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

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section 06
Fi gure 6 -8 9 . Cl i ni ca l Protocol - Cer vical 1
Depending on the test, ever y screen will look slightly dif ferent, but most will have the following 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 per form the tests
• Comments f ield
Step 3. Fo llow the instructions, which are located at the top lef t of the screen, and indicate whether the patient showed positive or negative results or if the location wasn’t
te ste d.
B . E D I T I N G AND CREATIN G CLIN IC AL PROTOCOL S
Access the pre-programmed Clinical protocols by clicking the Clinic al Te s ts icon on th e
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 lef t box and clicking Edit
Te s t.
Create a new test by clicking on N ew Tes t.
I f yo u a r e ed it ing a tes t , a s c r een will ap p ear with the current setting s of the test you
selected. If you are creating a test, a screen will appear with the same headings as if you
we r e e d it ing a tes t , b ut a ll of t h e text f ields will blank (Fig ure 6-90).
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section 06
F i gure 6 -9 0 . Cu stom Clin ical P r otocol
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 follow ing c a n t y pic a lly b e e dited or created on Clinical Protocols:
A . Te s t Name - Ty pe in t h e na me of the test
B . S u b - H e a d i n g - Ty pe in t h e s ub-heading s to include in the test
C . E xa m i n e r D e s c r i p t i o n - Ty pe in any descrip tion the examiner will need to p er form th e
te st - this f ield is especially useful for supplying instructions on how to per form the evaluation
D . Re p o r t D e s c r i p t i o n - Ty pe in any descrip tion that should be included on the rep or t
E. Reference Information - Include any reference information that needs to be adde d to
t h e repor t
F. B o d y Reg i o n - S elec t w h ic h body reg ion is being evaluated
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 .
VI. SUPER P ROTOCOL S
S u p e r P rotoc ols c a n b e c r ea ted w h en you require a standardized p rotocol for testing (i. e . Post
O f fe r o f E mploy ment Tes t ing). T h ey can also be used if you want to decrease the amoun t of
t i m e r e quir ed to s elec t s pec if ic tests for sp ecific injuries.
The Melbourne Protocol has def ined the optimal sequence of testing suitable for a patient suffe r i n g W h ipla s h a nd As s oc ia ted Disorder s (WAD); this Sup er Protocol is covered in The Me l 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
a b ove t h e Ad minis t r a t ion ic on (F igu re 6-91).
F i gure 6-91. Su p er P rotocol Lin k
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T h i s w i l l b r ing you to t h e ma in S uper Protocols screen (Fig ure 6-92).
F i gure 6 -9 2 . S upe r Protocol Main Screen
Step 1 . Create a new protocol by clicking on N ew . A new icon will ap p ear within the main S u p e r
Protocols screen.
Step 2. To view the super protocol, f ir st click on Edit; the Edit icon should chang e to Canc e l
Edit. Next click on the super protocol you just created.
A s cre e n wi l l a ppea r w it h b oxes of test names on the lef t and a blank box on the rig ht (Figu r e
6-93).
Fi gure 6 -9 3 . Cre a te /Edi t S u p er P r otocol
Step 3. Select the applicable tests from the lists on the lef t-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,
f i n i s h t h e p roc es s by c lic king Loc k Super Protocol.
Step 5 . Yo u w ill b e prompted to enter and confirm a p assword to lock the Sup er Protocol.
Step 6 . To apply a Super Protocol, select a client then click Super Protocol from the Home
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Screen.
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 below them (Figure 6-94).
Fi gure 6 -9 4 . S upe r Protocol Ad d ed to Clien t
Edit a super protocol by clicking Edit in the main Sup er Protocol screen and selecting th e super protocol you wish to modify. You can then add and remove tests by highlighting a test and
cl i ck i n g A d d or Rem ove.
To d e l e t e any protocol, f ir st click the Delete icon in the main Super Protocol screen; the Delete icon should change to Cancel Delete. Next click on the super protocol you wish to delete.
VII. VALIDI TY A NA LY S I S
T h e Va l i dit y Ana ly s is a llow s you to evaluate the p atient’s actual results versus the exp e cte d
results. This may be done for any or all of the tests completed by the patient.
Acce s s t he Va lid it y Ana ly s is by c lic king on the Validity Analysis icon located on the Home
S cre e n . ( F igur e 6-95)
F i gure 6-95. Valid ity An alysis Icon
T h i s w i l l b r ing you to t h e ma in Va lidity Analysis screen (Fig ure 6-96).
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Fi gur e 6- 96 . Va l i di ty Ana l ys i s Ma i n Screen
Step 1 . Once the Validity Analysis screen is open, click on the arrow to the right of the f ir st
drop-down menu and select the protocol you wish to evaluate. You may also click Use All Ava ila bl e i f yo u w is h to us e a ll of t h e tes t s (Fig ure 6-97).
