once the computer is running and the printer is turned on, print a test page. 3. CPU Remove the CPU (computer tower) from its box and place it on the 3 rd shelf of the computer car t. Plug in the power cord, monitor serial cable, and printer USB cable. 4.
section 01 IV.
section 02 0 2 - G EN ER A L O PE R ATI O N Getting Star te d 3 Basic S of twa re Nav iga tion 3 T h e Win dows XP E nv iron ment 3 U s ing the OD ES Sof twa re 3 Home (S ta r t-Up) S creen 4 Adm inistra tion Men u 5 Clinic In forma tion 6 Pr act ition er In forma tion 6 Environ men t S ettin gs 7 Data Acqu isition Cha n n el 7 Device Settings 7 Global Settings 8 U RFIO Con f igu ra tion A ppl i c at i on 8 U s e r Ma n a ger 9 Imp or t, E x por t, a n d Archive Dat a 10 Jo b
section 02 Ins ura n ce In forma tion 15 Statistica l Qu eries 15 Real Time Analysis 15 Exp or t Cer v ica l D a ta 16 Exp or t Admin In forma tion 16 Imp or t Admin In forma tion 17 Snap s h ots Cr e at in g a Sn a pshot 18 Em ailin g, Sav in g, Remov in g, an d V i ew i n g a Sn aps h ot 18 Forms Drop-Down Menu 18 U tilitie s D rop-D own Men u 18 Stand in g/Sittin g Tolera n ce Re por t C a l c u l a to r s D ro p - D ow n M e n u page 2 17 18 18 Calcula tor 18 Devia tion Ca lc
section 02 GENERAL OPERATION I. G ETTIN G S TA RTED Ensure that you have carefully read Section 1 of this manual prior to star ting up your MCU™. IMPO RTANT Vo l t a ges over 125V c a n r es ult in eventual damag e to the MCU™ electronics and p rodu ce f re qu ent er ror mes s a ges . E ven if you have a dedicated circuit for your MCU™, have a te ch nician check the outlet with a voltmeter to ensure that the wall voltage does not exceed 1 2 5 Volt s (U.S . a nd C a na d a ).
section 02 B . U S IN G TH E O D ES SO FTWARE O n ce you a r e c omfor t a b le w it h Win dows XP, take some time to familiarize yourself with th e g e n e ra l layout a nd f unc t ioning of the ODES sof tware. Doing this now will maximize you r e ff i ciency down the line. To access ODES, click on the ODES icon, which is displayed on the computer’s desktop. You wi l l b e prompted for a us er na me and p assword (Fig ure 2-3).
section 02 A B C D E F G H I J K L M N O P Q R S T U V W X Y Z Fi gure 2 -4 . OD ES Home Scr een A . H i s to r y – Patient Histor y Te mplates N . RO M Tes ts – Rang e of Motion Protocol s B. Examination – Patient Examination Res u l t s Te mpla tes O . Str e ng th Tes ts – Muscular Strength Proto cols C . D i a g n o s i s – Patient Diagnosis Templates P. Wo rk Si m Tes ts – Work Simulation Protocols D . X- R ay s / L a b – Patient X-Ray and Lab Res u l t s Te mpla tes E.
section 02 F i gure 2-5. Ad m in istr ation Men u A . C L I N IC IN FORMATIO N T h i s s creen a llow s you to per s onalize the rep or ts with your clinic’s information and lo g o F i g u re 2-6). Add a cl inic by c lic king N ew . To e n te r a c linic logo, d oub le c lic k on the Clinic Logo blank f ield. Locate the saved logo f ile on your hard drive. T h e l o g o c a n b e in a ny gr a ph ic f ile fo rmat (.jpg, .gif, etc.) and should be 3.2” x 0.
section 02 Step 1 . Ty pe in t h e na me a nd demog rap hics of the p r a ct it ioner. Step 2 . To a d d a d igit a l s igna ture, you must fir st s ca n t h e s igna t ur e a nd s ave it to your hard drive in a graphic f ile format (.jpg, .gif, etc.). C l i ck t h e ’a llow d igit a l s igna t ure‘ box, enter a p asswo rd (optional), and double click the icon in order to locate the signature f ile on your hard drive. Step 3 . C lic k Ad d to include the practitioner to the da t a b a s e.
section 02 2. DEVICE SETTINGS T h e D evic e S et t ings s ec t ion indicates which channel va rious tools are being read from based on the set-up the sof tware (Figure 2-10). This section is most helpful t ro u bles h oot ing. th e of for Fig u re 2-10. Device Set t i ngs 3. GLOBAL SETTINGS (FIGURE 2-11) F i gure 2 -1 1 . G lob al Settin g s Countr y, U nits, and Language – Sp ecify the countr y, lang uag e, and the units of me a s u re m ent to b e us ed in pr inted rep or ts.
