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Operation Manualergometrics er900

Art-Nr: 475.037 � Version: 05/02

Version: 05/02 er900 Operation ManualArt-No: 475.037

Operation Manual for Bicycle Ergometer er900

Printed in Germany.We reserve the right of modifications due to technical development at any time and without prior notice.Reprinting, translation and copying in any form - also in parts - is only permitted after prior written consentby the manufacturer.

This Operation Manual is not registered for automatic update in case of possible alterations.Information regarding the latest version is available from the manufacturer.

This Operation Manual Ergometer ergometrics 900Version: 05/02

is valid for the following Software-Versions:

V.236, V.240 and V.243

ergoline GmbHLindenstraße 5D-72475 BitzTel.: +49 7431 98 94 - 0Fax: +49 7431 98 94 - 127e-mail: [email protected]: http://www.ergoline.com

Version: 05/02 er900 Operation ManualArt-No: 475.037

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Version: 05/02 1 er900 Operation ManualArt-No: 475.037

ErgometerType er900��

Table of Contents

EC Declaration of ConformityTable of Contents.............................................................................................. 1Foreword ........................................................................................................... 4

1. Introduction ....................................................................................................... 51.1 Comments by the Manufacturer for the User......................................................... 51.2 Product Relevant Regulations .............................................................................. 61.3 Warranty Regulation ............................................................................................ 6

2. Safety Notices ................................................................................................... 72.1 Safety .................................................................................................................. 72.2 Intended Use ....................................................................................................... 72.3 Basic Safety Comments ...................................................................................... 72.4 Normative Notices ............................................................................................... 82.4.1 Notice for EMC (electromagnetic compatibility) ................................................... 82.5 Requirements for Operating Personnel ................................................................ 82.6 Safety and Device Protecting Features................................................................ 92.7 Maintenance, Safety Relevant and Metrological Inspections ................................. 92.8 Identification Plate, Labelling ............................................................................. 10

3. Installation ....................................................................................................... 113.1 Installation Steps ............................................................................................... 113.2 Scope of Delivery .............................................................................................. 113.3 Accessories ...................................................................................................... 123.4 Transport ........................................................................................................... 12

4. Putting into Operation .................................................................................... 134.1 Operating Elements and Connections................................................................ 134.2 Measurement Head ........................................................................................... 144.2.1 Keypad ............................................................................................................. 144.3 Connectors and Interfaces ................................................................................. 154.3.1 Power Connection ............................................................................................. 154.3.2 Connector for Blood Pressure Cuff .................................................................... 154.3.3 Signal Connections ........................................................................................... 164.4 Power on Sequence .......................................................................................... 17

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er900 Operation Manual 2 Version: 05/02Art-No: 475.037

ErgometerType er900

5. Operation ......................................................................................................... 185.1 The Computer - Your Helper............................................................................... 185.2 The Display Unit ................................................................................................ 195.2.1 Displayed Parameters and their Meaning .......................................................... 195.2.2 Speed display for the patient ............................................................................. 205.3 The Printer ........................................................................................................ 215.3.1 Configuration of Printer ...................................................................................... 215.3.2 Printed Parameters ........................................................................................... 21

6. Ergometry Process......................................................................................... 226.1 General Preparations ........................................................................................ 226.1.1 Preparation of the Patient .................................................................................. 226.2 Preparation of the Ergometer (ECG Type P1 or P2) ......................................... 236.2.1 Basic Preparations for all Programs .................................................................. 236.2.2 Special Entries for to the Use of Program 0 ....................................................... 246.2.3 Special Entries for to the Use of Program 9 ....................................................... 246.3 Preparations for Control by ECG or PC ............................................................. 256.4 Starting the Ergometry ....................................................................................... 256.4.1 Starting Ergometry with Internal Control.............................................................. 256.4.2 Starting an ECG or PC Controlled Ergometry .................................................... 256.5 Flowchart for Complete Ergometry Process....................................................... 266.6 Ergometric Protocol .......................................................................................... 296.7 Manual Control of Ergometry Session ................................................................ 30

7. Configuration .................................................................................................. 317.1 General ............................................................................................................. 317.2 Call-up of the Monitor Program .......................................................................... 317.3 Basic Settings ................................................................................................... 347.3.1 Date and Time ................................................................................................... 347.3.2 Select Unit for Pressure Display ........................................................................ 357.3.3 ECG Start Pulse Duration (only for remote start of ECG).................................... 367.3.4 Select Language ............................................................................................... 377.3.5 RPM Control ...................................................................................................... 387.3.6 Other Parameters .............................................................................................. 397.4 Defining an Ergometry Program ........................................................................ 407.4.1 Setup of Automatic Program 0 .......................................................................... 417.4.2 Definition of Programs 1-8................................................................................. 427.4.3 Definition of Program 9 for Pulse-Steady-State Training .................................... 44

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ErgometerType er900

8. Structure of Programs.................................................................................... 468.1 General Structure of Programs 1-8 .................................................................... 468.1.1 Factory Settings ................................................................................................ 468.1.2 Creating Your Own Load Program ..................................................................... 478.2 Systematic Setup of Programs .......................................................................... 488.2.1 Setup of Automatic Load Program 0.................................................................. 488.2.2 Setup of the Fully Programmable Load Programs 1-8........................................ 528.2.3 Setup of Program 9, Steady-Pulse (Cardiovascular Training)............................. 54

9. Cleaning .......................................................................................................... 579.1 Cleaning the Unit ............................................................................................... 579.2 Cleaning the Blood Pressure Cuff ...................................................................... 57

Appendix A: Interfaces ................................................................................... 59A.1 Input and Output Pin Specifications.................................................................... 59

Appendix B: Monitor Program....................................................................... 71B.1 Additional Settings in the Monitor Program ........................................................ 71B.1.1 Setting the ECG Type ........................................................................................ 71B.1.2 Setting the Baud Rate ....................................................................................... 72B.1.2 Switching Between Internal and External Load Control ....................................... 73B.1.4 Hardware Diagnostics ....................................................................................... 74

Appendix C: Program Listing ........................................................................ 75

Appendix D: Indicators .................................................................................. 76D.1 PWC Values ...................................................................................................... 76D.1.1 What is a PWC Value? ...................................................................................... 76D.2 Training Indicator ............................................................................................... 77

Appendix E: HR Recording ........................................................................... 78E.1. Heart Rate Feedback from ECG ....................................................................... 78E.2. Pulse Monitor .................................................................................................... 78

Appendix F: Specification.............................................................................. 79F.1: Technical Data ........................................................................................................ 79F.2: The Speed-correlated Capacity of Brake Power Control ......................................... 80

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ErgometerType er900

Foreword:We are pleased with your decision to purchase our computerized ergometer er900. This isthe appropriate decision for quality and performance.

The computerized ergometer er900 has been specially designed with the medical and ergo-nomic requirements in mind for quick and valid stress analysis of the cardiovascular system.Computer control makes a fully automatic process of the entire spectrum of ergometrics.Numerous programming options ensure that for every patient type there is a specific stressor training program ready at the touch of a button. Manually controlled stress analysis canalso be carried out by the operator, independent of programs, through manual entry of theload data. Programs in progress may also be interrupted to control subsequent load stepsby hand.

The built-in automatic blood pressure meter was especially designed for ergometrics. Itassures that systole, diastole and heart rate limits are continuously, automatically, monitored.The computer controlled execution of all measurements and analysis of results markedlysimplifies the work of the operating personnel. Accordingly, the patient can be more closelyobserved and instructed. This allows the ergometric process to be performed with the high-est level of safety.

The display integrated into the console provides the operator continuously with current mea-surement data. The integrated printer provides continuous documentation of all measure-ments resulting from the ergometric process.

We hope that you are successful in your work with the ergometrics er900 ergometer. Wealways welcome your constructive remarks and improvement suggestions with regard to theunit as well as to this handbook.

Your ergoline team

Attention !

This Operation Manual is a part of the unit in accordance with EN 60601-1:1990. Itshould always be kept close to the unit. The necessary safety considerations, con-forming to EC Guideline 93/42 EC are in chapter 2 of this manual.

Complying to the Safety Considerations protects against danger and risk for lifeand limb, and prevents from improper application of the Ergometer.

Please comply with all warning signs at the ergometer. Replace missing or dam-aged signs immediately.

Familiarize yourself with the appropriate handling of the ergometer and all its con-trol facilities prior to operating the equipment.

While being at work, it is too late !Never allow that a person without the necessary expert knowledge is operating theequipment.

By the above guidelines, a save and smooth operation is achieved, delays due to repairs areavoided, and the requirements for the optimal employment of the equipment are fulfilled.

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ErgometerType er900

1. Introduction

Within this Operation Manual, important comments to ensure the safety and to avoidpotential damage are labelled with the following symbols:

Warning !Describes a potentially dangerous situation.Failure to comply may lead to death or serious injuries, or may cause dam-age to the equipment or to the environment.

� Important !Application hints to achieve an optimal application of the device and furtherhelpful information.

This Operation Manual is an integral part of the device and has to be available at theequipment at any time.

This Operation Manual is designed by the manufacturer according to his best knowl-edge and experience in the construction, production and operation of the device.

The Operation Manual may be extended via special statements by the operating com-pany, e.g. for supervision and obligatory registrations, internal maintenance plans, test-ing intervals.

1.1 Comments by the Manufacturer for the UserAs the user, you are responsible for :

- the professional application as directed via expert personnel which has been in-structed for the correct operation of the equipment,

- compliance to the safety relevant information and maintenance comments,- compliance to the safety regulations, safety comments as well as the precautions in

respect to vocational safety and accident prevention,- the technical instruction of the operating personnel at the device and for having taken

notice of the Operation Manual,- the Operation Manual being accessible for the operating personnel.

The following guidelines and regulations apply to the operation of the ergometer:

- EN 60601-1 (1996) „Medical electrical equipment; General requirements forsafety“

- EN 60601-1-2 (1993) „Medical electrical equipment; General requirements forsafety; 2.“

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ErgometerType er900

1.2 Product Relevant Regulations

- EC-Directive 93/42/EEC concerning medical products of June, the 14th 1993- EC-Directive 89/336/EEC concerning „Electromagnetic compatibility“

1.3 Warranty Regulation

ergoline GmbH is only responsible for the safety and reliability of this device, if:� all revisions, enhancements, repairs and service to the device are carried out by

ergoline authorized personnel, e.g. an ergoline dealer,� ambient electrical service where the device is installed conforms to IEC 601-1 and� the device is operated in accordance with the Operation Manual.

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ErgometerType er900

2. Safety Notices

2.1 Safety

Complying to the safety comments protects from potential injuries and prevents im-proper application of the ergometer. Each operator of this ergometer as well as per-sonnel which is in charge of installation, maintenance, examination or repair of thisergometer, must have read and fully understood the contents of this Operation Manualprior to operating the unit or doing any work on this device.

Special attention is required at sections labelled with additional symbols .