Fi gur e 6- 97 . S e l e ct Protocol for Valid ity An aly sis
T h e P roto col or S ec t ion Na me, Res ult , Exp ected Result, and Dev iation fields will automatica l l y
be populated.
Step 2 . Add a ny nec es s a r y notes r egarding the validity of the p rotocols.
Step 3 . C l i ck Print to pr eview t h e r epor t (Fig ure 6-98).
Fi gur e 6-9 8 . Pre vi e w Va l i di ty An aly sis Rep or t
You may also add protocols to the analysis by clicking Add Validity Nam e and typing in the proto col name, section name, and expected result.
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section 07
0 7 - R EP O RT S
Accessing the Repor ts
Ty p e s of Repor ts
Ce r vica l Assessmen t
Cus tom Repor t
Cus tom Repor t (Non -In tegra te d )
F CA P rogress A ssessmen t (N on - I n te gr ate d )
F CA (Non -In tegra ted)
M CR P A ssessmen t
M CR P D ischa rge A ssessment
M CR P Progress A ssessmen t
M CR P G en era l Progress Asse s s me n t
M CR P Rea ssessmen t
M CR P S u mma r y Repor t
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REPORTS
I. ACCESS ING TH E REP ORTS
ODES allows you to create a unique repor t that can include any information you deem necessar y, such as the raw data from a protocol, hear t rate capture, or comments about the patient’s per formance.
Acce s s t h e Repor t s s c r een by c lic k ing the Repor ts icon on the Home Screen.
E a ch re p or t w ill b e s ligh t ly d if fer en t with resp ect to what may be included in it; the foll ow in g
steps are a combination of what may be encountered for any one test. Therefore, follow only
t h o s e s teps w h ic h a pply to t h e r epor t you wish to v iew.
Step 1 . C lic k on t h e a r row to t h e rig ht of Rep or t Title to access the drop -down menu a n d se l e ct t h e r epor t you would like to view (Fig ure 7-1).
F i gure 7 -1 . R e port Title Selection
Step 2.
7-2).
Verify the appropriate star t and end dates for the notes and for the protocol (Figure
F i gure 7 -2 . R e port Selection & Date Ran g e
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Step 3.
C l ic k N ex t. The Patient Notes to Print screen will appear (Figure 7-3).
Fi gure 7 -3 . Pa ti e nt Notes to P rin t
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 Note s screen.
Step 6. Select whether you would like to star t page numbering when printing the notes from
the Notes Screen.
Step 7. C h oos e w h ic h notes you wou ld like to include in the rep or t by hig hlig hting the note
i n t h e l e f t box a nd c lic king Add Note . If you wish to include all of the listed notes, click Select
A l l . I f yo u would like to r emove a note, hig hlig ht the note in the rig ht box and click Rem ove
N o te.
Step 8 . D epend ing on w h ic h s tep yo u 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 click Next, the Tests to Print Screen will appear (Figure 7-4).
Fi gur e 7 -4 . Te s ts to Pri nt
Step 9. C h oos e w h ic h tes t s you would like to include in the rep or t by hig hlig hting the test in
t h e l e f t b ox a nd c lic king Add Tes t. 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 Rem ove Tes t.
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Step 10 . Depend ing on w h ic h r epor t you have selected to v iew and which step you wou l d l ike
to do next, click N ex t, Print Notes, or Preview Notes. Note that if you click Preview Note s, you
will be able to print them from the Preview Screen. If you are able to click Next, the Repor t Opt i o n s s cr een w ill a ppea r (F igur e 7-5 ).
F i gure 7 -5 . R e port Option s
Step 1 1 . Choose whether you would like to address the repor t for a Referral, Insurance, Atto rney, 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 repor t to a per son 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 f ield.
Step 1 2 . Select whether you would like to include the following in the repor t (note that these
m ay n ot b e ava ila b le for ever y r epor t):
• I n j u r y L oc a t ion Dia gr a m
• I n j u r y L oc a t ion C h a r t
•Evaluator Comments
• J o b D e m a nd s on a s epa r a te pa ge
•Page numbering
• C l i e n t ’ s na me a t t h e b ot tom of ever y p ag e
• C l i e n t ’ s f ile numb er a t t h e b ot tom of ever y p ag e
Step 1 3 . Ty pe in a t it le na me for t his rep or t and click Sto re. Note that this option may not appear for ever y type of repor t.
Step 1 4 . C h ec k t h e b ox if you woul d like to return to the Home Screen af ter p rev iewing or
p ri n t i n g th e r epor t .
Step 1 5 . Depend ing on w h ic h s tep you would like to do next, click Pr ev iew Re po r t or Print Rep o r t. Note that if you click Preview Repor t, you will be able to print it from the Preview screen.