section 02 F i gure 2 -1 3 . U RFIO Con fig u ration Tool Map p in g If a tool needs to be mapped: click on the tool name under Tool Selection, highlight the tool’s serial number under Available Tools, and then click the green arrow to map the tool; t h e s er ia l numb er s h ould ap p ear under Current Map p ing .
section 02 L ow - All r igh t s exc ept a c c es s to client notes, Administration, Rep or ts, and unable to edit, delete or create tests L owes t - Only access to client information and client case information E . I M PO RT, EX P O RT & ARCH IVE D ATA T h i s s creen a llow s you to impor t and exp or t data with var ying deg rees of detail (Fig ure 2 15 ) . Step 1 . C lic k B r ow s e to loc a te t he datab a s e yo u w is h to impor t or ex por t the data f ro m.
section 02 A p rogr es s s c r een w ill a ppea r and then a notification will indicate whether the imp o r t/ exp o r t wa s s uc c es s f ul or not . F. J O B DEMAN D TEMP LATES T h i s s c r een a llow s you to c r ea te, edit, delete, and p rint Job Demand Temp lates (Figu r e 2-16). These te mplates can be used within the Job Demands screen that is accessed from the Home Screen. F i gure 2 -1 6 . Job D e ma nd Tem p lates Add a new Job Demand Template by clicking N ew .
section 02 Fi gure 2 -1 7 . S upe rfi ci a l Ten d ern ess Tem p lates Add a n ew templa te by c lic king N ew . E d i t a n ex is t ing templa te by c lic king Edit and then selecting the temp late. Remove a n ex is t ing templa te by clicking Rem ove and then selecting the template. H . PR O T O COL H IBERN ATION T h i s s creen a llow s you to pla c e protocols, which may not be used of ten, in hibernation as well as remove protocols, which may be needed, from hibernation.
section 02 Step 2 . A wa r ning w ill a ppea r p rior to deleting data. Click Yes to remove the case. V. TASKBA R (F I G URE 2- 19) Fi gur e 2 -1 9 . OD ES Ta s kba r A . F I L E D RO P - D O W N MENU 1. DATABASE UTILITIES This screen allows you to open a database, create a new database, rename an existing d at a b a s e, a nd r emove a n existing database (Fig ure 2-20).
section 02 B a c k u p a d a t a b a s e by loc a t in g the director y you wo u ld like to s ave t h e d a t a b a s e to, selecting whether o r n ot to us e a pa s s word , s electing whether or not to b a ck up t h e impa ir ment r a t ings, selecting whether or n ot to er a s e t h e d is k, a nd t h en clicking St ar t Bac k up. Fig u re 2-22. Back U p Dat abase N ote t h a t BT E Tec h nologies c a nnot recover any lost or fo rgotten passwords that have been used for back ups.
section 02 puter). 3. PATIENT INFORMATION Provides a summar y of all client information that has been added to the database. The repor t can be printed, expor ted to a snapshot f ile format, or expor ted to Microsof t Word ( i f Word is ins t a lled on t h e comp uter). 4. REFERRAL INFORMATION Provides a summar y of all referral sources that have been entered into the database.
section 02 Step 3 . S pec if y w h et h er you wish to a n a ly z e a s pec if ic t r ia l or t he ave ra ge of t h e t r ia ls r ela t ing to the s p e c i f i c p roto c o l fo r a s p e c i f i c c l i ent. Step 4 . S pec if y w h ic h pos it ion you wo uld like to graph. Step 5 . Indicate the time frame yo u would like to analyze (optional). Step 6 . C lic k An aly ze a nd a grap h o f t h e r ea l t ime a na ly s is w ill a p p e a r. Fig u r e 2-25. Real TIm e An aly sis 8.
section 02 F i gure 2 -2 7 . Expor t Ad m in istr ation In for m ation Step 1 . Select which protocols, super protocols, or templates you would like to expor t. Step 2 . C lic k B r ow s e to f i n d t h e d i r e c to r y yo u wo u l d l i ke to ex p o r t i n to . Step 3 . Enter a password (optional) and click St ar t Expor t. 10. IMPORT ADMIN INFORMATION Allows you to impor t the administrative information related to the various protocols, s uper protoc ols , a nd templates (Fig ure 2-28).
section 02 1. CREATING A SNAPSHOT Step 1 . C lic k on Repo r ts within the Home Screen. Step 2 . P r eview t h e r epor t you would like to snap shot. Step 3 . Wit h in t h e t a s kb a r, s elect Expor t then Create a Re por t Snapshot. T h e repor t w ill now b e ex por ted into a rep or t snap shot, and a messag e will ap p ear on ce the save is successful. 2. EMAILING, SAVING, REMOVING, AND VIEWING A SNAPSHOT Step 1 . From t h e H ome S c r een taskbar, click on Snapshots . Step 2 .
section 02 F i gure 2 -3 1 . D i gi ta l Ca ptu re Step 1 . Take the picture with a digital camera. Step 2 . Dow nloa d t h e pic t ur e to your hard drive using your camera sof tware. Step 3 . Wit h in t h e Digit a l C a pture Obser vations screen, click on the binocular s ico n to locate the picture in the director y it was saved and click Open . Step 4 . C lic k Inser t and the picture should appear in the large box. Step 5 . E nter a pic t ur e t it le a nd any comments if desired.
