BTE Technologies WER-1 MCU Wireless User Manual 40040005 rev 000

BTE Technologies, Inc. MCU Wireless 40040005 rev 000

Contents

Users Manul Part II

page 40section 06 40040005 rev. 000Depending on the test, every screen will look slightly different, but most will have the fol-lowing features:• Name of the test• Delete icon to delete the selected test’s results• New icon to begin a new set of test results• Close icon to return to the protocol screen• Next Protocol icon to move on to the next protocol• Date of Test• Instructions on how to perform the tests• Comments fieldStep 3. Follow the instructions, which are located at the top left of the screen, and in-dicate whether the patient showed positive or negative results or if the location wasn’t tested.B. EDITING AND CREATING CLINICAL PROTOCOLSAccess the pre-programmed Clinical protocols by clicking the Clinical Tests icon on the Home Screen.This will bring you to the Clinical Protocols main page, where you can edit and create tests.Edit a test by highlighting the test you would like to edit in the left box and clicking Edit Test.Create a new test by clicking on New Test.If you are editing a test, a screen will appear with the current settings of the test you selected. If you are creating a test, a screen will appear with the same headings as if you were editing a test, but all of the text fields will blank (Figure 6-90).Figure 6-89. Clinical Protocol - Cervical 1
section 06 page 4140040005 rev. 000Since editing and creating protocols are very similar, an example of an edited test will be given, but the same guidelines apply for creating a test.The following can typically be edited or created on Clinical Protocols:A. Test Name - Type in the name of the testB. Sub-Heading - Type in the sub-headings to include in the testC. Examiner Description - Type in any description the examiner will need to perform the test - this field is especially useful for supplying instructions on how to perform the evalu-ationD. Report Description - Type in any description that should be included on the reportE. Reference Information - Include any reference information that needs to be added to the reportF. Body Region - Select which body region is being evaluatedOnce the screen has been closed, the protocol is saved under the assigned test name with the new specifications.VI. SUPER PROTOCOLSSuper Protocols can be created when you require a standardized protocol for testing (i.e. Post Offer of Employment Testing). They can also be used if you want to decrease the amount of time required to select specific tests for specific injuries.The Melbourne Protocol has defined the optimal sequence of testing suitable for a patient suf-fering Whiplash and Associated Disorders (WAD); this Super Protocol is covered in The Mel-bourne Training Protocol. Refer to Section 10 for more information on this training program.To create or access a super protocol, click on the Super Protocol link on the Home Screen above the Administration icon (Figure 6-91).Figure 6-91. Super Protocol LinkFigure 6-90. Custom Clinical ProtocolABCDEF
page 42section 06 40040005 rev. 000This will bring you to the main Super Protocols screen (Figure 6-92).Step 1. Create a new protocol by clicking on New. A new icon will appear within the main Super Protocols screen.Step 2. To view the super protocol, first click on Edit; the Edit icon should change to Cancel Edit. Next click on the super protocol you just created.A screen will appear with boxes of test names on the left and a blank box on the right (Figure 6-93).Step 3. Select the applicable tests from the lists on the left-hand side of the page and Add them to the Super Protocol.The order of testing can be changed by highlighting one of the included tests and using the Change Order arrows to move it up or down within the list.Step 4. Once you have added all the applicable tests and arranged them in the desired order, finish the process by clicking Lock Super Protocol.Step 5. You will be prompted to enter and confirm a password to lock the Super Protocol.Step 6. To apply a Super Protocol, select a client then click Super Protocol from the Home Figure 6-92. Super Protocol Main ScreenFigure 6-93. Create/Edit Super Protocol
section 06 page 4340040005 rev. 000Screen.Step 7. Click the Super Protocol you wish to use.A testing screen will appear with the tests for the super protocol already added to your client. If other tests have already been added to the client, the super protocol tests will be listed be-low them (Figure 6-94).Edit a super protocol by clicking Edit in the main Super Protocol screen and selecting the su-per protocol you wish to modify. You can then add and remove tests by highlighting a test and clicking Add or Remove.To delete any protocol, first click the Delete icon in the main Super Protocol screen; the De-lete icon should change to Cancel Delete. Next click on the super protocol you wish to delete.VII. VALIDITY ANALYSISThe Validity Analysis allows you to evaluate the patient’s actual results versus the expected results. This may be done for any or all of the tests completed by the patient.Access the Validity Analysis by clicking on the Validity Analysis icon located on the Home Screen. (Figure 6-95)This will bring you to the main Validity Analysis screen (Figure 6-96).Figure 6-94. Super Protocol Added to ClientFigure 6-95. Validity Analysis Icon