2.2 Intended Use

a) The ergometer ergometrics 900 must only be used for precise cardiovascular testsunder resting and stress test conditions.

b) Special test methods, e.g. Echo-Cardiography or other high-risk test methods mustnot be performed by using the bicycle ergometer. For such purpose special supineergometers are offered by ergoline.

c) Application under outdoor conditions is not permitted.d) In case the ergometer is not being used according to above conditions, and if be-

cause of that any injuries or serious impact on individuals or damage of property iscaused, the manufacturer cannot be held liable.

2.3 Basic Safety Comments

Note: We herewith notify that this manual is in accordance with regulations set forth bythe EC-Directive 93/42 EEC and the standards IEC601-1 (1996) and EN60601-1-2 (1993). These regulations are however, not contained within this handbook.

The ergometer must only be operated in perfect working order in techni-cal respect.

Despite the precautions, the operation of the ergometer may involve cer-tain risk or danger, especially in case of- improper application or,- application is not as directed.

There is the hazard of injuries or of property damage, in case of noncon-formance to the Operation Manual, especially to the Safety Notes.

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ErgometerType er900

It is necessary to ensure that no dangerous ground currents occur as aresult of attaching the ergometer to other devices. Device specificationsof the ergometrics er900 are in the appendix to this manual. Direct yourquestions to your dealer or to ergoline’s service department. Especiallyat the coupling of several devices to a measurement system it has to betaken care that proper grounding is achieved via a single power sup-ply, e.g. wall socket.

The ergometrics er900 ergometer should only be operated where elec-trical requirements meet IEC 601-1.

This device is not suitable for use in rooms or areas where there is dan-ger of explosion.

Always observe accident prevention precautions when operating thisdevice.

In the event that the pressure in the blood pressure cuff is too high,remove the cuff from the patient's arm immediately.

� This unit may only be operated for therapy or diagnosis purposes underthe supervision of qualified personnel.

2.4 Normative Notices

2.4.1 Notice for EMC (electromagnetic compatibility)

- The EMC test was done with an interference level of 3 V/m. The device should not beused in areas with a higher level.

- The device should not be used beside a high voltage system.- To connect the device with other devices it is only allowed to use special shielded

cables provided by ergoline.- Strong transmitting equipment may not be operated in the immediate vicinity of this

device.- Electromagnetic interferences will appear first by an instable value of load in the

display. If the value changes without any reason while the speed is >30 /min, this maybe caused by an electromagnetic interference.

2.5 Requirements for Operating Personnel

The operating personnel of this ergometer have to :- be properly instructed and trained regarding the operation of the ergometer,- have full command regarding the handling of the device,- be aware of the relevant safety requirements for the operation of such devices, and

act accordingly (see Chap. „Introduction“),- be informed regarding additional regulations, e.g. safety regulations,- be informed regarding potential hazard and risk arising from the operation of such

devices.

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ErgometerType er900

2.6 Safety and Device Protecting Features

The device is equipped with the following safety and device protecting features :- High current protection which prevents damage to the device and potential danger to

persons, e.g. in case of short circuit.

2.7 Maintenance, Safety Relevant and Metrological Inspections

• Before each use, visually check the ergometer for mechanical damage.If you detect any damage or functional deficiencies which could impair the patient´sor operator´s safety, do not use ergometrics 900 until it is checked and repaired.

• Maintenance:The user is responsible that the proper function of the ergometer is regularly checkedin time intervals of at least six months.

• Safety Relevant and Metrological InspectionsThe ergometrics 900 bicycle ergometer must be regularly inspected and main-tained, in time intervals of two years, in accordance with lawful regulations.Alterations to the ergometer’s measurement capabilities are cause for re-certifica-tion.These inspections are to be performed by an ergoline authorized service technician.

A) Routine Control of the Blood Pressure Measurement UnitEC-Directive 93/42/EEC operator regulations stipulate that the automatic blood pres-sure unit in the ergometer´s console must undergo a routine technical inspectionevery two years.

B) Load Unit InspectionBased on the metrological check which is compulsory in Germany every two years, itis necessary to check the load accuracy of the ergometer.EC-Directive 93/42/EEC operator regulations requires qualified technical mainte-nance of the load unit at two years intervals.In all other countries, the frame and method of the metrological check depend on thelegal regulations of each country.

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ErgometerType er900

2.8 Identification Plate, Labelling

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label with serial number

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ErgometerType er900

3. Installation

This section describes the required installation steps in order to establish operationalreadiness. The steps described are also required at initial installation after delivery ofthe device.

3.1 Installation steps

1) Loosen screws and clamp lever for clamp fixture, and remove upper clamp jaw;Insert handlebar, secure, and screw tight with screws and clamp lever.Adjust appropriate handlebar position and fix position with clamp lever.

2) Insert measurement head with the tin flaps into the handlebar pipe;Attach grounding cable, connection cable and tubing.

3) Adjust black rear cover onto the measurement head and tighten with screw.4) Insert saddle pipe into the guidance and tighten with clamp lever.5) Feed saddle bellows into the saddle pipe, and put on to the intended notch .6) Connect blood pressure cuff according to 4.3.2 at the measurement head.7) Connect mains cable according to 4.3.1 at the power inlet.

3.2 Scope of DeliveryThe standard scope of delivery consists of :

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1

2

34

5

1 blood pressure cuff

2 thermal paper for printer (2 rolls)

3 handle bar

4 measurement head with rear cover

5 saddle bar with saddle and folding bel-lows

not in picture:

mains cable, 2,5 m

Final test protocol

Operation Manual

optional :connecting cable to ECG (not in picture)

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ErgometerType er900

3.3 Accessories

Order No. Description

100.948 Thermal paper roll (1 Set = 10 pieces)200.194 Cuff for ergometry, adults200.199 Cuff for ergometry, adults (connecting hose 2 m)200.230 Cuff for ergometry, long version for strong arms200.231 Cuff for ergometry, special (strong arms/connecting hose 2 m)200.200 Cuff for ergometry, children313.420.9 Polar receiver er900424.016 Polar chest-belt200.892 Triathlon handle bar er900, incl. Polar receiver cable extension300.937 Adjustable cranks, pediatric size200.850 Saddle for children, incl saddle pipe and saddle bellows475.037 er900 Operation Manual, English Version475.190 er900 Service Manual

3.4 Transport

� Please ensure that the mains cable is removed prior to transporting the device.

During transport within the same room respectively within the same building, hold ontothe ergometer such that the measurement head is pointing towards you.Take hold of the handle bar at both sides, and pull the ergometer towards yourself, sothat it is resting on the casters only, and is in balance. Now you may pull the ergometereasily to the working space within the room.

Please be careful when putting the ergometer down. Otherwise the WSG (= wirestring gauge) of the driving unit may be damaged.

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ErgometerType er900

4. Putting into Operation

Check the mains fuse at the respective workstation prior to putting the device into op-eration. Maximal fuse value: 16A

4.1 Operating Elements and Connections

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1 power connector, fuse

2 main power switch

3 clamp handle for seat adjustment

4 clamp handle for handlebar angle adjustment

5 console with keypad, display and printer

6 blood pressure cuff

7 clamp handle for handlebar height adjustment

8 transport casters

9 levelling feet for optimal stability

12

3

4

5

6

7

8 9

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ErgometerType er900

4.2 Measurement Head

4.2.1 Keypad

1 LCD-Display2 paper ejection slot3 numeric keypad4 START to start the ergometric

process5 STOP for interrupting the load

increments6 END to stop the ergometric

process7 MONITOR to call up the monitor pro-

gram: to program ergom-eter, test routines, adjust-ments, and assign stan-dard settings

8 RETURN to confirm and store entries9 PROGR. key to call up, and make

temporary modifications to,ergometric programs

10 PWC to call up definable PWCvalues subsequent to anergometric process

1 3 7 8

2

910

11

12

13

14

15

16

4 5 6

11 BLOOD PRESS. I/0 to initiate or stop bloodpressure measurement ( atanytime possible)

12 START to manually initiate a bloodpressure measurement, canbe done anytime when theblood pressure is enabled

13 Printer switches printer output (inter-nal, external or turned off)

14 Copy produces a copy of the re-sult protocol

15 toggle QRS beep on/off

16 printer paper feed

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ErgometerType er900

4.3 Connectors and Interfaces

4.3.1 Power Connection

1) Make sure that the power switch is in the“Off” position (not depressed).

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When using an ergoline utility cart with suction device, connect the unit’s powerplug to one of the white outlets on the utility cart. The ergometer can then beswitched on and off together with the suction device.

4.3.2 Connector for Blood Pressure Cuff

The cuff tube is to be connectedvia Luer-Lok to J16 with the measure-

ment head

The microphone cable is to beconnected via RCA-Jack to J12

2) Connect the unit’s power plug via the sup-plied mains cable to a power outlet withthe same voltage as indicated on the label

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ErgometerType er900

4.3.3 Signal Connections

1

2 3

1) Digital RS232 interface connector for PC or ECG.

2) Analog interface for analog control and analog data transfer to ECG.

3) Fiber-optic connector for POLAR receiver, or HR input from an ECG.

�The interface pin configuration as well as related technical data are in theappendix of this Operation Manual.

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ErgometerType er900

4.4 Power on Sequence

Mains power switch

The unit will subsequently execute a self-test. At the end of the self-test the main menuwill appear as below:

P = 000 W r = 000 /minHR= 000 /min t = 00 minS = 000 mmHg D = 000 mmHgPROG 0 BPM OFF PR. INT

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ErgometerType er900

5. Operation

5.1 The Computer - Your Helper

The ergometrics er900 for stress testing was designed so that the ergometric processcan be conducted

simply - quickly - precisely- safely.

In order to achieve this, the computer is an indispensable aid. The integrated and espe-cially designed blood pressure module for the ergometric process makes computermonitoring of the patient and his blood pressure condition largely autonomous. Theschematics below demonstrate the versatility of the unit .

Automatic LoadProgram No. 0

Load program for patients whosecirculatory condition is not clear.The ergometer tests the conditionof the patient’s circulatory sys-tem, and then selects an optimalload program for the stress test.

Load ProgramsNo. 1 through 8

These load programs can be defi-ned by the operator. Selection ofup to 12 load increments is pos-sible. Blood pressure measurementinterval and parameter monitoringare fully selectable.

Load Program No. 9Pulse-Steady-State

Special program for pulse-steady-state-training. A selected heartrate will be maintained over theentire training period.

With CirculationMonitoring

Blood pressure and heart rate aresampled and documented at the pre-set time interval. Heart rate and bloodpressure are simultaneously moni-tored for alarm limits and, if neces-sary, cause an alarm and abort theload program.

Without CirculationMonitoring

Blood pressure module is off. Thecirculation condition is not monitoredand exceeding alarm limits do notcause an alarm.

Experimental ProgramPrior to starting the program, eachprogram may be altered for this spe-cific ergometry. These alterations arenot stored, and the standard settingsare restored after this ergometry.Such sessions can also be manuallycontrolled and run with, or without,circulation monitoring.