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section 03 0 3 - C L I EN T I N F O R M ATI O N Intro duc tion 3 Adding a Clien t 3 Adding a Case 4 Adding a Fa mily Physicia n /S pe c i al i s t /At tor n ey / Re fe rra l Sou rce/In su ra n ce Company /Empl oye r 4 Adding Cu rren t Medica tion s 4 Clie nt Photos 4 Clie nt S ta tu s 5 Star t/En d Time 5 Evalua tor 1 a n d 2 5 Adding in ICD -9 Codes 5 Ar e as of Compla in t 5 Lo ck i n g Ca ses 5 F inding a Clien t/Ca se 6 Adding a n d Remov in g Tests 6 40 0 4 0 0 0 5 re v.
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section 03 CLIENT INFORMATION I. IN TRO D UCTION T h e cl i e nt infor ma t ion s c r een c a n be accessed from the center of the home screen, jus t a b ove t h e cl i e nt d rop-d ow n menu (F igur e 3-1). Fi gur e 3 -1 . Cl i e nt Informa ti on Icon AD D IN G A CL IENT In order to utilize the sof tware, a client must f ir st be entered.
section 03 III. AD D ING A CA S E A l l cl i e n t s m us t h ave a c a s e a s s oc ia te d with their f ile. Within the Client Information screen, click N ew C a s e. T h e C l i e n t C a s e Infor ma t ion s c r een a llows you to enter information reg arding the client’s phy sician, medications, referral sources, employment, insurance, ICD-9 codes, etc. (Figure 3-3). Fi gure 3 -3 . Ca s e Informa ti on A .
section 03 cl i ck Inser t to add the photo. D . C L IEN T STATUS The client status f ield is useful for keeping track of the amount and type of assessments yo u have completed. Client status can also be used as a criterion under Statistical Quer i e s . T h e d rop-d ow n menu s h ou ld already be p op ulated with status op tions, but you ca n also add, edit or remove status information by double clicking on the blank text f ield. E .
section 03 appear prompting you to enter and conf irm a password. Click OK when you are done. Once locked, you will see the Lock Case icon change to Unlock Case. O n ce t h e C l ient C a s e pa ge is c omplete, you may click the C l o s e button located at the bottom right hand corner of the page; this will bring you back to the Client Information page, and a ca s e n u m b er w ill now b e a s s oc ia ted with your client. Click the C l o s e button in order to return to the Home Screen.
section 03 Add a n ew tes t to t h e c lient by eit her hig hlig hting the test name in the lef t box and clic k in g Add to Client or by double clicking on the test name in the lef t box. O n ce t h e tes t h a s b een a s s igned to the client it will ap p ear in the rig ht box. Change the order the tests will be completed in by highlighting the test in the right box and use the up and down arrow s under Change Protocol Order.
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section 04 0 4 - T EM P L AT ES Pr e -Progra mmed Templa tes 3 Custom Templa tes 4 40 0 4 0 0 0 5 re v.
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section 04 TEMPLATES Each of the Notes pages in ODES has a template section that allows you to create any number of te mplates. This feature allows you to specify which client information you would like to include on each repor t and in which location. For example, the client’s name, date of injur y, and injur y locations could be inser ted in the upper lef t hand corner of a repor t. This feature speeds up repor ting time, improves ef f iciency, and hence, prof itability.
section 04 Step 4 . C l i c k Cancel Edit a nd t h en s elect the temp late you just v iewed. This will bring yo u to the corresponding screen (Figure 4-4). F i gure 4 -4 . Bl a nk Not es Screen Step 5 . While in the home template screen, click within the white text box to place the cur sor and paste in the code.
section 04 T h i s wi l l b r ing you to t h e ma in Temp lates screen (Fig ure 4-7). F i gure 4 -7 . Ma i n Tem p lates Scr een Step 1 . C r ea te a new templa te by clicking on N ew . A new icon will ap p ear within the m a in Te mplates screen. Step 2 . To view the template, f i r s t click on Edit; the Edit icon should change to Cancel Edit. Next click on the template you just created. A s cr e e n w ill a ppea r w it h a b la nk text box (Fig ure 4-8). F i gure 4 -8 .