page 44section 06 40040005 rev. 000Step 1. Once the Validity Analysis screen is open, click on the arrow to the right of the first drop-down menu and select the protocol you wish to evaluate. You may also click Use All Avail-able if you wish to use all of the tests (Figure 6-97).The Protocol or Section Name, Result, Expected Result, and Deviation fields will automatically be populated.Step 2. Add any necessary notes regarding the validity of the protocols.Step 3. Click Print to preview the report (Figure 6-98).You may also add protocols to the analysis by clicking Add Validity Name and typing in the pro-tocol name, section name, and expected result.Figure 6-96. Validity Analysis Main ScreenFigure 6-97. Select Protocol for Validity AnalysisFigure 6-98. Preview Validity Analysis Report
section 07 page 140040005 rev. 00007 - REPORTSAccessing the Reports 3Types of Reports 6Cervical Assessment 6Custom Report 6Custom Report (Non-Integrated) 6FCA Progress Assessment (Non-Integrated) 7FCA (Non-Integrated) 7MCRP Assessment 7MCRP Discharge Assessment 8MCRP Progress Assessment 8MCRP General Progress Assessment 8MCRP Reassessment 9MCRP Summary Report 10
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section 07 page 340040005 rev. 000REPORTSI. ACCESSING THE REPORTSODES allows you to create a unique report that can include any information you deem neces-sary, such as the raw data from a protocol, heart rate capture, or comments about the pa-tient’s performance.Access the Reports screen by clicking the Reports icon on the Home Screen.Each report will be slightly different with respect to what may be included in it; the following steps are a combination of what may be encountered for any one test. Therefore, follow only those steps which apply to the report you wish to view.Step 1. Click on the arrow to the right of Report Title to access the drop-down menu and se-lect the report you would like to view (Figure 7-1).Step 2. Verify the appropriate start and end dates for the notes and for the protocol (Figure 7-2).Figure 7-1. Report Title SelectionFigure 7-2. Report Selection & Date Range
page 4section 0740040005 rev. 000Step 3. Click Next. The Patient Notes to Print screen will appear (Figure 7-3).Step 4. Select whether you would like to include the dates in the margin.Step 5. Select whether you would like to include page numbering when printing the notes from the Notes screen.Step 6. Select whether you would like to start page numbering when printing the notes from the Notes Screen.Step 7. Choose which notes you would like to include in the report by highlighting the note in the left box and clicking Add Note. If you wish to include all of the listed notes, click Select All. If you would like to remove a note, highlight the note in the right box and click Remove Note.Step 8. Depending on which step you would like to do next, click Next, Print Notes, or Pre-view Notes. Note that if you click Preview Notes, you will be able to print them from the Pre-view Screen. If you click Next, the Tests to Print Screen will appear (Figure 7-4).Step 9. Choose which tests you would like to include in the report by highlighting the test in the left box and clicking Add Test. If you wish to include all of the listed tests, click Select All. If you would like to remove a test, highlight the test in the right box and click Remove Test.Figure 7-3. Patient Notes to PrintFigure 7-4. Tests to Print
section 07 page 540040005 rev. 000Step 10. Depending on which report you have selected to view and which step you would like to do next, click Next, Print Notes, or Preview Notes. Note that if you click Preview Notes, you will be able to print them from the Preview Screen. If you are able to click Next, the Report Op-tions screen will appear (Figure 7-5).Step 11. Choose whether you would like to address the report for a Referral, Insurance, At-torney, Patient, Physician, Employer, Case Manager, or Specialist. If you select once of these listed icons, the address needs to have been entered in the client information screen. If you wish to address the report to a person or company other than the ones listed, or an address hasn’t been entered in the client information screen, you may manually enter the address in the text field.Step 12. Select whether you would like to include the following in the report (note that these may not be available for every report):•Injury Location Diagram•Injury Location Chart•Evaluator Comments•Job Demands on a separate page•Page numbering•Client’s name at the bottom of every page•Client’s file number at the bottom of every pageStep 13. Type in a title name for this report and click Store. Note that this option may not ap-pear for every type of report.Step 14. Check the box if you would like to return to the Home Screen after previewing or printing the report.Step 15. Depending on which step you would like to do next, click Preview Report or Print Re-port. Note that if you click Preview Report, you will be able to print it from the Preview screen. If you choose Preview Report, the Report Preview screen will appear (Figure 7-6).Figure 7-5. Report Options