I f yo u ch oos e P r eview Repor t , t h e Rep or t Prev iew screen will ap p ear (Fig ure 7-6).
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F i gure 7 -6 . Pre view Rep or t
II. TYPES O F REP ORTS
D e p e n d i n g on w h ic h r epor t you elec t to v iew, each will look somewhat dif ferent. The followin g
is a list that includes each repor t type all the options that may be incorporated into it.
A . C E R V ICAL ASSESSMEN T
T h i s r e p or t a llow s you to:
• S e l e ct d a te r a nge of d a t a
•Add and remove client notes from the repor t
•Alter page number s
•Enter dates in the margins beside client notes
• S e l e ct a ll or only s pec if ic tes t s to include on the rep or t
• P r i n t or pr eview t h e r epor t
B . C U S T O M REP O RT
T h i s r e p or t a llow s you to:
• S e l e ct d a te r a nge of d a t a
•Alter pages number s
•Add and remove client notes from the repor t
•Address the repor t to the following: Referral, Insurance Company, Attorney, Client, Physici a n , E mployer, C a s e M a na ger
•Include injur y diagram and/or char t on the repor t
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• Pu t t h e job d ema nd on a s eparate p ag e
•Add or remove page number s from the repor t
• I n clud e c lient s na me a t t h e bottom of each p ag e of the rep or t
• Pr i n t or pr eview t h e r epor t
• C rea te a c us tom t it le for t h e rep or t
C . C U S TOM REP O RT ( NO N - IN TEGRATED)
This repor t is designed to include only Non-Integrated tests that have been per formed.
T h i s r epor t a llow s you to:
• S e lec t d a te r a nge of d a t a
•Alter pages number s
•Add and remove client notes from the repor t
•Add specif ic non-integrated tests to your repor t
•Address the repor t to the following: Referral, Insurance Company, Attorney, Client, Physici a n, E mployer, C a s e M a na ger
•Include injur y diagram and/or char t on the repor t
• Pu t t h e job d ema nd on a s eparate p ag e
•Add or remove page number s from the repor t
• I n clud e c lient s na me a t t h e bottom of each p ag e of the rep or t
• Pr i n t or pr eview t h e r epor t
• C rea te a c us tom t it le for t h e rep or t
D . F C A P ROG RESS ASSESSMENT (NON-I NT EGRATED)
This repor t is designed to include only Non-Integrated tests that have been per formed. It is
specif ically used to track the progress of multiple assessments.
T h i s r epor t a llow s you to:
• S e lec t d a te r a nge of d a t a
•Alter pages number s
•Add and remove client notes from the repor t
•Add specif ic non-integrated tests to your repor t
•Address the repor t to the following: Referral, Insurance Company, Attorney, Client, Physici a n, E mployer, C a s e M a na ger
•Include injur y diagram and/or char t on the repor t
• Pu t t h e job d ema nd on a s eparate p ag e
•Add or remove page number s from the repor t
• I n clud e c lient s na me a t t h e bottom of each p ag e of the rep or t
• Pr i n t or pr eview t h e r epor t
E . F C A ( N O N - IN TEG RATED)
T h i s r epor t a llow s you to:
• S e lec t d a te r a nge of d a t a
•Alter pages number s
•Add and remove client notes from the repor t
•Add specif ic non-integrated tests to your repor t
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F. MC R P A SSESSMEN T
T h i s r e p or t a llow s you to:
• S e l e ct d a te r a nge of d a t a
•Alter pages number s
•Add and remove client notes from the repor t
•Address the repor t to the following: Referral, Insurance Company, Attorney, Client, Physici a n , E mployer, C a s e M a na ger
•Include injur y diagram and/or char t on the repor t
• P u t t h e job d ema nd on a s epa r a te p ag e
•Add or remove page number s from the repor t
• I n cl u de c lient s na me a t t h e b ot tom of each p ag e of the rep or t
• P r i n t or pr eview t h e r epor t
G . MC R P DISCH ARG E ASSESSMENT
T h i s r e p or t a llow s you to:
• S e l e ct d a te r a nge of d a t a
•Alter pages number s
•Add and remove client notes from the repor t
•Address the repor t to the following: Referral, Insurance Company, Attorney, Client, Physici a n , E mployer, C a s e M a na ger
•Include injur y diagram and/or char t on the repor t
• P u t t h e job d ema nd on a s epa r a te p ag e
•Add or remove page number s from the repor t
• I n cl u de c lient s na me a t t h e b ot tom of each p ag e of the rep or t
• P r i n t or pr eview t h e r epor t
H . M C R P PROG RESS ASSESSMEN T
T h i s r e p or t a llow s you to:
• S e l e ct d a te r a nge of d a t a
• P u t t h e job d ema nd on a s epa r a te p ag e
•Add or remove page number s from the repor t
• I n cl u de c lient s na me a t t h e b ot tom of each p ag e of the rep or t
• P r i n t or pr eview t h e r epor t
I. M C R P GEN ERAL P RO G RESS ASS ESSM ENT
T h i s r e p or t a llow s you to:
• S e l e ct d a te r a nge of d a t a
•Alter pages number s
•Add and remove client notes from the repor t
• Ad d s pec if ic tes t s to your r epor t
•Address the repor t to the following: Referral, Insurance Company, Attorney, Client, Physici a n , E mployer, C a s e M a na ger
•Include injur y diagram and/or char t on the repor t
• P u t t h e job d ema nd on a s epa r a te p ag e
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•Add or remove page number s from the repor t
• I n clud e c lient s na me a t t h e bottom of each p ag e of the rep or t
• Pr i n t or pr eview t h e r epor t
• C rea te a c us tom t it le for t h e rep or t
J . MC R P REASSESSMEN T
T h i s r epor t a llow s you to:
• S e lec t d a te r a nge of d a t a
•Alter pages number s
•Add and remove client notes from the repor t
• Add s pec if ic tes t s to your r ep or t
•Address the repor t to the following: Referral, Insurance Company, Attorney, Client, Physici a n, E mployer, C a s e M a na ger
•Include injur y diagram and/or char t on the repor t
• Pu t t h e job d ema nd on a s eparate p ag e
•Add or remove page number s from the repor t
• I n clud e c lient s na me a t t h e bottom of each p ag e of the rep or t
• Pr i n t or pr eview t h e r epor t
K . MC RP SUMMARY REP ORT
T h i s r epor t a llow s you to:
• S e lec t d a te r a nge of d a t a
• Pr i n t pr eview a ll r aw d a t a ob tained for a sp ecific client
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0 8 - C ER VI C A L C ONDI TI ONI NG
Acce s s in g Cer v ica l Con dition ing
Se le cting E xercises
Blackou t Fea tu re
Target Feature
Tr ack ing D a tes
Sup e r visin g Pra ctition er
We ig h t Sta ck S election
Se at Va lu es
M inimum Va lu es
T ime
Star ting %
De fault
Accuracy Value
Note s
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CERVICAL CONDITIONING
Recently, the exercise program por tion of the ODES sof tware has been reintroduced. Included
i n t h i s fe a t ur e is a protoc ol for c er v ical conditioning . This function was created sp ecific a l l y for
Multi-Cer vical™ Units and allows evaluators to customize cer vical exercise programs for their
clients. Results are directly integrated into the sof tware, making this feature extremely user
f r i e n d l y, f u n c t i o n a l , a n d e f f i c i e n t .
The Rehabilitation Program on the MCU for patients suf fering cer vical conditions is covered
ex tensively during the training program on The Melbourne Protocol. This training program includes basic to advanced set-up to accommodate various patients groups including:
•
•
•
•
W h i p l a s h a nd As s oc ia ted Dis ord e r s (WAD)
Acu te a nd C h ronic C er vic a l Injur y Manag ement
Specif ic Cer vical Pathologies
Hyper trophy Training for the Athlete
I. ACCESSING CERV ICA L CONDIT I O N I N G
T h e ce r vic a l c ond it ioning protoc ol can be located within the Exercise Prog ram Menu. To l oca te
i t , cl i ck on t h e E xercise Program Button located on the main screen of your ODES sof tware
( F i g u re 8-1).
F i gure 8 -1 . Exe rci s e P rog ram Icon
T h i s w i l l b r ing you to t h e Ac t ive C on ditioning Protocol Screen (Fig ure 8-2):
F i gure 8 -2 . Acti ve Con d ition in g P r otocols
In order to use the cer vical conditioning feature, you may per form either of the following steps:
1. H i gh l igh t Cer vical Con d it ion in g on the lef t hand side and click the Add button.
2 . D o u ble c lic k on Cer vical Con d itio ning to add this protocol to the Exercises Assigned to
C l i e n t lis t .
C e r vi ca l C ond it ioning w ill now a ppe ar on the rig ht hand side of your screen under Exerc ise s A ssigned to Client (Figure 8-3).
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F i gure 8 -3. Cervical Con d ition in g Selected
W h e n e n te r ing t h e progr a m for t h e f ir st time, two warning s will ap p ear; one is shown below
( F i g u re 8 - 4 ) .
F i gure 8-4. War n in g Scr een
S i mp l y cl i ck OK and you will be allowed into the cer vical conditioning program.
Yo u wi l l n ow enter into t h e c er vic a l c onditioning screen (Fig ure 8-5).