section 04 F i gure 4 -9 . Cus tom Tem p late Cod e Step 4 . Once you have f inished creating the code, highlight the code and either press C T R L - C on your keyboard or pull down the Edit menu in the taskbar and select C o py . This will copy th e code to your clipboard. Next, click the C l o s e icon within the custom temp late’s screen. Th is will return you to the main Templates screen. Step 5 . C l i c k Cancel Edit a nd t h en s elect the temp late you just v iewed.
section 04 with carets and select which bracketed options apply. Edit a cu s tom templa te by c lic king Edit in the main Templates screen and selecting the template you wish to modify. You can then add f i elds by selecting the desired f i eld from the Inser t Field drop down menu and clicking Inser t or delete f i elds using the delete key on your key board. The text may also be modif ied as you see f i t.
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section 05 0 5 - C A L I B R AT I O N & V E R I FI CATI ON Introduc tion 3 Pe r for min g the Ca libra tion 3 Pe r fo r m i n g t h e Ve r i f i c a t i o n 7 Calib r ation Repor ts 8 40 0 4 0 0 0 5 re v.
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section 05 CALIBRATION & VERIFICATION I. IN TRO D UCTION C a l i b ra t i on is a n impor t a nt c omponent of the Multi-Cer v ical™ system. Since one of the m a in attributes of the system is the ability to track the progress of your patients, it is essential that the equipment is always giving accurate feedback . Therefore, we recommend calibrating ever y 7 d ay s a nd ver if y ing t h e b eginning of ever y day.
section 05 S e l e ct t h e Cer vical ic on f rom t h e ma in calibration screen to bring up the MCU™ calibration screen (Figure 5-3). F i gure 5 -3 . Ce rvi ca l Ca l ib r ation Screen T h e s cre e n w ill a lway s ind ic a te t h e la st day of successful calibration in addition to the am ou n t o f we i gh t u sed for t h e la s t c a lib r a t ion. Step 1 . Secure the head brace you wish to calibrate to the calibration plate.
section 05 Step 3. P la c e t h e c a lib r a t ion weig ht(s) on the calibration block (Fig ure 5-6). Enter the a m ou n t o f we i gh t you a r e us ing to c a lib r a te (remember to add the weig ht of the calibration block , w h i ch i s 0.7lb / 0.3k g) in t h e c a lib r ation screen and then click O K . F i gure 5-6. Calib r atin g th e H ead Brace Step 4. Remove the calibration weights from the calibration block before proceeding with the rest of the calibration. Step 5 .
section 05 Step 8 . If it isn’t already, set the halo flexion/extension angle to 0 degrees and inser t the ROM s to p p i n ( F i g u r e 5 - 9 ) . C l i c k O K on the calibration screen. F i gure 5 -9 . Ha l o at 0 o Flexion / Exten sion Step 9 . Remove the ROM stop pin, set the halo flexion/extension angle to 70 degrees flexion, a n d t h e n i n s er t t h e ROM s top pin (F ig ure 5-10). Click O K on the calibration screen. F i gure 5 -1 0 . Ha l o at 70 o Flexion Step 10 .
section 05 Step 1 2 . Make sure the seat back is at its lowest position, and then raise the seat height to i t s h i g h e s t p o s i t i o n ( F i g u r e 5 - 1 2 ) . C l i c k O K on the calibration screen. F i gure 5 -12. Seat H eig h t at H ig h est P osition Step 1 3 . Once the device has been successfully calibrated, a screen will appear requesting the name of the individual who just completed the calibration. III.
section 05 S e l e ct t h e Cer vical ic on f rom t h e ma in verif ication screen to bring up the MCU™ verif ication s c r e e n ( F i g u r e 5 - 15 ) . F i gure 5 -1 5 . Ce rvi ca l Ver ification Scr een T h e s cre e n w ill a lway s ind ic a te t h e la st day of successful verif ication. The verif ication tools and process are the same as calibration. However, you mus t make sure to use a dif ferent amount of weight for the verification than you did for the calibration .
section 05 Re por ts include the name of the person who per formed the calibration/verif ication, the date when the calibration/verif ication occurred, and actual weight vs. measured weight, and any d evi a t i o n f rom t h e a c c ur a c y of t h e dev ice (Fig ure 5-18). F i gure 5 -1 8 . Ca l i bra ti on an d Ver ification Rep ort 40 0 4 0 0 0 5 re v.