page 6section 0740040005 rev. 000II. TYPES OF REPORTSDepending on which report you elect to view, each will look somewhat different. The following is a list that includes each report type all the options that may be incorporated into it.A. CERVICAL ASSESSMENTThis report allows you to:•Select date range of data•Add and remove client notes from the report•Alter page numbers•Enter dates in the margins beside client notes•Select all or only specific tests to include on the report•Print or preview the reportB. CUSTOM REPORTThis report allows you to:•Select date range of data•Alter pages numbers•Add and remove client notes from the report•Address the report to the following: Referral, Insurance Company, Attorney, Client, Physi- cian, Employer, Case Manager•Include injury diagram and/or chart on the reportFigure 7-6. Preview Report
section 07 page 740040005 rev. 000•Put the job demand on a separate page•Add or remove page numbers from the report•Include clients name at the bottom of each page of the report•Print or preview the report•Create a custom title for the reportC. CUSTOM REPORT (NON-INTEGRATED)This report is designed to include only Non-Integrated tests that have been performed.This report allows you to:•Select date range of data•Alter pages numbers•Add and remove client notes from the report•Add specific non-integrated tests to your report•Address the report to the following: Referral, Insurance Company, Attorney, Client, Physi- cian, Employer, Case Manager•Include injury diagram and/or chart on the report•Put the job demand on a separate page•Add or remove page numbers from the report•Include clients name at the bottom of each page of the report•Print or preview the report•Create a custom title for the reportD. FCA PROGRESS ASSESSMENT (NON-INTEGRATED)This report is designed to include only Non-Integrated tests that have been performed. It is specifically used to track the progress of multiple assessments.This report allows you to:•Select date range of data•Alter pages numbers•Add and remove client notes from the report•Add specific non-integrated tests to your report•Address the report to the following: Referral, Insurance Company, Attorney, Client, Physi- cian, Employer, Case Manager•Include injury diagram and/or chart on the report•Put the job demand on a separate page•Add or remove page numbers from the report•Include clients name at the bottom of each page of the report•Print or preview the reportE. FCA (NON-INTEGRATED)This report allows you to:•Select date range of data•Alter pages numbers•Add and remove client notes from the report•Add specific non-integrated tests to your report
page 8section 0740040005 rev. 000F. MCRP ASSESSMENTThis report allows you to:•Select date range of data•Alter pages numbers•Add and remove client notes from the report•Address the report to the following: Referral, Insurance Company, Attorney, Client, Physi- cian, Employer, Case Manager•Include injury diagram and/or chart on the report•Put the job demand on a separate page•Add or remove page numbers from the report•Include clients name at the bottom of each page of the report•Print or preview the reportG. MCRP DISCHARGE ASSESSMENTThis report allows you to:•Select date range of data•Alter pages numbers•Add and remove client notes from the report•Address the report to the following: Referral, Insurance Company, Attorney, Client, Physi- cian, Employer, Case Manager•Include injury diagram and/or chart on the report•Put the job demand on a separate page•Add or remove page numbers from the report•Include clients name at the bottom of each page of the report•Print or preview the reportH. MCRP PROGRESS ASSESSMENTThis report allows you to:•Select date range of data•Put the job demand on a separate page•Add or remove page numbers from the report•Include clients name at the bottom of each page of the report•Print or preview the reportI. MCRP GENERAL PROGRESS ASSESSMENTThis report allows you to:•Select date range of data•Alter pages numbers•Add and remove client notes from the report•Add specific tests to your report•Address the report to the following: Referral, Insurance Company, Attorney, Client, Physi- cian, Employer, Case Manager•Include injury diagram and/or chart on the report•Put the job demand on a separate page