Fi gur e 8- 5. Ce rvi ca l Condi ti oni ng S creen
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This exe rcise
has not b e e n
chose n
II. SELECT I NG EX ERCI S ES
Selecte d
exercis e
T h e r e a r e va r ious opt ions to c h oose from within the Cer v ical
Conditioning screen. On the lef t hand side of the screen, all
possible movements are listed. In order to select the exercises for the client, simply click on the name of the movement. A number will be assigned to the exercise, and the
n a me o f t h e movement w ill t ur n b lack . If you wish to order
t h e exe rcis es d if fer ent ly (e.g. pla c e flexion in a neutral
p o s i t i o n a s exerc is e #2), s imply d ouble click on the number
beside the exercise, and all the number s will change accordi n gl y ( F i gur e 8-6).
Exercis e s
have been
rever se d
Fig u re 8-6. Selectin g Ex erci ses
III. BLACK OUT F EATURE
Fo r cer tain movements, a blackout option is available. This is
impor tant for client safety since it may be set to limit the range
o f mot i o n a c lient c a n per for m s a fe ly. The blackout feature
automatically defaults to “no” – meaning no value is assigned
a n d t h e client c a n per for m a ll exercises without any limitations
( F i g u re 8-7).
N o b l a ckou t
has b e e n
sele cte d
Fig u re 8-7. N o Black out
In order to set the blackout value, place your mouse over the word “no” – it should turn yellow.
Then double click your lef t mouse button in order to specify the maximum range of motion the
cl i e n t s h ould per for m (F igur e 8-8).
No t ur ns
yellow
Setting
blackout
value
Blackout has
been set to 30 o
F i gure 8 -8 . S e tti ng Blackou t Valu e
In the example above, the client should not exceed 30 degrees of neutral flexion. Therefore,
t h e p i n on t h e h a lo s h ould b e pla c e d in the 30 deg ree p osition to limit the movement.
IV. TARG ET F EATURE
The target represents the number of sets and repetitions to be per formed for each selected
exerc ise. The default for this is 3 sets of 10 . It can, however, be changed. If you double click
on the wo rd “target”, two number s will appear above it. The number on the lef t 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, lef t click on the number you wish to change. Once
ch a n ge d, t h es e va lues w ill b e t h e new defaults for AL L clients (Fig ure 8-9).
Sets
Rep s
Double click
to change
sets or reps
F i gure 8 -9 . S e tti ng Targ et Valu e
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V. TRACKIN G DATES
Multiple dates can be tracked within the sof tware in order to per form continual conditioning
programs. The sof tware also reminds you to do re-assessments to compliment the conditioni n g p ro gr a m . T h er e is no limit or c a p to how many conditioning p rog rams a client may p er for m .
The date does not need to be manually inputted into the correct f ield. Instead, it will be impor ted automatically af ter the rehab program has been initiated. You may also double click in
t h e b l a n k f i eld – a c a lend a r w ill a ppear and you can select the correct date (Fig ure 8-10).
Double click
fo r calendar
F i gure 8 -1 0 . Settin g th e Date
V I. SUPERVIS I NG P RA CTITI ONER
To e n te r yo ur na me a s a s uper vis ing p ractitioner, your name must be entered in case inform a t i o n . I f yo u h ave a lr ea d y enter ed your self as a sup er v ising p ractitioner, your name will app e a r
in the drop down menu. If not, go into case information; double click in the space besides sup e r vi s i n g p r a c t it ioner (F igur e 8-11).
F i gure 8 -1 1 . Ad d in g Su p ervisin g P r actition er
T h e n , f i l l o u t t h e h ea lt h pr a c t it ioner screen (Fig ure 8-12).
F i gure 8 -1 2 . Health P ractition er In form ation
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Yo u r n a me w ill now a ppea r in t h e drop down menu (Fig ure 8-13).
F i gure 8 -1 3 . S upervisin g P r actiion er Dr op -Dow n Men u
VII. WEIG HT S TA CK S EL ECTION
In order to make the cer vical conditioning program specif ic to your
Multi-Cer vical™ Unit, a feature was added to the sof tware to allow you
to change the weight stack type. In order to alter this setting, you must
cl i ck o n View in t h e b ot tom r igh t h and corner of your screen (Fig ure 814 ).
Fig u r e 8-14. Wei ght
Stack Settin g
O n ce t h e V iew b ut ton is c lic ked , a table will ap p ear that disp lays the p in
n u m b e r and it s c or r es pond ing weig ht (Fig ure 8-15).
Fig u re 8-15. Wei ght
Stack Valu es
VIII. SEAT VA L UES
I n t h e b ot tom r igh t h a nd c or ner of your screen, you will f ind an icon that will all ow yo u to ma ke notes on t h e pos itioning of your seat (Fig ure 8-16).
Fig u r e 8- 16.
Seat I con
To enter in information on your seat positioning, click on Seat.