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section 06 0 6 - P R OTO C O L S Se lf Re por ts 3 U tilizin g Self Repor ts 3 Editing a n d Crea tin g S elf Repor t s 4 Cardiova scular Protocols 5 U tilizin g Ca rdiova scu la r Protoc ol s 5 Editing a n d Crea tin g Ca rdiovas c u l ar P rotoc ol s 5 ROM Protocols 7 Positioning the Patient for a Cer vical ROM Protocol 7 Positioning the Patient for a ROM Flexion or Extension Test 8 Positioning the Patient for a ROM L/R Rotation Test 9 Positioning the Patient for a ROM Lateral Flexion
section 06 U tiliz in g the Stren gth L a tera l Te s t 34 U tiliz in g the Stren gth Protra c t i on Te s t 36 U tiliz in g the Stren gth Retra c t i on Te s t 37 Cr e atin g Cu stom Cer v ica l In te gr at i on P rotoc ol s 38 Clinical Protocols 39 U tilizing Clin ica l Protocols 39 Editing a n d Crea tin g Clin ica l P rotoc ol s 40 Super Protocols 41 Validity An a lysis 43 page 2 40040005 rev.
section 06 PROTOCOLS Through the ODES sof tware, you can access many pre-programmed protocols as well as crea te cu s to miz ed protoc ols . T h e follow in g p rotocol categ ories can be accessed throug h the Hom e Screen: •Self Repor ts •Cardio •ROM Tests •Strength Tests •Clinical Tests B T E Te ch n ologies r ec ommend s t h a t t he MCU™ be used in conjunction with a cer tified train in g program on The Melbourne Protocol .
section 06 B . E D I T I N G AN D CREATIN G SELF R EPORT S Access the pre-programmed Self Repor ts protocols by clicking the Se lf Re po r ts icon on th e Home Screen. This will bring you to the Self Repor ts Protocols main page, where you can edit and create te st s. Edit a test by highlighting the test you would like to edit in the lef t box and clicking Edit Te s t. Create a new test by clicking on N ew Tes t.
section 06 t h e n ew s pec if ic a t ions . II. CARD IOVA S CUL A R P ROTOCOL S ODES includes several pre-programmed Cardiovascular protocols. A . U T IL I ZIN G CARDIOVASCULAR PROT OCOL S Access the pre-programmed Cardiovascular protocols by clicking the Cardio icon on the Home Screen. This will bring you to the Cardiovascular Protocols main page.
section 06 A L B C D E F G M N H I J K F i gure 6 -4 . Cus tom Ca r d iovascu lar P rotocol Since editing and creating protocols are ver y similar, an example of an edited test will be given, but the same guidelines apply for creating a test. T h e fo l low ing c a n t y pic a lly b e ed ited or created on Cardiovascular Tests: A . Te s t Name - Ty pe in t h e na me of the test B. Set Maximum Allowable Hear t Rate - Select whether to set the maximum allowable hear t rate and at what percentage of age.
section 06 N . Parameter s to be Measured (Heading Labels) - Ty p e i n t h e p a r a m eter s t h a t w i l l b e m e a s u re d O n ce t h e s c r een h a s b een c losed, the p rotocol is saved under the assig ned test nam e w ith t h e n ew s pec if ic a t ions . III. CERVICA L RA NG E OF M OTIO N ( R O M ) P R O T O C O L S A .
section 06 S te p 6 . S ec ur e t h e pa t ient w it h t he waist strap and shoulder strap s (Fig ure 6-8). F i gure 6 -8 . Waist an d Sh ou ld er Str ap s Step 7. Close and lock the halo (Figure 6-9). F ig u re 6-9. Close a nd Lock th e H alo 1. POSITIONING THE PATIENT FOR A ROM FLEXION OR EXTENSION TEST Step 8 . For a flexion test, inser t both of the head braces in the halo. For an extension te st, inser t the back head brace with a Velcro strap attached.
section 06 s pine lines up w it h t h e pivot p oint of the halo (Fig ure 6-12). F i gure 6 -1 2 . Fin al Ad ju stm en ts an d Locatin g C5/ C6 Step 1 2 . Firmly secure the patient’s head with the head brace(s) and Velcro strap (if p er for ming a n ex tens ion test). Step 1 3 . Remove the range-of-motion stop pin before per forming the test (Figure 6-13). Extension F lex ion F i gure 6 -1 3 . Fin al Set-u p s for RO M Flexion & Exten sion Note that the RJ45 cable is not required for this test. 2.
section 06 Step 1 1 . Make f ine adjustments to the seat to line up C5/C6 of the patient’s spine with t h e p ivot point of t h e h a lo (F igu re 6-16). F i gure 6 -1 6 . F i nal Ad ju stm en ts an d Locatin g C5/ C6 Step 1 2 . Firmly secure the patient’s head with the head braces. Step 1 3 . While holding onto the side of the halo, unlock the rotation pin, which is located at the top middle of the halo, before per forming the test (Figure 6-17).