section 07 page 940040005 rev. 000•Add or remove page numbers from the report•Include clients name at the bottom of each page of the report•Print or preview the report•Create a custom title for the reportJ. MCRP REASSESSMENTThis report allows you to:•Select date range of data•Alter pages numbers•Add and remove client notes from the report•Add specific tests to your report•Address the report to the following: Referral, Insurance Company, Attorney, Client, Physi- cian, Employer, Case Manager•Include injury diagram and/or chart on the report•Put the job demand on a separate page•Add or remove page numbers from the report•Include clients name at the bottom of each page of the report•Print or preview the reportK. MCRP SUMMARY REPORTThis report allows you to:•Select date range of data•Print preview all raw data obtained for a specific client
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section 08 page 140040005 rev. 00008 - CERVICAL CONDITIONINGAccessing Cervical Conditioning 3Selecting Exercises 5Blackout Feature 5Target Feature 5Tracking Dates 6Supervising Practitioner 6Weight Stack Selection 7Seat Values 7Minimum Values 8Time 8Starting % 8Default 9Accuracy Value 9Notes 9
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section 08 page 340040005 rev. 000CERVICAL CONDITIONINGRecently, the exercise program portion of the ODES software has been reintroduced. Included in this feature is a protocol for cervical conditioning. This function was created specifically for Multi-Cervical™ Units and allows evaluators to customize cervical exercise programs for their clients. Results are directly integrated into the software, making this feature extremely user friendly, functional, and efficient.The Rehabilitation Program on the MCU for patients suffering cervical conditions is covered extensively during the training program on The Melbourne Protocol. This training program in-cludes basic to advanced set-up to accommodate various patients groups including:• Whiplash and Associated Disorders (WAD)• Acute and Chronic Cervical Injury Management• Specific Cervical Pathologies• Hypertrophy Training for the AthleteI. ACCESSING CERVICAL CONDITIONINGThe cervical conditioning protocol can be located within the Exercise Program Menu. To locate it, click on the Exercise Program Button located on the main screen of your ODES software (Figure 8-1).This will bring you to the Active Conditioning Protocol Screen (Figure 8-2):In order to use the cervical conditioning feature, you may perform either of the following steps:1. Highlight Cervical Conditioning on the left hand side and click the Add button.2. Double click on Cervical Conditioning to add this protocol to the Exercises Assigned to Client list.Cervical Conditioning will now appear on the right hand side of your screen under Exercises As-signed to Client (Figure 8-3).Figure 8-1. Exercise Program IconFigure 8-2. Active Conditioning Protocols
page 4section 08 40040005 rev. 000When entering the program for the first time, two warnings will appear; one is shown below (Figure 8-4).Simply click OK and you will be allowed into the cervical conditioning program.You will now enter into the cervical conditioning screen (Figure 8-5).Figure 8-4. Warning ScreenFigure 8-5. Cervical Conditioning ScreenFigure 8-3. Cervical Conditioning Selected
section 08 page 540040005 rev. 000II. SELECTING EXERCISESThere are various options to choose from within the Cervical Conditioning screen. On the left hand side of the screen, all possible movements are listed. In order to select the exer-cises for the client, simply click on the name of the move-ment. A number will be assigned to the exercise, and the name of the movement will turn black. If you wish to order the exercises differently (e.g. place flexion in a neutral position as exercise #2), simply double click on the number beside the exercise, and all the numbers will change accord-ingly (Figure 8-6).III. BLACKOUT FEATUREFor certain movements, a blackout option is available. This is important for client safety since it may be set to limit the range of motion a client can perform safely. The blackout feature automatically defaults to “no” – meaning no value is assigned and the client can perform all exercises without any limitations (Figure 8-7).In order to set the blackout value, place your mouse over the word “no” – it should turn yellow. Then double click your left mouse button in order to specify the maximum range of motion the client should perform (Figure 8-8).In the example above, the client should not exceed 30 degrees of neutral flexion. Therefore, the pin on the halo should be placed in the 30 degree position to limit the movement.IV. TARGET FEATUREThe target represents the number of sets and repetitions to be performed for each selected exercise. The default for this is 3 sets of 10. It can, however, be changed. If you double click on the word “target”, two numbers will appear above it. The number on the left represents the number of sets that the program will default to, and the number on the right is the number of repetitions. To change these default values, left click on the number you wish to change. Once changed, these values will be the new defaults for ALL clients (Figure 8-9).This exercise has not been chosenSelected exerciseExercises have been reversedFigure 8-6. Selecting ExercisesNo blackout has been selectedFigure 8-7. No BlackoutNo turns yellowSetting blackout valueBlackout has been set to 30oFigure 8-8. Setting Blackout ValueSets Reps Double click to change sets or repsFigure 8-9. Setting Target Value
