Just Four Steps from Setup to Training

• STEP 1 Training Setup
  MELTz consists of a main unit with a monitor, a supporter and unit worn on the hand, and an EMG cable for measuring muscle potentials. The therapist attaches the EMG cables, electrodes, the supporter, and hand unit to the patient, and patient sits in a chair during the training. The hand unit can be attached to either the left or right hand by replacing the thumb unit. The main unit is started once usage preparation is complete.

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    The therapist operates the main unit. The patient wears the training equipment, including the hand unit, supporter, and EMG cable.

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    Training requires a table to hold the upper limb support device in place and a chair for the patient. To train the left hand, place the device on the left side; to train the right hand, place the device on the right side.

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    Attach the EMG cable to the electrode and set the hand unit according to the hand to be attached.Turn on the main unit, start the system, and initialize the equipment. During initialization, adjust the thumb unit's orientation so that the fingers do not hit each other, and press the [▶] button on the initialization screen.

• STEP 2 Equipping the Devices
  Set up the equipment to be worn by the patient. The EMG cable band is secured to the patient's upper arm. After attaching the reference electrode, the three electrodes are applied to the arm. The dedicated supporter and hand unit are fitted and adjusted to suit the distance between the fingers and the length of each finger.

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    Wrap the EMG cable band around the patient’s upper arm to secure it. After attaching the reference electrode (GND/RLD) to the patient’s elbow, attach electrode Ch1 to the extensor digitorum muscle, electrode Ch2 to the flexor digitorum profundus muscle, and then attach electrode Ch3 to the flexor digitorum superficialis muscle.

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    With the supporter’s hand unit attachment facing the back of the hand, pass the hand through the supporter, and then tighten the hook and loop fastener strap. The hand unit is worn over the supporter and secured with the MP belt.

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    Adjust finger spacing by raising the finger spacing adjustment lock lever. The hand unit’s finger size is adjusted to the length of each finger, and the DIP joint is secured with the DIP belt.

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    Attach the thumb unit to the thumb. Adjust the position of the thumb joints in accordance with the training to be performed.

• STEP 3 Configuring the Range of Movement
  The range of movement is adjusted on the main unit. Extension mode is used to configure the extension movement range of the thumb and fingers. Flexion mode adjusts the movement range of the flexion side of the fingers. Speed, flexion forces, and extension forces can be adjusted, and the movement range settings can be saved. Three assessment menus are available when performing assessments: Electromyography and force, AROM, and Spasticity.

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    [Press the "Adjust Range of Movement" button and select extension or flexion to adjust the range of movement for each finger. Press the [▲] (extension side movement) and [▼] (flexion side movement) buttons to adjust the range of movement for extension of the thumb and fingers. The four fingers can also be adjusted together.

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    There are 10 adjustment levels for speed, flexion force, and extension force. Speed adjusts the device's operating speed, while flexion force and extension force adjust the motor output in these respective directions.

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    To run the assessment (Optional), press [Run] under “Assessment”. Electromyography and force, AROM, and spasticity will be measured.

• STEP 4 Conduct training.
  Start the training. Select a mode of training to be performed: passive, active instruction, and active-free. In all modes, the instruction style, exercise pattern, and the number of repetitions are configured before training begins.

  Passive mode

  Operates without myoelectricity.

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    Press [Task], [Times], and [Progress] in the lower left training box to configure the exercise pattern. The Task tab configures the amount of time each position is held. The Times tab configures the number of movements, the number of sets, and the rest time between sets. Finally, the Progress tab is used to turn audio on/off and configure relax movements.

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    Press the [▶︎]Button to start training.

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    A: Shows Training Time and Total Time.
    B: Shows movement instructions and countdown.
    C: Pause and Stop buttons.
    D: Shows the time elapsed for the current task. Displays the progress status bar.
    E: Shows the configured range of movement.

  Active Instruction Mode

  Controls patient movement using myoelectricity
  and performs training in accordance with the configured instructions.

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    Press [Task], [Times], and [Progress] in the lower left training box to configure the exercise pattern. The Tasks tab is used to configure the three exercise patterns “Make fist, extend fingers, relax,” “Make fist, relax,” and “Extend fingers, relax,” as well as the duration. The Counts tab is used to configure the number of movements, sets, and rests between sets. Finally, the “Progress” tab is used to turn audio on/off and limited mode on/off.

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    Pressing the [▶︎] button starts automatic calibration. The device identifies when an exercise (attempt) is performed in accordance with the instructions. The equipment assists with the exercise (attempt) during training.
    Note: Calibration can also be configured manually.

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    A: Shows Training Time and Total Time.
    B: Shows movement instructions and countdown.
    C: Pause and Stop buttons.
    D: Shows the time elapsed for the current task. Displays the progress status bar. Displays how many movements have been configured and the progress of the number of sets.
    E: Shows the configured range of movement.
    F: Represents identified myoelectric patterns as graph positions and colors.
    G: Displays muscle shape and identification status (as colors).

  Active Free Mode

  Controls patient movement using myoelectricity
  but allows patients to perform the exercise at their own pace.

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    When the task display box displays “Calibration is required to start” press the [Calibrate and Commence Training] button. Have the patient perform the exercises in accordance with the instructions to calibrate.

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    If the automatic calibration fails to recognize the myoelectricity, manual calibration is required. Stop the device and press the Calibration button located in the EMG pattern box, then select Manual from the Calibration Mode box on the left.

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    A: Shows Training Time and Total Time.
    B: Pause and Stop buttons.
    C: Shows the time elapsed for the current task. Displays the progress status bar. Displays how many movements have been configured and the progress of the number of sets.
    D: Shows the configured range of movement.
    E: Represents identified myoelectric patterns as graph positions and colors.
    F: Displays muscle shape and identification status (as colors).

Benefits of MELTz
for Neurorehabilitation