Manual InterventionThe preset program can be interruptedat any time and the load levels maybe manually altered. When circula-tion conditions are being monitoredonly load increments are interrupted.Circulation data will continue to besampled, documented and checkedagainst alarm limit values in the pre-set time interval.

Use of the BloodPressure Module

without Load

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ErgometerType er900

5.2 The Display Unit

5.2.1 Displayed Parameters and their Meaning

P = 000 W r = 000 /minHR = 000 /min t = 00 minS = 000 mmHg D = 000 mmHgPROG 0 BPM OFF PR. INT

P = 000 W = current load in Watts (Po= initial load, Pmax=maximum load)

n = 000 /min = current revolutions per minute

HR = 000 /min = heart rate at the time of the last blood pressure reading(current heart rate in case of continuous HR-signal )

t = 00 min = duration of the ergometry in min

S = 000 mmHg = systolic value of the last blood pressure reading (the mea-surement may be displayed either in mmHg or kPa)

D = 000 mmHg = diastolic value of the last blood pressure reading (themeasurement may be displayed either in mmHg or kPa)

PROG 0 = program selected (No. 0...9)

BPM ON /OFF = status of the blood pressure measurement (on or off)

PR. INT = status of the printer driver (Intern, Extern or Off)

Wt. = weight of the test subject

INT = interval of the blood pressure measurements in minutes

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ErgometerType er900

5.2.2 Speed display for the patient

On the patient’s side, the measuring head has a display to show the current speed.Next to the speed display there are LEDs which show the most favorable conditions formeasurement. For blood pressure measurement at rest and following the post-loadphase for the recovery measurement, the “stop” lamp is on. This means that the patientshould stop cycling.t the beginning of every load stage, the ergometer computer suggests a speed to thepatient which is best for achieving the best reproducible increase in heart frequency.

At the suggested speed, the patient reaches an ideal total pulse curve, because musclefriction is kept as low as possible. During the ergometric test, the system monitorswhether the patient keeps to the suggested speed by means of the two LEDs to theright of the speed display. If the patient’s speed falls too far, the upper LED flashes(<<<n+ ); if the patient is too fast, the lower LED flashes ( >>>n- ).

Patient’s display window: revStop<<<n+ (faster)>>>n- (slower)

� The indicated speeds are medically sound recommendations. They should bemaintained because this is the best way of achieving reproducible measuringresults. This ergometer operates independent of speed in the range between30 and 130 crank revolutions, thus always guaranteeing load precision in allother speed ranges within the “ characteristic curve of the working range of thebraking torque control “.

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5.3 The Printer

5.3.1 Configuration of Printer

The printer may be configured in any one of three modes. This is done by pressing thebrown key „Printer“ (13). The status of the printer can be read from the lower rightcorner of the display. The various configurations have the following meaning:

PR INT = The integrated system printer is enabled and prints all displayed parametersimmediately after each load change and/or blood pressure measurement.

PR EXT = The integrated printer is disabled. All data are exported to another system(ECG, PC or external printer) and printed there.

PR OFF = The printer is turned off. (This setting is only valid for the current stress testand will revert to „INT“ as soon as the current stress test is terminated.)

5.3.2 Printed Parameters

The printer documents all parameters that are shown in the display. Printing will occurimmediately following each load change and/or blood pressure measurement. Printingwill also occur after the recovery period when the ergometry is aborted or comes to aprogrammed termination. There are three parts of the ergometric protocol:

1. Load Protocol:Documents the blood pressure reading at rest,at each load increment and after each bloodpressure reading during the load phase and theelapsed time at termination.

2. Recovery Protocol:Documents each blood pressure measurementduring the recovery phase.

3. Summary Protocol:A summary of the ergometry with the PWC val-ues and the training index at the end of the totalergometry.

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ErgometerType er900 ��

6. Ergometry Process

6.1 General Preparations

6.1.1 Preparation of the Patient

1. Have the patient take his place on the saddle.2. Position the saddle such that an angle of approx. 10 degrees exists between the extended

axis of the upper body and the thigh when the pedal is at its lowest position. Ask thepatient to stand on the pedals while you adjust the saddle position. Saddle height is ad-justed by loosening the saddle clamp screw and moving the saddle to the correct position.

3. Move the handlebar to a position such that the test subject can comfortably sit upright. Todo this, loosen the handlebar height clamp handle and adjust appropriately. Next you canadjust the angle of the handlebar by loosening the handlebar angle clamp handle.

4. Check to see that all of the adjustment clamps are secured. (Do not tighten these withextreme force.)

5. Put the blood pressure cuff on the patient’s arm. Position it so that the microphone (markedwith a red ring) is right over the Arteria Brachialis on the inner side of the upper arm. Besure that the cuff is not placed so that it can touch another object when the patient hasplaced his hand on the handlebar.

clamp handle for handlebarangle

clamp handle for handlebarheight

clamp handle for saddleheight

microphone fixed over thearteria brachialis

cuff position

appr

. 10°

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ErgometerType er900

6.2 Preparation of the Ergometer (ECG Type P1 or P2)

� These preparation instructions are only applicable to usage of the ergom-eter in conjunction with interface modes ECG-Type P1 or P2, see Appen-dix A. The ergometer can only be controlled by its own program in thesemodes.

6.2.1 Basic Preparations for all Programs

1. Press the red key „PROG.“ and select the appropriate program for the patient withthe numeric keypad.

2. Enter the patient’s weight. The ergometer needs this information to calculate exactPWC values.

PROG x Wt. = xxx HR < xxxS < xxx mmHg D < xxx mmHgPo = xxx W Pmax = xxx WINTERV.BPM = xx min.

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3. When necessary, you can alter any parameter to create a special ergometric ses-sion. These alterations will be lost as soon as the special session is ended. Thenthe program will again show the standard base values (see chapter 7. „Configura-tion“).

� Altered parameters that are entered prior to program start are lost after theend of the ergometric session.

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ErgometerType er900

6.2.2 Special Entries for to the Use of Program 0

When using program 0, the maximum heart rate (HR) should always be entered specifi-cally for the individual patient. Since this value serves as the target frequency for load-ing, it must be specifically adapted to the age and health of the patient. The remainingparameters, in particular the alarm parameter, should be established in the configura-tion so that even a weak patient can perform the ergometric session without danger.Here also, all other parameters may be altered for a specific ergometric session.

� Always enter the maximum heart rate (HR) for program 0 specific to theage and strength of the patient. When possible, provide the ergometerwith a continuous heart rate by using an ear/finger clip, a pulse monitor orthe HR feedback from an ECG.

6.2.3 Special Entries for to the Use of Program 9

Patient specific maximum heart rate (HR) should also be entered for program 9 toreflect the patient’s training requirements.

� Only use program 9 when a continuous heart rate source is used. That is,when an ear/finger clip, a pulse monitor or a HR feedback from an ECG isconnected.

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ErgometerType er900

6.3 Preparations for Control by ECG or PC

The ergometer must be specifically configured to the controlling ECG-Type or PC, seeAppendix. The ECG or PC is then in total control of the ergometry. Any entries that mayhave been made on the ergometer are therefore nullified. There is no preparation ofthe ergometer to be made on the console. Configure your ECG or PC in accordancewith the appropriate operator’s instructions for ergometry. Start the ergometric ses-sion with the ECG or PC.

6.4 Starting the Ergometry

6.4.1 Starting Ergometry with Internal Control

1. Check to see if all the parameters are correctly entered.2. Start the ergometric procedure by pressing the red „START“ key.

The ergometer will begin by measuring the blood pressure value at rest.

6.4.2 Starting an ECG or PC Controlled Ergometry

Start the ergometric program on your ECG or PC in accordance with the correspond-ing instructions. After a successful start the ergometer will begin by measuring the bloodpressure value at rest.

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ErgometerType er900

6.5 Flowchart for complete Ergometry Process

� This ergometric process flow description is only valid for use of the ergom-eter under internal control. When control is exercised by an ECG or PCrefer to the documentation for those devices.

Legend:

1

Start of ErgometryPress the red „START“ key to begin the ergometric session.

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= input via operatingpersonnel

= Print-out = action viaergometer

Selection of Specific Ergometric ProgramAssign patient to patient group, and select program for this patient accordingly, or select the

automatic program 0 for patients who you cannot be classified, or select program 9 forpatients who are to undergo Pulse-Steady-State training.

.

Possible Modification of ParametersPrior to beginning an ergometric session you may alter any parameter for this specific ergometry.

Blood Pressure Measurement at RestImmediately after starting the ergometer, the blood pressure measurement at rest will be

taken. It is important that the patient remains absolutely still during this measurement as thefilter parameters for the blood pressure during stress are established by this measurement.

Artifacts during this measurement may lead to false results under stress.

Print-out of the Blood Pressure Measurement at RestThe resulting blood pressure data will either be printed out on the internal printer or fed to

the ECG via the RS232 interface and documented there.

Establishment of the Initial Load PoThe load program will begin with initial load Po when

the blood pressure data has been put out.

First Blood Pressure Measurement under StressBlood pressure measurement will begin at the pre-programmed interval.

Output of Load and Blood Pressure DataBlood pressure and load data readings are either printed by the internal printer or passed

over the RS232 interface to an ECG for documenting there.

.

Proceeding to First Load incrementThe load will be increased by the programmed first load increment as soon as data has

been put out.

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ErgometerType er900

�

2

1

Second Blood Pressure Measurement under StressBlood pressure will be measured again at the programmed interval.

The measured blood pressure data and the current load data will either be printed by theinternal printer or passed over the RS232 interface to an ECG for documenting there.

Advancing to the Second Load IncrementThe load will be increased by the programmed second load increment as soon as data hasbeen put out.

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n-th Blood Pressure Measurement under StressBlood pressure will be measured again at the programmed interval.

.

The measured blood pressure data and the current load data will either be printed by theinternal printer or passed over the RS232 interface to an ECG for documenting there.

Proceeding to the n-th Load IncrementThe load will be increased by the programmed n-th load increment as soon as data has beenput out.

Concluding the Load Program and Transition to Recovery PhaseThe load program will end and the recuperative phase will begin after the red „END“ key ispressed once. The load will be reduced to 25 Watt for the first minute of the recovery phaseand reduced to zero beginning with the second minute. The patient should continue to pedal forat least the first minute to avoid venous congestion in the legs.If the load program is terminated after a blood pressure measurement, the final protocol will beprinted which contains the load, RPM, and heart rate data at the time of termination.No termination protocol will be printed if termination occurs during an ongoing blood pressuremeasurement.

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ErgometerType er900

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First Blood Pressure Measurement during RecoveryBlood pressure measurements continue to be taken during the recovery phase at the setinterval.

Output of Measured blood Pressure DataThe resulting blood pressure data are either printed by the internal printer or passed over theRS232 interface to an ECG for documenting there.

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n-th Blood Pressure Measurement during RecoveryBlood pressure measurements continue to be taken during the recovery phase at the intervalset.