page 6section 08 40040005 rev. 000V. TRACKING DATESMultiple dates can be tracked within the software in order to perform continual conditioning programs. The software also reminds you to do re-assessments to compliment the condition-ing program. There is no limit or cap to how many conditioning programs a client may perform. The date does not need to be manually inputted into the correct field. Instead, it will be im-ported automatically after the rehab program has been initiated. You may also double click in the blank field – a calendar will appear and you can select the correct date (Figure 8-10).VI. SUPERVISING PRACTITIONERTo enter your name as a supervising practitioner, your name must be entered in case informa-tion. If you have already entered yourself as a supervising practitioner, your name will appear in the drop down menu. If not, go into case information; double click in the space besides su-pervising practitioner (Figure 8-11).Then, fill out the health practitioner screen (Figure 8-12).Double click for calendarFigure 8-10. Setting the DateFigure 8-11. Adding Supervising PractitionerFigure 8-12. Health Practitioner Information
section 08 page 740040005 rev. 000Your name will now appear in the drop down menu (Figure 8-13).VII. WEIGHT STACK SELECTIONIn order to make the cervical conditioning program specific to your Multi-Cervical™ Unit, a feature was added to the software to allow you to change the weight stack type. In order to alter this setting, you must click on View in the bottom right hand corner of your screen (Figure 8-14).Once the View button is clicked, a table will appear that displays the pin number and its corresponding weight (Figure 8-15).VIII. SEAT VALUESIn the bottom right hand corner of your screen, you will find an icon that will al-low you to make notes on the positioning of your seat (Figure 8-16).To enter in information on your seat positioning, click on Seat.This Seat Positioning screen allows you to comment on certain seat features which may or may not be taken into account. For example, if you are utilizing lumbar support, place a check mark in the box located beside “lumbar support”. You may now track these specifications for your client and ensure that the same positioning is achieved for each conditioning session (Figure 8-17).Figure 8-13. Supervising Practiioner Drop-Down MenuFigure 8-14. Weight Stack SettingFigure 8-16. Seat IconFigure 8-15. Weight Stack ValuesThis space is for additional commentsSeat height values (present and previous) are shown hereStore seat back position hereFigure 8-17. Seat Settings
page 8section 08 40040005 rev. 000IX. MINIMUM VALUESThis feature in the cervical conditioning program allows the practitioner to enter a minimum range that must be obtained in order for the motion to register in the software (Figure 8-18).For example, if the practitioner wishes to set a minimum value of 50 de-grees for flexion, a minimum value of 50 should be selected. If this is the case, the client must now perform at least 50 degrees of flexion before the repetition will register in the software (Figure 8-19). Any minimum can be selected, and if you wish, you can set these values as default values by clicking on the Set as Defaults button.X. TIMEThe total time of the conditioning program (daily and cumulative) is shown in the lower right hand corner of the testing screen. You may modify the client’s rest time with the correspond-ing arrow (up increases the time allotted, down decreases the time allotted). Click start timer when ready to begin (Figure 8-20).XI. STARTING %Before performing a cervical exercise program, a starting % should be selected. This feature refers to the amount of weight being used (i.e. the PIN # you select on your weight stack). After you select the correct weight stack type, you may use this feature (Figure 8-21).The data you receive from your cervical assessment of the client will provide you with the maximum amount of weight that they can maneu-ver in that motion. You will want to use a percentage of this weight for the cervical conditioning program (i.e. 40% of their maximum capabili-ties). In order to do this, select the correct percentage from the drop down menu. When you click go, the software will automatically fill the grid with the correct Pin # (i.e. the Pin that is associated with 40% of the client’s maximum) (Figure 8-22).XII. DEFAULTThe default button sets the values entered into the Starting %, Minimum Values and Weight Stack fields as the default values for ALL patients (Fig-ure 8-23).XIII. ACCURACY VALUEAfter double clicking on the word “Target”, a number “7” will appear in the very bottom left hand corner of your screen (Figure 8-24).Figure 8-18.Minimum SettingsFigure 8-19.Minimum FlexionSettingLeft clicking with your mouse in the yellow box increases rest time by 1 hour.Figure 8-20. TimerFigure 8-22.Setting Starting %Figure 8-21.Starting %Figure 8-23.Set as Default