This Seat Positioning screen allows you to comment on cer tain seat features which may or may
not be taken into account. For example, if you are utilizing lumbar suppor t, place a check mark
i n t h e b ox loc a ted b es id e “lumb a r sup p or t”. You may now track these sp ecifications for you r
cl i e n t a nd ens ur e t h a t t h e s a me positioning is achieved for each conditioning session ( Fig u r e
8 - 17 ) .
T h is s pa c e is
for additional
c omment s
Seat heig ht
values (p resent
and previous)
are shown here
Store seat back
p osition her e
F i gure 8 -17. Seat Settin g s
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IX . MIN IMUM VA L UES
T h i s fe a t u re in t h e c er vic a l c ond it ioning p rog ram allows the p ractitioner
to enter a minimum range that must be obtained in order for the motion to
register in the sof tware (Figure 8-18).
Fig u r e 8-18.
Min im u m Set t i ngs
Fo r example, if the practitioner wishes to set a minimum value of 50 degrees for flexion, a minimum value of 50 should be selected. If this is the
ca s e , t h e cl ient mus t now per for m a t least 50 deg rees of flexion before
the repetition will register in the sof tware (Figure 8-19). Any minimum can
b e s e l e cte d , a nd if you w is h , you c a n set these values as default values by
cl i ck i n g o n t h e S et a s Defa ult s b ut ton .
Fig u r e 8-19.
Min im u m Flexi on
Settin g
X . TIME
The 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 correspondi n g a r row ( up inc r ea s es t h e t ime a llot ted, down decreases the time allotted). Click star t tim e r
when ready to begin (Figure 8-20).
L ef t clicking with your
mouse in the yellow box
increases rest time by 1
hour.
F i gure 8 -2 0 . Tim er
X I. STARTIN G %
Before per forming a cer vical exercise program, a star ting % should be selected.
T h i s fe a t u r e r efer s to t h e a mount of weig ht being used (i.e. the PIN # you select
o n yo u r we i g h t s t a c k). Af ter you s elect the correct weig ht stack typ e, you may
u s e t h i s fe a t ur e (F igur e 8-21).
T h e da t a yo u r ec eive f rom your c er vic al assessment of the client will
p rovi d e yo u w it h t h e ma x imum a mount of weig ht that they can maneuve r i n t h a t mot ion. You w ill wa nt to use a p ercentag e of this weig ht for
t h e ce r vi ca l c ond it ioning progr a m (i.e . 40% of their maximum cap abilities). In order to do this, select the correct percentage from the drop
down menu. When you click go, the sof tware will automatically f ill the
gr i d w i t h t h e c or r ec t P in # (i.e. t h e P in that is associated with 40% of
t h e cl i e n t ’ s ma x imum) (F igur e 8-22).
Fig u r e 8- 21.
Startin g %
Fig u re 8-22.
Settin g Star tin g %
X II. D EFAULT
The default button sets the values entered into the Star ting %, Minimum
Va l u e s a n d Weigh t S t a c k f ield s a s t h e default values for AL L p atients (Fig u re 8 - 2 3 ) .
X III. ACCURACY VA L UE
Fig u r e 8-23.
Set as De f aul t
Af ter double clicking on the word “Target”, a number “7” will appear in the ver y bottom lef t
h a n d co rn e r of your s c r een (F igur e 8-24).
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section 08
F i gur e 8-24. Accu r acy Valu e
This number relates to the number of degrees a client is allowed to be within to register a repetition. 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 lef t hand corner.
IXV. N O TES
Notes can be added into the conditioning program. In order to do this, click on
N o te s i n t h e upper r igh t h a nd c or n er (Fig ure 8-25).
Fig u r e 8- 25.
N otes I con
T h e N otes s c r een w ill a ppea r, w h ic h will allow you to enter in multip le notes on your cli e n t ( Fig u re 8 - 2 6 ).
F i gure 8 -2 6 . Note s S creen
To e n te r in notes , pla c e your c ur s or in the larg e up p er white box. You may now typ e any in forma t i o n t h a t you w is h to inc lud e. If you wish to include to date p rior to entering your note, cl ick
Inser t Date (located on the tool bar). The date will now appear in the text box (Figure 8-27).
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Fi gure 8 -2 7 . Ins e rt D a te
You 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
yo u wi s h to s ave in t h e lower tex t b ox and then click Add to Lis t, which is hig hlig hted in g r e e n
(Figure 8-28).
F i gure 8 -2 8 . Cre a te a Com m on N ote
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Yo u r i n for ma t ion w ill now a ppea r in a list, which you can access by clicking on the drop d ow n
icon (Figure 8-29).
F i gure 8 -2 9 . Add Comm on N ote to List
To i n s e r t t h is infor ma t ion into your note, select the p hrase you wish to include and clic k Inser t
into Note, w h ic h is h igh ligh ted in blue (Fig ure 8-30).