Output of Measured Blood Pressure DataThe resulting blood pressure data are either printed by the internal printer or passed over theRS232 interface to an ECG for documenting there.

Concluding ErgometryErgometry is terminated completely by pressing the red „END“ key for a second time

Output of the Summary ProtocolThe termination protocol is either printed by the internal printer or passed over the RS232interface to an ECG for documenting there.

2

� This process flowchart is only representative when the interval for blood pressuremeasurements and load increment are equal, otherwise the sequence of mea-surements and print-outs will be altered. Data output occurs basically at everyvalue change in blood pressure or load. The sequence will also be altered if theprogram is manually modified.

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ErgometerType er900

6.6 Ergometric Protocol

An ergometric protocol is recorded during the ergometric session. The protocol is eitherproduced by the internal printer or by an ECG. The picture below shows such a protocol asdocumented by the internal printer. Program parameters were:

heart rate max. = 180, systole max. > 200, diastole max. > 130,initial load Po = 50 watt, maximum load Pmax. = 999 watt,blood pressure measurement interval = 01 min.,load interval = 01 min., load change per interval = 25 watt.

The PWC values to be ascertained were predefined for heart rates between 130 and 150beats per minute. The values in this protocol are not representative of a patient as they weregenerated with a simulator.

blood pressure at rest

blood pressure measurements forindividual load increments

termination of the load program withtermination protocol

blood pressure measurements inthe recovery phase

end of ergometry with concludingprotocol

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ErgometerType er900

6.7 Manual Control of Ergometry session

If necessary, the ergometry session , i.e. the load program may be manually controlledvia the measurement head .That is done by starting a suitable ergometry program and then interrupting the auto-matic sequence of the program at the desired instant by pressing the key „STOP“.The requested load is then set by means of the white cursor keys.

�Start of Ergometry Session

Press the green button „START“ to begin the ergometric session.

Blood Pressure Measurement at RestImmediately after starting the ergometer, the blood pressure measurement at rest will be

taken. It is important that the patient remains absolutely still during this measurement as thefilter parameters for the blood pressure during stress are established by this measurement.

Artefact during this measurement may lead to false results under stress.

Establishment of the Initial Load PoThe load program will begin with initial load Po when

the blood pressure data has been put out.

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Enable Manual ControlBy pressing the „STOP“ button, the automatic ergometer control is interrupted.

Increase or Decrease Load ManuallyBy pressing the white cursor buttons, the load is adjusted at 5 Watt steps.

Terminate Load Program and Change to Recovery PhaseThe load program is stopped by pressing the green button “END”, and the recovery phase isstarted.

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� The interval of the blood pressure measurement still takes place automati-cally at the preset interval .

� Manual control is only possible if the following ECG-type is set:ECG-type P1, P2 or P10 (see Annex A or Annex B.1.1)

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ErgometerType er900

7. Configuration

7.1 General

The ergometrics er900 ergometer has numerous setup options to allow the operator toadapt the device optimally. The most important configuration support is the monitorprogram. The monitor program allows the operator to use a set of menus to modifyparameters.

7.2 Call-up of the Monitor ProgramTwo yellow buttons on the measurement head are provided for management of themonitor program. Both of these buttons are at the upper right portion of the keypad andhave the following basic functions:

Call-up monitor program mode, as well as call-up of the various sub-menus. Whenin monitor program mode, the sub-menu at the position of the cursor is selectedby pressing button „MONITOR“ once more.

Confirm and save changes made in monitor program or the appropriate sub-menu as well as exit from monitor program mode or a sub-menu.

The programming diagrams on the next page illustrate the structure of the monitorprogram.

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ErgometerType er900

MONITOR V.XXXACTIVATE PROGRAMADJUST CLOCKmmHg - kPa

ACTIVATE PROGRAM MPROGRAM No XMax.HEARTFREQ. HR < XXXMax.Syst. S < XXXmmHg

ACTIVATE PROGRAM Mmax.Diast. D < XXXmmHgSTART LOAD Po = XXX WMAX. LOAD Pmax.=XXX W

ACTIVATE PROGRAM MInterv. BPM = XX min.PWC = XXX PWC = XXXTRAININGSIND. [Y/N]

ACTIVATE PROGRAM MLOAD STEP 01 : 12INTERV.LOAD = XX min.LOAD CHANGE XXX W

MONITOR V.XXXTESTADJUST TORQUEADJUST OUTPUT

TEST M+- 5 Va = 5.XX V [ 0.2 ] + 5 Vd = 5.XX V [ 0.3 ] +24 V = 2X.X V [ 6V ]

LOAD EXT = 000 W TEST MU-TD = XXX [ 020 - 150 ]U-DMS = XXX [ 050 - 250 ]S = XXXmmHg D = XXXmmHg

ADJUST CLOCK MYEAR XX MONTH XXDAY XX HOUR XXMINUTE XX

ADJUST TORQUE M

ZERO DMS-AMPL.TORQUE

ZERO DMS-AMPL. MMSET CODE . . .U - DMS = XXX [050 - 250]EV.RESET SPRING

ADJUST SYS OUTPUT MMSET CODE . . .

300 mmHg = < >

ADJUST BPM OUTPUT MMSET CODE . . .

200 BPM = < >

ADJUST DIA OUTPUT MMSET CODE . . .

300 mmHg = < >

TORQUE MMSET CODE . . .PUT 3 - 6 KgWEIGHT = X.XX Kg

ADJUST OUTPUT M

LOAD BPMSYSTOLE DIASTOLE

ADJUST LOAD OUTPUT MMSET CODE . . .

300 W = < >

mmHg - kPa M

mmHg (*)kPa (*)

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ErgometerType er900

MONITOR V.XXXLOAD INT/EXTADJUST LOAD INPUTECG RECORD

ZERO LOAD EXT MMSET CODE . . . .

LOAD - ZERO = XXX W

ADJUST LOAD INPUT MMSET CODE . . .

= 000 W < >

MONITOR V.XXXECG - TYPETRANSM.SPEEDLANGUAGE

P1 * P5 * P9 * MP2 * P6 * P10 *P3 * P7 * P11 *P4 * P8 * P12 *

MONITOR V.XXXCONTR. RPMCONTR. INT / EXTRESERVE CONTR. INT / EXT MM

INT ( * )EXT ( * )

CONTR. RPM MM

ON ( * )OFF ( * )

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LOAD INT - EXT M

INT [ * ]EXT [ * ]

ADJUST LOAD INPUT M

ZERO LOADLOAD EXT

ECG RECORD XX sec M�

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TRANSM.SPEED M

2400 Baud ( * )4800 Baud ( * )

LANGUAGE M

GER ( * ) ENG ( * )FRZ ( * )

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ErgometerType er900

7.3 Basic Settings

7.3.1 Date and Time

The system has an integrated real-time clock that can be set by the monitor program.This clock is set correctly when the unit is delivered but may require re-setting, for ex-ample when changing from winter time to summer time. Proceed as follows:

� Press the button „MONITOR“.

The monitor main menu will appear in thedisplay.

� Using the cursor buttons in the alpha-numeric keypad, move the cursor to themenu item ADJUST CLOCK.

� Call up this subprogram by pressing thebutton „MONITOR“ again.

� Use the numeric keypad to enter the cor-rect time and date. The cursor will auto-matically advance from field to field. Usethe arrow keys to move the cursor to a par-ticular field.

� Confirm that the information is correct bypressing the button „RETURN“ . The mainmenu will reappear.

You may now proceed to other menu itemsor exit the monitor program by pressing the„RETURN“ key again.


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ADJUST CLOCK MYEAR XX MONTH XXDAY XX HOUR XXMINUTE XX

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ErgometerType er900

7.3.2 Select Unit for Pressure Display

It is possible to select either mmHg or the SI unit kPa for use in the print-out. Proceedas follows:



� Using the arrow keys in the alphanumerickeypad, move the cursor to the menu item„mmHg - kPa“.


� Use the arrow keys in the alphanumerickeypad to move the cursor to the desiredunit of measure.

� Confirm the entry by pressing the button„RETURN“ . The main menu will then re-appear.

You may now proceed to other menu itemsor exit the monitor program by pressing thebutton „RETURN“ again.

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mmHg - kPa M

mmHg ( * )kPa ( * )

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ErgometerType er900

7.3.3 ECG Start Pulse Duration (only for remote start of ECG)

The ergometer has a remote start output with which an ECG device can be triggered(provided that the ECG device has a corresponding input). The feature programmedbelow determines the period during which the remote start signal is applied to the out-put. Signal duration is fully selectable in 1 second steps within a range of 0 - 99. Signalduration is determined as follows:



� Using the arrow keys in the alphanumerickeypad, move the cursor to the menu item„ECG RECORD“.


� Enter the period in seconds using the al-phanumeric keypad. The cursor will auto-matically advance.

� Confirm the entry by pressing the „RE-TURN“ key. The main menu will then re-appear.


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MONITOR V.XXXLOAD INT/EXTADJUST LOAD - INPUTECG - RECORD

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ECG - RECORD XX sec M

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ErgometerType er900

7.3.4 Select Language

The language used in the display and on the print-outs may be selected. There are twoversions of software available, each with three languages. The available languagesare: German (GER), French (FRZ), English (ENG), or Spanish (ESP), Italian (ITA), Dutch(DUT).



� Using the arrow keys in the alphanumerickeypad, move the cursor to the menu item„LANGUAGE“.


� Use the arrow keys in the alphanumerickeypad to move the cursor to the desiredlanguage.



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MONITOR V.XXXECG - TYPTRANSM.SPEEDLANGUAGE

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LANGUAGE M

GER ( * ) ENG ( * )FRZ ( * )

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ErgometerType er900

7.3.5 RPM Control

Sometimes, it may be necessary for the patient to discontinue pedaling for one reasonor another. Normally, when the RPM value drops below the minimum value (30 RPM),this will lead to an abort of the load program since a defined load is no more present.

Now it is possible to turn off RPM control for these special applications. The loadprogram is then not aborted, but rather continues regardless of the presence of a mini-mum RPM value or not. Re-entry into the program is therefore possible at any time.



� Using the arrow keys in the alphanumerickeypad, move the cursor to the menu item„CONTR: RPM“.(„CONTR: RPM“ is a main menu option thatwill appear eventually as the main menuscrolls through the display with repeatedpressing of the arrow keys.)


� Use the arrow keys in the alphanumerickeypad to move the cursor to the desiredselection.



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MONITOR V.XXXCONTR. RPMCONTR. INT / EXTRESERVE

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CONTR. RPM MM

ON ( * )OFF ( * )

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ErgometerType er900

7.3.6 Other Parameters

Numerous other parameters can be specified by using the monitor program, amongthese are:* analog input/output adjustments, load unit adjustment, etc.Some of these parameters are code protected and should not be modified by the op-erator due to safety considerations. Notify your authorized dealer or the ergoline ser-vice department if you wish to alter any one of these protected parameters.