section 08 page 940040005 rev. 000This number relates to the number of degrees a client is allowed to be within to register a rep-etition. In this case, the range is “7” degrees. Therefore, the repetition will not register until the client is within 7 degrees from the initiation point of the motion. To change this value, simply click on the number located in the bottom left hand corner.IXV. NOTESNotes can be added into the conditioning program. In order to do this, click on Notes in the upper right hand corner (Figure 8-25).The Notes screen will appear, which will allow you to enter in multiple notes on your client (Fig-ure 8-26).To enter in notes, place your cursor in the large upper white box. You may now type any infor-mation that you wish to include. If you wish to include to date prior to entering your note, click Insert Date (located on the tool bar). The date will now appear in the text box (Figure 8-27).Figure 8-24. Accuracy ValueFigure 8-25.Notes IconFigure 8-26. Notes Screen
page 10section 08 40040005 rev. 000You may also enter information into a template format. This allows you to save popular phrases so that you do not have to re-enter them time and time again. To do this, enter the information you wish to save in the lower text box and then click Add to List, which is highlighted in green (Figure 8-28).Figure 8-27. Insert DateFigure 8-28. Create a Common Note
section 08 page 1140040005 rev. 000Your information will now appear in a list, which you can access by clicking on the drop down icon (Figure 8-29). To insert this information into your note, select the phrase you wish to include and click Insert into Note, which is highlighted in blue (Figure 8-30).Figure 8-29. Add Common Note to ListFigure 8-30. Select Common Note to Insert
page 12section 08 40040005 rev. 000Your information will now appear in the notes section (in the upper text box) (Figure 8-31).Figure 8-31. Common Note Inserted into Main Notes Field
section 09 page 140040005 rev. 00009 - RECOMMENDED MAINTENANCEGeneral Computer Maintenance 3Do Not Install Additional Software 3Shut Down the Computer Properly 3Maintenance Schedule 3General Product Maintenance 3Do Not Disassemble Any Components of the MCU 3Maintenance Schedule 3After Each Client 4Daily 4Weekly 4Monthly 4Prevention of Interference between Wireless Components 4
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section 09 page 340040005 rev. 000RECOMMENDED CARE AND MAINTENANCEI. GENERAL COMPUTER MAINTENANCEODES software runs in the Microsoft Windows XP environment; Windows XP Professional is an extremely reliable and secure operating system, but extended use requires some degree of system maintenance.It is recommended that a log is kept for the maintenance of the computer equipment.B. SHUT DOWN THE COMPUTER PROPERLYTo avoid possibly damaging the computer system, do not shut down the computer by simply pressing the power button.Step 1. When you are ready to shut down the MCU™, click Start at the bottom left corner of the computer screen.Step 2. Click Shut Down.Step 3. Make sure Shut Down is highlighted in the drop-down menu and click OK.C. MAINTENANCE SCHEDULE1. DAILY• Backup the database - you should have a backup disk for each day of the week2. WEEKLY• Backup the database - you should have a backup disk for each week of the month3. MONTHLY• Compact and repair the ODES database - see Section 2 for instructions• Clear hard drive of any unnecessary files (go to Start| Programs | Accessories | Sys- tem Tools | Disk Cleanup, select the C Drive and then the files you would like to de- lete)• Run the defragment program to ensure optimum computer performance (go to Start | Programs | Accessories | System Tools | Disk Defragmenter)II. GENERAL PRODUCT MAINTENANCEThe MCU™ station and tools are designed to be robust and used frequently, but extended use requires some degree of maintenance.It is recommended that a log is kept for the maintenance of the system.A. DO NOT DISASSEMBLE ANY COMPONENTS OF THE MCU™ Do not attempt to disassemble any component of the MCU™ or its tools. The system is as-sembled in such a way that components of it may break if disassembled incorrectly.If one of the BTE Technologies products is not working properly, call customer service at 1-800-331-8845 so the problem may be properly diagnosed and repaired.A. DO NOT INSTALL ADDITIONAL SOFTWAREDo not install any additional software onto the controlling computer. The BTE Technologies MCU™ system is in constant communication with the computer, so a “clean”, dedicated computer system is crucial to the integrity of this communication system.