F i gure 8 -3 0 . S e l e ct Com m on N ote to In sert
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Yo u r i n fo rma t ion w ill now a ppea r in t he notes section (in the up p er text box) (Fig ure 8-31) .
Figure 8 -3 1 . Common Note In ser ted in to Main N otes Field
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section 09
0 9 - R EC O M M END E D M AI NTE NANCE
Ge ne r al Compu ter Ma in ten a n c e
Do Not In sta ll Addition a l S of t war e
Shut Down the Computer Properly
M ainten a n ce S chedu le
Ge ne r al Produ ct Ma in ten a n ce
Do Not D isa ssemble Any Compon e n t s of t h e MC U
M ainten a n ce S chedu le
Af ter E a ch Clien t
Daily
Weekly
M on thly
Pr eve ntion of In ter feren ce bet we e n Wi r e l e s s C ompon e n t s
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RECOMMENDED CARE AND MAINTENANCE
I. G EN ERA L COM P UTER M A I NTE N A N C E
O D E S s o f t wa r e r uns in t h e M ic ros o f t Windows XP env ironment; Windows XP Professiona l is a n
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.
A . D O NO T IN STALL ADD ITION AL SOF TWARE
Do not install any additional sof tware onto the controlling computer. The BTE Technologies
M C U ™ s y s tem is in c ons t a nt c ommunication with the comp uter, so a “clean”, dedica te d
co mp uter s y s tem is c r uc ia l to the integ rity of this communication system.
B . S H U T D O W N TH E COMP UTER PROPERLY
To avoid possibly damaging the computer system, do not shut down the computer by simply
p r e s sing t h e power b ut ton.
Step 1. When you are ready to shut down the MCU™, click St ar t at the bottom lef t corner
of the computer screen.
S te p 2. C lic k Shut Down .
Step 3. Make sure Shut Down is highlighted in the drop-down menu and click O K .
C . M A IN TEN AN CE SCH EDULE
1. DAILY
• Ba c kup t h e d a t a b a s e - you should have a backup disk for each day of the wee k
2. WEEKLY
• Ba c kup t h e d a t a b a s e - you should have a backup disk for each week of the mo n th
3. MONTHLY
• C ompa c t a nd r epa ir t h e ODES database - see Section 2 for instructions
• C lea r h a rd d r ive of a ny un necessar y files (g o to Star t| Prog rams | Accessories | S y stem Tools | Dis k C lea nup, select the C Drive and then the f iles you would like to d e lete)
• Run the defragment program to ensure optimum computer per formance (go to Star t |
Programs | Accessories | System Tools | Disk Defragmenter)
II. G EN ERA L P RODUCT M A I NTEN A N C E
The 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 . D O NOT D ISASSEMBLE ANY COM PONENT S OF T HE M CU™
D o n ot a t tempt to d is a s s emb le any comp onent of the MCU™ or its tools. The system is a ssembled in such a way that components of it may break if disassembled incorrectly.
I f o n e of t h e BT E Tec h nologies p roducts is not working p rop erly, call customer ser vice a t
1 - 8 0 0-331-88 45 s o t h e prob lem may be p rop erly diag nosed and rep aired.
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B . M A IN T EN AN CE SCH EDULE
1. AFTE R EACH CLIENT
• C l e a n t h e h ea d b r a c es a nd arm rests with an antibacterial wip e or rubbing alcohol
( 7 0% a lc oh ol). M a ke s ur e to not allow any liquid to enter the RJ45 jacks on the he a d
braces or the top of the column.
2. DAILY
• Verify any equipment that has been calibrated. If verif ication fails, then recalibrate
t h e tool
• C l ea n t h e h a lo w it h a n a nt ibacterial wip e or rubbing alcohol (70% alcohol)
• C l ea n t h e s ea t b ot tom a nd back with an antibacterial wip e or rubbing alcohol (70 %
alcohol)
3. WEEKLY
• C a lib r a te a nd ver if y a ll tools
4. MONTHLY
• C h ec k a ll t h e c a b les to ens u re they are secure and in g ood working condition
III. PREVEN T I ON OF INTERF ERENC E B E T WE E N WI R E L E S S C O M P O N E N T S
Inter fe rence, which can result in an inability to acquire accurate data, may occur in the follow ing scenarios:
a . T h e r e a r e mult iple w ir eles s s y stems within 50 feet of each other that are on the sam e
w i r e l es s c h a nnel (e.g. 2 w ir eless 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 anten n a on t h e H ub is w it h in 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 inter ference.
You may prevent inter ference 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
i n s e c ur ing it to t h e c omputer car t.
b. Regularly check the USB cable that is attached to the Hub and check the power cable
t h a t is a t t a c h ed to t h e M C U.
c. Verify the antennas are in good working order and properly secured.