„Appendix B“ contains setup instructions for the following parameters:

Setting of ECG-TypeType selection for an attached ECG unit (for data transmission)

TRANSM.SPEEDECG specific TRANSM.SPEED selection

Toggle between internal and external load controlDetermines if load is to be controlled internally (by the ergometer) or externally (by

the ECG unit)

Hardware TestsDetermines if the voltages of the system are correct

Parameters that are only to be altered by personnel authorized by ergoline :

Blood Pressure Measurement Unit CertificationTest routine that is run by the office of certification

Torque AdjustmentAdjustment of the drive train unit

Analog Output AdjustmentAdjustment of the analog data outputs

Analog Input AdjustmentAdjustment of the analog data inputs

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ErgometerType er900

7.4 Defining an Ergometry Program

The operator may select from 10 different ergometric programs when using theergometrics er900. Of these 10 programs, eight are fully programmable, one programoffers automatic loading and one program is for pulse-steady-state training.

� Ergometric program definition is only possible when the ergometer is controlledinternally, i.e. not controlled by a PC or ECG unit.

� Mixed control is also possible, that is, normal control is internal and, when needed,control may be transferred to an external device. For mixed control operationsone should ensure that program 8 can be used as a buffer for several interfacemodes. Therefore, for mixed control operations only programs 0 through 7, or 9may be used since program 8 will be used for switching the control type.

The monitor program can be used to establish a basic stress program. Program cre-ation is done as follows:



� Call up this subprogram by pressing thebutton „MONITOR“ once more.

� Select the program number that you wishto program by entering the program num-ber with the numeric keypad.

� Program the selected stress program asdescribed in this chapter.

� Confirm the entry by pressing the „RE-TURN“ key. The main menu will then re-appear.In order to proceed to other menu items,e.g. defining another program, the moni-tor program must be called up again.See above.

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ACTIVATE PROGRAM MProgram No 0max. HEARTFREQ. HF < XXXmax. Syst. S < XXX mmHg

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ErgometerType er900

7.4.1 Setup of Automatic Program 0

Automatic program 0 is for the fully automated testing of patients with unknown circula-tion condition, in particular, weak patients. The ergometer’s control computer uses thisprogram to test the patient’s circulation response across two or three different but spe-cific load increments. The computer then determines three standard load incrementswithin which the pre-set maximum heart rate should be attained. The standard loadincrements and the corresponding time intervals are taken from the WHO table for stressanalysis.

� Call up program creation as described in thepreceding section.

� Select program 0 in the field „Program No“.

� You can now assign the individual parameters.The meaning of these parameters for thisspecial analysis program is described below.

� The cursor will automatically skip to the nextfield when entry is complete for the currentfield. Complete entry must be made in eachfield in accordance with the number of char-acter positions provided. The arrow keys maybe used to move to any field desired. Thedisplay will scroll automatically when the up-per or lower display margins are reached.

� Close data entry with the „RETURN“ key.Now program 0 is configured in accordancewith your choices. Any parameter may stillbe changed at the beginning of ergometry fora specific ergometric run.

The meaning of the various training parameters:max. Heartfreq. = heart rate which is to be attained in three standard load steps. When

this goal has been reached the program will stop. (Any one of the alarmconditions described below will also cause program termination.)

max. Syst. = alarm parameter, when reached will cause program termination.max. Diast. = alarm parameter, when reached will cause program termination.Start load = load value with which the system begins stressing the patient.max. Load = maximum load value that is not to be exceeded.Interv. BPM = interval at which blood pressure readings are to be made.PWC = heart rate value at which a PWC value is to be determined (see Ap-

pendix D.1).TRAININGIND. = see appendix (see Appendix D.2).

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ACTIVATE PROGRAM MProgram No 0max. HEARTFREQ. HF < XXXmax. Syst. S < XXX mmHg

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ACTIVATE PROGRAM Mmax . Diast . D< XXXSTART LOAD Po = XXX Wmax. LOAD Pmax = XXX W

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ACTIVATE PROGRAM MInterv . BPM = XX min . 0PWC = XXX PWC = XXXTRAININGIND. [ Y / N ] N

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ErgometerType er900

7.4.2 Definition of Programs 1-8

The operator has the choice of eight stress programs that are freely programmable tospecific requirements on the ergometrics er900. In these eight programs, all controland alarm parameters are fully selectable. As with programs 0 and 9, the setup accom-plished with the monitor program represents a basic setup that can still be changed forany specific ergometry run at the beginning of that particular ergometry.

� Program 8 is an exception to this rule in case the ergometer is operated in mixed-control mode. That is, when the ergometer switches back and forth between inter-nal and external (from an ECG or PC) control. Program 8 should not be used insuch cases as it is used as an interface buffer for various external control modeswhich will cause parameters to be lost.

� Call up program definition as described in thepreceding section.

� Select the desired program to be modified(1-8) in the field „Program No“.

� Now you can set the individual parameters.The significance of the parameters for thisspecial analysis program are described be-low.

The cursor will automatically skip to the nextfield when entry is complete for the currentfield. Complete entry must be made in eachfield in accordance with the number of char-acter positions provided.(Example: Start Load Po = 3 characters; en-try value of 50 Watt would be entered as Po =050W).The arrow keys may be used to move to anyfield desired. The display will scroll automati-cally when the upper or lower display marginsare reached.

� Close data entry with button „RETURN“ . Theselected program is now configured accord-ing to your choices. Any parameter may stillbe changed at the beginning of ergometry fora specific ergometric run.

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ACTIVATE PROGRAM MProgramm No 0max. HEARTFREQ. HF < XXXmax. Syst. S < XXX mmHg

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ACTIVATE PROGRAM Mmax . Diast . D< XXXSTART LOAD Po = XXX Wmax . LOAD Pmax = XXX W

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ACTIVATE PROGRAM MInterv . BPM = XX min . 0PWC = XXX PWC = XXXTRAININGIND. [ J / N ] N

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ACTIVATE PROGRAM MLOAD STEP 01 : 12 0INTERV. LOAD = XX min .LOAD INCREMENT XXX W

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ErgometerType er900

The meaning of the various training parameters :

max. Heartfreq = alarm parameter, when reached will cause program terminationmax. Systole = alarm parameter, when reached will cause program terminationmax. Diastole = alarm parameter, when reached will cause program terminationStart Load = load value with which the system begins stressing the patient.

The time interval for the initial load is specified by the intervalfor the first load increment.

max. Load = maximum load value that is not to be exceededInterv. BPM = interval at which blood pressure readings are to be madePWC = heart rate value at which a PWC value is to be determined

(PWC value see appendix)TRAININGSIND. = see appendixLOAD STEPS = twelve load steps may be programmed individually. An entry

made into any one of these load steps will cause the samevalue to be entered into all subsequent load steps.The load settings of the 12. load step are maintained for allsubsequent load steps up to the 99. load step.

INTERV.LOAD = time interval of the load, that is elapsed time for the respectiveload step.

LOAD CHANGE = amount of load change with respect to the previous load stepExample: Initial load = 025 W

Load change 1 = 015 W +__________

Load step 1 = 040 W

� In Annex C attached to this operator’s manual, you will find programmingforms. We recommend that these forms be filled out before actually pro-gramming the ergometer. Save these forms as they will be useful if theergometer should malfunction and these program settings need to be re-stored.

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ErgometerType er900

7.4.3 Definition of Program 9 for Pulse-Steady-State Training

Program 9 offers pulse-steady-state training capability. A continuously available heartrate input is prerequisite for this program. Heart rate input can be accomplished invarious ways. You can attach an ear/finger clip, a pulse monitor (such as the PolarPacer) or connect a QRS trigger output from an ECG device being used (see Annex Eto this operator’s manual).

� Call up program creation as described in thepreceding section.

� Select program 9 in the field „Program No“.

� Now you can set the individual parameters.The significance of the parameters for thisspecial analysis program are described be-low.The cursor will automatically skip to the nextfield when entry is complete for the currentfield. Complete entry must be made in eachfield in accordance with the number of char-acter positions provided(Example: Start Load Po = 3 characters; en-try value of 50 Watt would be entered as �P

0

= 050W).The arrow keys may be used to move to anyfield desired. The display will scroll automati-cally when the upper or lower display marginsare reached.

� Close data entry with the „RETURN“ key.Now program 9 is configured in accordancewith your choices. Any parameter may still bechanged at the beginning of ergometry for aspecific ergometric run.

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ACTIVATE PROGRAM MProgram No 0 > X<max. HEARTFREQ. HF < XXXmax. Syst. S < XXX mmHg

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ACTIVATE PROGRAM Mmax . Diast . D< XXXSTART LOAD Po = XXX Wmax . LOAD Pmax = XXX W

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ACTIVATE PROGRAM MInterv . BPM = XX min . 0PWC = XXX PWC = XXXTRAININGIND. [ Y / N ] N

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ACTIVATE PROGRAM MLOAD STEP 01 - 12 0INTERV. LOAD = XX min .LOAD CHANGE XXX W

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ErgometerType er900

The meaning of the various training parameters:

max. Heartfreq. = This is the pulse-steady-state limit for heart rate that is to be usedin this training. When this limit is reached, the ergometer willtake over complete load control to ensure that the patient’s heartrate remains stable at this level (by lowering and raising the loadautomatically).

max. Systole = Alarm parameter, when reached will cause program termination

max. Diastole = Alarm parameter, when reached will cause program termination

Start Load = Load value with which the system begins stressing the patient.The time interval for the initial load is specified by the intervalfor the first load increment.

max. Load = Maximum load value that is not to be exceeded

Interv. BPM = Interval at which blood pressure readings are to be made.

PWC = Heart rate value at which a PWC value is to be determined(see ANNEX D.1)

TRAININGIND. = see ANNEX D.2

LOAD STEP = Twelve load steps may be individually programmed. An entrymade into any one of these load steps will cause the samevalue to be entered into all subsequent load steps.The load settings of the 12. load step are maintained for allsubsequent load steps up to the 99. load step.

Interv. LOAD = Time interval of the load, that is elapsed time for the respectiveload step.

LOAD CHANGE = Amount of load change with respect to the previous load step

Example: Initial load = 025WLoad change 1 = 015W +

------------LOAD step 1 = 040 W

� When running pulse-steady-state training, the significance of the load in-crements and load changes is limited to the preliminary training prior toreaching the desired maximum heart rate (Pulse-Steady-State limit). Loadcontrol is dependent upon heart rate response after this limit is reached.

Pulse-Steady-State training may only be carried out when the heart rate iscontinuously provided to the system.

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ErgometerType er900

8. Structure of Programs

8.1 General Structure of Programs 1-8

8.1.1 Factory Settings

The programs 1-8 can be individually programmed for the testing of various patientgroups such that at the push of a button the right program is at hand. Programs 1-4have been pre-programmed with sample programs by ergoline prior to delivery. Theseprograms are only exemplary and can, of course, be changed.