page 4section 09 40040005 rev. 000B. MAINTENANCE SCHEDULE1. AFTER EACH CLIENT• Clean the head braces and arm rests with an antibacterial wipe or rubbing alcohol (70% alcohol). Make sure to not allow any liquid to enter the RJ45 jacks on the head braces or the top of the column.2. DAILY• Verify any equipment that has been calibrated. If verification fails, then recalibrate the tool• Clean the halo with an antibacterial wipe or rubbing alcohol (70% alcohol)• Clean the seat bottom and back with an antibacterial wipe or rubbing alcohol (70% alcohol)3. WEEKLY• Calibrate and verify all tools4. MONTHLY• Check all the cables to ensure they are secure and in good working conditionIII. PREVENTION OF INTERFERENCE BETWEEN WIRELESS COMPONENTSInterference, which can result in an inability to acquire accurate data, may occur in the follow-ing scenarios:a. There are multiple wireless systems within 50 feet of each other that are on the same wireless channel (e.g. 2 wireless MCUs in the same clinic on channel 16).b. The antennas of any wireless components are within 3 feet of each other (e.g. the an- tenna on the Hub is within 3 feet of the antenna on top of the MCU).c. There is not a direct line of sight between the antennas of the wireless components. In addition, any metal that is between the antennas will cause interference.You may prevent interference by maintaining your system in the following manner:a. Do not allow the Hub to fall on the floor; there are magnets inside the Hub that will aid in securing it to the computer cart.b. Regularly check the USB cable that is attached to the Hub and check the power cable that is attached to the MCU.c. Verify the antennas are in good working order and properly secured.You may also prevent interference by using the following guidelines:a. If there are multiple wireless systems within 50 feet of each, verify that each unit is on a different wireless channel. Refer to Section 02-IV-C-4 (URFIO Configuration Applica- tion) for how to determine on which channel a system is operating.b. The recommended location for the Hub is on the second shelf of the computer cart. This ensures the antenna of the Hub will always be at least 3 feet from the antenna on the top of the MCU.c. Verify there is a direct line of sight between the Hub antenna and the MCU antenna.
section 10 page 140040005 rev. 00010 - THE MELBOURNE PROTOCOLIntroduction 3Outcome Data Reliability Summary 4Reliability Study Data 5World Wide Spine Article 6“Pain in the Neck” Article 11
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section 10 page 340040005 rev. 000THE MELBOURNE PROTOCOLTo compliment the BTE User Manual, Robert De Nardis, (Physiotherapist, Director of the Mel-bourne Whiplash Centre and Panel Member for the International Whiplash Taskforce) has de-signed a specific protocol (The Melbourne Protocol), which is gaining international recognition and is being used in over 50 specialist whiplash facilities around the world. The Melbourne Protocol details evaluation and treatment protocols based on evidence from ongoing research into the treatment of Whiplash and Associated Disorders (WAD). Some of the topics covered in training include:- Assistance with branding your Center as a Neck Care Center of Excellence- Whiplash Center Marketing Strategies (12 month Marketing Plan provided - Whiplash Center Business Administration- Reliability and Validity on the Multi-Cervical™ Unit- Initial assessment protocols including Vertebro-Basilar Insufficiency (VBI) Testing and the application of Functional Questionnaires- Management of the Irritable Patient and Exclusion Criteria for The Multi-Cervical™ Unit- Treatment Protocols including Contra-indications for Treatment and Key Prognostic Indica- tors from current research- Patient Positioning for Evaluation of Range of Motion and Isometric Strength on The Multi-Cervical™ Unit- Patient Positioning for Treatment on the Multi-Cervical™ Unit- Advanced Treatment Ideas and Options for Whiplash and Associated Disorders Patients- Current Whiplash and Associated Disorders Research Trends- Collecting and Analyzing Data Collected on The Multi-Cervical™ Unit- Research at The Melbourne Whiplash CentreContact BTE Technologies for more information on registering for this program:U.S. & Canada: 800.331.8845International: 410.850.0333Fax: 410.850.5244Internet: www.btetech.com/training_sched.htm