You may also prevent inter ference by using the following guidelines:
a . I f t h e r e a r e mult iple w ir eles s s ystems within 50 feet of each, verify that each unit i s on
a dif ferent wireless channel. Refer to Section 02-IV-C-4 (URFIO Conf iguration Application) for how to determine on which channel a system is operating.
b . T h e rec ommend ed loc a t ion for the Hub is on the second shelf of the comp uter car t. T h is
ensures the antenna of the Hub will always be at least 3 feet from the antenna on the
top o f t h e M C U.
c. Verify there is a direct line of sight between the Hub antenna and the MCU antenna.
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1 0 - T H E M EL B O U R NE PR OTOCO L
Introduc tion
Outcome D a ta Relia bility S u mm ar y
Re liab il ity S tu dy D a ta
Wor ld Wide S pin e A r ticle
“Pain in the Neck” Ar ticle
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THE MELBOURNE PROTOCOL
To compliment the BTE User Manual, Rober t De Nardis, (Physiotherapist, Director of the Melbourne Whiplash Centre and Panel Member for the International Whiplash Taskforce) has des i g n e d a s pec if ic protoc ol ( The Melbourne Protocol ), which is g aining international reco g n ition
a n d i s b eing us ed in over 50 s pec ialist whip lash facilities around the world. The Melbo u rne
Protocol details evaluation and treatment protocols based on ev idence from ongoing research
i n to t h e tr ea t ment of Wh ipla s h a nd Associated Disorders (WAD). Some of the top ics cove r e d in
t r a i n i n g inc lud e:
- Assistance with branding your Center as a Neck Care Center of Excellence
- Whiplash Center Marketing Strategies (12 month Marketing Plan prov ided
- W h ipla s h C enter Bus ines s Ad ministration
- Reliability and Validity on the Multi-Cer vical™ Unit
- I n i tia l a s s es s ment protoc ols including Ver tebro-Basilar Insuf f iciency (VBI) Testing a n d th e
application of Functional Questionnaires
- Management of the Irritable Patient and Exclusion Criteria for The Multi-Cer vical™ Unit
- Treatment Protocols including Contra-indications for Treatment and Key Prognostic Indicator s from current research
- Patient Positioning for Evaluation of Range of Motion and Isometric Strength on The
Multi-Cer vical™ Unit
- Patient Positioning for Treatment on the Multi-Cer vical™ Unit
- Advanced Treatment Ideas and Options for Whiplash and Associated Disorders Patients
- C u rr ent Wh ipla s h a nd As s oc iated Disorders Research Trends
- Collecting and Analyzing Data Collected on The Multi-Cer vical™ Unit
- Res ea rc h a t T h e M elb our ne Whip lash Centre
Contact BTE Technologies for more information on registering for this program:
U. S . & C a na d a : 800.331.88 45
I n te rn a t iona l: 410.850.0333
Fax : 410 . 8 5 0 . 5 24 4
Internet: www.btetech.com/training_sched.htm
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Greenwood, K.M. & De Nardis, R.J. (2000). Melbourne Whiplash Centre Outcome Data.
Preliminary Report. Melbourne Whiplash Centre (Manuscript in preparation).
Summary of Findings
Having 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 refers
to the “appropriateness, meaningfulness, and usefulness of the specific inferences made from test scores”
(Standards for Educational and Psychological Testing, 1985, p.9).
Method
The 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
df
33.8
17.5
15.165
98
<.001
Flexion
58.2
65.5
-8.041
116
<.001
Extension
48.7
55.3
-6.530
115
<.001
Measure
Neck Disability Index
ROM (degrees)
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 MultiCervical 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.
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Greenwood, 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 Findings
The 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 Trial
To 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 interobserver and intra-observer reliability.
Results:
Inter-Tester Reliability
The consistency of a measurement technique when used by different clinicians over time.
Systematic Difference between Therapists
Results 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.
Order of Testing Effects
There 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.
Relationship Between the Therapists’ Scores – Correlations
Correlation coefficients are high (.747 to .949 [approaching 1.0]) indicating good inter-observer
reliability.
Relationship Between Therapists’ Scores – ICCs
Intra-Class correlation coefficients are high (.767 to .930 [approaching 1.0]) indicating good interobserver reliability.
Standard Error of Measurement
SEM’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.
Systematic Changes Over Time
No systematic differences were identified in scores over time.
Relationship Between the Therapists’ Scores – Test-Retest Correlations
The 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.
Test-Retest Reliability of Therapists’ Scores – ICCs
The 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).
Standard Error of Measurement
SEM’s are low (1.54 to 5.73) indicating good test-retest reliability.
Minimum Detectable Change – Test-Retest
The 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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