section 06 F i gure 6 -20. Set h alo an g les Step 1 1 . Position the head braces against the patient’s head, but do not secure his/her head in place. Step 1 2 . Make f ine adjustments to the seat to line up C5/C6 of the patient’s spine with t h e pivot point of t h e h a lo (Fig ure 6-21). F i gure 6 -2 1 . Fin al Ad ju stm en ts an d Locatin g C5/ C6 Step 1 3 . Firmly secure the patient’s head with the head braces. Step 1 4 .
section 06 F i gure 6 -2 3 . R a nge of Motion P r otocols Step 1 . Assign a test to a client by highlighting the test in the lef t box and clicking Add to Client or by double clicking on the test in the lef t box. Step 2 . Once a test has been assigned to a client, highlight the test name in the right b ox a nd c lic k Per for m Te s t to bring up the testing screen (Fig ure 6-24). Figure 6 -2 4 .
section 06 • • • • • Lateral Flexion icon, which switches to the Lateral Flexion test screen Extension icon, which switches to the Extension test screen Graphs and tables to illustrate the test results Instructions on how to per form the tests Threshold icon, which allows a threshold force to be set 2. UTILIZING THE ROM FLEXION TEST The ROM Flexion test measures the patient’s range of motion with respect to the flexor muscle group. Step 1 . S elec t t h e F l ex i o n icon.
section 06 Figure 6 -2 6 . Ce rvi ca l R OM - Com p leted Flexion Test You may retest a trial by clicking on the R icon to the lef t or right of the trial table, depending on which trial you would like to redo. However, once a test has been closed, the trials can not be retested. 3. UTILIZING THE ROM ROTATION TEST T h e RO M Rot a t ion tes t mea s ur es the p atient’s rang e of motion with resp ect to the l a teral rotator muscle group. Step 1 . S elec t t h e L / R Rot at i o n icon.
section 06 Step 2 . Position the patient as described in Section 06-III of this manual. Step 3 . C l i c k St ar t Te s t to begin testing. Step 4 . O nc e ea c h s id e is comp leted, a p ain scale will ap p ear. Ask the p atient to r a te his/her pain on a ten-point scale (0 is equivalent to no pain and 10 is equivalent to the wor st pain possible). Click on the number the patient stated and then click O K . The ROM Rotation test calls for three trials to be per formed per side.
section 06 Figure 6 -2 9 . Ce rvi ca l R OM - Later al Flexion Test Step 2 . Position the patient as described in Section 06-III of this manual. Step 3 . C lic k St ar t Te s t to begin testing. Step 4 . O nc e ea c h s id e is c omp leted, a p ain scale will ap p ear. Ask the p atient to r a te his/her pain on a ten-point scale (0 is equivalent to no pain and 10 is equivalent to the wo r st pain possible). Click on the number the patient stated and then click O K .
section 06 F i gure 6 -3 0 . Ce rvi ca l RO M - Com p leted Lateral Flexion Test You may retest a trial by clicking on the R icon to the lef t or right of the trial table, depending on which trial you would like to redo. However, once a test has been closed, the trials can not be retested. 5. UTILIZING THE ROM EXTENSION TEST The ROM Extension protocol measures the patient’s range of motion with respect to the extensor muscle group. Step 1 . S elec t t h e Extension icon.
section 06 Step 2 . Position the patient as described in Section 06-III of this manual. Step 3 . C lic k St ar t Te s t to begin testing. Step 4 . O nc e t h e tes t is c ompl eted, a p ain scale will ap p ear. Ask the p atient to rate h i s / h er pa in on a ten-point s c ale (0 is equivalent to no p ain and 10 is equivalent to th e wo r st pain possible). Click on the number the patient determined and then click O K . The ROM Extension test calls for three trials to be per formed.
section 06 Fig u re 6-33 In sert RO M Stop Step 2 . Lower t h e c h a ir a ll t h e way down to its lowest p osition. Step 3 . Using the latch on the right side, open the halo (Figure 6-34). F i gure 6 -3 4 . Op en H alo Step 4 . As k t h e pa t ient to s it in the chair. Step 5 . Adjust the height of the seat, the position of the seat, the position of the back of the chair, the height of the back of the chair, and the arm rests to accommodate the patient’s size, height, and posture.
section 06 Fig u re 6-37. Close an d Lock th e H alo 1. POSITIONING THE PATIENT FOR AN ISOMETRIC FLEXION/EXTENSION TEST Step 8 . For a flexion test, inser t the front head brace. For an extension test, inser t the back head brace. Note that the bottom of the back brace is located at the external occi p i t al prot ub er a nc e (F igur e 6-3 8). L ocation of Back Brace F lex ion Set-up F i gure 6 -38. In itial Isom etr ic Flexion & Exte ns ion Set-u p Step 9 .