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Program No. 1 2 3 4

max. heart rate 150 150 150 170

max. systolic pressure 230 230 230 240

max. diastolic pressure 130 130 120 100

Start load Po 25 50 50 50

max. Load Pmax 999 999 999 999

Interval BP in min. 1 1 2 2

PWC 110 130 130 150

PWC 130 150 150 170

Training index N J J J

Load steps 01 01 01 0102 02 02 02. . . 03. . . .. . . .

Interval load 01 01 01 01in min 01 01 02 02

. . . 02

. . . .

. . . .

Load change 010 010 025 025in Watts 010 010 025 025

. . . 025

. . . .

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ErgometerType er900

8.1.2 Creating Your Own Load Program

Programs 1-8 were intended to be programmed from the monitor program, as de-scribed in this manual, for various pre-defined patient groups. This allows you to selectthe appropriate program for a patient at the touch of a button. This gives you basicsettings with which the stress test of the patient can be performed. You may still changeany of the parameters prior to starting ergometry. Such a parameter change, that is notaccomplished within the monitor program, is only temporary and effective for this spe-cific one ergometry. Such changes are voided at the end of the ergometry.This is why, when you use the monitor program to program the load programs, you needto proceed such that only the absolute limits for an entire patient group be pre-set asalarm parameters. The patient specific alarm parameter should be entered when theprogram is called up. In general eight programs with differing load characteristics areadequate to serve various types of patient groups if patients are grouped by their loadrequirement patterns. The flowchart below serves to clarify the process of an ergometry.

Determine the correct patient group for the patient.

Select the appropriate program for the patient.

If necessary, change circulation alarm parameters

Start the program (blood pressure measurement at rest)

Print-out of the resulting data

Start load program at Po

Print-out of the loaded data with every load changeand/or every blood pressure measurement

Load increments 1...12 as programmed

Load program termination (caused by reaching an alarm parameter,dropping below the minimum RPM rating of 30 RPM or because the „END“

key was pressed); transition to the recovery phase

Print-out of measurement results for the on-goingblood pressure measurements

Terminate ergometry by again pressing the „END“ key

Output of the summary protocol

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ErgometerType er900

8.2 Systematic Setup of Programs

8.2.1 Setup of Automatic Load Program 0

Program 0 does not permit any load settings from the operator. The initial load is set to25 Watt, the maximum load is set to 999 Watt, and the blood pressure interval is set to1 minute. Individual load increments are not programmable.The loading process is determined automatically by the ergometer during the ergometryprocess and is only dependent upon the circulation response of the patient.Program 0 is intended for critical patients whose circulatory condition is unknown. It istherefore necessary that the parameters are accordingly conservative. Establish alarmparameter values such that even very weak patients will not be over-stressed.The program will calculate three standard load increments of 5, 10 or 25 Watt withinwhich the patient can reach the pre-set heart rate. The resulting protocol data will en-able you to subsequently classify the patient into one of the patient groups for which youhave a specific program (1-8).

� Continuous doctor’s attention is also required for patients who arestressed with automatic program 0 since the circulatory response is notcontinuously monitored. Parameters can change abruptly between indi-vidual blood pressure measurements without the system being able tocounteract appropriately.

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ErgometerType er900

Program flowchart:

Patients with unknown circulatory conditionsselect program 0


Start program (blood pressure measurement at rest)

Print-out of resulting data

Load program start at Po

Print-out of the loaded data with every blood pressure measurement

Calculation of standard increments via 2-3 free load increments, subsequentlystressing with 3 standard load increments to reach the max. heart rate

Load program termination (caused by reaching an alarm parameter, droppingbelow the minimum RPM rating of 30 RPM or because

the „END“ key was pressed); then transition to the recovery phase




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ErgometerType er900

Pay attention to the execution of the program when programming. The base values thatwere entered via the monitor program are not necessarily those that are appropriate fora given patient. When programming you should only enter upper limit values that applyto the largest possible group of patients. Any parameter can still be changed for anyspecific ergometric run such that the parameters are tailored to the patient. You shouldalso select alarm values that will prevent over stressing even weaker patients but stillallow for a meaningful test. Select an initial load that will not overburden the weakerpatients. If you do not the circulation condition will show false results and automaticergometry is then impossible.In general, automatic ergometry is only used for acute, mostly weak, patients. Accord-ingly, you should set the parameters at relatively low levels.Heart rate is one exception in these parameters. It should only be entered via the moni-tor program as a nominal value. Adapt this value however, to each individual patient,prior to ergometry. The ergometer works toward attaining this maximum heart rate.Program 0 will try to reach the maximum heart rate by using three standard load incre-ments. You should, therefore, set the maximum heart rate in accordance with the capa-bilities of the individual patient so as to avoid excessive stress. It is also astute to pro-vide the ergometer with a continuous heart rate. This can be done with an ear/fingerclip, a pulse monitor or with a heart rate feedback from an ECG unit (see appendix).

� Enter the maximum heart rate via the monitor program only as a nominal value butadapt this value to each individual patient prior to ergometry.

You should write your program on one of the programming forms before entering theprogram on the console of the ergometer. The programming form is an aid that helpsthe operator to maintain an overview of the various parameters. The program formsalso represent a permanent record of the programs that are available if the unit shouldmalfunction. You will find blank programming forms in the appendix to this manual. Anexample of a programming form already filled out can be found in this chapter.

� Write your programs on the program forms (as found in the appendix of this manual)before entering them in the console of the ergometer. This contributes to clarityand proper record keeping.

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Program Listing

Program No.: 0

maximum heart rate HR = 140140140140140 1/min.

maximum Systole S = 230230230230230 mmHg (kPa)

maximum Diastole D = 130130130130130 mmHg (kPa)

initial load Po = 2525252525 watt

maximum load Pmax = 999999999999999 watt

blood press. measurement interv. INTERV.BDM = 0101010101 min.

desired PWC value PWC = 130130130130130 PWC = 150150150150150

Training index. J N

Load increments:

Step 1 Step 2

Load interval = min. Load interval = min.

Load change = watt Load change = watt

Step 3 Step 4



Step 5 Step 6



Step 7 Step 8



Step 9 Step 10



Step 11 Step 12



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ErgometerType er900

8.2.2 Setup of the Fully Programmable Load Programs 1-8

Programs 1-8 serve to provide the user with a stress program spectrum that will ac-commodate the patient groups that are to undergo ergometry. Every parameter in theseeight programs is freely definable and will be upheld by the ergometer unless an alarmparameter is exceeded or a manual change is made to ergometry by the operator.In this manual you will find examples of such patient group oriented programs. Theseexample programs are the same as those that are factory pre-programmed prior toshipment. Naturally, these programs can also be overwritten and individually adaptedto the wishes and needs of the user.

Program Flow:

Classify the patient as belonging to a particular patient group.Select the appropriate program (1-8).


Start program (blood pressure measurement at rest)




Increasing the load according to the pre-programmedload increments at the pre-programmed intervals

Load program termination (caused by reaching an alarm parameter,dropping below the minimum RPM rating of 30 RPM or because the „END“ key

was pressed); transition to the recovery phase




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ErgometerType er900

Pay attention to the execution of the program when programming. Determine the pa-rameters for the various patient groups before you begin to program. Select alarm andload parameters according to average strength characteristics of patient groups. Se-lect parameter values such that most individuals in the group require no parameterchanges and those that may become necessary are minor. Reserve a program, prefer-ably program 8, for special patients that require an individualized program. Here, youcan create experimental programs suited to the patient’s specific requirements. To makesuch an experimental program, set all of the parameters for the selected program (e.g.program 8) to minimum or maximum values, i.e. 0 or 999, so that all automatic controlfunctions are turned off. Then you can enter the actually desired values for this specificergometry just before starting the session.

� For special ergometrics, setup one program (e.g. program 8) as experi-mental with all maximum or minimum parameter values.

You should write your program on one of the programming forms before entering theprogram on the console of the ergometer. The programming form is an aid that helpsthe operator maintain an overview of the various parameters. The program forms alsorepresent a permanent record of the programs that are available if the unit should mal-function. You will find blank programming forms in the appendix to this manual.

� Write your programs on the program forms (as found in the appendix tothis manual) before entering them in the console of the ergometer. Thiscontributes to clarity and proper record keeping.

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ErgometerType er900

8.2.3 Setup of Program 9, Steady-Pulse (Cardiovascular Training)

Program 9 is for pulse-steady-state training. The ergometer increases the load fromthe outset of the training according to your parameters. Upon reaching the maximumheart rate setting, instead of causing program termination, the unit switches over topulse-steady-state control. That means that load changes are calculated to maintainthis heart rate. It is absolutely necessary to provide the ergometer with a continuousheart rate signal when running the pulse-steady-state program. This can be accom-plished with an ear/finger clip, a pulse monitor or a heart rate feedback from an ECGunit.Once reached, the ergometer will hold the maximum heart rate value stable until anadditional alarm parameter is exceeded or the training session is manually ended bythe operator.

Program Flow:

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Patient for pulse-steady-state trainingselect program 9

Possible change of the maximum heart rate

Start program (blood pressure measurement at rest )




Increasing the load according to the pre-programmed load increments at thepre-programmed intervals until the max. heart rate value is reached

Transition to pulse-steady-state control. Load will beautomatically altered in response to the heart rate.

Load program termination (caused by reaching an alarm parameter,dropping below the minimum RPM rating of 30 RPM or because the „END“

key was pressed); transition to the recovery phase




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ErgometerType er900

Pay attention to the execution of the program when programming. Since program 9 is apure training program, alarm parameters (except for heart rate) should be chosen sothat any danger to the patient is remote. Select a warm-up load parameter (used untilreaching the max. heart rate value set) such that reaching the heart rate value will not gotoo quickly or take too long. When the warm-up phase is too short, reasonable pulse-steady-state training is not possible as the circulatory system has not yet adjusted tothe load. When the warm-up phase is too long, the patient is already tired before theactual training phase has been reached.

� Program 9 is purely a training program. Parameters must be selected thatreflect the requirements of this mode of operation (as opposed to pro-grams 0-8).

You should write your program on one of the programming forms before entering theprogram on the console of the ergometer. The programming form is an aid that helpsthe operator maintain an overview of the various parameters. The program forms alsorepresent a permanent record of the programs that are available if the unit should mal-function. You will find blank programming forms in the appendix to this Operation Manual.

� Write your programs on the program forms (as found in the appendix tothis manual) before entering them in the console of the ergometer. Thiscontributes to clarity and proper record keeping.

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ErgometerType er900

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ErgometerType er900

9. Cleaning

� The unit, blood pressure cuff and related accessories should be regularly cleaned,if required, daily.

Important !!Be sure to disconnect the power cord prior to cleaning the unit.

9.1 Cleaning the Unit

� Use a soft cloth moistened with a mild cleanser to wipe off the unit as needed.Ensure that the cloth is not fully saturated. A fully saturated cloth may allowliquid to enter the unit and cause a defect.

Do not use strong household cleaners or disinfectants toclean the unit. This may damage the unit’s finish and lead todefects.Recommended are disinfectants like Fugaten spray,Lysoform or Promanum N.