page 4section 10 40040005 rev. 000Greenwood, K.M. & De Nardis, R.J. (2000). Melbourne Whiplash Centre Outcome Data. Preliminary Report. Melbourne Whiplash Centre (Manuscript in preparation). Summary of FindingsHaving established that the measures produced by The Melbourne Protocol on the BTE Multi-Cervical Unit have an acceptable degree of reliability (Greenwood & De Nardis, 2000a), the focus of research attention should now move to the issue of the validity of measurements and the efficacy of therapy using the unit. Validity refersto the “appropriateness, meaningfulness, and usefulness of the specific inferences made from test scores” (Standards for Educational and Psychological Testing, 1985, p.9). MethodThe data were obtained from 123 patients (66% female, average age 40.4 years, average chronicity of symptoms 98.0 months, average duration of treatment 6.9 weeks). Patients were assessed before and after the treatment program on 8 variables: scores on Neck Disability Index, strength of isometric Flexion/Extension/Lateral Flexion and range of motion of Flexion/Extension/Lateral Flexion/Rotation. Paired t-tests were used to compare changes from pre- to post-program values. Results Pre-Program Post-Program t df p Measure Neck Disability Index 33.8 17.5 15.165 98 <.001 ROM (degrees) Flexion 58.2 65.5 -8.041 116 <.001 Extension 48.7 55.3 -6.530 115 <.001 Lateral Flexion 38.8 48.0 -10.695 114 <.001 Rotation 63.5 73.4 -8.593 114 <.001 Isometric Strength (lbs) Flexion 10.1 17.1 -15.808 116 <.001 Extension 14.5 25.0 -15.352 117 <.001 Lateral Flexion 10.9 18.6 -14.490 116 <.001 It can be seen that highly significant changes were found in all variables in the expected direction, most notably for strength. It is clear from these results that treatments using the Melbourne Protocol with the BTE Multi-Cervical Unit results in improvements in Neck Disability Index, strength and ROM in these patients as a group. Six month follow-up data (thus far only available for 18 patients) indicates that there is no evidence of changes in the values of NDI, strength and ROM from post-program to 6 month recording. Therefore, treatment gains have persisted in this sample.
section 10 page 540040005 rev. 000Greenwood, K.M. & De Nardis, R. (2000). An assessment of the reliability of measurements made using the Melbourne Protocol and the BTE Multi-Cervical Unit. Melbourne Whiplash Centre (Manuscript in preparation). Summary of FindingsThe reliability of a measurement refers to “the consistency, the reproducibility and the repeatability of the instrument or measurement procedure” (Richman, Makrides & Prince, 1980). The Reliability TrialTo assess the reliability of measures made using The Melbourne Protocol and the BTE Multi-Cervical Unit, a trial was designed in which 26 individuals (who did not have ailments involving the neck) were assessed by three therapists on two occasions each. The trial allowed assessment of inter-observer and intra-observer reliability. Results:Inter-Tester ReliabilityThe consistency of a measurement technique when used by different clinicians over time. xSystematic Difference between TherapistsResults indicate a good degree of agreement between therapists. All averages reported were within 3.3 degrees for ROM measurements and 0.8 lbs for strength measurements. xOrder of Testing EffectsThere were no systematic differences between the first, second and third measurements. Results indicate that there are no major “warm-up” or familiarisation of technique changes in value and further indicate that the pre-measurement trials conducted in the protocol are sufficient to rule out these effects. xRelationship Between the Therapists’ Scores – CorrelationsCorrelation coefficients are high (.747 to .949 [approaching 1.0]) indicating good inter-observer reliability. xRelationship Between Therapists’ Scores – ICCsIntra-Class correlation coefficients are high (.767 to .930 [approaching 1.0]) indicating good inter-observer reliability. xStandard Error of MeasurementSEM’s are low (1.56 to 4.10) indicating good inter-therapist reliability. Intra-Tester Reliability The consistency of a measurement technique when used by the same clinician over time. xSystematic Changes Over TimeNo systematic differences were identified in scores over time. xRelationship Between the Therapists’ Scores – Test-Retest CorrelationsThe majority of the correlation coefficients are high (.667 to .895 [approaching 1.0]) indicating good test-retest reliability. ROM extension scores were lower (.529 to .747) indicating some attention is required for this particular measure. xTest-Retest Reliability of Therapists’ Scores – ICCsThe majority of the ICC’s are high (.654 to .879 [approaching 1.0]) indicating good test-retest reliability. Again ROM extension was lower (.531 to .742). xStandard Error of MeasurementSEM’s are low (1.54 to 5.73) indicating good test-retest reliability. xMinimum Detectable Change – Test-RetestThe same therapist over a one week period can reliably detect changes of around 10 degrees in ROM and around 5lbs in strength.
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