section 06 cl os es t to t h e f ront of t h e un it at the top of the MCU™ (Fig ure 6-41). Flexion Extension Fi gu re 6 -4 1 . MCU™ R J4 5 J ack an d Fin al Isom etric Flexion & Exten sion Set- ups 2. POSITIONING THE PATIENT FOR A ISOMETRIC LATERAL TEST Step 8 . Unlock the rotation pin and rotate the halo to 90 degrees right rotation. Lock t h e rot a t i o n p i n ( F i g u r e 6 - 4 2 ) . F i gur e 6-42. H alo at 90 o Rotation Step 9 .
section 06 F i gure 6 -4 5 . F i nal Ad ju stm en ts an d Locatin g C5/ C6 Step 1 3 . Attach the RJ45 cable to the head brace being used and the RJ45 jack that is cl o s e s t to t h e f ront of t h e unit at the top of the MCU™ (Fig ure 6-46). F i gure 6 -4 6 . MCU™ R J45 J ack an d Fin al Isom etr ic Later al Set-u p B .
section 06 F i gure 6 -48. O p en H alo Step 4 . As k t h e pa t ient to s it in the chair. Step 5 . Adjust the height of the seat, the position of the seat, the position of the back of the chair, the height of the back of the chair, and the arm rests to accommodate the p a t i ent ’s s iz e, h eigh t , a nd pos ture (Fig ure 6-49). F i gure 6 -4 9 . S e a t Adj ustm en ts Step 6 . S ec ur e t h e pa t ient w ith the waist strap and shoulder strap s (Fig ure 6-50). F i gure 6-50.
section 06 1. POSITIONING THE PATIENT FOR A 25 DEGREE ISOMETRIC FLEXION/EXTENSION TEST Step 8 . For a flexion test, inser t the front head brace. For an extension test, inser t the back head brace. Note that the bottom of the back brace is located at the external occi p i t al prot ub er a nc e (F igur e 6-5 2). L ocation of Back Brace F lex ion Set-up F i gure 6-52. In itial Isom etric Flexion & Exte nsion Set-u p Step 9 . S et t h e h a lo to 15 d egrees below the horizontal (Fig ure 6-53).
section 06 Step 1 3 . Attach the RJ45 cable to the head brace being used and the RJ45 jack that is cl os es t to t h e f ront of t h e un it at the top of the MCU™ (Fig ure 6-56). Flexion Extension Fi gure 6 -5 6 . MCU™ R J4 5 Jack an d Fin al 25 o Isom etr ic Flexion & Exten sion Set - ups 2. POSITIONING THE PATIENT FOR A 25 DEGREE ISOMETRIC LATERAL TEST Step 8 . Unlock the rotation pin, which is located at the top middle of the halo.
section 06 t h e p ivot point of t h e h a lo (F igu re 6-60). F i gure 6 -6 0 . Fin al Ad ju stm en ts an d Locatin g C5 Step 1 3 . Attach the RJ45 cable to the head brace being used and the RJ45 jack that is cl o s e s t to t h e f ront of t h e unit at the top of the MCU™ (Fig ure 6-61). F i gure 6 -6 1. MCU ™ RJ 45 J ack an d Fin al 2 5 o Is ome t ric Later al Set-u p C .
section 06 F i gure 6 -6 3 . O p en H alo Step 4 . As k t h e pa t ient to s it in the chair. Step 5 . Adjust the height of the seat, the position of the seat, the position of the back of the chair, the height of the back of the chair, and the arm rests to accommodate the patient’s size, height, and posture. Set the halo height to 3 as a star ting position (Figure 6-64). F i gure 6 -6 4 . S e a t Adj ustm en ts Step 6 . S ec ur e t h e pa t ient w ith the waist strap and shoulder strap s (Fig ure 6-65).
section 06 1. POSITIONING THE PATIENT FOR A 45 DEGREE ISOMETRIC FLEXION/EXTENSION TEST Step 8 . For a flexion test, inser t the front head brace. For an extension test, inser t the back head brace. Note that the bottom of the back brace is located at the external occi p i t al prot ub er a nc e (F igur e 6-6 7). L ocation of Back Brace F lex ion Set-up F i gure 6-67. In itial Isom etric Flexion & Exte nsion Set-u p Step 9 . S et t h e h a lo to 15 d egrees below the horizontal (Fig ure 6-68).
section 06 Step 1 3 . Attach the RJ45 cable to the head brace being used and the RJ45 jack that is cl os es t to t h e f ront of t h e un it at the top of the MCU™ (Fig ure 6-71). Flexion Extension Fi gure 6 -7 1 . MCU R J4 5 Ja ck an d Fin al 25 o Isom etr ic Flexion & Exten sion Set - ups 2. POSITIONING THE PATIENT FOR A 45 DEGREE ISOMETRIC LATERAL TEST Step 8 . Unlock the rotation pin, which is located at the top middle of the halo.