9.2 Cleaning the Blood Pressure Cuff

� The blood pressure cuff may also be cleaned with mild soapsuds. Only alcoholmay be used to disinfect the cuff. Other disinfectants or the use of strong cleans-ers may damage the cuff and lead to defects.The microphone should also be cleaned at regular intervals. To clean the micro-phone, remove it from its pocket in the cuff (pay attention to its position in the cuff,it must be replaced in the same position after cleaning - the level side of themicrophone has to be pointing towards the arteria).Clean it with a mild detergent or alcohol.

� Defects caused by improper detergent and disinfectants as well as de-fects originating from insufficient cleaning of the unit are excluded fromthe guarantee.

� ��

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ErgometerType er900

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ErgometerType er900

Appendix A: Interfaces

The bicycle ergometer er900 features a number of interfaces. Data can be transmitted orreceived by the ergometer in analog or digital modes. Complete external control of the ergo-meter from a PC or ECG is possible via these interfaces. These interfaces are also capableof transferring information to external devices (PC or ECG). ergoline provides a wide rangeof control variations using a variety of control protocols with a combination of analog anddigital signals. These protocols permit the ergometer’s connection to practically all ECGunits on the market that have an ergometric program. You will find the interface protocols inthis appendix.

A.1 Input and Output Pin Specifications

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Pin1 = TxD Pin1 = External Load Pin1 = +5VAnalog

Pin2 = GND Pin2 = Remote Start BPM Pin2 = ECG input.Pin3 = RTS Pin3 = Remote Start ECG Pin3 = NCPin4 = CTS Pin4 = Pulse output Pin4 = NCPin5 = RxD Pin5 = Load output Pin5 = Opto input

Pin6 = Diastole output Pin6 = GND Analog

Pin7 = ECG inputPin8 = Systole output

Housing = GND

Inputs = Kursiv Outputs = Normal

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ErgometerType er900

Baud rate:2400/4800 Baud

Protocol:Format ASCIIStart bit 1Data bits 8Stop bit 1Parity NoneHandshake None

Hardware Connection :

ergometrics er900Interface ECG Type P1

Software Version V.243

Interface for digital data transfer from er900 to PC or ECGwith internal control of er900

Voltages:logic low logic high

Transmit Output (Pin 1) >+7 V <-7 V

Receive Input (Pin 5) >+3 V <-3 V

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Pin 1 Transmit (Output)Pin 2 GNDPin 3 NCPin 4 NCPin 5 Receive (Input)

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ErgometerType er900

DATE 14.06.91 TIME 08.23LOAD (watt) 000 HR (pulse/min) XXXSYSTOLE(mmHg) XXX DIASTOLE(mmHg) XXX

TORQUE (n/min) XXX TIME 08.24LOAD (watt) XXX HR (pulse/min) XXXSYSTOLE(mmHg) XXX DIASTOLE(mmHg) XXX

•••


TORQUE (n/min) XXX TIME 08.27LOAD (watt) XXX HR (pulse/min) XXX

DATE 14.06.91 TIME 08.28SYSTOLE(mmHg) XXX DIASTOLE(mmHg) XXXHR (pulse/min) XXX


DATE 14.06.94 TIME 0829P max (watt) XXX HR (pulse/min) XXXPWC110 (watt) XXX PWC110 (watt/kg) XXXPWC130 (watt) XXX PWC130 (watt/kg) XXXPWCXXX (watt) XXX PWCXXX (watt/kg) XXXTRAINING IND. = XXXXX

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Protocol of measure-ment at rest

Protocol of first loadstep

Protocol of fourthload step

Protocol of loadprogram termination

Protocol of firstrecovery measurement

Protocol of secondrecovery measurement

Summary protocol atthe end of the completeergometry

Transmission Protocol :

A protocol will automatically be produced at every blood pressure measurement and at ev-ery load increment. This data will be sent to the RS-232 interface without a prompt, com-mand, or service request from the external device.Control of load and blood pressure measurements as well as the monitoring of alarm param-eters is handled internally from the console of the ergometer.

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ErgometerType er900



Interface for digital data transfer from er900 to PC or ECGwith internal control of er900

Pin 1 Transmit (Output)Pin 2 GNDPin 3 -Pin 4 -Pin 5 Receive (Input)


Protocol:Format ASCIIStart bit 1Data bits 8Stop bit 1Parity NoneHandshake None


Voltages:logic low logic high



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DATE 14.06.91 TIME 08.23LOAD (watt) 000 HR (pulse/min) XXXSYSTOLE(mmHg) XXX DIASTOLE(mmHg) XXX

LOAD (watt) XXX

LOAD (watt) XXX

TORQUE (n(min) XXX TIME 08.24LOAD (watt) XXX HR (pulse/min) XXXSYSTOLE(mmHg) XXX DIASTOLE(mmHg) XXX

LOAD (watt) XXX

LOAD (watt) XXX


LOAD (watt) XXX

LOAD (watt) XXX


LOAD (watt) XXX

LOAD (watt) XXX



DATE 14.06.94 TIME 0829P max (watt) XXX HR (pulse/min) XXXPWC110 (watt) XXX PWC110 (watt/kg) XXXPWC130 (watt) XXX PWC130 (watt/kg) XXXPWCXXX (watt) XXX PWCXXX (watt/kg) XXXTRAINING IND. = XXXXX

Protocol ofmeasurement at rest



Protocol of first load step

Load rep., begin increm.



Load rep., end increm.








Transmission Protocol

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ErgometerType er900

Pin 1 = Load argument (input)Pin 2 = Remote Start BPM (input)Pin 3 = Remote Start ECG (output)Pin 4 = Pulse frequency (output)Pin 5 = Current load (output)Pin 6 = Current diastole (output)Pin 7 = QRS signal (input)Pin 8 = Systole (output)Case = GND



Interface for digital data transfer from er900 to an ECG,with analog control via the ECG

Voltages:

Pin 1 Transmit (Output)Pin 2 GNDPin 3 NCPin 4 CTSPin 5 Receive (Input)

Digital logic low logic high

Transmit Output (Pin 1) >+7V <-7V

Receive Input (Pin 5) >+3V <-3V

Analog minimal maximal resolution

Load argument (input) 0V 5V adjustable

Load return (output) 0V 6V adjustable

RPM return (output) 0V 6V 1V = 50 1/min

Baud rate : 2400 or 4800 Baud

Protocol:

Format ASCIIStart bit 1 Remark: Applies only to the RS-232Data bits 8 digital interfaceStop bit 1Parity NoneHandshake None

Hardware Connections :

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ErgometerType er900

Transmission Protocol:In contrast to purely digital transmission, ECG type P4 protocol always responds, upondemand, with a standardized data record. The string consists of 54 alphanumeric char-acters with „Carriage Return“ and „Line Feed“ as line delimiters. The RS-232 will onlyaccept the „S“<CR> command. All other characters will be ignored. Ergometry cannotbe terminated with an interface command. The ergometry will automatically terminate,at the latest, six minutes after the test subject ceases to pedal. Error measurements ofthe blood pressure unit are discernible in that all values in the data string are set to„000“.

Control flow with P4 :

Remark:

NR.xx, SYST: xxx mmHg , DIAST: xxx mmHg ,PULSE: xxx/min <CR><LF>

measurement no. diastolic value

systolic value heart rate value

Start command sent from controlling device (e.g. ECG)S<CR>

The ergometer will begin the ergometry by taking the blood pressure measurement at rest. Afterthe blood pressure measurement is completed, the following string will be sent from the ergometer.

NR.01,SYST:xxxmmHg,DIAST:xxxmmHg,Pulse:xxx/min<CR><LF>

The pre-set load will be applied after the data record has been sent.

Every subsequent blood pressure measurementmust be triggered with the

„S“<CR> command.

After every new start command a new blood pressure measurement will be taken and then the data record(as below) reported.

NR.xx,SYST:xxxmmHg,DIAST:xxxmmHg,Pulse:xxx/min<CR><LF>

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ErgometerType er900

logic low logic high




Protocol:

Format ASCII Start bit 1 Data bits 8 Stop bits 1 Parity None Handshake None




Interface for digital data transfer from er900 to PC or ECG(for Cardiosunny / Polymed)

Voltages :

Pin 1 Transmit (Output)Pin 2 GNDPin 3 NCPin 4 CTSPin 5 Receive (Input)

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ErgometerType er900

Transmission Protocol:

A protocol will automatically be produced at every blood pressure measurement and at everyload increment. This data will be sent to the RS232 interface without a request from theexternal device.

Control of load and blood pressure measurements as well as the monitoring of alarm para-meters is handled internally from the console of the ergometer.

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DATE 14.06.91 TIME 08.23LOAD (watt) 000 HR ((pulse/min) XXXSYSTOLE(mmHg) XXX DIASTOLE(mmHg) XXX



TORQUE (n/min) XXX TIME 08.27LOAD (watt) XXX HR (pulse/min) XXX



DATE 14.06.94 TIME 0829P max (watt) XXX HR (pulse/min) XXXPWC110 (watt) XXX PWC110 (watt/kg) XXXPWC130 (watt) XXX PWC130 (watt/kg) XXXPWCXXX (watt) XXX PWCXXX (watt/kg) XXXTRAININGSIND. = XXXXX

Protocol of measure-ment at rest

Protocol of first loadstep






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ErgometerType er900

Voltages: logic low logic high




Protocol:

Format ASCII Start bit 1 Data bits 8 Stop bit 1 Parity None Handshake None

Hardware connection:


Interface for digital data transfer from er900 to PC or ECG.The ergometer control is done via PC or ECG

Pin 1 Transmit (Output)Pin 2 GNDPin 3 -Pin 4 -Pin 5 Receive (Input)


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ErgometerType er900

Remark:

W xxx <CR>

command value (e.g. load value) carriage return (end of line)

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Transmission Protocol :

Command from PC Response Description(ECG) from er900

W xxx <CR> --- Sets a load target of xxx Watts.

L xxx <CR> --- Sets load increment to xxx Watts per minute. (The load will beincreased in 1 Watt steps over the period of one minute.)

A xxx <CR> --- Sets the initial load Po (load value to start of ergometry ) to xxx inWatts.

P xxx <CR> --- Sets the maximum pulse rate to xxx per min. (Only makes sensefor pulse steady state training.)

S <CR> --- Start of blood pressure measurement at rest with subsequentstart of ergometry with initial load Po.

s <CR> --- Start of ergometer with the initial load Po without a prior Poblood pressure measurement at rest.

B <CR> B xxx <CR> Query for current load.Output of current load in W.

D <CR> n xxx <CR> Query for current rpm value.Output of current rpm value in 1/min.

Query for current heart rate.H <CR> H xxx <CR> Output of current heart rate in 1/min.

Query for current systolic value.O <CR> O xxx <CR> Output of current systolic value in mmHg.

Query for current diastolic value.U <CR> U xxx <CR> Output of current diastolic value in mmHg.

F <CR> --- End of ergometry process (should be sent three times ).

