DuoBravo N biofeedback/EMS/ETS device

The DuoBravo N is a modern, versatile medical device combining biofeedback therapy, neuromuscular stimulation (NMES), and EMG-controlled stimulation (ETS) into a single device. It is primarily developed for neurological and orthopedic treatments, suitable for both clinical and home use.

Main functions of the device

• EMG (Electromyography) function
  The EMG function measures the electrical activity of muscles. When a muscle contracts or relaxes, it emits electrical signals measurable in the microvolt range. The DuoBravo N can detect and process these signals on two channels within a 0.2-2000 μV range.
  The EMG signals are visually displayed on the screen as a bar graph and numerical values, providing immediate feedback to the patient and therapist on muscle activity.
  During measurement, the patient learns to consciously control muscle function, crucial for rehabilitation.
• Neuromuscular electrostimulation (STIM)
  This function stimulates muscles with electrical impulses. The device emits precisely controlled, biphasic impulses that cause muscle contractions via nerve stimulation.
  Stimulation parameters are widely adjustable: frequency ranges from 1-100 Hz, pulse width from 50-450 microseconds, and current intensity from 0-90 mA.
  Stimulation can be continuous, modulated, or in work/rest cycles. The device automatically regulates ramp-up and ramp-down times for smooth and comfortable muscle contractions.
• EMG-controlled Stimulation (ETS)
  This function combines EMG measurement and stimulation in an innovative therapy method. The device continuously measures muscle activity during treatment.
  When the patient reaches a preset threshold through active muscle work, the device automatically activates stimulation to induce further contraction.
  This method is particularly effective because:
  • It links voluntary and stimulated muscle work
  • Strengthens the brain-muscle connection
  • Motivates patient active participation
  • Provides instant feedback and reinforcement for successful effort

Suitable for complex therapy

The combined use of the three functions enables complex therapy program development. The device can execute up to five-phase treatment protocols where different functions follow each other or combine.

For example, a typical stroke rehabilitation program may include:

1. Muscle activity assessment via EMG measurement
2. Stimulation phase to prepare muscles
3. ETS phase to practice active movement
4. Another stimulation phase to close the treatment

The device gives detailed feedback and statistics for each function, allowing precise monitoring and documentation of therapy progress. Built-in safety features like electrode contact check and automatic intensity limit ensure safe use in every mode.

Main application areas

The DuoBravo N is primarily used for post-stroke rehabilitation, assisting in regaining muscle control and strength.

It is excellent for treating various paralyses and for general EMG biofeedback training.

The device effectively improves circulation, reduces muscle spasticity, and boosts muscle strength.

It is particularly effective in restoring muscle balance, activating muscle fibers, and combating muscle fatigue. Helps prevent and delay muscle atrophy and supports muscle building. Plays an important role in preserving and extending range of motion.

Pain relief effect

The device is also suitable for many painful conditions. It effectively relieves arthritis pain and various back pains including chronic back pain and cervical, thoracic, and lumbar spine issues.

Pain from circulation disorders, post-fracture pain, various muscle pains, and neuralgias can be treated. It's even applicable for phantom pain treatment.

Benefits for therapists

The biggest advantage for therapists is its versatility and precise monitoring of therapeutic results. The device generates detailed statistics for each treatment that can be analyzed later.

Freely programmable protocols allow customized therapies.

The device can store data for up to 200 treatment days, enabling long-term therapy result tracking. Optional PC connection allows easy documentation and analysis.

Benefits for patients

The main advantage for patients is safe home use, eliminating the need for frequent clinic visits.

Visual feedback aids conscious muscle control development; integrated safety features guarantee safe operation.

Compact size and battery operation ensure mobility.

Treatment duration and intensity are precisely controlled, allowing patients to gradually increase load.

Usage and treatment protocols

The device is simple and user-friendly. It has 12 preset and 4 freely configurable programs.

Prior to treatment, self-adhesive electrodes must be applied to the targeted skin area as guided by a specialist.

During treatment, the display continuously shows current values and feedback to the patient. Biofeedback allows patients to see their muscle activity, facilitating conscious muscle control improvement. During stimulation phases, the device automatically controls electrical impulses based on the selected program.

Detailed description of DuoBravo N device programs:

Rehabilitation and strengthening programs:

1. Alternating STIM and EMG - Neurological program

• 45 Hz frequency
• 250 μs pulse width
• 15 repetitions alternating stimulation and EMG phases

1. EMG - Basic neurological program

• 30 repetitions
• 8 seconds work
• 12 seconds rest

1. ETS (EMG-controlled stimulation)

• 25 repetitions
• 45 Hz work frequency
• 8 seconds work / 16 seconds rest

4-7. Strengthening programs (Force 1-4)

• Various combinations of STIM, EMG, and modulated current forms
• Variable work/rest ratios
• 45 Hz base frequency
• 20-15 repetition count

8. Relaxation program

• Combination of modulated and EMG phases
• 8-12 Hz frequency
• 20 repetitions

9-10. Rehabilitation programs

• Different work/rest rhythms
• 50-60 Hz frequency range
• Gradual intensity increase

11-12. Strength-endurance and explosive strength programs

• Alternating short and long contractions
• 45 Hz frequency
• Variable ramp times

13. Partial Peripheral paralysis program

• 60 Hz frequency
• 450 μs pulse width
• Short work period, long rest period

14-15. Pain relief programs

• High-frequency modulation (70-110 Hz)
• Han stimulation (2/100 Hz alternation)
• 30-minute treatment duration

Freely programmable slots:

PC1 - Custom STIM program PC2 - Custom EMG program PC3 - Custom ETS program PC4 - Combined STIM-EMG-ETS program

The following parameters can be adjusted:

• Frequency (1-100 Hz)
• Pulse width (50-450 μs)
• Work time (1-99 seconds)
• Rest time (1-99 seconds)
• Ramp-up and ramp-down times (0.1-9.9 seconds)
• Treatment duration (1-99 minutes)
• Intensity (0-90 mA)

Programs can be combined and modified to optimally meet therapeutic goals.

Safety considerations and contraindications

The device is prohibited for use in patients with pacemakers as it may interfere with their function. Not suitable for myocardial damage or arrhythmia.

Use is forbidden near flammable anesthetic gases, during machine operation or driving.

Contraindicated in epilepsy, severe local inflammation, or thrombosis.

Not for use in febrile or infectious diseases. Special caution during pregnancy.

Maintenance and lifespan

The device is practically maintenance-free, requiring only regular cleaning with mild detergent and a damp cloth. Batteries provide about 12 hours of operation under average use. Expected lifespan with proper use is at least 5 years.

Electrodes are reusable as long as adhesion remains effective. Electrode cables may need replacement if bent or damaged.

The device comes with a 36-month warranty.

Recommendation

The DuoBravo N is a versatile and effective therapeutic tool combining modern rehabilitation technologies. It offers many benefits to therapists and patients and is widely applicable for various neurological and orthopedic conditions. The integrated safety features and user-friendly design ensure safe and effective use in both clinical and home settings.