section 06 F i gure 6 -7 5 . F i n al Ad ju stm en ts an d Locatin g C5/ C6 Step 1 3 . Attach the RJ45 cable to the head brace being used and the RJ45 jack that is cl o s e s t to t h e f ront of t h e unit at the top of the MCU™ (Fig ure 6-76). F i gure 6 -7 6. MCU ™ RJ 45 J ack an d Fin al 4 5 o Is ome tric Later al Set-u p D . U T IL I Z I NG TH E CERVICAL STRENGTH PROTOCOL S 1.
section 06 the halo is set (i.e. 0 degrees, 25 degrees, and 45 degrees). Step 1 . Assign a test to a client by highlighting the test in the lef t box and clicking Add to Client or by double clicking on the test in the lef t box. Step 2. Once a test has been assigned to a client, highlight the test name in the right b ox a nd c lic k Per for m Te s t to bring up the testing screen (Fig ure 6-78). F i gure 6 -7 8 .
section 06 Fi gure 6 -7 9 . Ce rvi ca l S tren g th - Flexion Test Step 2 . Position the patient as described in Section 06-IV of this manual. Step 3 . C lic k St ar t Te s t to begin testing. Step 4 . O nc e t h e tes t is c ompl eted, a p ain scale will ap p ear. Ask the p atient to rate his/her pain on a ten-point scale (0 is equivalent to no pain and 10 is equivalent to the wo r st pain possible). Click on the number the patient stated and then click O K .
section 06 F i gure 6 -8 0 . Ce rvi ca l Str en g th - Com p leted Flexion Test You may retest a trial by clicking on the R icon to the lef t or right of the trial table, depending on which trial you would like to redo. However, once a test has been closed, the trials can not be retested. 3. UTILIZING THE STRENGTH EXTENSION TEST T h e S t r engt h E x tens ion tes t measures the p atient’s streng th with resp ect to the exten sor muscle group. Step 1 . S elec t t h e Extension icon.
section 06 Step 2 . Position the patient as described in Section 06-IV of this manual. Step 3 . C lic k St ar t Te s t to begin testing. Step 4 . O nc e t h e tes t is c ompl eted, a p ain scale will ap p ear. Ask the p atient to rate his/her pain on a ten-point scale (0 is equivalent to no pain and 10 is equivalent to the wo r st pain possible). Click on the number the patient stated and then click O K . The Strength Extension test calls for three trials to be per formed.
section 06 F i gure 6 -8 3 . Ce rvi ca l Str en g th - Later al Test Step 2 . Position the patient as described in Section 06-IV of this manual. Step 3 . C l i c k St ar t Te s t to begin testing. Step 4 . O nc e ea c h s id e is comp leted, a p ain scale will ap p ear. Ask the p atient to r a te his/her pain on a ten-point scale (0 is equivalent to no pain and 10 is equivalent to the wor st pain possible). Click on the number the patient determined and then click O K .
section 06 Fi gure 6 -8 4 . Ce rvi ca l S tren g th - Com p leted Later al Test You may retest a trial by clicking on the R icon to the lef t or right of the trial table, depending on which trial you would like to redo. However, once a test has been closed, the trials can not be retested. 5. UTILIZING THE STRENGTH PROTR ACTION TEST Step 1 . S elec t t h e Protraction icon. The Protraction Testing screen will appear (Figure 6 - 8 5 ).
section 06 Step 3 . C l i c k St ar t Te s t to begin testing. Step 4 . O nc e t h e tes t is c omp leted, a p ain scale will ap p ear. Ask the p atient to r a te his/her pain on a ten-point scale (0 is equivalent to no pain and 10 is equivalent to the wor st pain possible). Click on the number the patient stated and then click O K . The Strength Protraction test calls for three trials to be per formed.
section 06 co e f f ic ient of va r ia t ion (C OV ), and the p ercent of normal. The p ain rating s determin e d by the patient will also appear in the pain scale text f ield. You may retest a trial by clicking on the R icon to the lef t or right of the trial table, depending on which trial you would like to redo. However, once a test has been closed, the trials can not be retested. 7.
section 06 ion or extension test to begin K . Rot at i o n T h r e s h o l d ( l b s ) - Set the amount of force (lbs) required for a rotation test to b egin L . Pain Rat in g Per S id e - Choose whether to display the pain rating scale Once the screen has been closed, the protocol is saved under the assigned test name w it h t h e new s pec if ic a t ions . V. CLIN ICA L P ROTOCOL S ODES includes several pre-programmed Clinical protocols, which are intended to be complete d without the use of any tools.