I <CR> 0900P10VXXX- Identification string of the ergometer. The string contains the device type

<CR> 0900-, ECG interface protocol - P10 - and software version number -VXXX

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ErgometerType er900

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ErgometerType er900

B.1 Additional Settings in the Monitor Program

B.1.1 Setting the ECG Type

Setting the ECG type determines the manner in which the interface is handled. Descriptionsof the various possible modes can be found in appendix C.

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P1 P5 P9 MP2 P6 P10P3 P7 P11P4 P8 P12

� Press the „MONITOR“ key.


� Use the arrow keys in the alphanumeric key-pad to move the cursor to the menu item „ECG-TYPE“.

� Call up this sub-program by pressing the„MONITOR“ key again.

� Move the cursor with the arrow keys in thealphanumeric keypad to the correct ECG-TYPE.

� Confirm your programming entries by press-ing the „RETURN“ key. The unit will then auto-matically reset and return to the starting stateonce again.

You may now continue with other settings orexit the monitor program by pressing the „RE-TURN“ key again.

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ErgometerType er900

�

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TRANSM.SPEED M

2400 Baud (*)4800 Baud (*)


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B.1.2 Setting the Baud Rate

Use of the RS-232 interface requires that the transmission rate of data sent and received(baud rate) be established. For some modes of operation this baud rate is fixed and withothers it must be selected. If you have selected a particular ECG device, the baud rate isalready fixed. The baud rate is 4800 for interface modes P1, P2 and P10. You only need toalter the baud rate when a value of 2400 is required (instead of 4800).


The monitor main menu will appear in the dis-play.

� Use the arrow keys in the alphanumeric key-pad to move the cursor to the menu item„TRANSM.SPEED“.

� Call up this subprogram by pressing the„MONITOR“ key again.

� Move the cursor with the arrow keys in thealphanumeric keypad to the desired baudrate.

� Confirm your programming entries by press-ing the „RETURN“ key. The main menu willappear again.

You may now continue with other settings orexit the monitor program by pressing the „RE-TURN“ key again.

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ErgometerType er900

�


�

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MONITOR V.XXXLOAD INT/EXTADJUST LOAD - INPUTECG - RECORD

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LOAD INT-EXT M

INT (*)EXT (*)

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B.1.2 Switching Between Internal and External Load Control

This setting is concerns the load control. Internal control means that the ergometer’s internalprogram will determine the load. External means that the load will be controlled by the deviceconnected to the analog interface. When the load is controlled externally, the ergometercontrols only the blood pressure measurements and data transfer over the RS-232 interface.Some interface modes are based upon external load control and others do not permit exter-nal load control. (see Appendix A).



� Use the arrow keys in the alphanumeric key-pad to move the cursor to the menu item„LOAD INT/EXT“.


� Move the cursor with the arrow keys in thealphanumeric keypad to the desired selec-tion.

� Confirm your programming entries by press-ing the „RETURN“ key. The main menu willappear again.

You may now continue with other settings orexit the monitor program by pressing the „RE-TURN“ key again.If external control has been selected, the dis-play will now show P=ext instead of P=000 inthe upper left-hand corner.

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ErgometerType er900

�

�

�

MONITOR V.XXXTESTADJUST TORQUEADJUST OUTPUT

�

�

TEST M+-5Va = X.XXV [0.2] +5Vd = X.XXV [0.3] +24V = XX.XV [6V]


�

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BEL-EXT = 000W TEST MU-TD = XXX [020 - 150]U-DMS = XXX [050 - 250]S = 000 mmHg D = 000 mmHg

�

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B.1.4 Hardware Diagnostics

This program can check the hardware in the event that an error in the system should occur.You can check for operating voltages being within their tolerances and, when necessary,check to see if the blood pressure measurement system has a leak, and also check it forcorrect display.



� Use the arrow keys in the alphanumeric key-pad to move the cursor to the menu item„TEST“.


The display will now show the current operat-ing voltages. To the right of each voltage theallowable tolerance will be displayed. Thenext test display is reached by pressing thedown arrow-key in the alphanumeric keypad.

� The current setting for external load will nowbe displayed along with the current values fornull voltages on the blood pressure unit’stransducer (C-BPT) and on the expansionstrip of the drive unit (C-ES). The air systemon the blood pressure measurement unit canalso be pressurized to test for a leak and tosee that it displays correctly.

� Pressing the „RETURN“ key will cause an exitfrom the test program at any time.

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Program Listing

Program No.: ____

maximum heart rate HR = 1/min.

maximum Systole S = mmHg (kPa)

maximum Diastole D = mmHg (kPa)

initial load Po = watt

maximum load Pmax = watt

blood press. measurement interv. INTERV.BDM = min.

desired PWC value PWC = PWC =

Trainingsind. J N

Load increments:

Step 1 Step 2



Step 3 Step 4



Step 5 Step 6



Step 7 Step 8



Step 9 Step 10



Step 11 Step 12



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age- A weight heightgroup n (years) (kg) (cm) PWC130 PWC150 PWC170

20 -30 14 24,7 77,6 182 1,45 1,98 2,51± 0,38 ± 0,38 ± 0,48

30 - 40 39 35,2 80,6 179 1,52 2,05 2,53± 0,40 ± 0,41 ± 0,45

40 - 50 28 45,0 79,8 176 1,51 1,96 2,48± 0,34 ± 0,37 ± 0,42

50 - 60 21 54,1 75,8 172 1,56 2,05 2,64± 0,25 ± 0,30 ± 0,40

60 - 70 21 65,2 76,3 172 1,49 1,94 2,37± 0,33 ± 0,33 ± 0,38

Standard values for PWC in Watt/kg body weight. The mean deviation is ±0.4 Watt

men womenPWC130 1,50 1,25PWC150 2,00 1,60PWC170 2,50 2,00

D.1 PWC Values

D.1.1 What is a PWC Value?

The PWC (Physical Work Capacity) value is an index of the physical power of a patient at agiven heart rate. Empirically derived values for men and women in various age groups areused as objectives. Various authors have established PWC tables. Naturally there are mi-nor performance variations in these assorted tables. To arrive at a standard, PWC values forthe following heart rates were calculated:

HR = 130/min. HR = 150/min. HR = 170/min.These values establish what performance a patient in the assorted age groups should haveat a heart rate of 130, 150 or 170 beats per minute to be considered normal for his/herrespective patient group.If only heart rate is considered with regard to a particular performance, the resulting absolutevalue is of little significance (e.g. 200 Watt at HR=150/min.). The patient’s weight must re-ceive consideration with regard to the performance factor in order for the results to be rel-evant and comparative. Continuing the same example, for a patient with a weight of 100kgthis means:

Performance at HR 150/min. = 200 Wattthe resulting PWC value is:

PWC150 = 200 Watt/100kg= 2 Watt/kg body weight

The following tables from the book „Stress Analysis in Practice“ from Rost and Hollmann canbe used as a standard for performance characteristics.

Table 5.3, Pulse relevant performance characteristics PWC130 PWC150 and PWC170, recorded in our institute, that are based upon non-condi-tioned men between ages 30 and 70 given in, Watt/kg.

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D.2 Training Indicator

The system can calculate and print a training indicator when ergometry is complete. Thesetraining indicators are reflective of the entire circulation response to the performance invokedby ergometry. This value however only has relevance when it is compared to values frommultiple ergometry sessions of the patient over a period of time. These values are very goodindicators of the patient’s training progress.The training indicator is calculated by the computer as follows:

training indicator = S - D * HR * M

PS = maximum systole

D = maximum diastole

HR = maximum heart rate

M = patient’s weight

P = maximum performance

�The training indicator serves to compare multiple ergometric sessions of a singlepatient. This value is not applicable for the comparison of different patients. Basi-cally, a drop in the value on a patient’s chronologically consecutive ergometricsessions is a positive indication of good training progress.

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E.1 Heart Rate Feedback from ECG

When an ECG device is connected to the ergometer it is advantageous to supply theergometer with a feedback of the recorded heart rate. This allows the heart rate to becontinuously monitored as an alarm parameter. When performing pulse-steady-statetraining a continuous heart rate input is indeed absolutely necessary. If the ECG deviceused supports a QRS trigger output, this can be connected to the ergometer. There aretwo possible connections (see appendix C), either the analog interface (J13, Pin 7) or overthe opto-input (J11, Pin 2).

E.2 Pulse Monitor

Ergoline offers a pulse monitor, type Polar, that can be used for heart rate input to the ergom-eter without an ECG. The receiver of the pulse monitor is connected to the opto-input of theergometer. The QRS impulse is then radio transmitted from the chest strap to the ergometer.

Polar-Pacer on a seat type ergometer

chest strap

receiver

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ErgometerType er900

F.1 Technical DataType : ergometrics 900

Operation mode: continuous operation

Power supply: 115 V / 230 V ~/ 50 Hz / 60 Hz

Power rating: 90 VA

Braking principal: computer controlled eddy current brakes with torque regulation (RPMindependent in accordance with DIN 13405)

Load range: 20 . . . 999 Watt

RPM range: 30 . . . 130 n/min-1

Deviation of load : acc. to DIN 13405: max. ± 5% in the range ot 25 and 400 Whowever: max. ± 3 W in the range of 25 and 100 Watt

acc. to manufacturer: max. ± 5% in the range of 20 and 900 Whowever: max. ± 3 W in the range of 20 and 100 W

Load increments: manual setting: 5W programmable: 5W or multiple thereof

Time interval: 1 min. ... 99 min

Load programs: 8 programs freely programmable1 automatic program (dependent from circulatory condition)1 program for Pulse-Steady-State training

Max. admissable patient weight: 120 kg

Seat adjustment: continuously adjustable for body sizes 1.20 m to 2.10 m

Handle bar adjustment: continuously adjustable for body sizes 1.20 m to 2.10 m

Display: 1x LCD-Display : 4 lines @ 20 char.1 x LED 10 mm: rpm display for patient

Blood pressure measurement : RR indirect with automatic artefact suppressionseparate time interval in range 1 min to 99 minswitchover between mmHg and kPa possible

Pulse measurement : priority principal: 1. ECG, 2. Opto, 3. RRMeasurement range: 35 to 230 bpm

Alarm settings: load, pulse, systole, diastole as limit values

Printer: thermal printer with 40 columns,paper width 80 mm

Electrical inputs: Digital control: RS232Analog: Opto, ECG 1V

Electrical outputs:Digital: RS232,Analog: load, pulse, systole, diastole

remote start ECG (1 to 99 sec)Weight: 64 kg

Dimensions (W x L): min: 400 x 900 mm, width of handle bar: approx. 540 mmheight: min: 950 mm; max: 1330 mm

Calibration: performed with switches and keypad

Protection of calibration: Code

Safety standard: BF according to IEC 60601-1

Device class: I according to IEC 60601

Classification MDD: class IIa according to 93/42 ECC

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RPM independent range in accordance with DIN 13405

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F.2: The Speed-Correlated Capacity of Brake Power Control

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